Routine chest physiotherapy is not more effective than usual supportive care in non-ventilated paediatric patients (0 to 24 months) with bronchiolitis : a systematic review

PURPOSE : To determine the effectiveness of chest physiotherapy (percussion, postural drainage and suctioning) in non-ventilated paediatric bronchiolitis patients aged 0 to 24 months. BACKGROUND : The field of paediatric cardiopulmonary physiotherapy has a limited evidence base and findings from this study may assist in choosing effective treatment options. METHODS : The following databases were reviewed by making use of a specified search strategy: African Health Line, CINAHL, Cochrane, Ebsco-Host, E-theses/dissertations, PEDro, Medline Ovid, Sabinet, Science Direct and Up-To-Date. Pre-set eligibility criteria were applied to the article title and/or abstract and full-text. Appraisal tools (CASP and PEDro scale) were used to evaluate and score the included studies. A qualitative synthesis was done as a meta-analysis was not possible. RESULTS : Evidence does not support routine chest physiotherapy in uncomplicated viral bronchiolitis in non-ventilated paediatric patients. Chest physiotherapy does not have a significant influence on various outcomes measures. CONCLUSION : Routine chest physiotherapy should not be prescribed for non-ventilated paediatric patients with bronchiolitis.http://jchs.epubs.ac.za/index.php/jchshb2017Physiotherap

Status of undergraduate community-based and public health physiotherapy education in South Africa

INTRODUCTION: The health profile of a country’s population and its vision as reflected in health policies are dynamic. Curricula of health education institutions therefore need to be periodically revised to be aligned with their context. This study explored the status of physiotherapy curricula in South Africa (SA) as a point of departure for benchmarking by individual institutions. METHODS: A document analysis was done of university physiotherapy departments (N=8) in SA. Institutional ethical clearance and permission from the heads of departments were obtained. Content analysis was used to analyse the South African Qualifications Authority exit-level outcomes and the university study guides for community placements. RESULTS: Most universities employed a form of service learning, with interventions in a range of settings. Five themes emerged: practice of evidence-based physiotherapy, rendering physiotherapy services, acting professionally, communication, and collaboration. The country’s priority conditions were addressed. Teaching and learning strategies included group activities (class or education sessions), community projects, home visits and portfolios of evidence. Personal- and small-group reflections were prominent. CONCLUSION: The undergraduate community physiotherapy curricula in SA address the health profile of the population and priorities in the health system to different degrees. The variation between universities should be interpreted with caution as the study guides only give a limited snapshot into each institution’s curriculum. However, findings suggest that each physiotherapy university department may have gaps in preparing physiotherapy undergraduate students for the needs of the SA population and expectations of the Government. Possible ways to share teaching-learning resources are recommended.http://www.physiosa.org.za/?q=node/238hb201

Health education training needs of educators at Makapanstad schools in the North West province

PURPOSE: The purpose of this study was to explore and describe the health education needs of educators at health promoting schools in Makapanstad in North West Province. METHODOLOGY: Qualitative, exploratory and descriptive paradigm was conducted. The population consisted of educators, at Makapanstad schools, who were directly involved with learners. The participants were purposively selected. Focus group interviews were conducted to collect relevant data from the participants. Tesch data analysis process was used to reach the findings of the research. FINDINGS: The following categories were identified and theoretically confirmed: The need for the support by the University for the training of educators; The need for the University’s acknowledgement of educators’ responsibilities; The need for basic knowledge of health promotion; Common health needs of learners; and indirect health problems. RECOMMENDATION: It was recommended that a health education package be developed to assist in empowering learners in Makapanstad schools.http://www.curationis.org.zaam2013ay201

Involvement in and views on social responsibility of Gauteng members

How do physiotherapists in Gauteng Province, who are members of the South African Society of Physiotherapy (SASP), view social responsibility? A cross-sectional survey was conducted after ethics approval. All 1 098 Gauteng members of the SASP were invited via a thirdparty e-mail to reach the a priori minimum sample size of 97. The web-based questionnaire was developed from literature, an earlier SASP survey and a position paper of the American Physical Therapy Association (APTA). Five experts validated the instrument. The Likert scale scores indicating agreement with indicators of social responsibility were totalled to form a composite social responsibility score. The chi-square test for independence was used to determine associations between the categorised composite social responsibility score and categorical variables. Mean difference of continuous variables between the categorised core for two groups were tested using the two-sample t-test. All variables with a P-value less than 0.05 were included in the logistic regression analysis to investigate predictors of the necessity of social responsibility. The survey was completed by 163 participants. Of the sample, 96.9% viewed social responsibility as important. Subjects agreed most with “advocating for the health needs of society” (74,2%) and the least with “political activism” (6.1%). Compulsory community service positively influenced 74.6%. Most physiotherapists in the study viewed social responsibility as important and were involved in volunteering. There is scope to broaden the understanding among physiotherapists of what social responsibility entails.http://www.sajp.co.zahb2017Physiotherap

High levels of self-efficacy in patients with type 2 diabetes attending a tertiary level clinic

Self-management is a vital element in the care of type 2 diabetes patients. In turn, self-efficacy plays a major role in patients’ self-management. Self-efficacy is the patient’s personal judgement of his/her confidence in performing aspects of diabetes self-management. This study investigated the level of self-efficacy of patients attending the Pretoria Academic Hospital Diabetes Clinic, in the light of high levels of re-admission due to complications, suggesting low self-efficacy levels. Eighty type 2 diabetes patients, mean age of 59 years, completed the published IDEALL baseline questionnaire, to establish a self-efficacy score. Relationships between self-efficacy and demographic factors were investigated using the chi-square test. The mean self-efficacy level of the sample population is excellent (mean = 85.44%). Although self-reported self-efficacy levels are excellent, in comparison to the Sarkar study (2006) in which participants only scored “fair”, it is speculated that self-efficacy is not transferred to self-management behaviour in this population. Afrikaans and English speaking participants score significantly better than those from other language categories. There is a positive relationship between self-efficacy and level of education and employment status (tended towards significance with p values of 0.06 and 0.07 respectively). Although self-efficacy scores of clients at this tertiary level outpatient clinic are excellent, further research is necessary to quantify self-management strategies and to correlate these with self-efficacy levels.http://www.sajp.co.zahb2017Physiotherap

Perceptions of educators regarding the implementation of the health promotion programme manuals for children in schools in Makapanstad, South Africa

BACKGROUND : Health promoting schools focus on, amongst other things, preventing leading causes of death such as Sexually Transmitted Infections (STI’s), Human Immune Deficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), a sedentary lifestyle and creating conditions that are conducive to health through health education. AIM : This study explored the perceptions of educators regarding implementation of the health promotion programme manuals in selected schools of the Makapanstad community. METHOD : A qualitative, exploratory, descriptive and contextual design was utilised in this study. Four schools were selected to participate in the study. Purposive sampling was used to select educators from these schools who were actively involved in the health promotion programme. Data collection was taken through focus group interviews. One focus group comprised of eight participants who were interviewed three times. The focus group interviews were conducted until data were saturated. Data were analysed using an adaptation of Tesch’s method. The eight steps of Tesch’s method enabled researchers to systematically analyse and organise data using colour coding to develop data into categories, sub-categories and themes. RESULTS AND CONCLUSION : The themes that emerged during data analysis were: the perceptions of educators regarding health promotion programme manuals before implementation of manuals, and the perceptions of educators regarding health promotion programme manuals after the implementation of manuals. Introducing health promotion materials to the schools served as a point of departure for developing personal skills and creating a supportive environment for health in schools. The health promotion manual assisted the educators to attain appropriate health promotion information.http://www.curationis.org.zaam201

High levels of self-efficacy in patients with type 2 diabetes attending a tertiary level clinic

Self-management is a vital element in the care of type 2 diabetes patients. In turn, self-efficacy plays a major role in patients’ self-management. Self-efficacy is the patient’s personal judgement of his/her confidence in performing aspects of diabetes self-management. This study investigated the level of self-efficacy of patients attending the Pretoria Academic Hospital Diabetes Clinic, in the light of high levels of re-admission due to complications, suggesting low self-efficacy levels. Eighty type 2 diabetes patients, mean age of 59 years, completed the published IDEALL baseline questionnaire, to establish a self-efficacy score. Relationships between self-efficacy and demographic factors were investigated using the chi-square test. The mean self-efficacy level of the sample population is excellent (mean = 85.44%). Although self-reported self-efficacy levels are excellent, in comparison to the Sarkar study (2006) in which participants only scored “fair”, it is speculated that self-efficacy is not transferred to self-management behaviour in this population. Afrikaans and English speaking participants score significantly better than those from other language categories. There is a positive relationship between self-efficacy and level of education and employment status (tended towards significance with p values of 0.06 and 0.07 respectively). Although self-efficacy scores of clients at this tertiary level outpatient clinic are excellent, further research is necessary to quantify self-management strategies and to correlate these with self-efficacy levels.http://www.sajp.co.zahb2017Physiotherap

Effect of kinesio taping on explosive muscle power of gluteus maximus of male athletes

OBJECTIVE: To determine the short-term effect of kinesio tape on the explosive gluteus maximus power of male athletes, comparing a recommended application pattern with a placebo. METHODS: Sixty healthy university male athletes participated in this double-blinded randomised controlled trial. Those athletes with musculoskeletal injury 6 weeks prior to screening, serious medical condition(s) in the previous 6 months, or metabolic conditions affecting joint integrity were not selected. A different investigator from the one who administered the intervention randomly allocated participants to groups. Allocation was concealed. Group A (n=30) received a recommended Y-strip kinesio tape application and group B (n=30) a neutral placebo application. Height displacement during a counter-movement jump was measured with a reliable Vertec apparatus. Measurements were recorded at baseline, immediately after strapping and 30 minutes later. Participants and raters were blinded to group assignment. Descriptive statistics and analysis of variance for repeated measures were used to determine the effect of time and group on the measurements. Post hoc analysis was done using the Tukey’s method. RESULTS: Time (before, immediately after and 30 minutes after taping) had a significant effect on the measurements. All the measurements after intervention (either immediately or 30 minutes after) had significant differences compared with baseline (95% CI [0.59, 2.29] and [1.50, 3.2] respectively.) CONCLUSION: The recommended application type of taping with kinesio tape was equally effective in significantly improving the explosive power of the gluteus maximus in male athletes immediately after and 30 minutes after taping in both groups.Hitech Therapy for sponsoring the Kinesio Tex Tape.http://www.journals.co.za/sama/m_sajsm.htm

The second physical therapy summit on global health: developing an action plan to promote health in daily practice and reduce the burden of non-communicable diseases

Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), the Second Summit (2011) identified themes to inform a global physical therapy action plan to integrate health promotion into practice across the World Confederation for Physical Therapy (WCPT) regions. Working questions were: (1) how well is health promotion implemented within physical therapy practice; and (2) how might this be improved across five target audiences (i.e. physical therapist practitioners, educators, researchers, professional body representatives, and government liaisons/consultants). In structured facilitated sessions, Summit representatives (n=32) discussed: (1) within WCPT regions, what is working and the challenges; and (2) across WCPT regions, what are potential directions using World CaféTM methodology. Commonalities outweighed differences with respect to strategies to advance health-focused physical therapy as a clinical competency across regions and within target audiences. Participants agreed that health-focused practice is a professional priority, and a strategic action plan was needed to develop it as a clinical competency. The action plan and recommendations largely paralleled the principles and objectives of the World Health Organization's non-communicable diseases action plan. A third Summit planned for 2015 will provide a mechanism for follow-up to evaluate progress in integrating health-focused physical therapy within the profession.info:eu-repo/semantics/acceptedVersio

Development of standards for undergraduate community physiotherapy education in South Africa

Introduction: Education of physiotherapists still fails to meet the health and social needs of society. One instrument to steer change in health sciences education is a re-designed curriculum. The overall intent of this study was to develop standards of competencies, teaching and learning strategies, and assessment, for an undergraduate community physiotherapy curriculum in South Africa. The grounding for this research was pragmatism. The Six-step model for curriculum development and the Clinical Prevention and Population Health Curriculum framework guided the research process and main analysis. Methods : A sequential mixed method design was used. First, a two-phase parallel situation analysis was conducted which included a qualitative document analysis of community physiotherapy curricula of the eight physiotherapy university departments in South Africa and a review of health policy documents. The experience of 12 purposively selected physiotherapists who had completed a compulsory community service year was qualitatively explored through interviews within an appreciative inquiry stance. In phase 2, input was gained from physiotherapists, from all ecological levels, on the community physiotherapy curriculum through a Delphi study. Three rounds were used. Round 1 explored the roles of physiotherapy in community health, round 2 quantified consensus in overarching competency domains, and round 3 gathered learning and teaching, and assessment, strategies to gain these competencies. Results : All eight universities had gaps in their community physiotherapy curriculum and were variedly aligned with South African health policies and health profile. Graduates need to be able to provide physiotherapy over the lifespan, to conditions mirroring the quadruple burden of disease, in settings varying from hospitals to homes of clients, with emphasis on health education and promotion within an interprofessional team. They must be prepared for suboptimal practice environments and to utilise the compulsory community service year as a gateway in professional development. Graduates need resilience to cope during the year and awareness about the importance of identifying a mentor in the frequent absence of a profession-specific supervisor. Community physiotherapy needs three core knowledge and skill sets; i.e. clinical physiotherapy, population health and community development. Consensus of 70%+ was gained on competency criteria in the domains of the following professional roles: clinician, professional, communicator and collaborator, scholar, health promoter, public health practitioner, community developer (change agent), and manager/leader. Service-learning was identified as a strategy to develop these roles supported by learning and assessment portfolios. Reflection in different formats – essays, presentations, case analysis, projects such as community wellness programmes, diaries - is a core activity to facilitate learning. A range of complementary strategies were suggested that included direct observation, role-play, and journal clubs. Core to assessment for professional competencies is for the students to be able to give evidence of their own learning (e.g. in a portfolio or oral examination) and to get frequent formative feedback. Conclusion : The physiotherapy profession is important for improving the health status of the South African population. Physiotherapy students should be educated to take on relevant professional roles through the application of appropriate educational standards. The study recommends that the curriculum standards be implemented and evaluated and that the application of complex theory in the further development and implementation of the curriculum be investigated. Lastly, future research in the generic professional domains, such as public health and community development, should be interprofessional in nature.Thesis (PhD)--University of Pretoria, 2013.gm2013PhysiologyUnrestricte