Browsing by Author "Van Niekerk, Sjan-Mari"
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- ItemAchieving universal health coverage for people with stroke in South Africa : protocol for a scoping review(BMJ Publishing, 2020-10) Van Niekerk, Sjan-Mari; Inglis-Jassiem, Gakeemah; Kamalakannan, Sureshkumar; Fernandes, Silke; Webster, Jayne; English, Rene; Smythe, Tracey; Louw, Q. A.Introduction Stroke is the second most common cause of death after HIV/AIDS and a significant health burden in South Africa. The extent to which universal health coverage (UHC) is achieved for people with stroke in South Africa is unknown. Therefore, a scoping review to explore the opportunities and challenges within the South African health system to facilitate the achievement of UHC for people with stroke is warranted. Methods and analysis The scoping review will follow the approach recommended by Levac, Colquhoun and O’Brien, which includes five steps: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarising and reporting the results. Health Systems Dynamics Framework and WHO Framework on integrated people-centred health services will be used to map, synthesise and analyse data thematically.
- ItemThe effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms : a systematic review(BioMed Central, 2012-08) Van Niekerk, Sjan-Mari; Louw, Quinette Abigail; Hillier, SusanBackground: Prolonged sitting has been associated with musculoskeletal dysfunction. For desk workers, workstation modifications frequently address the work surface and chair. Chairs which can prevent abnormal strain of the neuromuscular system may aid in preventing musculo-skeletal pain and discomfort. Anecdotally, adjustability of the seat height and the seat pan depth to match the anthropometrics of the user is the most commonly recommended intervention. Within the constraints of the current economic climate, employers demand evidence for the benefits attributed to an investment in altering workstations, however this evidence-base is currently unclear both in terms of the strength of the evidence and the nature of the chair features. The purpose of this study was to evaluate the evidence for the effectiveness of chair interventions in reducing workplace musculoskeletal symptoms. Methods: Pubmed, Cinahl, Pedro, ProQuest, SCOPUS and PhysioFocus were searched. ‘Ergonomic intervention’, ‘chair’, ‘musculoskeletal symptoms’, ‘ergonomics’, ‘seated work’ were used in all the databases. Articles were included if they investigated the influence of chair modifications as an intervention; participants were in predominantly seated occupations; employed a pre/post design (with or without control or randomising) and if the outcome measure included neuro-musculoskeletal comfort and/or postural alignment. The risk of bias was assessed using a tool based on The Cochrane Handbook. Results: Five studies were included in the review. The number of participants varied from 4 to 293 participants. Three of the five studies were Randomised Controlled Trials, one pre and post-test study was conducted and one single case, multiple baselines (ABAB) study was done. Three studies were conducted in a garment factory, one in an office environment and one with university students. All five studies found a reduction in self-reported musculoskeletal pain immediately after the intervention. Bias was introduced due to poor randomization procedures and lack of concealed allocation. Meta-analysis was not possible due to the heterogeneity of the data (differing population, intervention and outcomes across studies). Conclusion: The findings of this review indicate a consistent trend that supports the role of a chair intervention to reduce musculoskeletal symptoms among workers who are required to sit for prolonged periods. However the amount, level and quality of the evidence are only moderate therefore we cannot make strong recommendations until further trials are conducted. The review also highlights gaps: for example in showing whether the effectiveness of a chair intervention has long-term impact, particularly with respect to musculoskeletal symptoms, as well as the recurrence of symptoms and the consequent cost of care.
- ItemErgonomic chair design for school computer laboratories in the Cape Metropole, Western Cape, South Africa(Stellenbosch : Stellenbosch University, 2013-03) Van Niekerk, Sjan-Mari; Louw, Quinette A.; Schreve, K.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences.ENGLISH SUMMARY : Background: Computers have become increasingly accessible in developing countries. Such increased computer usage is also noted in the Western Cape, South Africa. Prolonged posture whilst using computers and a learner‐chair mismatch is associated with spinal pain in adolescents. In South Africa, the prevalence of spinal pain among high school learners has been reported as being about 70%. Consideration of learner anthropometrics and school furniture design is essential to evolving strategies to be adopted to promote adolescent spinal health. Aim: The aim of this project is to determine whether the school computer laboratory chair or a commercially‐available chair matches the anthropometric profile of high school learners and, if not, to develop and test a prototype chair that will also facilitate postural changes, whilst the sitter is using a desktop computer. Methods: This study consisted of two phases. Phase one dealt with the anthropometric match of the learners to their school chair and to commercially‐available chairs. The following body dimensions were measured: stature; popliteal height (PH); buttock‐topopliteal length (BPL) and hip width (HW). These body dimensions were matched with the corresponding chair seat dimensions; and height, depth and width, using standard matching criteria. During Phase two, a prototype chair was designed according to the anthropometric profile of the learners concerned. The chair’s ability to reduce static sitting postures by facilitating postural changes in sitters whilst they are seated at a desktop computer was evaluated. The three‐dimensional (3D) sitting posture of twelve learners was evaluated while they were sitting on the school and the prototype chairs. The anthropometric and 3D data were analysed using descriptive statistics, including means (and standard deviations), medians (and interquartile ranges (IQR)) and ratios. To determine the difference in the number of postural changes between chairs, the Wilcoxon match pair test was used. Results: The sample consisted of 689 male and female learners aged 13 to 18 years, for the anthropometric study (phase 1). Of the learners, 65% to 80% did not match the school chairs’ dimensions. Five commercial chairs offered a good match for the seat height, but neither the seat depth nor the seat width matched 50% of the learners. The prototype chair matched 97% for height, 65% for depth and 60% for seat width. The prototype chair was associated with more postural changes in the frontal and transverse planes for the pelvis (ρ <0.05). Conclusions: This thesis is the first to report on the lower body anthropometric size of high school learners in the Cape Metropole area, Western Cape, South Africa. Neither the school computer laboratory chair nor commercially‐available adjustable computer chairs offered an acceptable fit for the anthropometric profile of the learners. The prototype “Dynamic” chair was consequently developed and provided the best match for the anthropometric profile. The prototype chair was also associated with an increased number of postural changes, particularly of the pelvis. The promising results obtained warrant further exploration of the prototype chair to determine the effect on the musculoskeletal pain experienced by school learners in South Africa.
- ItemMeasuring the sitting posture of high school learners, a reliability and validity study(Stellenbosch : University of Stellenbosch, 2007-03) Van Niekerk, Sjan-Mari; Louw, Quinette; Vaughn, Kit; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.Objective The objective of this study was to establish the reliability and validity of a Portable Posture Analysis Method (PPAM). Design The design for the reliability section was a repeated measures observational study and the design for the validity section was a correlation study. Background The prevalence of spinal pain among high school learners is high (Murphy et al, 2002). It is also notable that the prevalence of back pain increases across the teenage years (Grimmer & Williams 2000, Burton et al 1996). In South Africa, the preliminary findings of a study conducted by a Physiotherapy masters candidate (Ms L Smith: ethics nr. N05/09/164) indicates that about 74% of high school learners in Cape Town complained of musculoskeletal pain. Posture has been identified by some researchers to be a primary predictor of the development of spinal, particularly upper quadrant pain among computer users (NIOSH 1997, Vieira et al 2004). Measurement of posture poses a real challenge to researchers wanting to accurately evaluate posture in research projects. Considering the practical implications in measuring posture, the validity and reliability of posture measurement are often reported to be poor. Many of these methods of indirect assessment of working posture have been reported on in the literature. These measures include; the goniometer, inclinometer, flexible electrogoniometer, flexicurve and photography (Harrison et al 2005, Christensen 1999, Nitschke et al 1999, Chen & Lee 1997). ...
- ItemThe prevalence of underweight, overweight and obesity in a multiracial group of urban adolescent schoolchildren in the Cape Metropole area of Cape Town(MedPharm Publications, 2014-10) Van Niekerk, Sjan-Mari; Grimmer, Karen; Louw, QuinetteAbstract Objective: The objective was to determine the prevalence of underweight, overweight and obesity in high school learners in the Cape Town area. Design: A cross-sectional study was conducted. Setting: High schools in the Cape Metropole Area of the Western Cape. Subjects: A complex cluster sampling procedure was followed. Thirty-six students per school were selected from each randomly selected school. Thirteen- to 18-year-old pupils were eligible for inclusion. Outcome measures: Height and weight measurements. Results: The sample comprised 689 students. There were considerably more underweight adolescent boys than adolescent girls (17.3% boys to 9.9% girls), and double the frequency of overweight adolescent girls than adolescent boys (7.7% girls to 3.5% boys). The 14-year-old boys had the highest prevalence of underweight (55.2%), and the 17-year-old girls the highest prevalence of overweight (22%). The highest prevalence of obesity was found in 15-year-old boys (11.1%), who also demonstrated a relatively high prevalence of underweight (30.2%). Conclusion: This study reported on a substantial percentage of underweight adolescents (27.1%). Noteworthy levels of overweight and obesity in adolescent girls added to the substantial prevalence of underweight in adolescent boys. Africa has enough to contend with in respect of transmissible diseases, without additional lifestyle-based health burdens.