Browsing by Author "Marume, Martin"

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    Rehabilitation following flexor tendon injury to the hand in African countries : a scoping review
    (Stellenbosch : Stellenbosch University, 2022-12) Marume, Martin; de Klerk, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Objective: To explore and ascertain the types of flexor tendon rehabilitation protocols, feasibility and outcomes following implementation in African countries. Design: This scoping review used Arksey and O’Malley’s methodological framework and the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews guidelines. Data sources: A search was conducted via Cochrane library, PubMed, Science direct, CINAHL-EBSCOhost, Sabinet online platform (Sabinet African Journal and African Journal Archive), Wiley online, Academic search premier, Google scholar, Africa wide information and Universities repositories between 1 June 2021 and 31 July 2021.The search string included the following terms; flexor tendon injury, hand injury, finger injury, hand function, rehabilitation, occupational therapy, physiotherapy, mobilisation and Africa. Eligibility criteria: All language versions from African countries, manuscripts published from 1960 up to 31 July 2021, literature on zone II-V of human hand flexor tendon injury inclusive of nerve and other additional injuries, including participants who are ten years and older were considered. Manuscripts were included if they reported on flexor tendon rehabilitation protocols and outcomes (body function and structure, and activity and participation). Data extraction and synthesis: Mendeley was used to manage identified references. Three reviewers used Covidence for title, abstract and full-text screening. Microsoft Excel and WeftQDA was used for data extraction, descriptive numerical summary and qualitative content analysis respectively. Themes and categories were developed to answer the research question. Results: 53 manuscripts were identified and their title, abstract and full text reviewed. 13 manuscripts from four countries (South Africa, Egypt, Zambia and Morocco) qualified for inclusion. The Kessler knot 4 is the surgery most practised in the African continent. The early passive mobilisation is the protocol of choice and therapists consider mostly body function and structure during outcome measurement with particular attention to range of motion. The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire, Jebsen-Taylor Hand Function Test (JTTHF) and Michigan Hand Outcomes Questionnaire (MHQ) were used to assess functional outcomes in Africa. Despite inconsistency in rehabilitation process, outcome measurement and reporting, generally, outcomes were poor in body function and structure, and activity and participation. Several factors were identified to impact outcomes, including adhesions, infection, expertise of the surgeons and rehabilitation personal and limited resources. Conclusion: There is inconsistency in the rehabilitation, measurement and outcomes following flexor tendon injury in the African context. Despite limited information from the included manuscripts, it can be ascertained that the management procedures are yielding poor results and several contextual factors influenced the attained results. Recommendations include conscientising the health care team, involved stakeholders and education facilities to conduct more research to inform good practice and better results for patients on the African continent.