Joanne Potterton
University of the Witwatersrand, Physiotherapy, Faculty Member
<jats:sec><jats:title>Background/Aims</jats:title><jats:p> Preventative care for people with spinal cord injury is neglected, even though secondary health conditions are prevalent among this group. There is limited... more
<jats:sec><jats:title>Background/Aims</jats:title><jats:p> Preventative care for people with spinal cord injury is neglected, even though secondary health conditions are prevalent among this group. There is limited information on preventative care for secondary health conditions among people with spinal cord injury. This study aimed to explore how people with spinal cord injury prevent and manage secondary health conditions. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A total of 17 individuals with spinal cord injury attending an outpatients clinic at a public rehabilitation hospital were interviewed face to face. All the interviews were transcribed verbatim and analysed using thematic content analysis. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> The participants used different strategies to prevent and manage secondary health conditions, such as medication, assistive devices, self-management, resilience coping strategies and therapeutic approaches. The participants found prevention of secondary health conditions 'challenging' and some of the strategies were ineffective. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Although many strategies are used by people with spinal cord injury to prevent and manage secondary health conditions, the experience is difficult. To minimise the occurrence and the consequence of secondary health conditions among people with spinal cord injury, health professionals must promote and support preventative care for secondary health conditions. </jats:p></jats:sec>
Research Interests:
BACKGROUND Pre-operative neurodevelopmental assessment in children with congenital heart disease may assist in the early identification of children at risk for or presenting with developmental delays. This study determined the... more
BACKGROUND Pre-operative neurodevelopmental assessment in children with congenital heart disease may assist in the early identification of children at risk for or presenting with developmental delays. This study determined the pre-operative neurodevelopmental status of young children undergoing cardiac surgery in central South Africa. Feasibility and clinical value of pre-operative assessment were also evaluated. METHODS Children 30 months and younger, scheduled to undergo cardiac surgery, were recruited into this prospective observational analytical study. Neurodevelopmental status was assessed using the Bayley-III and neuromotor examination. Variables associated with developmental performance were determined using ANOVAs. Sociodemographic and medical information were collected using a self-developed questionnaire. Pre-operative neurodevelopmental assessment was completed for 40 children at a median age of 7.4 months, including 30 children without and 10 with Down syndrome. Mean ca...
Research Interests:
Background The environment where people live, work or play can influence health and disability outcomes. People with spinal cord injury are at risk for secondary health conditions, with this increasing readmission rates and decreasing... more
Background The environment where people live, work or play can influence health and disability outcomes. People with spinal cord injury are at risk for secondary health conditions, with this increasing readmission rates and decreasing quality of life. Studies on preventative care for secondary health conditions and factors influencing the prevention of secondary health conditions are scarce in low to middle-income countries. Aim To explore environmental factors influencing the prevention of secondary health conditions in people with spinal cord injury. Setting This study was based at a public rehabilitation hospital, South Africa. Methods Explorative qualitative design was used. Semi-structured interviews were conducted with 21 therapists, 17 people with a spinal cord injury and six caregivers. The interviews were transcribed verbatim. Analysis was conducted using content analysis. Results The categories that emerged included the impact of social support, inaccessible built environm...
Research Interests:
Research Interests:
Background Secondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI). Studies have reported that SHCs... more
Background Secondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI). Studies have reported that SHCs decrease life expectancy and increase health care costs. Studies on the lived experience of SHCs are, however, limited. Objectives To explore the experiences of SHCs amongst people with SCI in a public rehabilitation hospital in South Africa. Method Face-to-face semi-structured interviews were conducted with people with SCI from August 2018 to July 2019. All interviews were transcribed verbatim and analysed using a content analysis approach. Results Seventeen people with SCI were interviewed. Participants experienced a range of SHCs. The most common experienced SHC was pain (94%). The main theme that emerged from the analysis was ‘the impact of secondary health conditions on health and well-being’. The categories linked to the impact were SHCs co-occurrenc...
Research Interests:
Sub-Saharan Africa has the highest prevalence of children at risk of not achieving their developmental potential, attributable largely to the human immunodeficiency virus (HIV) pandemic coupled with negative environmental factors.... more
Sub-Saharan Africa has the highest prevalence of children at risk of not achieving their developmental potential, attributable largely to the human immunodeficiency virus (HIV) pandemic coupled with negative environmental factors. Childhood developmental stimulation programmes can mitigate adverse outcomes. Neonates testing HIV positive at birth will be initiated on antiretroviral treatment (ART) and receive an age-appropriate stimulation program, updated at 3 monthly intervals through the first year of life. Neurodevelopment at 12 months of age will be assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Outcomes will be compared with HIV-infected and HIV-exposed uninfected children (HEU) not having received the stimulatory intervention. Associations between neurodevelopmental outcomes, environmental factors, and parental stress will be investigated. The study will take place at a single site in Johannesburg, South Africa. This non-randomise...
Background: The healthcare sector requires graduates with the ability to confidently assess and manage the majority of the medical conditions seen in hospitals.Objective: To establish whether the most prevalent medical conditions treated... more
Background: The healthcare sector requires graduates with the ability to confidently assess and manage the majority of the medical conditions seen in hospitals.Objective: To establish whether the most prevalent medical conditions treated by physiotherapists in Gauteng (South Africa) state health facilities align with the University of the Witwatersrand (Wits) physiotherapy curriculum.Methods: This was a retrospective review of condition-related statistics from physiotherapy departments within the Gauteng province state health facilities. Data from all Gauteng government hospitals that had submitted at least 75% of their physiotherapy condition–related statistics to the provincial statistics coordinator from January 2012 to December 2014 were considered and compared to medical conditions covered in the Wits 2015 physiotherapy curriculum to check if all conditions listed in the Gauteng statistics appeared within the Wits curriculum document. The number of teaching hours for the common...
Research Interests:
BACKGROUND HIV is known to cause neurodevelopmental problems in infants and young children. The impact of HIV on the development of preschool-age children has been less well described. METHOD The study was conducted at an urban paediatric... more
BACKGROUND HIV is known to cause neurodevelopmental problems in infants and young children. The impact of HIV on the development of preschool-age children has been less well described. METHOD The study was conducted at an urban paediatric HIV clinic in Johannesburg, South Africa. A sample of convenience was used. Sixty-eight medically stable children between the ages of 3 and 5 years were assessed with the Griffiths Scales of Mental Development. Children were excluded from the study if they had severe HIV encephalopathy, which made it impossible for them to participate in the items on the Griffiths Scales of Mental Development. RESULTS The children had started combination antiretroviral treatment (cART) at a mean age of 8.1 months. The majority of the children were virologically suppressed and did not present with wasting or stunting. Severe overall developmental delay (z-scores < -2SD) was detected in 55.88% of children. Developmental facets related to speech, cognition and perception were the most severely affected. Personal-social development was the least affected with only 13.4% of the children demonstrating severe delay. CONCLUSION Despite having early access to cART, children infected with HIV are still at risk for severe developmental delay across a number of facets. Very early initiation of cART may help alleviate this problem. All preschool children infected with HIV should have routine developmental screening.
Research Interests:
Research Interests:
Neurodevelopmental delay or HIV encephalopathy is a stage four disease indicator for paediatric HIV/AIDS according to the World Health Organisation (WHO), and may be used as a criterion for initiation of highly active antiretroviral... more
Neurodevelopmental delay or HIV encephalopathy is a stage four disease indicator for paediatric HIV/AIDS according to the World Health Organisation (WHO), and may be used as a criterion for initiation of highly active antiretroviral therapy (HAART). To date, the only means of prevention of this condition is early initiation of HAART. Studies which have been carried out in South African clinics have revealed the high prevalence of this condition. In developing countries, commencement of HAART is based on declining virologic and immunologic status, as standardised neurodevelopmental assessment tools are not widely available. A standardised developmental screening tool which is suitable for use in a developing country is therefore necessary in order to screen for neurodevelopmental delay to allow for further assessment and referral to rehabilitation services, as well as providing an additional assessment criterion for initiation of HAART. The infant gross motor screening test (IGMST) was developed for this purpose. The standardisation sample of the IGMST consisted of 112 HIV-infected infants between six and 18 months of age. Item selection for the IGMST was based on the Gross Motor scale of the Bayley Scales of Infant Development (BSID)-III. Content validity was assessed by a panel of experts using a nominal group technique (NGT; agreement &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;80%). Concurrent validity (n=60) of the IGMST was carried out against the BSID-III, and agreement was excellent (K=0.85). The diagnostic properties of the IGMST were evaluated and revealed: sensitivity 97.4%, specificity 85.7%, positive predictive value (PPV) 92.7%, and negative predictive value (NPV) 94.7%. Reliability testing (n=30) revealed inter-rater reliability as: r=1, test-retest reliability: r=0.98 and intra-rater reliability: r=0.98. The results indicate that the statistical properties of the IGMST are excellent, and the tool is suitable for use within the paediatric HIV setting.
Research Interests: Pediatrics, Neurodevelopment, Medicine, Paediatrics, Nominal Group Technique, and 15 moreHumans, Developing Country, Infant Development, Infant, Developmental disabilities, Hiv Infection, Human immunodeficiency virus, Motor Function, Highly Active Antiretroviral Therapy, Assessment Tool, AIDS Dementia Complex, AIDS care, Neuropsychological Tests, Negative predictive value, and mass Screening
Paediatric HIV remains a major challenge in Sub-Saharan Africa. Paediatric HIV is a multi-generational disorder with far-reaching implications for the whole family. Parenting stress in caregivers of HIV infected children has been studied... more
Paediatric HIV remains a major challenge in Sub-Saharan Africa. Paediatric HIV is a multi-generational disorder with far-reaching implications for the whole family. Parenting stress in caregivers of HIV infected children has been studied in developed countries but never in South Africa. The aim of this study was to determine the extent of parenting stress in caregivers of children infected with HIV in South Africa. Further objectives were to monitor the levels of stress over one year after caregivers started attending a paediatric HIV clinic and to ascertain what factors were predictive of a decrease in parenting stress over that time. One hundred and twenty two caregiver and children dyads were recruited into this study. Caregivers completed the Parenting Stress Index/ Short form at baseline and after six and 12 months. Demographic information was collected and the children's heights, weights and CD4 counts were recorded at each visit. The families that participated in this stu...
Research Interests:
Background Across the lifespan, people with spinal cord injury (SCI) may experience preventable secondary health conditions (SHCs) such as pressures sores, muscle spasms and urinary tract infections (UTIs). Some factors influencing... more
Background Across the lifespan, people with spinal cord injury (SCI) may experience preventable secondary health conditions (SHCs) such as pressures sores, muscle spasms and urinary tract infections (UTIs). Some factors influencing prevention of SHCs include social support, poor access to care and the prevention style of individuals. There is limited research on these factors. Objective To explore personal factors influencing the prevention of SHCs in people with SCI. Method An explorative qualitative study included participants recruited in an outpatient department at a rehabilitation hospital. Semi-structured interviews were conducted with patients with SCI. Interviews were transcribed verbatim. Data analysis was conducted using content analysis. Results Seventeen individuals with SCI were interviewed. From the interview analysis, six personal factors were identified, namely, socio-economic status; mental well-being (forgetfulness, beliefs, attitude); lack of knowledge of SHCs and...
Research Interests:
Background. The Department of Physiotherapy at the University of the Witwatersrand, Johannesburg, South Africa has a programme that allows 4th-year physiotherapy students to experience learning about public health in a rural setting. This... more
Background. The Department of Physiotherapy at the University of the Witwatersrand, Johannesburg, South Africa has a programme that allows 4th-year physiotherapy students to experience learning about public health in a rural setting. This experience is assessed using a portfolio. To date, the portfolios have only been assessed in terms of the students achieving the learning objectives. The process has not been evaluated for its effectiveness in promoting a reflective learner. A reflective learner is considered as one who will develop critical thinking and better accountability for their own learning. Objective. To analyse the level of reflective practice attained by the students. Methods. A qualitative approach was used to analyse evidence of reflective practice in student reflective diaries. Guided content analysis, using a framework compiled from the literature, was used to code the data. The coding framework outlined the levels of reflective practice – from the lowest level, iden...
Background. As children with perinatally acquired HIV (PHIV) are living longer, long-term physical sequelae of the disease are becoming more pertinent. Muscle strength is known to be adversely affected in adults infected with HIV but... more
Background. As children with perinatally acquired HIV (PHIV) are living longer, long-term physical sequelae of the disease are becoming more pertinent. Muscle strength is known to be adversely affected in adults infected with HIV but little is known about the muscle strength of children with PHIV. Objectives. To determine the muscle strength of children perinatally infected with HIV compared with an uninfected control group. Associations between clinical and anthropometric variables and muscle strength were investigated. Methods. In this cross-sectional descriptive study, 175 children who acquired HIV perinatally and 171 children who were HIV-uninfected had their muscle strength assessed by hand-held dynamometry and the ‘make test’. Clinical data were extracted from the children’s clinic files. Height and weight were assessed using a stadiometer and a digital scale, respectively. Children were between the ages of 5 and 11 years of age at assessment. The children living with HIV had ...
Research Interests:
Research Interests:
Research Interests:
The presence of developmental delay in children who are HIV positive has been well described. International studies have identified 25 - 40% of HIV infected infants to have developmental delay. This study aimed to establish the... more
The presence of developmental delay in children who are HIV positive has been well described. International studies have identified 25 - 40% of HIV infected infants to have developmental delay. This study aimed to establish the prevalence of developmental delay in HIV positive infants in South Africa.The study was conducted at Coronation Hospital, Gauteng, South Africa. Infants under 12 months of age attending an out-patient follow-up clinic were assessed for developmental delay using the Neurodevelopment Assessment Score. Informed written consent was obtained from the caregivers prior to assessment. The results from 30 HIV positive and 30 HIV negative infants were analysed. Descriptive analyses were used to analyse most of the data. Data were summarised using means for continuous variables and frequencies and proportions for categorical variables. The two groups were well matched for age, weight and socio-economic status. Forty percent of the HIV positive sample presented with de...
Research Interests:
ABSTRACT With the success of evolving cART, HIV has become a chronic condition, however, children vertically infected with HIV have been shown to have developmental difficulties and disabilities. This study aimed to investigate the... more
ABSTRACT With the success of evolving cART, HIV has become a chronic condition, however, children vertically infected with HIV have been shown to have developmental difficulties and disabilities. This study aimed to investigate the prevalence of disabilities among a group of HIV infected children in South Africa and whether they are being referred to and accessing support services. A cross-sectional study was conducted at a paediatric HIV clinic in Johannesburg. Parents were interviewed about their child using the Ten Question Screen for Disability questionnaire along with a follow-up questionnaire. Data from the child’s clinic file were recorded. Of the 200 children whose parents were interviewed, 50.5% experienced disabilities, where 58.4% of those had more than one co-existing disability. The most commonly reported disabilities were, developmental delay (27%), cognitive and behaviour difficulties (21%), communication difficulties (17%) and physical disabilities (13%). Of the children who reported disability only 46% had been referred to one or more of the following support services; Audiologist, Occupational Therapist, Physiotherapist, Psychologist and/or Speech and Language Therapist. A history of low birth-weight, tuberculosis, lower respiratory tract infections and low pre-ART CD4% were found to be factors associated with the presence of developmental difficulty and/or delay. The prevalence of disability in children infected with HIV is high and these children are not being referred to and/or accessing the appropriate support services. Government policy and clinic practice need to shift the focus of management of children with HIV, to integrate services that can assist with developmental potential and quality-of-life.
Research Interests: Psychology and Medicine
Paediatric HIV is a major cause of morbidity and mortality in South African children. Physiotherapists working in the government sector are seeing large numbers of HIV infected children on a daily basis. This paper provides a general... more
Paediatric HIV is a major cause of morbidity and mortality in South African children. Physiotherapists working in the government sector are seeing large numbers of HIV infected children on a daily basis. This paper provides a general overview of paediatric HIV. Common conditions associated with HIV infection are highlighted and the possible role of physiotherapy is discussed. Suggestions for research on the role of physiotherapy in the management of children with HIV are made.
Research Interests:
The purpose of this study was to explore the effects of isometric exercises and stretching on postural stability in Non – Insulin Dependent Diabetes Mellitus (NIDDM) patients with diffuse symmetrical sensory motor neuropathy. Patients... more
The purpose of this study was to explore the effects of isometric exercises and stretching on postural stability in Non – Insulin Dependent Diabetes Mellitus (NIDDM) patients with diffuse symmetrical sensory motor neuropathy. Patients were assigned to an experimental group and amatched control group. The experimental group received isometric exer-cises and stretching three times weekly for 12 weeks in addition to routine medication and dietary advice. A t the end of this period, this group wascompared with the control group, which received routine medication anddietary advice only. Measurements of muscle strength of quadriceps, ham-strings, ankle plantar and dorsiflexors, and Romberg’s test for postural sta-bility were carried out before and after the 12 weeks intervention. The study showed that isometric exercises and stretching for the lower extremities improved postural stability (p = 0.00)and strength of the quadriceps (p = 0.001) hamstrings (p = 0.001) dorsiflexors (p = 0.001) pl...
Research Interests:
The effects of paediatric HIV on the respiratory system are seen daily in paediatric wards. The nature of respiratory disease and the needs of HIV-positive patients have changed subsequent to the introduction of anti-retrovirals to South... more
The effects of paediatric HIV on the respiratory system are seen daily in paediatric wards. The nature of respiratory disease and the needs of HIV-positive patients have changed subsequent to the introduction of anti-retrovirals to South Africa in 2004. One hundred and twenty-five children admitted to the paediatric wards under the age of seven years were recruited for this study. The purpose of this study was to understand the disease profile of children with HIV/AIDS, their health status, presenting respiratory conditions, and need for chest physiotherapy. The most common respiratory conditions included bacterial pneumonia (66.4%), tuberculosis (48%) and pneumocystis jirovecii pneumonia (23.2%) (n=125). Two thirds of the children (68.8%) presented with a high burden of disease. Forty percent (40.8%) of the children were taking anti-retrovirals with an average length of use of 9.81 months (±SD=11.61). Analysis of immune status revealed a mean CD4 percentage of 17.33% (±SD=10.96), C...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Correspondence Author: Joanne Potterton PhD Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown 2193 Johannesburg, South Africa Email: Joanne.potterton@wits.ac.za ABSTRACT:... more
Correspondence Author: Joanne Potterton PhD Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown 2193 Johannesburg, South Africa Email: Joanne.potterton@wits.ac.za ABSTRACT: Paediatric HIV remains a significant health and social challenge in sub-Saharan Africa despite many countries gaining improved access to antiretroviral treatment. Paediatric HIV affects multiple body systems and has the potential to cause wide ranging impairments as well as activity and participation limitations. The aim of this paper is to highlight some of the impairments that remain, despite the children having access to better medical care, in order to establish a possible role for physiotherapists. Nine studies conducted through the department of physiotherapy at the University of the Witwatersrand, South Africa are presented. The results of these studies demonstrate the neurodevelopmental, musculoskeletal, respiratory and quality of life challenges ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Background: The popularity of video game use in burns rehabilitation has grown because, in addition to facilitating maintenance of range of motion (ROM), the virtual imaging characteristics of these games provide distraction from... more
Background: The popularity of video game use in burns rehabilitation has grown because, in addition to facilitating maintenance of range of motion (ROM), the virtual imaging characteristics of these games provide distraction from pain.Objectives: The effect of using Xbox Kinect™ as an adjunct to physiotherapy in a Paediatric Burns Unit (PBU) has not been established. This study aimed to investigate the effect of using the Xbox Kinect™ on outcomes of children in the PBU at Chris Hani Baragwanath Academic Hospital.Methods: This non-equivalent, post-test only control group study took place over a period of 14 months. The control group received standard physiotherapy management and the experimental group received standard physiotherapy management and additional Xbox Kinect™. Outcome measures were ROM, Activities Scale for Kids (ASK©p) and a modified Wong-Baker FACES® enjoyment rating scale. Outcomes were assessed at discharge and then 1 week post-discharge at the usual follow-up appoint...
Background: Participating in postgraduate study is daunting and as yet there is a dearth of literature on what students’ experiences are when obtaining their Master’s degree in Physiotherapy.Objectives: The aim of this study was to gain... more
Background: Participating in postgraduate study is daunting and as yet there is a dearth of literature on what students’ experiences are when obtaining their Master’s degree in Physiotherapy.Objectives: The aim of this study was to gain insight into the perceived barriers and facilitators in completing a Master’s degree in Physiotherapy.Method: Semi-structured, in-depth interviews were conducted with 10 physiotherapists who had completed a Master’s degree in Physiotherapy from a university in South Africa, representative of coursework and dissertation Master’s degrees, completed within the stipulated time period as well as taking longer to complete the degree. The topics covered a range of speciality areas. The interviews were transcribed, sent for member checking and analysed thematically.Results: Within 10 interviews data saturation was reached. Two themes were identified: research environment and support, both of which were seen as either a facilitator or a barrier, depending on ...
This study sets out to establish the epidemiology of cerebral palsy in the drought stricken Giyani district in the Northern Province. Seventy-nine children with cerebral palsy were assessed at Nkhensani hospital. The cause and type of... more
This study sets out to establish the epidemiology of cerebral palsy in the drought stricken Giyani district in the Northern Province. Seventy-nine children with cerebral palsy were assessed at Nkhensani hospital. The cause and type of cerebral palsy were established as well as the main concerns of the parents. Thirty-two percent of cerebral palsy was found to be due to postnatal causes, which may be attributed to the prevalence of meningitis and gastroenteritis. Only sixteen percent of the children had diplegia, which is in keeping with findings in other third world countries. Major concerns expressed by the parents included issues of education and institutionalisation as facilities for children with disabilities in this area are inadequate. An obvious need exists to impart neuro-developmental skills to therapy assistants and to parents who play the biggest role in managing children with cerebral palsy in the Northern Province.
Background: Caregivers of children with cerebral palsy (CP) are at risk of having high stress levels and poor quality of life (QOL) which could have a detrimental effect on themselves and their children. Taking caregivers’ well-being into... more
Background: Caregivers of children with cerebral palsy (CP) are at risk of having high stress levels and poor quality of life (QOL) which could have a detrimental effect on themselves and their children. Taking caregivers’ well-being into consideration is therefore important when providing rehabilitation to children with CP. Interventions to mediate primary caregiver stress and QOL using an educational tool have not been tested in this population in South Africa.Objectives: The aim of this study was to determine the effect of a group-based educational intervention, Hambisela, on stress levels and QOL of primary caregivers of children with CP in Mamelodi, a township in Gauteng, South Africa.Method: Eighteen primary caregivers of children with CP participated in a quasi-experimental pretest–post-test pilot study. Hambisela, a group-based educational intervention, was carried out once a week over 8 consecutive weeks. Caregiver stress and QOL were assessed before and after the intervent...