Research Articles (Occupational Therapy)
Permanent URI for this collection
Browse
Browsing Research Articles (Occupational Therapy) by Title
Now showing 1 - 20 of 30
Results Per Page
Sort Options
- ItemArbeidsterapie aan die Universiteit van Stellenbosch 1961 - 1974(Health and Medical Publishing Group (HMPG), 1975) Dyke, A. P.
- ItemClients’ subjective experience of their participation in rehabilitation at an out-patient community rehabilitation center(Occupational Therapy Association of South Africa, 2016) Kloppers, Maatje; Pretorius, Blanche; Vlok, Elizabeth DaphneIntroduction: Rehabilitation services in South Africa are governed by various policies. It is important to evaluate these services to assess if the services are achieving their aims as set out in these policies. The evaluation should include the outcomes that clients achieve by participating in rehabilitation services. Method: The findings presented were obtained as part of a larger mixed methods descriptive study and this paper will focus on clients’ subjective experience of participating in rehabilitation. Convenience sampling was used to select 78 clients from the five most prevalent diagnostic groups seen at the centre. Semi-structured interviews were conducted, transcribed and analysed by means of basic content analysis. Results: Clients commented on the emotional impact that participating in rehabilitation had had on them and on the physical changes it had brought about. Clients experienced a high level of satisfaction with the service and enjoyed participating in rehabilitation. The knowledge, skills and confidence that they gained enabled them to be more independent in Daily life activities and to share this knowledge with others in their community. Conclusions: The results emphasise the importance of providing rehabilitation services for persons with disabilities that are based in their community. It will be useful in further service and policy planning for persons with disabilities.
- ItemCognitive interviewing during pretesting of the prefinal Afrikaans for the Western Cape disabilities of the arm, shoulder and hand questionnaire following translation and cross-cultural adaptation(Hindawi, 2019) De Klerk, Susan; Jerosch-Herold, Christina; Buchanan, Helen; Van Niekerk, LanaWhen patient-reported measures are translated and cross-culturally adapted into any language, the process should conclude with cognitive interviewing during pretesting. This article reports on translation and cross-cultural adaptation of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire into Afrikaans (for the Western Cape). This qualitative component of a clinical measurement, longitudinal study was aimed at the pretesting and cognitive interviewing of the prefinal Afrikaans (for the Western Cape) DASH questionnaire highlighting the iterative nature thereof. Twenty-two females and eight males with upper limb conditions were recruited to participate at public health care facilities in the Western Cape of South Africa. Cognitive interviews were conducted as a reparative approach with an iterative process through retrospective verbal probing during a debriefing session with 30 participants once they answered all 30 items of the translated DASH questionnaire. The sample included Afrikaans-speaking persons from low socioeconomic backgrounds, with low levels of education and employment (24 of 30 were unemployed). Pragmatic factors and measurement issues were addressed during the interviews. This study provides confirmation that both pragmatic factors and measurement issues need consideration in an iterative process as part of a reparative methodology towards improving patient-reported measures and ensuring strong content validity.
- ItemThe effect of a repeated course of constraint-induced movement therapy, implemented in the home environment, on the functional skills of a young child with cerebral palsy(Occupational Therapy Association of South Africa, 2012-12) Hamer-Rohrer, Ursula; Smit, Neeltje; Burger, MarletteThe lack of research in South Africa related to the use of Constraint-Induced Movement Therapy (CIMT) motivated this single-system (A-B-A-B-A) study. The aim was to investigate whether a repeated course of CIMT would improve self-care, play and functional skills of a young boy with asymmetrical cerebral palsy (CP). The subject’s less affected arm was placed in a sling for a period of six hours during the intervention phases. The duration of the CIMT was 10 working days, followed by a two-week withdrawal phase. This sequence was repeated once. The subject was engaged in play and self-care activities in his home environment during the intervention phases. The Pediatric Evaluation of Disability Inventory (PEDI) was used to assess the subject six times: at the start; before and after interventions; and after the last withdrawal phase. The minimal clinically important difference (MCID) was calculated between the first and last assessments to determine the effectiveness of the CIMT. The critical 11 points difference was reached in the PEDI self-care domain for functional skills (such as dressing and washing) and in the social functioning domain for caregiver assistance (indicating that the caregivers were giving less assistance with regards to participation in household chores, communication and play ability).
- ItemAn enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study(BMC (part of Springer Nature), 2020-07-08) Prior, Susan; Maciver, Donald; Aas, Randi W.; Kirsh, Bonnie; Lexen, Annika; Van Niekerk, Lana; Fitzpatrick, Linda Irvine; Forsyth, KirstyBackground: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Results: Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p < .001. Conclusion: An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment.
- ItemExploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa : a qualitative study(BMC (part of Springer Nature), 2018-11-06) Adebiyi, Babatope O.; Mukumbang, Ferdinand C.; Cloete, Lizahn G.; Beytell, Anna-MarieBackground: Fetal alcohol spectrum disorder (FASD) is among the leading causes of developmental and intellectual disabilities in individuals. Although efforts are being made toward the prevention and management of FASD in South Africa, the prevalence remains high. The sustained high prevalence could be attributed to several factors, including the lack of policy for a coordinated effort to prevent, diagnose and manage FASD nationally. In this study, our aim was to explore the perspectives of service providers (health and allied professionals, teachers, social workers) on the prevention and management of FASD towards developing a guideline to inform policy. Method: Guided by the exploratory qualitative research design, we purposively sampled relevant service providers in the field of FASD prevention and management for focus group discussions. Nine of these discussions were conducted with to eight participants per discussion session. The discussants were asked various questions on the current and required interventions and practices for the prevention and management of FASD. Following the Framework Method, data were transcribed verbatim and analysed using the thematic content analysis approach. Results: Our findings show that aspects of the prevention and management of alcohol-related conditions are present in various policies. However, there is no clear focus on coordinated, multi-sectoral efforts for a more comprehensive approach to the prevention and management of FASD. The participants recognized the need for specific requirements on broad-based preventive awareness programs, training and support for parents and caregivers, inclusive education in mainstream schools and training of relevant professionals. Conclusion: Comprehensive and coordinated prevention and management programs guided by a specific policy could improve the prevention and management of FASD. Policy formulation demonstrates commitment from the government, highlights the importance of the condition, and elaborates on context-specific prevention and management protocols.
- ItemExploring the factors that affect the transition from student to health professional : an integrative review(BioMed Central, 2021-11) Opoku, Eric Nkansah; Jacobs‑Nzuzi Khuabi, Lee-Ann; Van Niekerk, LanaBackground: The nature of a new health professional’s transition from student to health professional is a signifcant determinant of the ease or difculty of the journey to professional competence. The integrative review will explore the extent of literature on the factors that impact the transition of new health professionals into practice, identify possible gaps and synthesise fndings which will inform further research. The aim was to identify research conducted in the last two decades on the barriers, facilitators and coping strategies employed by new health professionals during their transition into practice. Methods: Whittemore and Knaf’s methodological framework for conducting integrative reviews was used to guide this review. Sources between 1999 and 2019 were gathered using EBSCOhost (including CINAHL, Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), PubMed, Scopus, Cochrane and Web of Science, as well as hand searching and follow-up of bibliographies followed. The Covidence platform was used to manage the project. All studies were screened against a predetermined selection criteria. Relevant data was extracted from included sources and analysed using thematic analysis approach. Results: Of the 562 studies identifed, relevant data was extracted from 24 studies that met the inclusion criteria, and analysed to form this review. Thematic analysis approach was used to categorise the fndings into theme areas. Four overarching themes emerged namely: systems and structures, personal capacities, professional competence and mediating processes. Each theme revealed the barriers, facilitators and coping strategies of transition into practice among new health graduates. Conclusion: The transition into practice for new health practitioners has been described as complex and a period of great stress. Increasing clinical and practical experiences during education are required to support new health professionals in the process of closing the gap between learning and practice. Continued professional development activities should be readily available and attendance of these encouraged.
- ItemIdentity construction and participation in work : learning from the experiences of persons with psychiatric disability(Thomson Reuters, 2016-03) Van Niekerk, LanaENGLISH SUMMARY : Background: In this article constructions of identity, occupation and performance are explored with a particular focus on the interrelatedness of these concepts. Insights were derived from a study in which the influences that impact on the work-lives of people with psychiatric disability were explored. Method: An interpretive biography design was utilised. Data construction took the form of narrative interviews and a combination of paradigmatic narrative analysis and narrative analysis was used. Participants, selected by means of purposive maximum variation sampling, had been diagnosed with psychiatric impairment and lived in the Western Cape, South Africa. Findings and discussion: Identity construction processes were explored, with a particular focus on how these impacted on decisions about participation in work. Conclusions: Performance elements of identity, called forth by occupational demands, occurring within work environments were found to be shaped through, and expressed as, doing. The notion of Punctualized Identity was shown to provide a lens that is able to capture the dynamic interplay of identity constructs and provide a synthesised perspective on participation.
- ItemIntroducing early active mobilisation following flexor tendon repair in the context of care in a developing country : a randomised feasibility study(Occupational Therapy Association of South Africa, 2019-08) Buttle Naude, Amy; De Klerk, SusanIntroduction: Flexor tendon injuries remain one of the most difficult hand injuries to manage post-operatively. Early active mobilisation protocols are considered ‘best practice’ internationally but have not been well researched in the developing country context. The feasibility of such research, and use of these protocols, need to be determined by considering the potential for improved functional outcomes for patients, together with various contextual and resource challenges. Purpose: To explore aspects of feasibility related to the recruitment, consent and retention rates in consideration of a future definitive Randomised Control Trail. In addition, preliminary results of an early active therapy protocol compared to an early passive therapy protocol were reported on, together with patient satisfaction and demographics. Methods: A parallel randomised pilot trial design was used. Thirty-one participants were recruited into one of two therapy groups (active or passive). Fourteen of these participants completed their therapy and eight-week assessments including: Total Active Motion, grip strength, the Michigan Hand Questionnaire and the Smith Hand Function Evaluation. 95% Confidence intervals examined feasibility data. Non-parametric data analysis was done primarily using medians and ranges. Results: Feasibility results of 37% recruitment rate, 97% consent rate and 45% retention rate, did not meet the criteria for success, deeming a trial in the present design, not feasible. Discussion: Due to the dearth of research from public health clinical settings in developing countries, this study contributes rich contextual data, but the challenges discussed need to be addressed before further research will achieve success.
- ItemA literature review on work transitioning of youth with disabilities into competitive employment(AOSIS publishing, 2017-08) Engelbrecht, Madri; Shaw, Lynn; Van Niekerk, LanaBackground: The marginalisation of youth with disabilities from employment opportunities is evident from literature in as far as they form part of the larger groups ‘people with disabilities’ and ‘youth’. A focused view of programmes that assist youth with disabilities into employment has not been presented, despite the worldwide crisis of youth unemployment. Aim: This review aimed to identify evidence on work transition programmes that are effective in assisting people with disabilities into open labour market (competitive) employment, as well as to highlight gaps in knowledge to inform future research on this topic. Methods: Literature and policy on programmes that support such transitions were considered, firstly from a global perspective and then with a view from developing countries. The SALSA (Search, Appraisal, Synthesis and Analysis) framework was used to source and analyse information from a diverse set of documents. Various online databases were searched for research papers published between 1990 and 2016, and websites were searched for reports pertaining to this topic. Results: Ninety-nine documents were selected to inform the review, out of an identified 259 scientific journal articles, policy documents, acts, organisational reports and book chapters. Conclusion: A synthesis of findings was presented in a narrative that reflects the themes of youth with disabilities and employment in the world, work transition endeavours in the developing world and a specific focus on this group in South Africa. The review revealed a gap in knowledge and evidence pertaining to youth with disabilities and employment, highlighting these as research foci, and emphasising the need for youth-focused research that generates knowledge about disability and transitions into the labour force.
- ItemThe lived experience of drivers with a spinal cord injury : a qualitative inquiry(Occupational Therapy Association of South Africa, 2016) Mtetwa, Lucia; Classen, Sherrilene; Van Niekerk, LanaIntroduction: Driving is an instrumental activity of daily living and a facilitator of meaningful participation in society for the majority of the population, including persons with spinal cord injuries. Persons with spinal cord injury may have impaired fitness to drive capabilities. Little is known about perceptions of drivers with spinal cord injury on driving, driver rehabilitation, or return to driving. This study examined the post spinal cord injury driving experiences of drivers and illuminates their rehabilitation and return-to-driving needs within the South African context. Method: This phenomenological study explored personal experiences of fourteen drivers with spinal cord injury, recruited through purposive sampling. Face-to-face, semi-structured interviews were audio recorded and transcribed verbatim. The data analysis was an inductive and iterative process. Results/findings: Six themes represent the study findings: adjusting to physical limitations, safety perceptions and influencing factors, the positive role of driving, contextual features and supports, environmental barriers, and inconsistent provision of rehabilitation services. Conclusions: The findings indicated that occupational therapists ought to consider incorporating driver rehabilitation services and adopt mediation approaches to advocate for persons with spinal cord injury, who want to drive. Plausible practice and research opportunities are discussed for occupational therapists who are interested in driving and spinal cord injury.
- ItemMixing-up research methods : a recipe for success or disaster?(Occupational Therapy Association of South Africa, 2016) Plastow, Nicola AnnENGLISH SUMMARY : The increase in the number of occupational therapists training and doing research at undergraduate and post-graduate degree level has led to an exciting growth in research capacity within our profession. My experiences of doing research and in supervising students have raised questions about which methodologies students should be able to apply at the beginning of their research careers. In this opinion piece I argue that concurrent mixed-methods research designs across more than one research paradigm are inappropriate for undergraduate and Masters-level research, because of issues with integration, transparency, and the time taken to develop the sufficient research expertise required for this methodology.
- ItemMothers' experiences of caring for a child with severe brain injury in a disadvantaged community in the Cape Flats(Occupational Therapy Association of South Africa, 2013-06) Du Toit, Christine; Coetzee, Zelda; Beeton, HilaryHealth professionals have a limited understanding of the experiences of mothers caring for a child with traumatic brain injury (TBI) in a context of disadvantage. This may be due to the dearth of qualitative research on this topic in the South African context. This phenomenological study aimed to explore and describe the lived experiences of four mothers caring for their children with severe TBI in disadvantaged communities in the Cape Flats. Their lived experiences were described in terms of lived space, lived body, lived social relationships and lived time. Two in-depth interviews were done with each of the four mothers. Interviews were transcribed verbatim and analysed inductively. Three themes which emerged from the analysis were: “personal burden of care”, “living a different life with a different child” and “holding onto faith and hope”. The findings highlighted that caring for a child with TBI changed the mothers’ circumstances in such a way that they had no time for themselves, because caring for and worrying about their children consumed their whole day. They also experienced increased financial burden as they resigned from their employment to care for their children fulltime. They had to change their parenting style as the children had different needs than before the TBI. The mothers also identified many needs of their own, including the need for meaningful occupations and support. However, they remained optimistic and experienced a stronger faith in God. The findings stressed the need for intervention with these mothers to prevent a decline in their well-being.
- ItemMotor skill intervention for pre-school children : a scoping review(AOSIS, 2020) Van der Walt, Janke; Plastow, Nicola A.; Unger, MarianneBackground: There is a high prevalence of motor skill difficulties amongst pre-school children living in low socio-economic areas. Motor skill impairment can affect these children’s school readiness and academic progress, social skills, play and general independence. Objectives: This scoping review investigates the key elements of existing motor skill interventions for pre-school children. Method: We gathered information through structured database searches from Cinahl, Eric, PubMed, Cochrane, ProQuest, Psych Net, PEDro and Scopus, using a keyword string. The PRISMA-SCR design was used to identify 45 eligible studies. All included studies investigated a motor skill intervention with well-defined outcome measures for children aged 4–7 years with motor skill difficulties. Studies that exclusively focused on children with neurological conditions such as cerebral palsy, physical disabilities or medical/physical deteriorating conditions were excluded. Information was charted on MS Excel spreadsheets. Fundamental concepts were categorised into common key themes and were converted into a proposed framework. Results: Fifteen intervention approaches were identified. Treatment is mostly managed by occupational therapists and physiotherapists. Evidence supports individual and group treatment with a child-centred, playful approach in a school or therapeutic setting. Whilst session information varied, there is moderate evidence to suggest that a 15-week programme, with two weekly sessions, may be feasible. Conclusion: Children with motor skill difficulties need therapeutic intervention. This study identified the key elements of existing therapy intervention methods and converted it into a proposed framework for intervention planning. It is a first step towards addressing motor skill difficulties amongst pre-school children in low socio-economic areas.
- ItemNon-attendance of occupational and physiotherapy appointments at Western Cape Rehabilitation Centre : a description of associated factors(The Occupational Therapy Association of South Africa, 2019-12) De Klerk, Susan; Eloff, Lize; Naude, Zani; Boon, Andrea; Carelse, Megan; Steward, Michaela; Zaidi, MinalIntroduction: Occupational therapists and physiotherapists use outpatient follow-up appointments to continue and monitor the effectiveness and outcome of therapy interventions. Attendance of follow-up appointments is essential, as non-attendance has negative implications for both the patient and the healthcare facility. Methodology: This retrospective, cross-sectional study made use of a period sample of all outpatients with scheduled appointments between January and December 2017 (n = 837) at the Western Cape Rehabilitation Centre (WCRC). Children under the age of 18 years were excluded. Descriptive statistics were used to describe the identified variables of the sample. Logistic regression was used to determine the adjusted odds ratio for the association between non-attendances and identified covariates. Results: The sample population of 837 patients, included 516 attenders and 321 non-attenders. Factors that had an association with non-attendance included hospital classification, diagnostic category and impairment according to ICD 10 coding (p ≤ 0.05). Conclusion: This article describe factors associated with non-attendance of outpatients to scheduled occupational therapy and physiotherapy appointments at the WCRC. Further research is needed to determine the reasons for non-attendance at institutions such as WCRC which will assist in the implementation of strategies to reduce high non-attendance rates.
- ItemOccupation based hand therapy in the South African context : challenges and opportunities(Occupational Therapy Association of South Africa, 2016) De Klerk, Susan; Badenhorst, Elretha; Buttle, Amy; Mohammed, Fairuz; Oberon, JeanetteOccupation-based hand therapy (OBHT) is an approach to practice that integrates multiple frames of reference, while remaining rooted in an occupational therapy perspective. There are a number of benefits and challenges that have been recognised in hand therapy settings. The use of an occupation-based approach in the field of hand therapy is of interest to all occupational therapists practising in this field. This commentary explores the challenges and opportunities of OBHT as an approach in the assessment and treatment of clients with hand conditions in the South African context. The authors describe OBHT, explore the barriers in practice and propose guidelines for such an approach in our context. Recommendations are made to enhance the understanding and practice of an OBHT approach in everyday hand therapy practice within South Africa.
- ItemOccupational therapists’ views on core competencies that graduates need to work in the field of neurology in a South African context(2020-03) Jacobs-Nzuzi Khuabi, Lee-Ann; Bester, JuanitaBACKGROUND: The burden of neurologically related conditions in South Africa (SA) necessitates that undergraduate occupational therapy education and training provide students with core competencies to deliver comprehensive, effective client-centred interventions. Given developments in the practice of neurology and changes in policy, funding and infrastructure, it is essential that training remains relevant and responsive to the needs of individuals and their context. Occupational therapists should be in touch with the local context and its challenges and consider the practicalities of the suggested interventionsOBJECTIVES: To explore occupational therapists' perspectives on the knowledge, skills and attitudes that graduates need to work in the field of neurologyMETHODS: An explorative qualitative study consisting of semi-structured interviews was conducted with 10 occupational therapists in Western Cape Province, SA. Data were analysed using inductive analysisRESULTS: Four themes emerged from the findings, including foundational knowledge and skills, intra- and interpersonal attitudes, suggestions to consider when revising a neurology curriculum and resource constraintsCONCLUSIONS: This study highlighted that, in addition to neurology-specific skills, graduates also require core generic knowledge, skills and attitudes that address the evolving needs of society. These competencies are further necessary to allow graduates to work within the constraints of the health and educational systems
- ItemOccupational therapy hand assessment practices : cause for concern?(Occupational Therapy Association of South Africa, 2015-08) De Klerk, Susan; Buchanan, Helen; Pretorius, BlancheIntroduction: Assessment is critical for measuring improvement, or lack thereof, and demonstrating the outcome of intervention. In response to the lack of research in this area, this study aimed to determine the assessment practices of occupational therapists working with clients with hand conditions. Methods: A quantitative cross sectional survey design was used. A convenience sample of occupational therapists was recruited from five provinces. Respondents completed a questionnaire developed for the study that comprised demographic information, assessments used, frequency of use and factors influencing assessment choice. Data were analysed with Statistica version 11. Results: Eighty-one respondents (n=114) completed questionnaires representing a 71% response rate. Goniometry (84.0%), manual muscle testing (76.5%) and testing for flexor tendon function (76.3%) were used most frequently. The most common reasons for not using assessments were lack of availability and unfamiliarity. Conclusion: It is of concern that the assessment practices of participants in this study focussed primarily on the assessment of body function and structure with few therapists using activity and participation measures. This could seriously limit the evidence needed to verify the outcomes achieved through occupational therapy intervention in the treatment of hand conditions.
- ItemOccupational therapy intervention intosteo-arthritis of the carpometacarpal joint of the thumb in the South African context(Occupational Therapy Association of South Africa, 2017) Teuchert, Robyn Michelle; De Klerk, Susan; Kotze, Marianne; Nieuwoudt, Hester Cecilia; Otero, Manja; Van Zyl, NicolaIntroduction: The carpometacarpal joint (CMCJ) plays a pivotal role in thumb function and essentially, hand function. Investigation concerning the most preferable occupational therapy treatment approach for osteoarthritis (OA) of the CMCJ was therefore indicated. Factors that affect the course of treatment in the South African context were to be identified. Methodology: A descriptive qualitative research design was implemented with a purposive sample of occupational therapists in the Western Cape. Semi-structured interviews were held. These were transcribed and analysed. Results: A fixed treatment regimen was not followed by participants of the study. Factors contributing to the choice of treatment emerged from the data. These included the source of the referral, aspects of the OT process and the patient. Results demonstrated that it would not be practical to set up a rigid regimen, due to the diverse nature by which OA of the CMCJ presents in patients as well as the contributing factors participants reported to impact intervention. Discussion: The compilation of a basic guideline is proposed. Each phase of the occupational therapy process according to the stage of OA of the CMCJ should be included to provide meaningful intervention. A proposed guideline is presented based on the results of the study.
- ItemThe rehabilitation programme and functional outcomes of persons with lower limb amputations at a primary level rehabilitation centre(Occupational Therapy Association of South Africa, 2013-12) Fredericks, Jerome P.; Visagie, SuronaThe study aimed to evaluate the amputation rehabilitation programme offered at an out-patient rehabilitation centre. Amputations have a severe physical, psychological and socio- economic impact. Effective rehabilitation can assist the individual in dealing with these. A quantitative, descriptive design was implemented. Thirty amputees who received rehabilitation and the therapists working at the centre participated in the study. An International classification of Function, Disability and Health based questionnaire, folder audit form and interview schedules were used for data collection. No programme vision, mission or objectives could be identified. Rehabilitation focused on impairment. The impact of prosthetic rehabilitation on in and outdoor activities requiring mobility was statistically significant, with p values ranging from 0.00069 to 0.037.`No indoor mobility training` had a negative impact on lifting and carrying objects (p 0.011), standing up (p = 0.042), getting around inside the house (p = 0.00023), picking up objects from the floor (p = 0.00068), getting up from the floor (p = 0.0072), getting out of the house (p = 0.0016) and moving around in the yard (0.0013). `Failure to address community mobility` had a statistically significant negative impact on all aspects of community mobility scores except transfers and driving. Recommendations include that a service vision and objectives be developed. In addition services should be evaluated and monitored on an ongoing basis and mentorship provided to therapists.