Theses and Dissertations (Physiotherapy)
http://hdl.handle.net/2263/31923
2024-03-29T04:43:57ZDevelopment of a school-based framework to support SIAS toolkit for learners with physical disabilities in Limpopo Province
http://hdl.handle.net/2263/91944
Development of a school-based framework to support SIAS toolkit for learners with physical disabilities in Limpopo Province
Background and aims: The Department of Basic Education (DBE) launched a policy to provide standardised procedures for Screening, Identifying, Assessing and Supporting (SIAS) learners experiencing barriers to learning. This policy is another strategy to give access to quality education that accommodates the needs of learners, including those living with various disabilities, in schools. Furthermore, it advocates for adopting the social model of disability and promotes interprofessional collaboration. Providing adequate and relevant support can retain learners with learning barriers and reduce dropout. Its implementation is met with significant barriers at the level of the child’s environment at school (microsystem) and the relationship between educators and caregivers (mesosystems). The shortage of physiotherapists is a challenge both nationally and internationally. The composition of support structures at school level lacks physiotherapists, and more so in Limpopo Province. The aim of the study was to develop a school-based framework for the three special schools to support a toolkit for learners with physical disabilities in Limpopo Province. To achieve this aim, the researcher explored the implementation, challenges and solutions related to the SIAS toolkit and evaluated support programmes developed for learners with physical disabilities.
Methodology: A parallel convergent mixed-method research design, underpinned by a dialectical pluralism approach, was employed in conducting this study. Both the qualitative and quantitative studies carried equal weight. Thus, data collection and analysis occurred concurrently. There were three main studies. Study 1 was qualitative in nature and comprised semi-structured interviews with caregivers of Grade 7 learners, focus group discussions with physiotherapists, Grade R educators and School-Based Support Teams, and a document analysis of the SIAS toolkits for the Grade R learners. Study 2 was quantitative and carried out through an online and paper survey with educators. Study 3 was the point of convergence to produce one data set through a joint display analysis. Study 3 led to the development of the school-based framework.
Research outputs: There was triangulation of data. Nine themes emerged pertaining to the challenges with implementation namely; human resource management, training, implementation of SIAS and other policies, support structures, support to learners, caregiver participation, knowledge of roles of therapists, collaboration and assistive devices whereas five themes emerged with regards to the solutions namely; human resource management, training, special school curriculum, functionality of School-Based Support Team and collaboration. The survey showed that not all SIAS toolkits were being used. The findings from the meta synthesis pointed out that educators were limited in the ability to identify and support learners with barriers due to lack of knowledge with the SIAS policy toolkits. Thus, these findings led to the development of the school-based framework which adopted the knowledge process management model. The model illustrated identifying, creating, gaining, sharing, applying, evaluating and preserving knowledge pertaining to the SIAS policy and toolkits. Contributions to the body of knowledge were disseminated at the 23rd AMCOA annual congress on the 4th of October 2022, titled: Self-study: a strategy applied by physiotherapists to gain knowledge on the SIAS policy in LIMPOPO province.
Impact of the research: This study was envisaged to, firstly, promote the practice of screening learners, identifying learners with barriers to learning, using relevant stakeholders to assess the nature of barriers and providing individualised support to learners at school; and secondly, to point out the need for interprofessional collaboration for effective implementation of the SIAS policy through its toolkits. Thus, the school-based framework is developed to assist special schools with the use of SIAS toolkits and foster interprofessional collaboration through knowledge sharing. This developed framework should be evaluated for its impact and outcome in Limpopo Province. The effect of dialectical pluralism in this study will undoubtedly provide SIAS policy reviewers with a valuable point of reference.
Keywords: SIAS policy, implementation, inclusive education, therapists, identification of barriers, educators, SBST, training, physical disabilities, caregivers.
Thesis (PhD (Physiotherapy))--University of Pretoria, 2023.
2023-01-01T00:00:00ZThe epidemiology, clinical characteristics and associated risk factors for injury among football players at an academy in Ghana
http://hdl.handle.net/2263/91391
The epidemiology, clinical characteristics and associated risk factors for injury among football players at an academy in Ghana
Background: Football is arguably the most common team sport in the world, with a resultant and rapid increase in the formation of young football academies, including Ghana. However, football is significantly associated with a risk of injury. Efforts are being focused on younger populations to reduce injuries through improving understanding of epidemiology and injury prevention strategies. Sparse knowledge on injuries and their risk factors specific to academy football players in Ghana is available.
Aim of the study: To determine the epidemiology, clinical characteristics and risk factors of football injuries, among players at a football academy in Ghana.
Design: Observational prospective cohort study.
Setting: A football academy in the Volta Region of Ghana.
Participants: Fifty-three young (under 18 years) and 27 adult (18 years and above) football players.
Methods: Eighty male, young and adult academy football players were recruited at a football academy in Ghana using total population sampling. Baseline measurements taken before the start of the football season included height using a stadiometer (Seca 213), weight using a digital scale (Omron HN-289), and ankle dorsiflexion (DF) range of motion (ROM) were measured with a tape measure. Functional ankle instability was measured with the Star Excursion Balance Test (SEBT) and the Cumberland Ankle Instability Tool (CAIT). A standardised injury surveillance form (SIS) developed by the International Olympic Committee (IOC), was used by two qualified senior physiotherapists to prospectively document players’ injuries and injury characteristics during one season. The first author visited the study site once a month to ensure` validity of data captured to extract data from physiotherapists’ files. All data collected were entered into a Microsoft Excel spreadsheet for analysis according to the International Olympic Committee (IOC) reporting guidelines. In addition to descriptive statistics, selected variables associated with football injuries were statistically investigated using Spearman’s rank correlation with interpretation at a significance level of 5%.
Results: A total of 126 injuries were reported during the assessed football season, with 66% and 60% occurring during matches and training, respectively. The average weekly injury prevalence was 4.1%, and overall injury incidence was 4.5 injuries per 1 000 hours. Match incidence (27.4 per 1 000 hours) was higher than training incidence (2.3 per 1 000 hours). The U14, U16 and U18 players suffered higher injury incidence (5.8, 5.1, 5.7 injuries per 1 000 hours respectively) compared to senior players (2.7 per 1 000 hours). A total of 109 injuries (86.5%) affected the lower limb, with the knee (n=30, 23.8%) being the most affected, followed by the ankle and the hip/groin (both n=17, 13.5%), and 57 (45.2%) injuries were due to acute trauma, occurring with direct contact with another player (n=42, 33.3%). The most common injury areas were joint sprains (n=54, 43.9%), followed by muscle strains (n=33, 26.2%), and bone contusions (n=11, 8.7%). The severity of injuries was mostly moderate (n=56, 44.4%). New injuries (n=112, 88.9%) occurred more commonly during matches than during training (n=59. 46.8% vs n=53, 42.1%). Of the total recorded number of recurrent injuries (n=14, 11.1%), most occurred among the U18 players (n=10, 17.2%). The following risk factors were associated with overall-, match- or training injury incidence during the season: Age was negatively associated with overall injury incidence (r=-0.589, p=0.000), and training injury incidence (r=-0.314, p=0.005). A record of previous injury among U18 players was associated with training injury incidence (r= 0.436, p=0.023). The Body Mass Index (BMI) was negatively associated with overall injury incidence (r=-0.513, p=0.000) and training injury incidence (r=- 0.395, p=0.000). However, only for U18 players the BMI was negatively associated with overall injury incidence (r=- 0.428, p=0.021), based on age category. CAIT scores (for ankle instability) were positively associated with overall (n=0.263, p=0.019) and match injury incidence (r=0.263, p=0.029) whilst only senior players’ range of motion (ROM) of the left ankle (dorsiflexion) was positively associated with training injury incidence (r=0.436, p=0.023). Player position was associated with match injury incidence (r=0.241, p=0.031) while the attacker position among U16 was associated with training injury incidence (r=0.669, p=0.003).
Conclusion: Injury incidence over a competitive season was higher among younger players, compared to senior players. The majority of training injuries occurred in non-contact scenarios, whereas contact injuries were more common during matches. Most reported injuries were joint sprains and muscle strains, which mostly affected the lower limb. A younger age, lower BMI and higher self-reported functional ankle instability were risk factors associated with overall injury incidence of the whole population. In U18 players, a lower BMI and a previous injury were risk factors associated with increased injury incidence. Adult players’ ankle dorsiflexion ROM was associated with injury incidence. The ‘Attacker’ playing position was associated with an increased injury incidence among U16 players. This study's findings contribute to the collective understanding of injuries and risk injury factors among academy football players. These results can guide the development of future injury prevention strategies, specifically in Ghana. Further studies should focus on examining risk factors for specific anatomical locations, especially the ankle and the knee as well as specific injury types.
Dissertation (MPhysT)--University of Pretoria, 2023.
2023-05-18T00:00:00ZDevelopment of a model for the rehabilitation of children with disabilities in the greater Giyani Municipality in Limpopo Province, South Africa
http://hdl.handle.net/2263/84105
Development of a model for the rehabilitation of children with disabilities in the greater Giyani Municipality in Limpopo Province, South Africa
The rehabilitation of children with disability (CWDs) in a rural area is difficult because of the multiple challenges associated with rural and under-resourced areas. These challenges include accessibility of health-care facilities, shortage of experienced rehabilitation professionals and limited rehabilitation models to direct how the rehabilitation of CWDs should be conducted within a rural South African context. The primary research question for this study was: how should a model for the rehabilitation of CWDs look like in Giyani?
The aim of the study was to develop a descriptive model for the rehabilitation of CWDs by health-care workers. The objectives of the study were to: (1) synthesise concepts, (2) synthesise non-relational statements, (3) organise relational statements, and (4) present the theory as a model with an ultimate goal of improving the health, function, and participation of CWDs.
A qualitative, theory-generating, exploratory, descriptive and contextual approach was used.
Data collection was divided into two phases. The primary objective of Phase 1 was to generate data through face-to-face interviews with caregivers of CWDs, rehabilitation professionals and community rehabilitation workers (CRWs) in order to develop concepts. The objective of Phase 2 was to expand data gathering from caregivers and rehabilitation professionals through focus group discussions (FGDs).
Data from the interviews and FGDs was transcribed verbatim, translated into English, and analysed using an inductive approach.
Ten caregivers participated in the interviews. Participants were predominantly mothers and unemployed. The CWDs whose caregivers participated in the interviews were under the age of six and had mostly a cerebral palsy diagnosis (80%). Eight rehabilitation professionals and two CRWs participated in the interviews.
A total of ten caregivers participated in three FGDs. Participants were predominantly mothers. The CWDs whose caregivers participated in FGDs were less than or equal to two years of age and were diagnosed with cerebral palsy (80%). Six rehabilitation professionals participated in one FGD.
Sixteen concepts and non-relational statements were developed:
1) cause of childhood disability
2) available services
3) role of caregivers
4) caregivers‘ source of support
5) caregivers‘ coping strategy
6) caregivers‘ level of satisfaction
7) caregivers‘ expectations
8) role of rehabilitation professionals
9) rehabilitation professionals‘ competency
10) factors that affect the rehabilitation professionals‘ work ethic
11) rehabilitation professionals‘ plan of action
12) role of CRWs
13) role of the municipality towards people with disabilities
14) role of Pfunanani Special School
15) challenges experienced
16) societal perception of CWDs
Seven relational statements were developed to show the relationship between the sixteen concepts. Lastly, a model for the rehabilitation of CWDs was presented.
The implication of the model is that the rehabilitation professionals and CRWs have a responsibility to reduce child-related, family-caregiver related, and health-care related challenges. In addition, the local government and the education sector have a responsibility to reduce community related challenges. The assumption of the model is that a reduction in child-related, family-caregiver related, health-care related, and community related challenges is likely to improve the caregivers‘ ability to support the CWD and ensure that there is continuity of care or treatment.
Thesis (PhD)--University of Pretoria, 2015.
2015-04-01T00:00:00ZInter- and intra-rater reliability of a technique for assessing the length of the Latissimus Dorsi muscle
http://hdl.handle.net/2263/84068
Inter- and intra-rater reliability of a technique for assessing the length of the Latissimus Dorsi muscle
Introduction
The length of a muscle has been described as one of the factors contributing to the ideal movement at a joint. A decrease in the length of a muscle results in a decrease in the range of motion at the joint in direct relation to the function of that specific muscle. M Latissimus Dorsi is a muscle which undergoes length changes (loss of extensibility) and this muscle has a functional role in many aspects of sport and rehabilitation. The loss of extensibility may result in a decreased range of motion at the glenohumeral joint leading to dysfunction. Evidence-based practise requires the use of objective, valid and reliable tests for measuring the length of a muscle. No scientific evidence of reliability for any documented technique testing the length of m Latissimus Dorsi (LD) was found.
Aim
The aim of this study was to assess the inter-rater and intra-rater reliability of a technique adapted by Commerford and Mottram (2012) for assessing the length of LD.
Study design
The design of the study is a within-participant test-retest non-experimental quantitative study for reliability purposes
Method
Fifty-six volunteering students recruited from the Physiotherapy Department of the University of Pretoria were the participants in this study. Four qualified physiotherapists with varying numbers of years of clinical experience independently performed the test for assessing the length of LD. The test was performed twice by each physiotherapist on every participant and two measurement sessions were done. A pilot study was also done.
Data Analysis and conclusion
A sample of 56 participants provided an intraclass correlation coefficient (ICC) of less than 0.9 and this is regarded as poor reliability. The agreement between each rater and the differences in the two levels of experience of raters were also assessed. The ICC was used to determine the inter-rater and intra-rater reliability of the LD length test. A 0.05 level of significance was employed.
The ICC between the experienced raters was found to be 0.48 with a novice rater ICC of 0.48 as well. The ICC between all the raters was 0.33. This constitutes poor reliability. The poor reliability of the technique testing the length of LD was identified and addressed in order for adequate usage thereof, in research and in practice. Recommendations of a new technique to test the length of LD was provided by the researcher.
A suggestion was made regarding a manner of testing its reliability.
Dissertation (MPhysT)--University of Pretoria, 2014.
2014-10-29T00:00:00Z