Physiotherapy

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Browsing Physiotherapy by Author "Barnes, R. Y."

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    Carpal tunnel syndrome in physiotherapists in Bloemfontein
    (University of the Free State, 2016-01-29) Human, Nadia; Barnes, R. Y.
    English: Introduction: Carpal tunnel syndrome (CTS) is the most common compression neuropathy of the upper limb with a 3-5% prevalence among the worldwide general adult population. It is associated with specific personal factors, certain medical conditions, repetitive and forceful hand and wrist movements and occupation. This study aimed at investigating the prevalence of CTS among physiotherapists. Method: The cross-sectional study included 64 participants, chosen by means of convenience sampling from a population of 158 physiotherapists. Demographic data, details of occupational activities; possible personal, medical and occupational causative factors and arm and hand symptoms were gathered by a structured interview. A participant-completed Katz hand diagram was used to clarify information on upper limb symptoms. Typical CTS signs, height and weight were determined by a physical examination. Results: According to the case definition the prevalence of definitive CTS was 7.8% and of probable CTS was 7.8%. Age over 40 years and rheumatoid arthritis as personal or medical history causative factors was statistically significant among the definitive diagnosis group. Overweight showed a tendency towards a definitive CTS diagnosis. Years in practice, hours working overtime and working in the neurosurgery field was occupational causative factors in the definitive CTS diagnosed group. No occupational activities or treatment techniques could be found to be associated with the CTS diagnosis. Longer resting periods between patients was the only statistically significant management strategy among the definitive CTS diagnosed group. Conclusion: Physiotherapy is an at risk occupation for the development of CTS with a prevalence of 15.6% when combining the definitive and probable diagnosis groups, but with no clear occupational activities or treatment techniques as possible risk factors identified.
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    The effect of a core stability, m. gluteus medius and proprioceptive exercise program on dynamic postural control in netball players
    (University of the Free State, 2014-11) Wilson, Marelise; Barnes, R. Y.
    English: Dynamic postural control is the ability to perform a functional task with purposeful movements that translates the body’s centre of gravity without compromising a stable base of support. The functional task might involve jumping or hopping to a new location and immediately attempting to remain as still as possible or attempting to create movements such as reaching or throwing without compromising the base of support (Winter, Patla and Frank, 1990; Kahle and Gribble, 2009, Gribble, Hertel and Plisky, 2012). Maintaining dynamic postural control is essential for netball players as netball players frequently find themselves on one leg having to make an accurate pass. Research by Ferreira and Spamer (2010) evaluated the physical profile of elite university netball players and found poor balance in these netball players during pre-season. No literature could be found regarding studies investigating a programme that utilized the combination of core stability, m.gluteus medius (GMed) strengthening and proprioceptive balance exercises on dynamic postural control or studies investigating the effect of an exercise programme on dynamic postural control in netball players. The research study was undertaken to determine if an exercise programme that incorporates core stability, m.GMed strengthening and proprioceptive balance exercises would lead to a significant improvement (p˂0.05) in dynamic postural control in a group of netball players. A cross-over randomised clinical trial was performed. Sixteen female university netball players selected in the top junior group participated in this study. Participants were randomly divided in two groups. Group A participated three times a week for six weeks in the exercise programme while group B was considered as the control group after which the roles were reversed. The simple Star Excursion Balance Test (SEBT) with three trials and four directions were used to measure dynamic postural control of the participants. All participants were assessed at baseline, after six weeks and after 12 weeks. Participants from both groups were tested simultaneously, and the data collector and assistant were blinded to which group the participants belonged. Data were analyzed by a biostatistician using student’s and paired t-tests. Dynamic postural control as measured with the SEBT demonstrated a statistically significant improvement (p<0.05) across three reach directions (anterior, medial and posterior) in a group of netball players post participation in an exercise programme that incorporated core stability, m.GMed strengthening and proprioceptive balance exercises. The study proposes that an exercise programme that incorporates core stability, m.GMed and proprioceptive balance exercises could be beneficial for improving dynamic postural control in a group of netball players. The results of the study provided substantial evidence for the use of a combination of core stability, m.GMed strengthening and proprioceptive balance exercises in programmes rehabilitating netball players with poor dynamic postural control. The present study also provides a baseline for further research whether an exercise programme that incorporated core stability, m.GMed strengthening and proprioceptive balance exercises would contribute towards improved performance and injury prevention in netball players. The effectiveness of the exercise programme described in the present study could be implemented and investigated in other sporting codes requiring dynamic postural control. Netball players can also confidently use the developed exercise programme in the present study to eliminate shortcomings in their physical profile, with regards to dynamic postural control.
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    A framework for the integration of simulation in undergraduate physiotherapy: contextualised for South Africa
    (University of the Free State, 2020) Van der Merwe, Anke; Barnes, R. Y.; Labuschagne, M. J.
    This thesis aims to describe the process of developing a framework for integrating simulation in the South African undergraduate physiotherapy programme. An exploratory multi-method research design comprising three study phases was utilised in the framework development. A systematic review, utilising deductive content analysis, identified the key elements making up the frameworks that were designed to facilitate the curricular integration of simulation. Following the review, a Delphi survey was compiled to develop a conceptual framework for integrating simulation in the South African undergraduate physiotherapy programme. Contextualisation and credibility were ensured by means of a validation meeting. The systematic review included eight articles, which have an almost equal distribution of low and high finding reliability. In total 18 descriptive themes, grouped under four analytical themes, were identified. Analytical themes identified were planning, implementation, evaluation and revision. All articles noted thoughtful planning of simulation-based learning experiences (SBLEs), including stipulating learning outcomes, considering resources and debriefing. Only three articles included the execution of needs analyses and identified the need for simulation-based educator training prior to simulation integration. Data obtained from the review was formulated into a Delphi survey and distributed to purposively selected international and national experts in healthcare education and/or simulation. Results from the Delphi survey confirm the importance of curriculum development, SBLE design, resource availability and development of learning outcomes. Panel members also highlighted educator competence as essential. Analysis of both institutional and student needs were deemed essential, with societal needs being regarded as merely useful. The majority of statements pertaining to student preparation, student assessment and mastery learning/deliberate practice only achieved stability during the Delphi survey. Following the Delphi survey, the conceptual framework was developed by the researcher, and it was refined further during a validation meeting. Participants in the validation meeting suggested modifying the unidirectional framework illustration, which resulted in adjustment of the framework. Noteworthy was the importance of addressing all stakeholder needs, including societal needs. A collaborative approach to simulation integration was emphasised by participants especially in a resource-restricted South African setting. Participants refined terminology, so that it was more applicable to the South African education environment. The framework was finalised by the researcher, who applied constructive and cognitive load education theories and the data of the current study. A framework depicting both the fluidity between framework elements and the need to adjust education approaches to optimise student training was designed/developed. The framework emphasises the preparation required by both educators and students. Curriculum and SBLE authenticity are essential framework components for optimising preparation of graduates for practice, which expects graduates to possess increased and complex skills early in their careers. The final product is a credible and contextualised framework for the integration of simulation in the South African undergraduate physiotherapy programme. Though it is generic in nature, it may be applicable for use in any healthcare programme. It is recommended that a dedicated simulation expert, who is well versed in simulation-based education, is appointed to drive framework implementation; to ensure that all stakeholder needs are addressed, and to promote the sustainability of the integrated framework. Engagement with national regulating bodies regarding the inclusion of simulation as part of the mandatory undergraduate physiotherapy training requirements is recommended. Further research, exploring the practical use of SBLEs for mastery learning/deliberate practice and assessment purposes, is required. Investigation into a standardised approach to peer assessment in SBLEs is advised, to encourage student participation. In light of national resource restrictions, the researcher recommends research is undertaken in relation to the development and/or identification of validated outcome measures that calculate the return on investment of simulation integration at institutional level.