Browsing by Author "Morris, Linzette Deidre"

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    Effect of a low-cost virtual reality system on reducing pain and anxiety in adult burn injury patients during physiotherapy
    (Stellenbosch : University of Stellenbosch, 2009-12) Morris, Linzette Deidre; Louw, Quinette; Crous, Lynette; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.
    ENGLISH ABSTRACT: Background Albeit Virtual Reality (VR) has been shown to be a useful adjunct in the reduction of pain during burn care and therapy, the current VR systems are expensive and may not be economically feasible for developing countries such as South Africa, where health budgets are stringent. Objective The purpose of this study was to ascertain the effect of a lowcost VR system (eMagin Z800 3DVisor), used in conjunction with pharmacologic analgesics, on reducing pain and anxiety in adult burn injury patients undergoing physiotherapy treatment, compared to pharmacologic analgesics alone at a South African hospital. Study design Single-blinded, within-subject study design. Methods Pain and anxiety outcome measures were measured by a blinded assessor using the Numeric Pain Rating Scale and Burn Specific Pain and Anxiety Scale. Descriptive statistics, Chi-square tests as well as the Student’s paired t-test were used to analyze data. Main findings Eleven eligible adult burn injury patients consented to participate in this study (3 female, 8 male; median age 33 years: range 23-54 years). A marginal (p=0.06) to insignificant (p=0.13) difference between the two conditions (analgesics with VR and analgesics alone) in reducing pain was found. No significant difference (p=0.58) was found between the two conditions (analgesics with VR and analgesics alone) for anxiety. Interpretation There is a trend that a low-cost VR system, when added to routine pharmacologic analgesics, is an economically feasible and safe adjunct therapy and could be of considerable benefit if implemented into the current pain management regimen of burn injury patients at a South African Hospital.
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    Rehabilitation needs in individuals with knee OA in rural Western Cape, South Africa : an exploratory qualitative study
    (Cambridge University Press, 2020) Coetzee, Marisa; Giljam-Enright, Marlie; Morris, Linzette Deidre
    Background: Current clinical practice guidelines have suggested that each individual with knee osteoarthritis (OA) should receive three core treatments from their health care provider. These core treatments comprise of exercise, education and weight loss. Identification of the health care and rehabilitation needs of individuals with knee OA in rural areas are imperative for focusing service delivery in a specific context in order to empower the individual. The aim of this study was to explore the rehabilitation needs of individuals with knee OA living in rural Western Cape in order to identify the gaps in services offered and inform rehabilitation programmes in these settings. Methods: Semi-structured in-depth individual interviews were performed on 16 individuals with knee OA living in rural settings of the Western Cape, South Africa. A deductive data analysis approach was used and the needs of the individuals were identified and categorised for interpretation and comparison with the reported services received. Findings: The three major themes identified were ‘I would like to know more’, ‘There’s not much support from the clinic’ and ‘I don’t feel myself anymore’. These themes relate to the lack of disease-specific education, barriers in the health systems and service delivery resulting in individuals lack of self-worth and poor mental wellbeing. The results revealed the integral relationship between health care systems, service delivery and the effect on patient wellbeing. Conclusion: The rehabilitation needs of individuals with knee OA in rural areas advocates for addressing barriers in rural primary health care system such as adequate human resources, referral systems and continuity of care. This will allow for a comprehensive, person-centred and context-specific multidisciplinary approach focused on empowering individuals with knee OA through disease-specific education, improving functional participation and symptom management strategies. This could improve the social inclusion and mental wellbeing of individuals living with knee OA.
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    Virtual reality exposure therapy as treatment for pain catastrophizing in Fibromyalgia patients : proof-of-concept
    (Stellenbosch : Stellenbosch University, 2013-03) Morris, Linzette Deidre; Louw, Quinette; Grimmer, Karen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.
    ENGLISH ABSTRACT: Research objective To test a novel concept that exposing patients with fibromyalgia syndrome (FMS) to visuals of exercise activities elicits neurophysiological changes in functional brain areas associated with pain catastrophization; thereby providing preliminary support for the further development/testing of a virtual reality exposure therapy (VRET) exercise program aimed at reducing pain catastrophization toward exercise therapy in patients with FMS. Methods The main study of this research consisted of a three-phase exploratory fMRI study. Phase 1 involved the development/validation of the fMRI visual task. Phase 2 involved the exploration of the differences in neural correlates associated with pain catastrophizing between participants with FMS and healthy controls when exposed to various visuals of exercise and passive/relaxing activities. Phase 3 involved the testing of the preliminary efficacy of a novel VRET exercise program on pain catastrophization in participants with FMS. The fMRI task consisted of two stimuli: active (exercise activity visuals)/passive (relaxing activity visuals). Structural images as well as blood-oxygenation-level-dependent (BOLD) contrasts were acquired for the conditions and compared within-subjects/groups and between-groups. The condition of interest was the active>passive condition (where brain activations for the passive condition were subtracted from the active condition). The brain volumes collected during ‗on‘ conditions were compared with the brain volumes collected during ‗off‘ conditions using Students‘ t test. Statistic images were thresholded using clusters determined by Z>2.3 and a (corrected) cluster significance threshold of p=0.05. Results The right (R) middle and inferior frontal gyrus and R posterior cerebellum were significantly activated for the participants with FMS, and not the healthy control group, during the active>passive condition (phase 2). At baseline, during the active>passive condition (phase 3), the intervention/VRET group showed significant activation (p<0.05) in the R insular cortex, R anterior and posterior cerebellum, R parahippocampal gyrus, R middle frontal gyrus, R corpus callosum, R thalamus, R supramarginal gyrus and R middle and superior temporal gyrus; the control group showed significant activation in the R anterior and posterior cerebellum, R middle and superior temporal gyrus, R middle frontal gyrus, R insular cortex, R supramarginal gyrus and R precentral gyrus. Post-intervention, during the active>passive condition, R posterior cerebellum activation was still significant (p<0.05) for the intervention group; R anterior cerebellum, left (L) middle and inferior frontal gyrus, and R superior parietal lobe activation was found to be significant (p<0.000) for the control group, although these areas were not found to be significantly activated at baseline for the control group. Conclusion We could not provide confirmatory evidence for the efficacy of a novel VRET program for pain catastrophization in patients with FMS. However, the findings of this study does suggest that pain catastrophization in patients with FMS could be confirmed with fMRI. Research is therefore warranted to further develop a proper VRET exercise program and to test the effect of this program on pain catastrophization in patients with FMS.