Masters Degrees (Occupational Therapy)

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Browsing Masters Degrees (Occupational Therapy) by browse.metadata.advisor "De Klerk, Susan"

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    Occupational therapy upper limb splinting practice for clients with acquired brain injuries : a cross-sectional study from South Africa
    (Stellenbosch : Stellenbosch University, 2022-04) van Wyk, Megan Barbara; Jacobs-Nzuzi Khuabi, Lee-Ann J.; De Klerk, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Introduction: Acquired brain injuries (ABI) form a large part of the caseload of occupational therapists providing services to adult clients with neurological conditions. One modality to the treatment of the upper limb condition following ABI is the use of splints. Yet not much is known about the splinting practices of occupational therapists working in this field within a South African context. Purpose: To describe the occupational therapy upper limb splinting practices for clients with acquired brain injuries in South Africa. Methods: A quantitative, cross-sectional survey design was employed for this study. A convenience sample of occupational therapists from across South Africa participated by completing a survey developed for the study. The questions comprised of demographic factors, types of splints used, splinting regimens, splint use during the motor recovery phases and client-, therapist- and environmental related factors that influence the decision to splint. Data were analysed for descriptive statistics using Statistical Package for Social Sciences (Version 27, 2020). Results: Fifty-two participants out of 115 who accessed the survey, completed the survey, representing a 45,2% response rate. One survey was excluded as the participant made reference to the use of splints for paediatric clients with ABI. Most participants represented the private sector (70.6%, n=36) and were very experienced – 66% had more than 5 years-experience working with adults with ABI. Participants (52.9%, n=27) indicated that splints are provided to 25% of clients with ABI. The most commonly used splints were static wrist extension splint (56%, n= 28), the cone/cylindrical splint (49%, n=25) and the soft elbow extension splint (55%, n=28). The most notable factors that influenced the decision to splint a client with ABI were the availability of support for the client (100%, n=51); the client’s occupational performance needs and goals (94.1%, n=48); the participant’s own experience in treating clients with ABI (92,2%, n=47) and the availability of materials (78.4%, n=42) and time (78.4%, n=40). Discussion: To the author’s best knowledge, this is the first study of its kind to provide evidence of the occupational therapy upper limb splinting practices for clients with ABI in South Africa. Splinting for clients with ABI is best practiced by experienced therapists with sound clinical reasoning. Splints are used to maintain soft tissue length and to ensure correct biomechanical alignment to maintain correct muscle resting length and protect joint integrity. Conclusion: Splinting for clients with ABI in South Africa is used as part of a preventative and maintenance approach. Failing more high-level evidence to substantiate the use of splints for clients with ABI, therapists should consider the client-, therapist- and environment-related factors and use these to determine the suitability and appropriateness of using a splint for a client with ABI.
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    Workplace-based rehabilitation of upper limb conditions : a systematic review
    (Stellenbosch : Stellenbosch University, 2018-03) Hoosain, Munira Begum; De Klerk, Susan; Burger, Marlette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY : Background: Upper limb conditions are a common and growing cause of work related ill health and disability. International and South African legislation support work rehabilitation and specifically workplace-based rehabilitation, but the availability of workplace-based rehabilitation services appears to be limited in South Africa, with more focus on once-off work evaluations. Evidence is needed on the effectiveness of workplace-based rehabilitation services, in order to inform future service delivery. Objective: The objective of this systematic review was to identify, collate and analyse the current available evidence on the effectiveness of workplace-based rehabilitative interventions in workers with upper limb conditions on work performance, pain, absenteeism, productivity and other outcomes such as ergonomic risk and mental health. Methods: This systematic review was designed in accordance with PRISMA guidelines and registered with PROSPERO as number: PROSPERO CRD42017059708. We searched Medline (PubMed), Cochrane Library, Scopus, Web of Science, EBSCOhost (Academic Search Premier, Africa-Wide, CINAHL), OTSeeker and PEDro with search terms in four broad areas: upper limb, intervention, workplace and clinical trial (no date limits). Studies including neck pain only or musculoskeletal pain in other areas were not included. Risk of bias in included studies was assessed using a question and rating system developed by the Institute for Work and Health (IWH). As meta-analysis was not possible, study results were analysed through a narrative synthesis. Results: The initial literature search located 1071 articles, of which 80 were full text reviewed. Seventeen studies were included, across 28 articles, reporting on various outcomes. Nine studies were of high methodological quality, seven of medium quality, and one of low quality. Studies were sorted into intervention categories: Ergonomic controls (n=3), ergonomic training and workstation adjustments (n=4), exercise and resistance training (n=6), clinic-based versus workplace-based work hardening (n=1), nurse case manager training (n=1), physiotherapy versus Feldenkrais (n=1), and ambulant myofeedback training (n=1). The largest body of evidence supported workplace exercise programs, with positive effects for ergonomic training and workstation adjustments, and mixed effects for ergonomic controls. Ambulant myofeedback training had no effect. The remaining three categories had positive effects in the single study on each intervention. Conclusion and Recommendations: There is substantial evidence supporting workplace exercise programs. Further research needs to be conducted on the remaining intervention categories. Researchers are encouraged to collaborate with clinicians to enable more high quality research in “real-life” rehabilitation contexts, including individualised work rehabilitation. Clinicians should build partnerships with the Department of Labour and stakeholders at workplaces, in order to develop rehabilitation resources in work environments.