Masters Degrees (Physiotherapy)
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Browsing Masters Degrees (Physiotherapy) by browse.metadata.advisor "Burger, Marlette"
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- ItemInvestigation into the immediate effect of ankle taping on temporal spatial gait parameters and affected ankle kinematics in ambulant adult hemiplegic patients(Stellenbosch : Stellenbosch University, 2012-03) Al-Talahma, Mohammad Y. M.; Inglis-Jassiem, Gakeemah; Burger, Marlette; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.ENGLISH ABSTRACT: SYSTEMATIC REVIEW ABSTRACT - BACKGROUND: Ankle Foot Orthoses (AFOs) are considered as the most suitable lower limb orthosis to correct gait deficits related to ankle instability. AFOs are recommended to minimize gait deviations and to correct drop foot or equinus foot in hemiplegic patients. OBJECTIVES - To identify the effectiveness of different ankle orthoses and/or supports on the temporal, spatial, kinetic and kinematic gait parameters. To critically appraise the methodological quality of the included studies and to provide a description of the studies with a view to identify opportunities to improve future research quality. METHODS - Search strategy A comprehensive search was conducted between March and October 2010, and updated in August 2011. Thirteen computerized bibliographic databases were individually searched, namely PubMed Central, Cohrane Library, CINAHL, OT Seeker, SPORTDiscus, PsyARTICLE, PEDro, Proquest, Biomed Central, Science Direct, Clinicaltrials.gov, Web of Science, and Ingenta Connect. All databases were searched since their inception. The following key terms were used: stroke, hemipleg*, assistive device*, ankle foot orthos*, AFO, (splint*), taping, and strapping. A secondary search (pearling) was conducted by screening the reference lists of all eligible full text studies. The authors of the unpublished studies were conducted to minimize publication bias. Selection criteria The following selection criteria applied: all relevant randomized and non-randomized controlled trails published in English; participants were post-stroke patients older than eighteen years; interventions included any type of ankle foot orthosis (AFO), ankle taping or strapping and ankle foot splint without any additional intervention and the comparison/control groups were limited to walking without support, either barefoot or walking with shoes only. Studies were excluded when the outcome measures did not focus on at least one of the following: temporal spatial gait parameters, kinetic gait parameters or kinematic gait parameters. Data collection and analysis Two reviewers independently selected trials for inclusion and assessed methodological quality. The data was extracted by the primary reviewer and validated by a second reviewer. In event of disagreement, a third reviewer was asked to re-evaluate until consensus could be reached. Homogenous data were statistically summarized in sub-group meta-analysis using Revman© Review Manager Software. The results of heterogeneous data were summarized in a narrative form. MAIN RESULTS - The search yielded 11134 initial hits. Sixteen studies met the inclusion/exclusion criteria. The studies investigated the immediate effect of various types of AFOs on a broad range of temporal spatial gait parameters mainly gait speed, cadence, stride and step length. Only two studies reported on the kinetic and six on various kinematic gait parameters. The meta-analysis yielded significant improvement in gait speed (0.06 m/s; 95% CI 0.04, 0.08. p < 00001), walking cadence (5.41; 95% CI 3.79, 7.03. p < 00001), stride length (6.67; 95% CI 3.29, 10.06. p < 00001) and step length (2.66; 95% CI 1.59, 3.72. p < 0.00001). CONCLUSION - AFOs are effective to improve mobility, gait speed, cadence, stride and step length for post-stroke patients and may have a positive impact on the daily function of post-stroke patients. . The long term benefit or adverse effects of AFOs are still inconclusive. The effectiveness of AFOs on the kinetic and the frontal- or transverse- plane joint kinematics is largely unresolved. There is insufficient evidence to either support or refute the effectiveness of taping/strapping and splinting of the ankle on hemiplegic gait. EXPERIMENTAL STUDY ABSTRACT - BACKGROUND: Temporal, spatial and affected ankle kinematic gait parameters of adults with hemiplegia are significantly different from the normal able-bodied population. Enabling hemiplegic patients to walk is a major goal of rehabilitation programs. Taping of the plegic ankle could be utilized by therapists as external support of the ankle to improve foot position and placement during gait rehabilitation. OBJECTIVE - The purpose of the study was to describe the immediate effect of neutral ankle taping on temporal spatial gait parameters and ankle joint kinematics of the affected ankle in ambulant adult hemiplegic patients. METHODS - A clinical trial using a crossover randomized testing order was conducted on a convenient sample of ten ambulant hemiplegic patients at the Physiotherapy and Motion Analysis Clinic, Faculty of Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa. The affected ankle joint was taped in a neutral talocrural dorsiflexion/ plantarflexion and neutral hindfoot inversion/ eversion position using rigid adhesive tape (5 cm). The gait parameters were analysed according to the Plug-In Gait Model using a motion analysis system (Vicon Nexus 1.1.7; Vicon Motion System Limited, Oxford, UK). The analyses were repeated six times for each testing condition and the average values were used for further analysis. The data were analyzed using Least Square Means tests and post hoc Fisher (Least Significant Difference) LSD multiple comparison tests to determine the significant differences at 95% confidence level. RESULTS - The main results of the study indicate that taping of the affected ankle joint in a neutral position does not significantly improve (p>0.5) temporal spatial gait parameters and ankle joint kinematics in ambulant adult hemiplegic patients. The following positive trends were however found and need to be further explored in larger homogeneous study samples: ankle taping of ambulant adult hemiplegic patients has limited benefits on selected temporal parameters as ankle taping could potentially improve cadence. Ankle taping could decrease plantarflexion of the plegic leg at initial contact. CONCLUSIONS - A systematic review revealed no conclusive evidence either to support or refute the beneficial effects of ankle taping on gait parameters of ambulant adult hemiplegic patients. Ankle taping of ambulant adult hemiplegic patients has potential clinical benefits on temporal, spatial and affected ankle kinematics, gait cadence and affected leg swing and stance duration.
- ItemThe manual motor control of South African children with and without foetal alcohol spectrum disorder during a pegboard task(Stellenbosch : Stellenbosch University, 2023-03) Abrahams, Adrian Ian; Burger, Marlette; Dr Brink, Yolandi; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.ENGLISH SUMMARY: Introduction: Foetal alcohol spectrum disorder (FASD) refers to a group of conditions caused by prenatal alcohol exposure (PAE) during pregnancy. Children with FASD have impairments with fine manual motor control when completing a task. These impairments may have a negative impact on these children's ability to execute tasks. Three-dimensional (3D) kinematics is increasingly being used to analyse and assess upper-limb motor tasks. The aim of the study was to use the most feasible and informative approaches while using a motion analysis system to describe manual motor control during a pegboard task in children aged nine to ten years diagnosed with FASD and children without FASD; and the secondary aim was to perform a preliminary analysis comparing spatio-temporal and 3D kinematic parameters between the two groups. Methodology: Participants completed a 16-hole pegboard task in which they reached for and placed individual pegs in the corresponding holes as quickly as possible. A MyoMotion measurement system was used to describe 1) spatio-temporal parameters (duration) and 2) 3D kinematic parameters (joint range of motion). 3D kinematics included range of motion of the shoulder, elbow, head, neck and thoracic in three different planes. Line graphs were used to display the results. The mean and standard deviation (SD) of the continuous variables were also provided in table format. The two-sample Hotelling's T2 test was used to determine if there were any significant differences in spatio-temporal and 3D kinematic characteristics between the FASD and no FASD groups (significance level of 0.05). Results: Thirty-seven children participated: 25 children (FASD) and 12 children (no FASD). The spatio-temporal results revealed that children with FASD completed the pegboard task slower overall; were slower when using the left-hand compared to the right hand; but were faster to perform the transport phase when using the right hand. The 3D kinematics results showed that children with FASD displayed greater elbow flexion/extension and shoulder abduction/adduction range of motion (ROM) when using either the right or left hands; greater flexion/extension and internal/external rotation ROM when using the right hand; greater head and neck side flexion and neck flexion/extension during the right-hand trials; and greater neck flexion/extension during the left-hand trials. Compared to the no FASD group, children with FASD had approximately 10 degrees more neck side flexion ROM during the right-side trials. There were no statistically significant differences between the groups in any of the spatio-temporal or 3D kinematic joint parameters. Conclusion: These findings suggest that children with FASD might find completing the pegboard task more difficult when the using the left (non-dominant) hand than the right hand and utilise different movement patterns when completing the pegboard task (as seen by the differences in joint ROM). Future research should be encouraged to use objective assessment methods to further describe the motor control abilities of children with FASD when completing a fine motor control task i.e. the pegboard task as it will help in the development of evidence-based therapies for these children.
- ItemPostural sway in rugby players with chronic groin pain(Stellenbosch : Stellenbosch University, 2018-03) September, Wendy; Moodien, Wendy; Unger, Marianne; Burger, Marlette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.ENGLISH SUMMARY : Introduction: Center of pressure (COP) has been frequently used as a guide of postural stability in standing. Objectives: The study aimed to describe postural sway (as determined by the center of pressure) during pelican stance and during foot contact of the landing phase of a double leg jump in rugby players with chronic adductor related groin pain compared to asymptomatic controls. Methodology: Study Design: A descriptive observational cross-sectional study was conducted. Setting: The study was performed at the 3D Human Biomechanics Central Analytical Facility at Stellenbosch University, South Africa. Participants: A consecutive sample of eight participants, four cases and four controls with chronic adductor related groin pain were included. One of the cases had bilateral groin pain and three had unilateral groin pain. Main Outcome Measures: Center of pressure (range of movement and velocity) were measured and analysed at foot contact during a double leg landing and during pelican stance by means of a force platform. Results: There were no significant differences between affected and unaffected sides within cases, nor between the affected side and same side in matched controls for any of the measurements recorded. However, in most cases greater antero-posterior range of movement and velocity is seen while standing on the affected side when compared to standing on the unaffected leg. There were also no significant differences found for postural sway when referring to antero-posterior and medio-lateral mean range of movement and velocity Conclusion: Postural Sway is not significantly affected in rugby players with chronic groin pain. There were no differences in center of pressure range of movement and velocity amplitude between cases and controls during a pelican stance test and after a double leg landing. It is postulated that a player with groin pain have over time learned to compensate in adjusting their COP. The study however tested participants who at the time of testing presented with no pain and were not fatigued prior to testing which may have obscured the impact of the condition on balance as determined by postural sway. Further research examining the risk of injury by fatiguing participants prior to testing may shed more light on the effect chronic groin pain has on postural sway in this population.
- ItemThe predictive validity of Hammersmith Infant Neurological Examination versus prechtl’s general movement assessment with the Motor optimality score on gross motor outcomes in high-risk infants at 12-15 months corrected age : a descriptive study(Stellenbosch : Stellenbosch University, 2022-04) Jansen van Rensburg, Emma Anita; Burger, Marlette; Unger, Marianne; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.ENGLISH SUMMARY: BACKGROUND: Advances in neonatal and maternal care have caused an increase in survival rate of high-risk infants, however with increased risk for developing adverse neurodevelopmental outcomes such as cerebral palsy (CP). Evidence supports the predictive value of Prechtl’s General Movement Assessment (GMA) with Motor Optimality Score (MOS), and the Hammersmith Infant Neurological Examination (HINE) for CP outcome before 5 months corrected age. Exploring usefulness of these measures and understanding how these two compare in predicting gross motor outcome in high-risk infants may enable earlier referrals for all and not just those at risk for developing CP. OBJECTIVE: To compare the predictive validity of the HINE versus Prechtl’s GMA with MOS (measured at 11-16 weeks corrected age) for determining the gross motor outcomes in high-risk infants at 12-15 months corrected age as measured by the Alberta Infant Motor Scale (AIMS). METHODOLOGY: A longitudinal descriptive study was conducted at Tygerberg Children’s Hospital (TCH). All high-risk infants assessed at 11-16 weeks corrected age using Prechtl’s GMA with MOS and HINE and whose parents consented to participation were re-evaluated using the AIMS to determine their gross motor outcome at 12-15 months corrected age. Data was analysed using STATA version 16 and IBS SPSS software. HINE and Prechtl’s GMA with MOS cut-off scores were determined and ROC curve analysis utilised to determine sensitivity and specificity values for both measures. RESULTS: The study enrolled 100 infants with a mean birthweight of 1525.6g and a mean gestational age of 31.1 weeks. Fifteen infants scored <5th percentile on the AIMS at 12-15 months corrected age and seven infants were suspected to have CP. The HINE with a sample specific cut-off score of 62.5 had an area under the curve (AUC) of 0.867 to predict gross motor delay with sensitivity of 87% and specificity of 81%, and positive predictive value (PPV) of 45%, negative predictive value (NPV) of 97%. Prechtl’s GMA with the MOS had AUC=0.713 with sensitivity of 47% and specificity of 100%, and PPV of 100%, NPV of 91%. The reflexes and reactions subcategory on the HINE, and the observed postural patterns and fidgety movements subcategories on the MOS were predictive of gross motor outcome. Both HINE and GMA with MOS total scores were more predictive of gross motor outcome than subcategory scores or single items. CONCLUSION: The results of this study indicate that both the HINE and Prechtl’s GMA with MOS are valid measures for predicting gross motor delay as determined by the AIMS in high-risk infants. The HINE, however, is more sensitive to predict gross motor delay than the GMA with MOS. The HINE showed lower PPV to predict gross motor delay compared to the GMA with MOS, however NPV values for both were similar. For both measures total scores were more predictive of gross motor outcome than subcategory or single item scores. The results of our study suggest either HINE or GMA with MOS total scores be used to predict gross motor outcome. However due to small sample size and recruitment from one site this topic warrants further research.
- ItemThe validation of the Canadian norms for the Alberta Infant Motor Scale within the Cape Metropolitan(Stellenbosch : University of Stellenbosch, 2010-03) Manuel, Alana; Burger, Marlette; Louw, Q. A.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.Information on the normal gross motor skills in a healthy population is important since normative data provides a benchmark for health professionals to evaluate deviations from the norm. The Alberta Infant Motor Scale (AIMS) was developed to assist with the motor assessment of young infants from birth through to independent walking. The validation of the Canadian cohort for the AIMS needs to be done with regards to infants in South Africa (Cape Town), before it can be utilised by health professionals working in Paediatric Health Care. To determine if the Canadian norms for the AIMS are valid for infants aged 4 - 18 months within the Cape Metropole, South Africa. A prospective descriptive study was conducted to validate the AIMS. A total of 67 infants from one private and one public institution participated in the study. Infants were assessed at 4, 8, 12 and 18 months of age with the AIMS. Results were analysed using ANOVA and t-tests to determine the relationship between age, ethnicity, gender and clinics.The AIMS gross motor scores of this sample of infants were not significantly different from the Canadian norms, bar at 4 months. Female infants performed significantly (p<0.05) better than males at four months. It was not possible to convert the 18 month old infants‟ raw scores into percentile rankings and therefore it could not be compared to the Canadian norms. The results yielded from this study indicate that the AIMS is a valid assessment tool for healthy infants from 8 - 12 months of age within the Cape Metropole, South Africa, however, care should be taken when infants‟ scores at 4 months are compared to the scores of the normative sample. The AIMS can therefore be used by health care professionals at the Baby Well clinics in the Cape Metropole to assess gross motor development in infants for this age group and can consequently refer infants who may display delays in motor development to appropriate paediatric specialists. The results from this pilot study also make provision for future in-depth research on the AIMS with a larger cohort and with more ethnic diversity.