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

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.

Young people with disabilities face a time of great stress as they move from child to adult care, which profoundly impacts them and their families. They 'transition' from very high and cohering levels of care, until they reach a point, determined by age, when they are receiving low levels of far less cohesive care. Further, the propensity shown by the Scottish Government to devolve down the responsibility for service and local policy delivery, can lead to unforeseen consequences resulting in variation in experiences. Does this devolution of responsibility, to local bodies and service users, produce a valuable personalisation of delivery or a worrying 'postcode lottery'? I draw on policy concepts to examine these two expectations:- 'street level bureaucracy' and the 'personalisation' agenda highlight the potential for discretion, learning and transfer, and accountability theory, highlight the potential to cooperate or conform to the same basic standards. I examine the case of young disabled people in Scotland moving from child orientated to adult care to show, through semi-structured interviews and documentary analysis, that there is some cooperation between various professions, but they make sense of policy from different perspectives. I found that, while broad parameters set by the Scottish Government were adhered to, council and health board protocols often varied, meaning that, in some cases, a house address number dictates the level of service delivered. The research is particularly important and timely in that it focuses on Scotland, is cross-professional in focus, has profound social implications and contributes to knowledge in placing 'transition' in the context of public policy theory. It confirms the importance of street level bureaucracy in a new context but, unexpectedly, I found that professionals would welcome increased accountability and outcome measurement.

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

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences