Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Ankle sprains are reportedly the most common lower limb injury amongst active
individuals.
Aim: The aim of this study was to investigate whether treatment interventions
employed by physiotherapists during the first week of functional rehabilitation of an
ankle sprain, at primary care level, were aligned with evidence-based guidelines for
acute ankle sprains.
Design: A descriptive cross-sectional study was conducted.
Participants: A total of 91 physiotherapists from the Western Cape Metropole
(WCM) completed questionnaires.
Method: Physiotherapists' treatment interventions were recorded based on a case
study of a typical moderately sprained ankle. According to classification of the West
Point Ankle Grading System, a moderate sprain is a partial macroscopic tear of the
ligaments with moderate pain, swelling and tenderness with some loss of motion and
mild to moderate instability of the joint. Anticipated return to sport is two to six weeks.
Relative occurrence of selected interventions during the first week of rehabilitation
was calculated. Chi-square tests were used to compare differences between
physiotherapists' responses and the recommendations of the practice guidelines.
Results: Physiotherapists' overall selections of treatment interventions were in
alignment with the "Koninklijk Nederlands Genootschap voor Fysiotherapie" (KNGF)
guidelines and correlated positively to the recommendations stipulated by KNGF
therein. Physiotherapists indicated many interventions for which good evidence
exists: compression, cryotherapy, early mobilisation, and neuromuscular exercises. It
is of concern that 49% – 91% (n = 91) physiotherapists indicated some form of
manual mobilisations for which there is a lack of evidence, and more than two-thirds
indicated the application of an electrotherapy intervention, which is not
recommended in the guidelines.
Conclusion: Physiotherapists should reconsider interventions for which there is no
evidence as this may reduce cost of care, without compromising patient outcomes. / AFRIKAANSE OPSOMMING: Verslae dui daarop dat verstuite enkels die mees algemene besering van die
onderste ledemaat van aktiewe persone is.
Doelwit: Die doel van hierdie ondersoek was om vas te stel of fisioterapeute in
primere gesondheidsorg se keuse van rehabilitasie tegnieke gedurende die eerste
week van funksionele rehabilitasie na 'n enkel besering, op koers is met
bewysgebaseerde kliniese riglyne in die hantering van akute enkel beserings.
Ontwerp: 'n Beskrywende deursnit ondersoek is geloods.
Deelnemers: 'n Vooraf opgestelde vraelys is deur 91 fisioterapeute in die
Weskaapse metropool voltooi.
Metodiek: 'n Gevalle studie is aangebied van 'n tipiese matige verstuite enkel. Die
respondent moes hulle tegnieke in die hantering van die geval aandui. Volgens die
klassifikasie van die “West Point Grading System” word so 'n verstuiting gekenmerk
deur makroskopiese gedeeltelike skeur van die enkel ligamente, matige pyn, swelsel
en tasteerheid van die area. Dit gaan gepaard met 'n effense verlies van beweging
en stabiliteit van die gewrig. Die prognose vir so 'n besering om na sport terug te
keer is om en by twee tot ses weke.
Die insidensie van aanwending van geselekteerde metodes van behandeling
gedurende die eerste week en die verhouding met die vooraf geselekteerde
behandelings riglyne opgestel deur die “Koninklijk Nederlands Genootschap voor
Fysiotherapie” (KNGF) is bereken en ontleed. Die “Chi-square” toets is gebruik om
die verskil te bereken tussen die respons van die Fisioterapeute en die aanbevelings
van die kliniese riglyne.
Resultate: Oorkoepelend is die keuses van behandelings tegnieke deur die
fisioterapeute in lyn met die riglyne van die 'Koninklijk Nederlands Genootschap voor
Fysiotherapie' (KNGF). Verskeie sinvolle behandelings is gekies waarvoor daar
positiewe aanduidings was, byvoorbeeld: lokale kompressie, ys terapie, en
oefeninge. Dit is egter kommerwekkend dat 49 – 91% (n=91) van die deelnemers 'n
manuele tegniek ingesluit het waar daar tans gebrekkige aanduidings voor bestaan. Verder, het meer as twee derdes van die fisioterapeute aangedui dat hulle
elektroterapie sou gebruik wat nie in riglyne aanbeveel word nie.
Gevolgtrekking: Fisioterapeute moet die gebruik van tegnieke waarvoor daar nie
duidelike bewyse in die literatuur bestaan nie, heroorweeg, want dit mag die koste
van behandeling verminder, sonder om die positiewe resultate van herstel, negatief
te beinvloed.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/85818 |
| Date | 12 1900 |
| Creators | Simpson, Helene |
| Contributors | Crous, Lynette, Louw, Quinette A., Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 123 p. |
| Rights | Stellenbosch University |
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