I am an associate professor and head of the physiotherapy Department at the University of Pretoria. My qualifications include BSc Physiotherapy (1986), Diploma in Tertiary Education (1995) Masters in Physiotherapy (1999), PhD in Rehabilitation (2011) and the Program for academic Leadership (2012). My research interests are spinal cord injury (SCI) rehabilitation and physiotherapy education, specifically research and clinical education. I have numerous congress presentations and publications in these areas, and have produced a number of masters and PhD students and graduates in these areas (currently supervising 4 PhD and 3 masters). I have also examined numerous postgraduate research thesis and dissertations in the field of SCI rehabilitation and general rehabilitation. As a physiotherapist, I am long standing member (more than 36 years) of the South African Society of Physiotherapy (SASP). I have served the physiotherapy profession in South Africa, Africa (WCPT Africa) and the World (WCPT) in various positions for more than 25 years
Background: Pain after spinal cord injury (SCI) is common, and physiotherapy plays a pivotal role... more Background: Pain after spinal cord injury (SCI) is common, and physiotherapy plays a pivotal role in alleviating pain for people with SCI.Objective: To determine the modalities that physiotherapists in South Africa use to treat SCI-related pain and the factors that guide the selection of treatment modalities.Method: A quantitative, cross-sectional design using a self-developed online survey was distributed to physiotherapists belonging to the South African Society of Physiotherapy and the Physiotherapy Association of South Africa. Data were analysed using SPSS v26, where descriptive data were analysed using frequency, percentages, means and standard deviations, and Fisher’s exact tests for inferential analyses. Open-ended questions underwent thematic analysis.Results: Forty-six responses were received. The most-used modalities were transcutaneous electrical nerve stimulation (29.8%), exercises (27.7%) and joint mobilisations (29.8%). Most physiotherapists used standardised measureme...
Background: Pain after spinal cord injury (SCI) is common and is likely to continue throughout li... more Background: Pain after spinal cord injury (SCI) is common and is likely to continue throughout life with varying levels of severity.Objective: To determine the presence of pain, the sociodemographic and injury profile of community-dwelling manual wheelchair users.Method: This quantitative correlational study used a sociodemographic and injury profile sheet and the Douleur Neuropathique 4 Questions (DN4) questionnaire to document demographic, SCI profiles as well as pain characteristics. Pain severity was determined using the Numeric Rating Scale. Data were analysed using the Statistical Package for the Social Sciences (SPSS) v27 at 0.05 level of significance.Results: The pain rate was 104; 85% of 122 participants and mainly in those with complete SCI (77.9%). Neuropathic pain was more common (76; 62.5%) and significantly associated (p 0.05) with higher pain severity. Pain was mainly in one area of the body (59; 48.4%) but occurring in up to five areas. The most painful area had a me...
Background: The development of secondary health conditions (SHCs) after spinal cord injury (SCI) ... more Background: The development of secondary health conditions (SHCs) after spinal cord injury (SCI) is common and can affect an individual’s emotional well-being, and his or her health-related quality of life (QOL). Little is known about relationships between performing health-benefiting behaviours and the presence (or absence) of SHCs and QOL, particularly in South Africa.Objectives: This research study was conducted in order to determine the associations between health behaviour, SHCs and QOL in people with SCI (PWSCI).Method: This cross-sectional study included 36 PWSCI discharged from a private rehabilitation facility in Pretoria, South Africa. The PWSCI completed questionnaires pertaining to lifestyle, independence, presence of SHCs, social support and QOL. Data were analysed using descriptive and inferential statistics such as correlation tests and chi-square test of independence (x2) using the SPSS v25. Moderate, moderately high and high correlations are reported (Pearson r ≥ 0....
Purpose: The focus of this retrospective review paper is toexplore and analyse pedagogic research... more Purpose: The focus of this retrospective review paper is toexplore and analyse pedagogic research development in physiotherapy education in South Africa.Methods: A content analysis of publications by educators in the SA Journal of Physiotherapy between 1989 and 2003 was conducted to identify and classify the pedagogic articles. Further analysis of physiotherapy education articles was performed to determine the primary foci of the education research, using a three- dimensional pedagogic outcomes research framework.Data analysis: Descriptive statistics in terms of frequencies, means and percentages was used for the analysis. Results: The results revealed that most of the educators’ articles focused on clinical practice. Only 23% of the articles were about education and the majority of those were on clinical education (72%), with few articles on curriculum issues and teaching methods. Conclusion: The research focus of South African Physiotherapy educators is more on the clinical practi...
This paper is written in honor of the memory of the late Jules Rothstein, editor in chief “emerit... more This paper is written in honor of the memory of the late Jules Rothstein, editor in chief “emeritus” of the Physical Therapy (the journal of the American Physical Therapy Association - APTA) who passed away on the 27-08-2005. It is fitting to dedicate a paper on disability to Dr. Rothstein, as he himself likened disability with the identity of physiotherapy. A paper focusing on disability at this time might be the wake up call needed to make physiotherapists heed the African decade of the disabled person, which is more than halfway through. The paper highlights the problem of sparse evidence in rehabilitation and emphasizes the need for an evidence-based approach to rehabilitation. Practical suggestions for the implementation of EBP in rehabilitation using the International Classification of Functioning, Disability (ICF) as a framework are proposed. This paper is envisaged to enthuse rehabilitation physiotherapists to embrace EBP, so that their focus is redirected to the ‘eradicat...
The evaluation of rehabilitation outcomes requiresmeasurementinstruments that are valid and relia... more The evaluation of rehabilitation outcomes requiresmeasurementinstruments that are valid and reliable, and have been psychometricallytested in the context of a particular population. The purpose ofthis study was to psychometrically test the validity and reliability of theReintegration to Normal Living Index (RNLI) as a measure of communityreintegration in a population of community-dwelling people living withspinal cord injury (PLWSCI) in South Africa.The study was a cross-sectional, involving community dwelling peopleliving with SCI (PLWSCI), who had been discharged from inpatient rehabilitation at for at least two years. RNLI datacollected from 160 PLWSCI were subjected to factor analysis and tested for reliability using chronbach’s alpha.Cronbach’s alpha for the RNLI instrument was 0.97 (ICC 95% CI: 0.97 – 0.98), indicating an excellent reliabilitycoefficient. A single -factor structure emerged from principal components analysis, indicating that there is onlyone factor structure fo...
IntroductionApproximately 80% of people with spinal cord injury experience clinically significant... more IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medic...
OBJECTIVE This scoping review will identify complementary alternative medicine methods used to ma... more OBJECTIVE This scoping review will identify complementary alternative medicine methods used to manage spinal cord injury-related pain. INTRODUCTION Spinal cord injury-related pain is common, with a third of individuals experiencing severe pain. Conventional interventions are well documented, however, pain relief remains elusive for people with spinal cord injuries. Although complementary alternative medicine is available to alleviate various health problems, little is known about the complementary alternative medicine methods used to manage pain in people with spinal cord injuries. INCLUSION CRITERIA This review will consider all studies on complementary alternative medicine treatment methods used by adults with spinal cord injury to treat their associated pain. The concept of interest in this study is complementary alternative medicine. Quantitative, qualitative, and mixed methods studies, text and opinion papers as well as systematic reviews will be included in this review. METHODS A three-step search strategy, consisting of an initial limited search, a full search, and a screening of the reference lists of all included articles will be undertaken. Key information sources to be searched include CINAHL, Cochrane Library, JBI Evidence Synthesis, MEDLINE, Scopus, Web of Science, DynaMed, Natural Medicines, HerbMed, Open Dissertations, and OpenGrey. All titles and abstracts of identified citations will be screened and then uploaded to a reference management program. The full text of studies potentially meeting the inclusion criteria will be assessed in detail, and relevant data will be extracted and reported in tabular format, in line with the objectives and scope of the review.
Background: Pain after spinal cord injury (SCI) is common, and physiotherapy plays a pivotal role... more Background: Pain after spinal cord injury (SCI) is common, and physiotherapy plays a pivotal role in alleviating pain for people with SCI.Objective: To determine the modalities that physiotherapists in South Africa use to treat SCI-related pain and the factors that guide the selection of treatment modalities.Method: A quantitative, cross-sectional design using a self-developed online survey was distributed to physiotherapists belonging to the South African Society of Physiotherapy and the Physiotherapy Association of South Africa. Data were analysed using SPSS v26, where descriptive data were analysed using frequency, percentages, means and standard deviations, and Fisher’s exact tests for inferential analyses. Open-ended questions underwent thematic analysis.Results: Forty-six responses were received. The most-used modalities were transcutaneous electrical nerve stimulation (29.8%), exercises (27.7%) and joint mobilisations (29.8%). Most physiotherapists used standardised measureme...
Background: Pain after spinal cord injury (SCI) is common and is likely to continue throughout li... more Background: Pain after spinal cord injury (SCI) is common and is likely to continue throughout life with varying levels of severity.Objective: To determine the presence of pain, the sociodemographic and injury profile of community-dwelling manual wheelchair users.Method: This quantitative correlational study used a sociodemographic and injury profile sheet and the Douleur Neuropathique 4 Questions (DN4) questionnaire to document demographic, SCI profiles as well as pain characteristics. Pain severity was determined using the Numeric Rating Scale. Data were analysed using the Statistical Package for the Social Sciences (SPSS) v27 at 0.05 level of significance.Results: The pain rate was 104; 85% of 122 participants and mainly in those with complete SCI (77.9%). Neuropathic pain was more common (76; 62.5%) and significantly associated (p 0.05) with higher pain severity. Pain was mainly in one area of the body (59; 48.4%) but occurring in up to five areas. The most painful area had a me...
Background: The development of secondary health conditions (SHCs) after spinal cord injury (SCI) ... more Background: The development of secondary health conditions (SHCs) after spinal cord injury (SCI) is common and can affect an individual’s emotional well-being, and his or her health-related quality of life (QOL). Little is known about relationships between performing health-benefiting behaviours and the presence (or absence) of SHCs and QOL, particularly in South Africa.Objectives: This research study was conducted in order to determine the associations between health behaviour, SHCs and QOL in people with SCI (PWSCI).Method: This cross-sectional study included 36 PWSCI discharged from a private rehabilitation facility in Pretoria, South Africa. The PWSCI completed questionnaires pertaining to lifestyle, independence, presence of SHCs, social support and QOL. Data were analysed using descriptive and inferential statistics such as correlation tests and chi-square test of independence (x2) using the SPSS v25. Moderate, moderately high and high correlations are reported (Pearson r ≥ 0....
Purpose: The focus of this retrospective review paper is toexplore and analyse pedagogic research... more Purpose: The focus of this retrospective review paper is toexplore and analyse pedagogic research development in physiotherapy education in South Africa.Methods: A content analysis of publications by educators in the SA Journal of Physiotherapy between 1989 and 2003 was conducted to identify and classify the pedagogic articles. Further analysis of physiotherapy education articles was performed to determine the primary foci of the education research, using a three- dimensional pedagogic outcomes research framework.Data analysis: Descriptive statistics in terms of frequencies, means and percentages was used for the analysis. Results: The results revealed that most of the educators’ articles focused on clinical practice. Only 23% of the articles were about education and the majority of those were on clinical education (72%), with few articles on curriculum issues and teaching methods. Conclusion: The research focus of South African Physiotherapy educators is more on the clinical practi...
This paper is written in honor of the memory of the late Jules Rothstein, editor in chief “emerit... more This paper is written in honor of the memory of the late Jules Rothstein, editor in chief “emeritus” of the Physical Therapy (the journal of the American Physical Therapy Association - APTA) who passed away on the 27-08-2005. It is fitting to dedicate a paper on disability to Dr. Rothstein, as he himself likened disability with the identity of physiotherapy. A paper focusing on disability at this time might be the wake up call needed to make physiotherapists heed the African decade of the disabled person, which is more than halfway through. The paper highlights the problem of sparse evidence in rehabilitation and emphasizes the need for an evidence-based approach to rehabilitation. Practical suggestions for the implementation of EBP in rehabilitation using the International Classification of Functioning, Disability (ICF) as a framework are proposed. This paper is envisaged to enthuse rehabilitation physiotherapists to embrace EBP, so that their focus is redirected to the ‘eradicat...
The evaluation of rehabilitation outcomes requiresmeasurementinstruments that are valid and relia... more The evaluation of rehabilitation outcomes requiresmeasurementinstruments that are valid and reliable, and have been psychometricallytested in the context of a particular population. The purpose ofthis study was to psychometrically test the validity and reliability of theReintegration to Normal Living Index (RNLI) as a measure of communityreintegration in a population of community-dwelling people living withspinal cord injury (PLWSCI) in South Africa.The study was a cross-sectional, involving community dwelling peopleliving with SCI (PLWSCI), who had been discharged from inpatient rehabilitation at for at least two years. RNLI datacollected from 160 PLWSCI were subjected to factor analysis and tested for reliability using chronbach’s alpha.Cronbach’s alpha for the RNLI instrument was 0.97 (ICC 95% CI: 0.97 – 0.98), indicating an excellent reliabilitycoefficient. A single -factor structure emerged from principal components analysis, indicating that there is onlyone factor structure fo...
IntroductionApproximately 80% of people with spinal cord injury experience clinically significant... more IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medic...
OBJECTIVE This scoping review will identify complementary alternative medicine methods used to ma... more OBJECTIVE This scoping review will identify complementary alternative medicine methods used to manage spinal cord injury-related pain. INTRODUCTION Spinal cord injury-related pain is common, with a third of individuals experiencing severe pain. Conventional interventions are well documented, however, pain relief remains elusive for people with spinal cord injuries. Although complementary alternative medicine is available to alleviate various health problems, little is known about the complementary alternative medicine methods used to manage pain in people with spinal cord injuries. INCLUSION CRITERIA This review will consider all studies on complementary alternative medicine treatment methods used by adults with spinal cord injury to treat their associated pain. The concept of interest in this study is complementary alternative medicine. Quantitative, qualitative, and mixed methods studies, text and opinion papers as well as systematic reviews will be included in this review. METHODS A three-step search strategy, consisting of an initial limited search, a full search, and a screening of the reference lists of all included articles will be undertaken. Key information sources to be searched include CINAHL, Cochrane Library, JBI Evidence Synthesis, MEDLINE, Scopus, Web of Science, DynaMed, Natural Medicines, HerbMed, Open Dissertations, and OpenGrey. All titles and abstracts of identified citations will be screened and then uploaded to a reference management program. The full text of studies potentially meeting the inclusion criteria will be assessed in detail, and relevant data will be extracted and reported in tabular format, in line with the objectives and scope of the review.
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