Masters Degrees (Physiotherapy)

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Analysis of the vertical ground reaction forces in sports participants with adductor-related groin pain : a comparison study
(Stellenbosch : Stellenbosch University, 2016-03) Coetsee, Anica; Brink, Yolandi; Morris, Linzette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.
ENGLISH ABSTRACT: Objectives: The objective of this study was to describe the differences in vertical ground reaction forces (VGRF) in male sports participants with adductor-related groin pain, compared to matched asymptomatic controls. Design: A descriptive observational study with cross-sectional time frame was conducted. Setting: Laboratory based setting at the 3D Human Biomechanics Central Analytical Facility were implemented. Participants: A consecutive sample of twenty-six active male sports participants, thirteen subjects with adductor-related groin pain (unilateral and bilateral) and thirteen matched asymptomatic controls were included. Main Outcome Measures: Three outcome measures were used: time to peak landing force, peak landing force and time to lowest vertical position of the pelvis. Results: Greater differences were seen in time to peak landing force and peak landing force in the unilateral pain group versus the matched controls. No statistical or clinical differences were found in either of the three outcome measures (p>0.05) between the subjects and their matched controls. Conclusions: This study demonstrates similar VGRFs between subjects with and without chronic adductor-related groin pain and that changes in VGRF might not result from adductor-related groin pain. Clinically, teaching appropriate landing strategies to decrease VGRF may not be useful in male sports participants with chronic adductor-related groin pain.
Balance in recreational/non-professional dancers with snapping hip : a cross-sectional study
(Stellenbosch : Stellenbosch University, 2022-04) Lategan, Roxanne; Brink, Yolandi; Berner, Karina; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
ENGLISH SUMMARY: Snapping hip (SH) or coxa sultans is a common condition amongst the dance population. The symptoms are insidious and often ignored until it becomes painful or problematic. Hip muscle weakness is a common characteristic of SH, particularly affecting the gluteus medius muscle. A weak gluteus medius muscle has been linked to poor balance in the healthy population, and balance is a skill dancers need to be proficient in. Furthermore, gluteus medius weakness may relate to the three main predictors of dance-related lower limb injuries (Functional Turnout [FTO], compensated turnout [CTO], and hip external rotation [HER]). To date no studies have been conducted on dynamic balance and associated factors in a group of dancers with SH. A better understanding of factors associated with SH in dancers could suggest potential strategies for screening and rehabilitation to improve performance, quality of life, and mitigate future recurrence of the condition. Aim: This study aimed to describe FTO, CTO, HER range of motion (ROM), hip muscle strength (HER and hip abduction), and dynamic balance in a group of recreational dancers with SH, to describe any differences between the affected and unaffected sides, and to determine whether there were any relationships between the variables. Methodology: A descriptive cross-sectional study was conducted. A questionnaire was filled in by potentially eligible volunteers, to screen for SH and to gather demographic information. Eligible participants were measured for FTO and HER ROM, hip muscle strength tests were conducted with a hand-held dynamometer, and the Y-test for dynamic balance was performed. Descriptive results were presented using means, percentages, standard deviations and 95% confidence intervals. Differences between groups were based on the paired t-test and relationships were calculated using Pearson’s correlation coefficients. A one-way ANOVA test was used to compare four pain categories according to age. The level of significance was set at p<0.05. Results: Twenty-three female participants aged 15-40 years were clinically diagnosed with internal SH. The relationship between HER muscle strength on the affected side and CTO was significant (p=0.013), and moderately positively correlated (r=0.51). Other noteworthy albeit non-significant relationships were hip abduction muscle strength and balance on the unaffected side (r=0.40; p=0.06), hip abduction strength on the unaffected side and CTO (r=0.37; p=0.08), and HER strength and balance on the unaffected side (r=0.37; p=0.08). There were no significant differences between sides (all p>0.05) and pain was not related to age (p= 0.416). Conclusion: Findings did not demonstrate poorer dynamic balance on the affected leg in dancers with SH than in the unaffected leg and were inconclusive in terms of other relationships and comparisons, including a relationship between gluteus medius and dynamic balance. HER muscle strength on the affected side and CTO may however need to be considered as related factors when screening for impairments in dancers with SH. Little knowledge remains regarding SH and dynamic balance in dancers. More studies with larger samples are needed to make more conclusive inferences about these outcomes.
Developing a guideline framework for school-based interventions to improve spinal health of children and adolescents in South Africa
(Stellenbosch : Stellenbosch University, 2018-03) Maart, Rentia; Brink, Yolandi; Louw, Quinette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.
ENGLISH SUMMARY : Background: Spinal pain prevalence in children and adolescents is high, increases with age and may lead to spinal pain in adulthood. Potential predisposing factors for spinal pain in children and adolescents are the usage of schoolbags; posture; sitting duration; psychosocial factors; age; gender and school furniture. Purpose: 1) To determine the effectiveness of school-based interventions in promoting spinal health in children and adolescents; 2) to present a schematic presentation of the effective interventions as part of development of an evidence-based framework. Methods: This study had two phases: 1) conducting a systematic review on the effectiveness of school-based interventions to promote spinal health in children and adolescents, 2) developing a schematic presentation of the evidence-based framework depicting the effective school-based interventions. Two comprehensive search strategies for primary research (strategy A) and grey literature (strategy B) respectively, were performed. School-based interventions which aims were to prevent poor spinal health and/or improve spinal health in school children and adolescents were considered. Spinal health outcomes included levels of pain or discomfort limited to the spinal area and other measurable components which is a direct result of the spinal pain/discomfort and which affects the individual’s optimal experience of a sense of well-being. Results: Search strategy A yielded 24 eligible articles and search strategy B, six documents of grey literature. Four main themes of intervention were identified i.e. exercise, education, exercise and education combined and furniture, which resulted in significant positive effects on different aspects of spinal health i.e. exercise only was most effective to address low back pain; education only was most effective to address spinal pain; exercise and education combined influenced neck and lower back pain the most and furniture adjustments impacted mostly neck and spinal pain. However, the grey literature lacked the scientific evidence base of support and the content of only two documents containing education on schoolbag weight and carriage could be incorporated in the schematic presentation of the evidence-based framework. Conclusion: There was a trend that certain school-based interventions might be more beneficial to address certain aspects of spinal health in children and adolescents, despite conflicting results in the literature. The findings from the review can be used towards formulating recommendations for guidelines to be implemented in schools in future.
Normative centre of pressure values for single leg standing and tandem stance in children between the ages of six and ten years : a pilot study
(Stellenbosch : Stellenbosch University, 2016-03) Nevin, Michaela; Unger, Marianne; Brink, Yolandi; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.
ENGLISH ABSTRACT: Introduction Balance in children, both static and dynamic, is a skill required for normal motor development. Postural stability, measured by force plate derived centre of pressure (COP) data is used to infer static balance. A baseline normative reference database for age and gender will allow for more accurate assessment of children’s static balance development and ability. Objective To describe age and gender differences in postural stability for single leg standing and tandem stance in typically developed children aged six to ten years, and to provide recommendations for future, larger normative database studies. Methodology Using a descriptive study design, a convenience sample of 28 children each performed five balance tasks while standing on a dynamic pressure mapping device: left and right single leg standing with eyes open and eyes closed, and tandem stance. Centre of pressure range of movement and COP velocity parameters were used to describe postural stability. Mann-Whitney tests were used to determine significant differences in COP parameters between different age groups and gender. Level of significance was set at p ≤ 0.05. Results For single leg standing with eyes open, significant differences were found between boys and girls for mean COP velocity in the anterior-posterior (AP) direction (p=< 0.02) and mean COP velocity combined. Significant differences in mean COP velocity AP were also demonstrated between younger (6-8 yrs) and older (9-10) girls (p=< 0.03) No significant differences were found in single leg standing with eyes closed, and tandem stance. Conclusion The significant differences in COP velocity AP during single leg standing with eyes open between the older and younger girls illustrates age related Stellenbosch University https://scholar.sun.ac.za iii improvement in postural stability via slowing of COP velocity with age. This maturation of postural stability was not demonstrated for boys possibly because the boys, as a group, performed better than the girls. The lack of any significant differences between age groups and gender during tandem stance may be attributed to a ceiling effect as the task was not challenging enough. The increased difficulty of performing single leg standing with eyes closed was illustrated by lesser successful trials, larger COP range of movement and faster COP mean velocity across the age groups and genders.
Perspectives of spinal health in school-going children and adolescents in the Langeberg Municipal District of South Africa : a qualitative study
(Stellenbosch : Stellenbosch University, 2018-03) Kriel, Rena Isabel; Louw, Quinette; Brink, Yolandi; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.
ENGLISH SUMMARY : Background: In order to improve the effectiveness of spinal health educational programs, in an effort to improve spinal behaviour of children and adolescents, research is needed to identify and explore the reasons why changes are stunted. To assist with the development of spinal health promotion strategies, the current perspectives and knowledge of different socio-economic societies and cultures need to be explored. Aim: The purpose of this study was to explore what the perspectives of learners (children and adolescents), teachers and parents/guardians were on the spinal health of learners in the Langeberg Municipal District of South Africa. Methodology: A descriptive qualitative case study design with an interpretative and phenomenological approach was used. Ninety-three participants were purposively sampled and participated in In-Depth Interviews (IDI’s) or Focus Group Discussions (FGD’s). An interview schedule guided the discussions. All IDI’s and FGD’s were recorded and transcribed. Analysis was done from the transcripts and inductive reasoning was used to explore the phenomena of spinal health in learners. Transcripts were coded based on initial and subsequent emerging themes. Results: A total of nine IDI’s and 11 FDG’s were conducted with 93 participants from 14 different schools. Three main themes emerged from the data: Barriers associated with self-care of spinal health; Facilitators to assist with Spinal Health and Back care; and Proposed Interventions for Spinal Health Barriers. Conclusion: The barriers emphasized by participants showed that there were problems with the spinal health of learners that needed to be addressed. The facilitators showed that barriers could be addressed but that the current facilitators weren’t sufficient. The participants’ proposed interventions gave plausible solutions to address the learners’ spinal health barriers and to enhance the effectiveness of the facilitators. Clinicians and therapists should consider knowledge, behaviour and exercise when treating learners with LBP for a wholistic intervention. Further research is needed on the effectiveness of different delivery methods for different ages aimed at long term effectiveness. Future research should also focus on development and implementation of spinal health educational programs by pilot testing spinal health educational programs in South African Schools, including all grades.
Single leg hopping in children with and without Fetal Alcohol Spectrum Disorder: a descriptive study of dynamic postural stability and kinematics
(Stellenbosch : Stellenbosch University, 2017-03) Moore, Keryn; Brink, Yolandi; Louw, Quinette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.
ENGLISH SUMMARY : Introduction: Fetal Alcohol Spectrum Disorder (FASD) is a leading preventable cause of acquired developmental disabilities. Impairments of motor function and dynamic postural stability (DPS) are found in children with FASD. These impairments may negatively impact on these children’s ability to perform their required activities of daily living and engage with their peers in play and sporting activities. To date no research has been conducted on DPS in children with FASD in South Africa. Aim: DPS and kinematics during single leg hopping were described in two groups of typically developed nine-year-old children from an urban and rural setting (controls) and a group of nine-year-old children with FASD from a rural setting (cases). Any differences in DPS and kinematics between the three groups were also determined. Purpose of the study Identifying and describing potential motor and DPS impairments in South African children with FASD will add to the body of available research and could provide the basis for the development of interventions aimed at improving overall motor function of these children, and therefore their ability to participate better in their activities of daily living. Methodology: Participants performed a consecutive single leg hopping task and landed on a pressure mat to stabilise on one leg. Motion analysis systems and a pressure mat were used to describe 1) spatiotemporal and centre of pressure (COP) parameters and 2) joint kinematics i.e. hip, knee and ankle angles in the sagittal plane. Spatiotemporal parameters included stance and swing times and speed. COP parameters included anteroposterior (AP) and mediolateral (ML) velocity and range of motion (ROM). Descriptive results are presented in median and ranges and differences between groups were determined by Kruskal-Wallis and Mann-Whitney U statistical tests. The level of significance was set at p<0.05. Results: Fifty-six children participated; 14 children with FASD (cases), 14 rural controls and 28 urban controls. The urban controls had statistically significant longer stance and swing times (p<0.001) than the case and rural control groups. COP parameters were not statistically significantly different; however the case group displayed greater AP velocity and AP ROM values compared to both control groups (APvel: p=0.78; APROM: p=0.66). In terms of kinematics, the urban controls hopped with statistically significant greater hip flexion compared to the case group (p=0.017). Rural and urban controls hopped with more knee flexion compared to the case group, although this was not significant (p=0.16). The cases and rural controls showed statistically significant greater knee flexion at initial foot contact (IFC) onto the pressure mat than the urban controls (cases and urban controls: p=0.04; rural and urban controls: p<0.001). The urban control group landed in statistically significant more plantarflexion at IFC onto the mat than the case group (p<0.001) and the rural control group (p=0.03) and during landing, the urban control group moved into statistically significant more hip flexion compared to the case group (p=0.015) and the rural control group (p= 0.026). Conclusion: The differences in spatiotemporal, COP and kinematic parameters highlight different movement strategies and DPS capabilities between the groups. The case group hopped in a more extended position of the lower limbs and displayed increased COP AP velocity and ROM compared to the control groups, which may be an indication of impaired DPS. Identifying and exploring the aspects that underlie these impairments through objective measurement methods may assist in the development of evidence-based physiotherapy treatments for these children. This is the first study of its kind in South Africa and further research is warranted.
The three-dimensional kinematics and spatiotemporal parameters of gait in 6-10 year old typically developed children in the Cape Metropole A Pilot Study
(Stellenbosch : Stellenbosch University, 2015-04) Smith, Yvonne; Brink, Yolandi; Louw, Q. A.; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.
ENGLISH ABSTRACT: BACKGROUND: A functional gait forms an integral part of life, allowing individuals to function within their environment and participate in activities of daily living. The evaluation of gait forms an essential part of a physical examination and can help screen for physical impairments. To the researchers‟ knowledge no 3D gait analysis studies of this nature have been conducted in South Africa. South African gait analysis laboratory protocols and procedures may differ from laboratories in other countries; therefore a South African data base of normative values is required to make a valid assessment of South African children‟s gait. OBJECTIVE: The aim of this study is to describe kinematics and spatiotemporal parameters of gait of typically developed children between the ages of 6-10 years in the Cape Metropole of the Western Cape, South Africa. METHODOLOGY: A descriptive study was conducted. Twenty-eight typically developed children were conveniently sampled from aftercare facilities and schools were performed in the Cape Metropole in the Western Cape, South Africa. The three-dimensional (3D) lower limb kinematics and spatiotemporal parameters of gait were analyzed. For data capture, the lower limb Plug-in-Gait (PIG) marker placement was used. Participants were asked to walk bare footed at self-selected speed. Due to a small sample size, children were also sub-divided into two groups (Group A: 6-8 years and Group B: 9-10 years) for comparison. Means and standard deviations (SD) were calculated for all outcomes, followed by statistical tests to determine significant differences between the two sub-groups for spatiotemporal parameters and kinematics. RESULTS: There was a significant difference between the sub-groups for all the non-normalized spatiotemporal parameters. A statistical significant difference between the sub-groups for the mean hip rotation minimum values (p=0.036) was found. There was no significant difference between the sub-groups for any other kinematic parameter or when comparing the normalized spatiotemporal parameters. CONCLUSION: This study provides descriptive gait parameters that can be used for comparison or gait analysis purposes. Our results suggest that normalized spatiotemporal parameters showed no significant difference between the age groups and are consistent with international children‟s spatiotemporal parameters. Kinematic values showed significant changes with hip rotation. Older children had more external rotation at their hips. KEYWORDS: 3D gait analysis, walking, children, spatiotemporal parameters, kinematics.

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