Thesis (B.Sc)--University of Hong Kong, 1996. / "A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, April 29, 1996." Also available in print.

M.A. (Psychology) / Please refer to full text to view abstrac

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Conducted within a critical disability studies framework, this study explored the experience of communicative participation by adults with cerebral palsy who live with severe communication impairments. The concept of the participation of communicatively disabled people is relatively new, and the theoretical understanding of communicative participation is underdeveloped although participation is increasingly recognised as a central goal in rehabilitation. In addition, there is a paucity of information with reference to the trajectory of lifelong communication disability. Little is known about the communicative participation of adults with cerebral palsy in South Africa. Nine adults with cerebral palsy, who lived with significant communication impairments, participated in the study. They were between 32 and 49 years of age, and had lived South Africa all their lives. They were observed in social interactions in their daily lives on multiple occasions and took part in serial interviews over a six-month period. Using a pragmatist grounded theory approach, the data were analysed from an interpretive basis. Four main categories were constructed. The first category was “being misrecognised as a communicator”, which showed that the participants were not acknowledged as having equal moral participatory status in communicative exchanges. The second category, “contexts for communicating”, indicated that the participants lived with significant communication impairments which resulted in their experiencing limitations in a broad spectrum of life’s activities. The third category, “an embedded communicative self”, illuminated that the participants saw their communicative disabilities as embedded within a broader picture of being disabled, and that their communication impairments had a marked effect on their identity development. Through an analysis of lifetime contributions to communicative participation, the final category, “dynamic participation” revealed how communicative participation is a fluid, ever-changing process. Extending Ikäheimo’s (2010) model of social participation and recognition, a “dynamic recognition-theoretical model of communicative participation” is presented. Communicative participation is defined as a dynamic social process. It is undergirded by the moral recognition of the interactants as communicative partners, and is influenced by time as the dimension through which all communication takes place. / AFRIKAANSE OPSOMMING: Die studie, vanuit `n kritiese benadering, het serebraalgestermde volwassenes (wie se vermoë om te kommunikeer ernstig aangetas is) se ervaringe met betrekking tot hul deelname aan kommunikasie of situasies waarin daar gekommunikeer word, verken. Die konsep wat fokus op die deelname aan kommunikasie deur diegene wie se vermoë om te kommunikeer ernstig aangetas is, is `n relatief nuwe begrip. Die teoretiese grondslag van die konsep is onderontwikkeld, maar die konsep word toenemend gereken as een van die belangrikste doelwitte van die rehabilitasie-proses. Daar is ook`n gebrek aan inligting wat handel oor die verloop van mense se lewenslange ervaringe wie se vermoë om te kommunikeer ernstig aangetas is. Daar bestaan beperkte kennis oor volwassenes met serebraalgestremdheid in Suid-Afrika se deelname aan kommunikasie. Nege volwassenes met serebraalgestremdheid, wie se vermoë om te kommunikeer ernstig aangestas is, het deelgeneem aan die studie. Die deelnemers se ouderdomme (gedurende die tydperk waarin data-insameling plaasgevind het) het gewissel van 32 tot 49 jaar, en die deelnemers het nog altyd in Suid-Afrika gewoon. Die deelnemers se kommunikasie-gedrag gedurende verskeie sosiale situasies is waargeneem. Die deelnemers het ook oor `n periode van ses maande aan `n reeks onderhoude deelgeneem. Pragmatiese, gegronde teoretiese benadering (ook verwys na as ‘grounded theory’) is gebruik om die data te analiseer. Die bevindinge dui op vier hoof temas. Die eerste tema verwys na bevindinge wat handel oor ‘om misken te word as as iemand wat deelneem aan kommunikasie’. Die bevindinge dui daarop dat deelnemers van mening is dat hulle nie as `n gelykke beskou word gedurende situasies waarin daar gekommunikeer word. Die tweede tema verwys na ‘die konteks van kommunikasie’, en dui daarop dat weens die feit dat deelnemers se vermoë om te kommunikeer ernstig aangestas is, word hulle ook op `n verskeidenheid van lewensaktiwiteite ingeperk. Die derde tema verwys na die volgende: ‘die aantasting van die vermoë om te kommunikeer gesetel in die self’. Die tema dui daarop dat deelnemers die aantasting van hulle vermoë om te kommunikeer, sien as deel van die geheelbeeld van gestremdheid en dat die vermoë om te kommunikeer `n betekenisvolle impak op hul identiteitsontwikkel gehad het. Die lewenslange ervaringe van die deelnemers het aanleiding gegee tot die vierde en laaste tema, naamlik ‘dinamiese deelname’. Dit dui daarop dat die deelname aan kommunikasie nie staties is nie, maar voortdurend verander. Die studie bevindinge suggereer dat Ikäheimo’s (2010) se model van sosiale deelname en erkenning, uitgebrei kan word tot `n dinamiese teoretiese model wat die deelname aan kommunikasie erken. Die deelname aan kommunikasie word gedefiniëer as `n dinamiese sosiale proses. Die grondslag van die model behels die erkenning van diegene wat kommunikeer as deelgenote wat beïnvloed word deur tyd as die dimensie waardeur alle kommunikasie plaasvind.

Thesis (M.S. (Hons.)) -- University of Western Sydney, 2004. / Includes bibliography.

Thesis (Ph. D.)--University of Hong Kong, 1998. / Includes bibliographical references (leaves 146-160).

The extent to which customers are satified with the care they receive from the health professionals has been an important area of interest for researchers, managers and health care workers. The physiotherapy cerebral palsy clinic at Mulago Hospital in Kampala Uganda provides physiotherapy services for parents/caregivers of children with cerebral palsy. The parents/caregivers visit the clinic seeking physiotherapy services that will address their problems and those of the child. The purpose of this study was to explore the satisfaction that the parents/caregivers of children with cerebral palsy get from utilising the physiotherapy services at the clinic and to identify the barriers/problems that they encounter that might affect their attendance.

The extent to which customers are satified with the care they receive from the health professionals has been an important area of interest for researchers, managers and health care workers. The physiotherapy cerebral palsy clinic at Mulago Hospital in Kampala Uganda provides physiotherapy services for parents/caregivers of children with cerebral palsy. The parents/caregivers visit the clinic seeking physiotherapy services that will address their problems and those of the child. The purpose of this study was to explore the satisfaction that the parents/caregivers of children with cerebral palsy get from utilising the physiotherapy services at the clinic and to identify the barriers/problems that they encounter that might affect their attendance.

Thesis (MSc)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: Although the neurodevelopmental therapy (NDT) treatment approach is used extensively in the management of children with cerebral palsy, there is currently very little documented research to support its efficacy. The purpose of this study was to evaluate the efficacy of NDT in terms of its effect on motor function in a group of 10 cerebral palsy children. A multiple simple single-subject design was used in which the children each acted as their own controls. A 5 week baseline period, during which no intervention was received by the children, was followed by a 5 week intervention phase during which the children received twice weekly NDT treatment. The children were assessed at the beginning and end of each phase using the Gross Motor Function Measure (GMFM), and an assessment tool, which allowed the establishment of individualised outcome measures, called TELER. The group of children demonstrated no statistically significant gains in motor function on either of the outcome measures during the baseline phase of the study. However during the intervention phase the overall improvements demonstrated by the group on both the GMFM and TELER were statistically significant. Nine out of the ten children achieved greater improvements in their goal total GMFM scores during the intervention phase than during the baseline phase. Similarly all of the children achieved a greater number of clinically significant improvements on the TELER outcome measures. NDT was beneficial and useful in promoting motor function in this group of cerebral palsy children. / AFRIKAANSE OPSOMMING: Alhoewel die Neuro-ontwikkelingsterapie (NOT) behandelingsbenadering wydeverspreid gebraik word in die behandeling van kinders met serebrale verlamming, is daar huidiglik baie min gedokumenteerde navorsing om die effektiwiteit daarvan te staaf. Die doel van hierdie studie was om die effektitiwiteit van NOT te evalueer met betrekking tot die impak daarvan op die motoriese funksie van ‘n groep van 10 kinders met serebrale verlamming. ‘n Veelvuldige eenvoudige enkeling -subjek raamwerk is gebruik waarvolgens die kinders elk as hul eie kontrolegoep ageer het. ‘n 5-weke basislyn fase, waartydens die kinders aan geen intervensies onderwerp is nie, is gevolg deur ‘n 5-weke intervensie fase waartydens die kinders twee keer per week NOT behandeling ontvang het. Die kinders is geevalueer aan die begin en einde van elke fase met die Oorhoofse Motoriese Funksie Maatstaf (OMFM)/Gross Motor Function Measure (GMFM), asook ‘n evalueringsmaatstaf genaamd TELER, wat die bepaling van geindivualiseerde resultate moontlik gemaak het. Die groep kinders het geen statistics bewese vordering in motoriese fiinksies getoon volgens beide die evalueringsmaatstawwe tydens die basislyn fase van die studie nie. Daarteenoor het die groep tydens die intervensie fase oorhoofs gesproke statistics bewese vordering getoon met betrekking tot beide die OMFM en die TELER. Nege uit die 10 kinders het groter vordering getoon met hul totale OMFM resultate tydens die intervensie fase as gedurende die basislyn fase. A1 die kinders het tegelykertyd ‘n groter hoeveelheid substantiewe kliniese verbeterings getoon met betrekking tot hul TELER uitkomste. NOT was voordelig en nuttig in terme van die verbetering van motoriese funksie in die groep van serebraal verlamde kinders.

Continuous inter-limb coordination is the movement relationship between body limb segments (e.g. an arm and a leg) (Magill & Anderson, 2014) and is organized within the framework of the characteristics of the environmental conditions, the task demands, and the limb dynamics (e.g. the action capabilities of the individual) (Holt et al., 2000). When maximal coordination is achieved, stability, which is the defined as the system’s ability to offset a perturbation (Li et al., 2005), is optimized (Meyns et al., 2012). Individual coordinative relationships provide insights into neuromuscular deficiencies and their corresponding coordination difficulties (Kurz & Stergiou, 2004), such as those affecting children with cerebral palsy (CP) (Meyns et al., 2012). CP describes a group of neurodevelopmental disorders attributed to a non-progressive disturbance in the developing brain (Bax et al., 2005). Children with unilateral spastic CP (USCP), the most common subtype (Odding et al., 2006), are affected on one side of their body, experience problems with bimanual coordination, and indicate lower levels of inter-limb coordination and stability compared to their typically developing peers. This can affect both their functional independence and quality of life (Steenbergen et al., 2008; Meyns et al., 2012). To date, no study has evaluated whether inter-limb coordination of this population during a gross motor task can be improved with treatment. The goals of this study were to evaluate continuous inter-limb coordination and stability in children with USCP compared to typically developing children (TDC) and to determine if coordination and stability of children with USCP could be improved with intensive upper extremity (UE) intervention. Constraint Induced Movement Therapy (CIMT) and Hand Arm Bimanual Intensive Therapy (HABIT) were employed to both improve UE function and determine whether inter-limb coordination and stability are also improved. A total of 33 age-matched children participated, divided evenly into three groups of Treatment (n=6, CIMT; n=5, HABIT), No-Treatment, and Typically Developing. Vicon 3-D motion capture was used to collect movement data. Continuous measures of coordination using relative phase analysis, including Mean Absolute Relative Phase (MARP) and Deviation Phase (DP) were used to quantify coordination (MARP) and stability (DP) during novel, gross motor tasks of standing and in-place marching with symmetric and asymmetric arm swing. Results indicated that children with USCP have a lower level of coordination compared to TDC (p<0.05), but there is no difference in the stability of their patterns (p>0.05). This indicates that all children have difficulty producing consistent cyclical movements with their arms, regardless of pathology. All children also demonstrated greater difficulty coordinating their UE during the in-place marching tasks compared to the standing tasks (p<0.05), which may be due to the inherent increase in degrees of freedom associated with the addition of the lower extremities to the task. Treatment of either CIMT or HABIT improved coordination between the arms (p<0.05), but also decreased stability between the more affected arm and leg during the in-place marching tasks (p<0.05) with symmetric and asymmetric arm swing, respectively. This decrease in stability may represent the children’s inability to consistently execute the same cyclical movements for an extended period of time due to their newly learned patterns resulting from improvements in UE function after treatment. This is the first study to identify similarities in stability between TDC and children with USCP and to demonstrate improvements in continuous, inter-limb coordination after intensive UE intervention in this pathologic population. The finding that TDC do not indicate greater stability in their motor patterns may imply that their patterns are not yet mature. Therefore, it may be efficacious to intervene at a young age to ensure correct coordinative patterns are learned and become stable as the child matures. Evidence that both function and continuous coordination between the arms are improved after intervention also suggests that with increased gross motor practice during the intervention, continuous inter-limb coordination may improve in a greater variety of tasks. Due to the prominence and accessibility of UE interventions, implementation of more gross motor tasks may be an economical way to advance coordination, which can positively impact activities of daily living and increase participation in community activities in children with USCP.

Thesis (MOccTher.--Faculty of Health Sciences)-University of Pretoria, 2006. / Includes bibliographical references.