https://sajp.co.za/index.php/sajp/issue/feedSouth African Journal of Physiotherapy2024-03-01T13:24:19+01:00AOSIS Publishingsubmissions@sajp.co.zaOpen Journal Systems<a id="readmorebanner" href="/index.php/sajp/pages/view/journal-information" target="_self">Read more</a> <img style="padding-top: 2px;" src="/public/web_banner.svg" alt="" />https://sajp.co.za/index.php/sajp/article/view/1996Psychosocial reintegration post-traumatic spinal cord injury in Rwanda: An exploratory study2024-03-01T13:24:19+01:00Maurice Kanyonininyoka77@gmail.comLena N. Wikmarlena.nilsson-wikmar@ki.seJoliana Philipsjphillips@uwc.ac.zaDavid K. Tumusiimedktumusiime@gmail.com<p><strong>Background:</strong> Traumatic spinal cord injury (TSCI) survivors are confronted by both physical and psychosocial barriers when returning to their communities. Therefore, reintegration is an important aspect of their journey back into social life.</p><p><strong>Objectives:</strong> To assess psychosocial reintegration after TSCI in Rwanda.</p><p><strong>Method:</strong> All community-dwelling adults who were registered in the previous epidemiological study were recruited and injury characteristics questionnaire and the Sydney Psychosocial Reintegration Scale version 2 (SPRS-2) were used to collect data through a telephone interview.</p><p><strong>Results:</strong> The study traced 58 participants, 77.6% (<em>n</em> = 45) were male and 56.9% (<em>n</em> = 33) were categorised with paraplegia. Overall, the results show poor community reintegration. The SPRS-2 and domain mean (SD) scores were: overall SPRS-2 of 20.95 (11.56), occupational activity (OA) of 3.68 (4.31), interpersonal relationship (IR) of 7.11(4.31) and living skills (LS) of 7.43 (5.32). Gender significantly influenced overall SPRS-2 (<em>p</em> = 0.011) and two domains: OA (<em>p</em> = 0.005) and LS (<em>p</em> = 0.012). Level of injury was significantly associated with an OA domain score of SPRS-2 (<em>p</em> = 0.002). Gender explained 29% of the variance in the LS domain of SPRS-2, with males reporting better psychosocial reintegration.</p><p><strong>Conclusion:</strong> Gender strongly predicted psychosocial reintegration following a TSCI, which is an indication of the role of social support.</p><p><strong>Clinical Implications:</strong> Traumatic SCI rehabilitation should be holistic to help prepare the person to return to the community. There should be an assessment of an individual’s readiness to return to the community before discharge from the hospital.</p>2024-02-29T07:00:00+01:00Copyright (c) 2024 Maurice Kanyoni, Lena N. Wikmar, Joliana Philips, David K. Tumusiimehttps://sajp.co.za/index.php/sajp/article/view/1922The knowledge, attitudes and perceptions of physiotherapists and chiropractors in South Africa2024-03-01T13:24:19+01:00Micaela Raviduttmicaelarav20@gmail.comSonill MaharajMaharajss@ukzn.ac.za<p><strong>Background:</strong> Effective healthcare delivery occurs when health professionals collaborate and provide holistic, patient-centred care. Physiotherapists and chiropractors treat a common range of patients with an overlap in their scope of practice and modalities because of typical healthcare roles that could lead to ‘perceived’ animosity.</p><p><strong>Objectives:</strong> To assess the knowledge, attitudes, and perceptions of qualified chiropractors and physiotherapists regarding each other’s practice.</p><p><strong>Method:</strong> A cross-sectional survey using an online questionnaire and analysed descriptively.</p><p><strong>Results:</strong> Participants were chiropractors (<em>n</em> = 116) and physiotherapists (<em>n</em> = 190). Chiropractors achieved a mean knowledge score of 75.7%, with physiotherapists at 59.7% on the assessments of each other’s patients; an average score of 85.3% and 72.0% respectively, on knowledge of treatment modalities; knowledge score of 82.4% and 77.3% respectively, on the conditions treated by the other professional. A total of 82.8% (<em>n</em> = 96) of chiropractors and 70.0% (<em>n</em> = 133) of physiotherapists indicated the other professionals’ competence in treating neuromusculoskeletal conditions. Inter-professional referrals occurred between 81.9% of chiropractors (<em>n</em> = 95) and 55.3% of physiotherapists (<em>n</em> = 105). Chiropractors (69.0%, <em>n</em> = 80) and physiotherapists (55.3%, <em>n</em> = 105) wanted to collaborate to manage patients.</p><p><strong>Conclusion:</strong> In the surveyed population in South Africa, chiropractors and physiotherapists had good knowledge, positive attitudes and perceptions of each other’s practices, especially in the private sector.</p><p><strong>Clinical implications:</strong> Inter-professional collaboration between chiropractors and physiotherapists should be encouraged so that healthcare delivery can be holistic and patient-centred for better clinical outcomes.</p>2024-02-29T06:00:00+01:00Copyright (c) 2024 Micaela Ravidutt, Sonill Maharajhttps://sajp.co.za/index.php/sajp/article/view/1954Quadriceps vascular occlusion does not alter muscle action or balance: A cross-sectional study2024-02-02T10:59:27+01:00Daiene C. Ferreiradaiene_ferreira@hotmail.comLetícia B. Valeleticiab.dovale@gmail.comFelipe H. Santosfelipe_.hs@hotmail.comChristiane S.G. Macedochmacedouel@yahoo.com.br<p><strong>Background:</strong> Partial vascular occlusion (PVO) can increase muscle strength and hypertrophy without joint overload. However, PVO could increase the possibility of imbalances and injuries during physical activity.</p><p><strong>Objectives:</strong> To identify changes in strength, muscle activation, and postural control during the use of PVO in young women.</p><p><strong>Method:</strong> A total of 14 healthy women aged between 18 and 30 years were evaluated. Dynamometry was used to analyse the strength of the quadriceps muscle, and surface electromyography to evaluate quadriceps muscle activity. A force platform was utilised to assess postural control, static single-legged support, single-legged squat, and climbing and descending stairs. Participants were randomly assigned to the evaluations either with or without PVO. The results were compared and correlated.</p><p><strong>Results:</strong> The performance of static, dynamic, or stair exercises, with or without PVO, did not indicate differences in muscle strength and recruitment (<em>p</em> > 0.05). The use of PVO improved the velocity of anteroposterior (AP) oscillation of static postural control (<em>p</em> = 0.001). We found a moderate negative correlation between muscle strength and postural control during the ascending stairs task with the use of PVO (<em>r</em> = −0.54; <em>r</em> = −0.59), while in the group without PVO, the correlation was moderate to high (<em>r</em> = −0.55; <em>r</em> = −0.76).</p><p><strong>Conclusion:</strong> The use of PVO did not impair muscle strength and recruitment of the quadriceps or postural control in healthy women.</p><p><strong>Clinical Implications:</strong> Partial vascular occlusion can be used during dynamic exercises without impairing the balance and muscle strength of the quadriceps during its execution.</p><p> </p>2024-01-31T12:12:00+01:00Copyright (c) 2024 Daiene C. Ferreira, Letícia B. Vale, Felipe H. Santos, Christiane S.G. Macedohttps://sajp.co.za/index.php/sajp/article/view/1965Managers’ perceptions on the implementation of community-based rehabilitation in KwaZulu-Natal2024-02-01T13:18:31+01:00Sithembiso Blosebloses1@ukzn.ac.zaVerusia Chettychettyve@ukzn.ac.zaSaul Cobbingcobbing@ukzn.ac.zaNomzamo Chemanechemanen1@ukzn.ac.za<p><strong>Background:</strong> Community-based rehabilitation (CBR) is a World Health Organization (WHO) strategy for social inclusion, equalisation of opportunities and provision of essential services for people with disabilities (PWDs). Community-based rehabilitation is a multi-sectoral strategy that requires all stakeholders to participate equally in its implementation. KwaZulu-Natal has implemented CBR for over two decades, with various stakeholders at the forefront of implementation. However, the status of stakeholder engagement, collaboration and coordination is unknown.</p><p><strong>Objective:</strong> The objective of our study was to understand how CBR is implemented in KwaZulu-Natal and the roles of each stakeholder in its implementation, with a focus, on managers from government and non-governmental organisations.</p><p><strong>Method:</strong> A descriptive explorative approach using semi-structured interviews was used to collect data from 20 managers from various stakeholders involved in implementing CBR in KwaZulu-Natal. Data were transcribed and analysed using thematic analysis.</p><p><strong>Results:</strong> The findings revealed five dominant themes: (1) the understanding of concepts, (2) missed opportunities for implementing CBR, (3) barriers to implementing CBR, (4) benefits to implementing CBR and (5) recommendations for future implementation.</p><p><strong>Conclusion:</strong> A formal management structure with clear roles and responsibilities was fundamental for implementation. Collaboration, coordination and planning were believed to be the critical roles of managers in the implementation of CBR. Training, awareness and sharing of resources among stakeholders were also identified as important factors in implementing CBR in KwaZulu-Natal.</p><p><strong>Clinical implications:</strong> Our study will assist managers and clinicians to improve their planning and implementation of CBR.</p>2024-01-26T13:12:00+01:00Copyright (c) 2024 Sithembiso Blose, Verusia Chetty, Saul Cobbing, Nomzamo Chemanehttps://sajp.co.za/index.php/sajp/article/view/1981Use of standardised outcome measures among physiotherapists in French-speaking sub-Saharan Africa2024-02-01T13:18:31+01:00Abdoulaye Sawadogokouka30@yahoo.frEmmanuel Segnon Sogbossiemmanuel.sogbossi@gmail.comGauthier J. Everardgjeve@ulaval.caToussaint Kpadonoukpadonou_toussaint@yahoo.frCharles Sèbiyo Batchocharles.batcho@fmed.ulaval.ca<p><strong>Background:</strong> The use of standardised assessment tools is a fundamental aspect of good clinical practice. However, to our knowledge, no study has documented the use of standardised assessment tools in physiotherapy in French-speaking sub-Saharan Africa.</p><p><strong>Objectives:</strong> Documenting the use of standardised outcome measures in physiotherapy in French-speaking sub-Saharan Africa.</p><p><strong>Method:</strong> Our cross-sectional survey used an online self-questionnaire on facilitators and barriers to the use of standardised outcome measures, distributed to physiotherapists in French-speaking sub-Saharan Africa.</p><p><strong>Results:</strong> A total of 241 physiotherapists working in French-speaking sub-Saharan Africa responded to the survey. The most represented countries were Benin (36.9%), Cameroon (14.1%), and Burkina Faso (10.8%). Although 99% of participants reported using standardised outcome measures, only 27% of the respondents used them systematically (all the time). The most reported facilitators included the recognition that standardised outcome measures help to determine whether treatment is effective, help to guide care, and improve communication with patients. The most significant barriers were the lack of time, unavailability of the standardised outcome measures, and non-sensitivity of measures to patients’ cultural and ethnic concerns. There was a higher proportion of use in the middle age group (30–40) (<em>p</em> = 0.02) and a lower proportion of use in physiotherapists simultaneously working in public and private sectors (<em>p</em> = 0.05).</p><p><strong>Conclusion:</strong> Standardised outcome measures are still not widely used by physiotherapists in French-speaking sub-Saharan Africa.</p><p><strong>Clinical implications:</strong> The perceived barriers and facilitators could help to develop strategies to improve the systematic use of outcome measures in French-speaking sub-Saharan Africa.</p>2024-01-26T06:00:00+01:00Copyright (c) 2024 Charles Sèbiyo Batcho, Abdoulaye Sawadogo, Emmanuel Segnon Sogbossi, Gauthier J Everard, Toussaint Kpadonouhttps://sajp.co.za/index.php/sajp/article/view/1985Bilateral versus unilateral upper limb training in (sub)acute stroke: A systematic and meta-analysis2024-02-01T13:18:31+01:00Justine Dembelejustine.dembele@uhasselt.beLisa Tedesco Triccaslisa.tedescotriccas@uhasselt.beElogni Renaud Amanzonwérenaud.amanzonwe@uhasselt.beOyéné Kossioyene.kossi@gmail.comAnnemie Spoorenannemie.spooren@uhasselt.be<p><strong>Background:</strong> Integrating high dosage bilateral movements to improve upper limb (UL) recovery after stroke is a rehabilitation strategy that could potentially improve bimanual activities.</p><p><strong>Objectives:</strong> This study aims to compare the effects of bilateral with unilateral UL training on upper limb impairments and functional independence in (sub)acute stroke.</p><p><strong>Method:</strong> Five electronic databases (PubMed, Scopus, PEDro, ScienceDirect, Web of Science) were systematically searched from inception to June 2023. Randomised controlled trials comparing the effect of bilateral training to unilateral training in stroke survivors (< 6 months poststroke) were included. The treatment effect was computed by the standard mean differences (SMDs).</p><p><strong>Results:</strong> The review included 14 studies involving 706 participants. Bilateral training yielded a significant improvement on UL impairments measured by FMA-UE compared to unilateral training (SMD = 0.48; 95% CI: 0.08 to 0.88; <em>P</em> = 0.02). In addition, subgroup analysis based on the severity of UL impairments reported significant results in favour of bilateral UL training in improving UL impairments compared to unilateral training in “no motor capacity” patients (SMD = 0.66; 95% CI: 0.16 to 1.15; <em>P</em> = 0.009). Furthermore, a significant difference was observed in favour of bilateral UL training compared to unilateral UL training on daily activities measured by Functional Independence Measure (SMD = 0.45; 0.13 to 0.78; <em>P</em> = 0.006).</p><p><strong>Conclusion:</strong> Bilateral UL training was superior to unilateral training in improving impairments measured by FMA-UE and functional independence in daily activities measured by Functional Independence Measure in (sub)acute stroke.</p><p><strong>Clinical implications:</strong> Bilateral upper limb training promotes recovery of impairments and daily activities in (sub)acute phase of stroke.</p>2024-01-23T12:30:00+01:00Copyright (c) 2024 Justine Dembele, Lisa Tedesco Triccas, Lisa Elogni Renaud Amanzonwé, Oyéné Kossi, Annemie Spoorenhttps://sajp.co.za/index.php/sajp/article/view/1955The knowledge and attitude concerning sport-related concussion among coaches: A survey study2024-02-01T13:18:31+01:00Thaer Manaseerthaers_su@hu.edu.joSaad M. Al-nassansaad@hu.edu.joAkef M. Taifourakef@hu.edu.jo<p><strong>Background:</strong> There are no studies investigating the level of knowledge about and attitude towards sports-related concussions (SRC) among sports coaches in Jordan.</p><p><strong>Objectives:</strong> This study aimed to examine the knowledge about and attitude towards SRC among Jordanian sports coaches.</p><p><strong>Method:</strong> Our study was based on a cross-sectional survey. An Arabic version of the questionnaire from the Centers for Disease Control and Prevention was used to collect data. The survey identified participants’ demographics and knowledge about (0–10 points with higher scores indicating a higher knowledge) and attitude towards (8–40 with lower scores indicating favourable attitudes) SRC. Descriptive statistics and the Kruskal–Wallis test were used to examine knowledge and attitude differences by demographic factors. Spearman’s correlation examined the correlation between the total knowledge and attitude scores.</p><p><strong>Results:</strong> Participants included 193 coaches (62 basketball, 66 martial arts, 30 soccer, and 35 swimming). The median total knowledge and attitude scores were 4 and 30, respectively. The total knowledge score was the highest in martial arts coaches (median = 4) and those with graduate degrees (median = 5). The total attitude score was the lowest among basketball coaches (median = 28) and those who were 40–50 years old (median = 28). No significant correlation between knowledge and attitude scores was observed.</p><p><strong>Conclusion:</strong> Jordanian coaches have a deficiency in knowledge about SRC and hold attitudes that are not consistent with current practice recommendations.</p><p><strong>Clinical implications:</strong> Knowledge and attitude about SRC can be improved through education, access to healthcare providers, and adherence to SRC management guidelines.</p>2024-01-19T12:04:00+01:00Copyright (c) 2024 Thaer Manaseer, Saad M. Al-nassan, Akef M. Taifourhttps://sajp.co.za/index.php/sajp/article/view/1879Competencies of undergraduate physiotherapy education: A scoping review2024-02-01T13:18:31+01:00Tonderai W. Shumbatshumba@unam.naAra TekianTekian@uic.edu<p><strong>Background:</strong> In recent years, the need for competency-based medical education has been emphasised. Each country needs a defined set of physiotherapy competencies from the associations and governing bodies.</p><p><strong>Objectives:</strong> Our review aimed to map competencies of undergraduate physiotherapy education and propose a context-specific competency framework for Namibia.</p><p><strong>Method:</strong> This scoping review was conducted following the Joanna Briggs Institute framework and was reported using the Preferred Reporting for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. Qualitative direct content analysis utilising the five main competency domains from the WHO Rehabilitation Competency Framework was adapted.</p><p><strong>Results:</strong> Five main competency domains were proposed: practice, professional growth and involvement, learning and development, management and leadership, and research. Nineteen potential competencies were identified, and each competency has a set of knowledge and skills activities that is expected of each student.</p><p><strong>Conclusion:</strong> The proposed competencies still need to undergo expert consensus and content validation before they can be adopted and implemented in Namibia. Future studies can explore the perspectives and experiences of the faculty, students and clinicians on the current status of competency-based education of undergraduate physiotherapy programme in Namibia. Similarly, future studies can focus on possible assessment strategies that can be used for each competency and an evaluation framework for assessing milestones in student competencies from entry into clinical education to graduation.</p><p><strong>Clinical implications:</strong> The review proposed a context-specific competency framework for Namibia with a set of knowledge and skills activities that is expected of each student. The faculty can adopt these competencies and improve on their competency-based physiotherapy education.</p>2024-01-19T06:00:00+01:00Copyright (c) 2024 Tonderai W. Shumba, Ara Tekianhttps://sajp.co.za/index.php/sajp/article/view/1921Factors affecting quality of life in adults with HIV: A local cross-sectional study2023-12-04T08:06:42+01:00Karina Bernerkberner@sun.ac.zaQuinette A. Louwqalouw@sun.ac.za<p><strong>Background:</strong> Understanding health-related quality of life (HRQOL) among people with HIV (PWH) can inform strategies to maintain or improve health and functioning. Most HRQOL research has focused on resource-rich settings, underrepresenting younger cohorts in low-resource settings.</p><p><strong>Objectives:</strong> To assess HRQOL and associated factors in PWH visiting two primary healthcare clinics in the Western Cape, South Africa.</p><p><strong>Method:</strong> A cross-sectional study included 48 PWH (58.3% women; mean age: 39.2 [10.3]). Health-related QOL was assessed using EQ-5D-5L descriptive domains, visual analogue scale (EQ-VAS), and index score (EQ-index). Mobility was assessed using clinical tests. Tobit regression determined associations.</p><p><strong>Results:</strong> Mean and median EQ-VAS scores were 88.14 (16.35) and 95.00. Mean and median EQ-index scores were 0.84 (0.10) and 0.90. PWH reported problems as pain/discomfort (35.4%), depression/anxiety (25.0%), mobility (22.9%), usual activities (18.7%) and self-care (12.5%) domains. Slow chair rise (<em>p</em> = 0.012), low income (<em>p</em> = 0.030), longer HIV duration (<em>p</em> = 0.009) and polypharmacy (<em>p</em> = 0.034) were associated with lower HRQOL. Antiretroviral therapy (ART) adherence was associated with higher HRQOL (<em>p</em> = 0.020).</p><p><strong>Conclusion:</strong> Despite high overall HRQOL, specific domains presented challenges to PWH. Health-related QOL was associated with chair rise repetitions, income, HIV duration, polypharmacy, and treatment adherence. Comprehensive care and contextualised interventions to address these through rehabilitation, including health promotion, are proposed strategies for future investigation.</p><p><strong>Clinical implications:</strong> Clinicians should be cognisant of potential physical and mental functioning problems, and factors related to drug therapy, socio-economic status and disease duration that may affect HRQOL even in seemingly unimpaired PWH.</p>2023-11-27T06:00:00+01:00Copyright (c) 2023 Karina Berner, Quinette Abegail Louwhttps://sajp.co.za/index.php/sajp/article/view/1942Hand therapy: Inclusive care by South African physiotherapists2023-12-04T08:06:42+01:00Monique M. Kellermonique.keller@wits.ac.za<p>Hand therapy for individuals who sustained hand injuries is included in the Health Professions Council of South Africa (HPCSA) physiotherapy scope of practice. The training that physiotherapists receive at the undergraduate level lays the foundation for them to deliver hand therapy or hand rehabilitation according to the International Classification of Functioning, Disability and Health domains in a uniquely South African health service context. Further structured formal and informal postgraduate continued education opportunities may put physiotherapists in the ideal position in a multidisciplinary team to deliver optimal hand therapy. The problem is that the physiotherapist’s role in the multidisciplinary team delivering hand therapy in the past two decades has decreased, leaving room for a lack of health professional services in South Africa’s private sector where physiotherapists are often the first consultation in, for example, sports teams, but more pertinently, in the public and rural areas. The International Federation of Societies for Hand Therapy (IFSHT) practice profile and physiotherapy scope of practice, curriculum and education information assist in achieving the aim of this commentary to position physiotherapists in South Africa as primary health practitioners in delivering hand therapy.</p><p><strong>Clinical implication:</strong> The effective management of individuals with hand-related conditions and injuries is pertinent to ensure optimal hand function and quality of life. Equal continued formal education opportunities should thus be created for all multidisciplinary team professions at a postgraduate level.</p>2023-11-24T06:00:00+01:00Copyright (c) 2023 Monique M. Keller