Browsing by Author "Leibbrandt, Dominique Claire"

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    The effect of a targeted functional movement retraining intervention on anterior knee pain and associated biomechanical mechanisms
    (Stellenbosch : Stellenbosch University, 2018-03) Leibbrandt, Dominique Claire; Louw, Quinette A.; Muller, Jacobus Hendrik; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY : Background: Anterior knee pain (AKP) frequently affects the knee joint and may limit an individual’s ability to perform common activities of daily living (ADLs). It tends to become chronic, making it difficult to treat as the causes are not well understood. Individualised interventions are recommended due to the large variation of clinical presentations in subjects presenting with AKP. Aims: The main aim of this research is to assess the effect of an individualised functional retraining intervention on kinematic contributing factors, pain, function and self-reported recovery in subjects with AKP. The secondary aims are: • To create an evidence-based checklist to assist with the diagnosis of AKP • To create a decision-making algorithm for treating subjects with AKP based on their kinematic risk factors • To establish the test-retest reliability of lower limb kinematics during gait Summary of methods: Four study phases consisting of five studies with different methods were included in this dissertation. Each phase contributed towards a better understanding of the main theme, i.e. the treatment of biomechanical factors associated with AKP. Phases A and B are preliminary research necessary to aid the conceptualisation of phase D (the main study). Phase A consisted of three studies. Study 1 was a systematic review to create an evidence-based checklist for the clinical diagnosis of AKP. Study 2 was a systematic review on kinematic risk factors for AKP in order to establish which factors clinicians should address first in treatment. Study 3 was a repeatability study to establish the test-retest reliability of our measurement procedures. Phase B was the pilot phase and consisted of one study. Study 4 was a case series to establish the feasibility of our decision-making framework and intervention procedures. Phase C was a planning phase where the preliminary research from previous phases were analysed and necessary changes were made in order to improve the execution of the main intervention component of the thesis (phase D). Phase D was the main intervention study (Study 5). This was a series of n of 1 studies investigating the effect of an individualised functional retraining intervention on kinematic and clinical outcomes in 31 subjects with AKP. Setting: The research was conducted at the Tygerberg CAF Motion Analysis Laboratory and the treatments done at the Tygerberg Physiotherapy Clinic of the University of Stellenbosch in Cape Town, South Africa. Main results: Following a six-week individualised functional retraining intervention, 30 of the 31 subjects (96.8%) demonstrated improved pain levels (NPRS). All 31 participants (100%) demonstrated improved functional scores (AKPS) immediately post intervention. Nineteen of the 31 participants (61.3%) demonstrated a clinically significant improvement in their priority kinematic outcome post intervention. At six-month follow up, 15 participants (48.4%) rated themselves as fully recovered or pain-free on a 7-point Likert scale. Conclusion: An individualised approach to exercise is recommended to improve pain, function, kinematics and self-reported recovery in subjects with AKP as the effects are greater than a standard intervention approach. Clinicians need to be educated on common biomechanical contributing factors and how to tailor treatment accordingly.
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    The effect of McConnell taping on knee biomechanics : what is the evidence?
    (Stellenbosch : Stellenbosch University, 2015-04) Leibbrandt, Dominique Claire; Louw, Quinette; Louw, Quinette; Stellenbosch University. Faculty of Health Sciences. Interdisciplinary Health Sciences. Physiotherapy
    ENGLISH ABSTRACT: This review aims to present the available evidence for the effect of McConnell taping on knee biomechanics in individuals with Anterior Knee Pain (AKP). Pubmed, Medline, Cinahl, Sportdiscus, Pedro and Science Direct electronic databases were searched from inception until September 2014. Experimental research into knee biomechanical or EMG outcomes of McConnell taping compared to no tape or placebo tape were included. Two reviewers completed the searches, selected the full text articles and assessed the risk of bias of eligible studies. Authors were contacted for missing data. Eight heterogeneous studies with a total sample of 220 were included in this review. All of the studies had a moderate to low risk of bias and compared taping to no tape and/ or placebo tape. Pooling of data was possible for three outcomes; average knee extensor moment, average VMO/VL ratio and average VMO-VL onset timing. None of these outcomes revealed significant differences. The evidence is currently insufficient to justify the routine use of the McConnell Taping technique in the treatment of Anterior Knee Pain. There is a need for more evidence on the aetiological pathways of Anterior knee Pain; level one evidence and studies investigating other potential mechanisms of McConnell taping.