Search

Background. The Department of Physiotherapy at the University of the Witwatersrand, Johannesburg, South Africa has a programme that allows 4th-year physiotherapy students to experience learning about public health in a rural setting. This experience is assessed using a portfolio. To date, the portfolios have only been assessed in terms of the students achieving the learning objectives. The process has not been evaluated for its effectiveness in promoting a reflective learner. A reflective learner is considered as one who will develop critical thinking and better accountability for their own learning. Objective. To analyse the level of reflective practice attained by the students. Methods. A qualitative approach was used to analyse evidence of reflective practice in student reflective diaries. Guided content analysis, using a framework compiled from the literature, was used to code the data. The coding framework outlined the levels of reflective practice - from the lowest level, identifying learning outcomes, to the highest level, i.e. abstract concept formation. Results. Forty-eight portfolios with reflective diaries were available for analysis. Data saturation was obtained after eight reflective diaries were analysed. The majority of the student diaries (6 of 8) reflected a low level of reflective practice, with only a few attaining a high level. Conclusion. This study showed that physiotherapy students who experienced learning in a rural setting achieved low levels of reflective practice. A minority of students were able to progress in their reflection to reveal elements of critical thought, reflective thinking and, further still, abstract concept formation. [ABSTRACT FROM AUTHOR]

Background: The undergraduate physiotherapy program at the University of the Witwatersrand, South Africa, aims to respond to global and national health needs across levels of care, with a focus on primary care. Ideally, contemporary health professionals' education focuses on a holistic approach that extends beyond addressing a patient's medical diagnosis. In South Africa, however, this approach also needs to address the country's colonial past by emphasizing decolonialization and social justice. Within this context, novel competencies are required to serve South Africans consistent with comprehensive health and disability frameworks based on the biopsychosocial approach such as the International Classification of Functioning, Disability and Health., Aim: As physiotherapy educators at the University of the Witwatersrand, we describe the rationale for the current public health and community physiotherapy curriculum in the context of decolonialization and social justice and provide an overview of the curriculum., Method: Narrative approach., Conclusion: Our curriculum is an example of a response to the 21st-century health needs of the South African population and the specific global and universal policies, philosophies, and principles that influence healthcare professionals and their service delivery. This curriculum prepares physiotherapy students to practice holistically, be responsive to health needs and contribute to decolonialization initiatives. Other programs may benefit from our experience.

Background: Sports development and promotion of physical activities (PA) through various sports in rural schools of South Africa (SA) is essential to optimise growth and wellbeing of children. There is a paucity of research specific to rural areas, and this is implicated on the lack of resources, effective programmes as well as resources to promote structured PAs and sports., Objectives: To explore sports development facilitators and barriers in rural schools., Method: We conducted an exploratory qualitative study and recruited Life Orientation (LO) teachers and school principals. We established structured interview guidelines and recorded the interviews which were transcribed verbatim. Data saturation was reached by the eighth participant. The data were analysed using thematic content analysis., Results: Participating schools experienced shared challenges in developing and promoting PAs. Five themes emerged addressing the barriers: sport facilities, time management, workload, financial constraints, and lack of participation. Six categories emerged as facilitators: intrapersonal factors, interpersonal factors, personal, social, physical and mental benefits., Conclusion: Most rural schools in Lephalale district struggle to promote and develop sports because of several targeted factors. These schools have little to no strategic plans to develop and promote sports because of the prioritisation of the core curriculum and/or examinable subjects in classroom duties which is deemed their highest priority., Clinical Implications: Implementation of tailored sports development policies in rural schools via acquisition of resources, education regarding the positive impact of sport, and focused planning is required. Healthcare professionals such as physiotherapists may aid in the encouragement of sports., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2024. The Authors.)

Purpose: A common factor in all forms of headache is the presence of myofascial trigger points (TrPs). The aim of this study was to compare the presentation of patients with cervicogenic headaches and patients with non-cervicogenic headaches in the sensitivity of TrPs in their upper trapezius, sternocleidomastoid, temporalis, and posterior cervical muscles. Method: This was a descriptive, cross-sectional study. The following variables were compared between patients with cervicogenic ( n =20) and patients with non-cervicogenic ( n =20) headaches: sensitivity (pain-pressure threshold) of TrPs in the upper trapezius, sternocleidomastoid, posterior cervical, and temporalis muscles (using a handheld, digital algometer); level of disability (using the Henry Ford Hospital Headache Disability Inventory questionnaire); demographics (age, sex); anthropometrics (BMI); and clinical presentation (duration and intensity of symptoms). The independent Student t -test and χ 2 test were used to determine the differences between the two groups. Effect sizes (Cohen's d ) were calculated when relevant. Results: The two groups were similar in level of disability, demographic and anthropometric data, and clinical presentation. However, TrP sensitivity in the right upper trapezius ( p =0.006; Cohen's d =0.96) and the left upper trapezius ( p =0.003; Cohen's d =1.06) muscles was higher in the cervicogenic group. Conclusions: Increased sensitivity of TrPs in the upper trapezius muscle may be used as a differentiating factor in the diagnosis of cervicogenic headaches. This finding emphasizes the importance of integrating this muscle into the rehabilitation programs of patients with cervicogenic headache.

Background: Human immunodeficiency virus (HIV) negatively impacts muscle strength and function. This study aimed to establish the relationship between lower limb muscle strength and lower extremity function in HIV disease., Method: A cross-sectional study was undertaken with a sample of 113 HIV-positive participants. Lower limb muscle strength and self-reported function were established using dynamometry and the Lower Extremity Functional Scale (LEFS), respectively. Muscle strength and functional status were established in a subset of 30 HIV-negative participants to determine normative values., Results: Muscle strength for participants with HIV ranged from an ankle dorsiflexion mean of 9.33 kg/m 2 to 15.79 kg/m 2 in hip extensors. In the HIV-negative group, ankle dorsiflexors recorded 11.17 kg/m 2 , whereas hip extensors were the strongest, generating 17.68 kg/m 2 . In the HIV-positive group, linear regression showed a positive relationship between lower limb muscle strength and lower extremity function ( r = 0.71, p = 0.00). Fifty per cent of the changes in lower extremity function were attributable to lower limb muscle strength. A simple linear regression model showed that lower limb ankle plantar flexors contributed the most to lower extremity function in this cohort, contrary to the literature which states that hip and trunk muscles are the most active in lower limb functional activities., Conclusion: Lower extremity strength impacts perceived function in individuals stabilised on antiretroviral therapy for HIV disease. These findings demonstrate that ankle plantar flexors produce more force over hip flexors. Careful attention should be paid to the implications for strength training in this population., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Background: Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver., Aim: To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area., Method: This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire., Results: A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% ( n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services ( r = 0.27, p < 0.0001) and QOL ( r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain ( r = -0.37, p < 0.0001)., Conclusion: Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services., Competing Interests: The authors declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article.

In 2005, 16.6% of South Africans between 15 and 49 years of age were HIV positive. The advent of anti-retroviral therapy has led to improved longevity, CD4 counts and clinical well-being of people living with HIV/AIDS (PLWHA). Physical impairments, activity limitations and participation restrictions of PLWHA have profound effects on the Health-related Quality of Life and functional abilities of those with the disease, and understanding thereof may assist in the formulation of rehabilitation protocols, health care interventions as well as vocational and legislative policies. The International Classification of Function, Disability and Health (ICF) is a standardised tool, endorsed by the World Health Assembly for international use, which aims to classify functioning and disability. It is structured to assess body functions and structure, functional activities and associated personal and environmental factors.This study aimed to develop a profile of the level of functional activity, using the ICF Checklist, of an urban cohort of 45 South African individuals who are HIV positive attending an outpatient clinic at the Helen Joseph Memorial Hospital, Gauteng, South Africa. The results showed a high prevalence of physical impairments, participation restrictions and selective activity limitations and that environmental factors influence their level of ability. Specific impairments where patients had problems were mental functions (69% (n=31), sensory and pain -- 71% (n=32), digestive and metabolic functions 45% (n=20) and neuromuscular 27% (n=12). Activity limitations included major life areas' 58% (n=26), interpersonal relationships 56% (n=25), mobility 40% (n=18) and general tasks and demands 38% (n=17). Limitations in mobility were significantly associated with problems of sensory functions (p=0.05), pain (p=0.006), neuromusculoskeletal and movement-related functions (p=0.006), muscle power (p=0.006) as well as energy and drive functions (p=0.001). The study identifies the level of function and ability of PLWHA, clinical markers, and how these affect the physical, psychological and social functioning of this population.