Browsing by Author "Burger, Marlette"

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    The 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, Marlette
    The 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).
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    Effect of corticosteroid injections versus physiotherapy on pain, shoulder range of motion and shoulder function in patients with subacromial impingement syndrome : a systematic review and meta-analysis
    (AOSIS Publishing, 2016) Burger, Marlette; Africa, Carly; Droomer, Kara; Norman, Alexa; Pheiffer, Chloe; Gericke, Anrich; Samsodien, Adeeb; Miszewski, Natasha
    Background: Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain. Limited research has been conducted into the efficacy of corticosteroid injections (CSIs) compared to physiotherapy in the management of SIS. Objective: To critically appraise and establish the best available evidence for the effectiveness of CSI in comparison with physiotherapy for the management of pain, shoulder range of motion (ROM) and shoulder function in patients with SIS. Methodology: Seven databases were searched from inception to February 2016, namely PubMed, Science Direct, EBSCO Host: SPORTDiscus, EBSCO Host: CINAHL, Cochrane, Scopus and PEDro. The main search terms were shoulder impingement syndrome and/or subacromial impingement syndrome, corticosteroid injections and/or steroid injections, physical therapy and/or physiotherapy. Only randomised controlled trials (RCTs) were considered for inclusion. The articles were appraised according to the PEDro scale. The Revman© Review Manager Software was used to combine the results of shoulder function and the data were illustrated in forest plots. Results: The PEDro scores of the three RCTs that qualified for this review ranged from 7 to 8/10. There is Level II evidence suggesting that besides a significant improvement in shoulder function in favour of CSI at 6–7 weeks follow-up (p < 0.0001), no evidence was found for the superiority of CSIs compared with physiotherapy for pain, ROM and shoulder function in the short- (1–3 months), mid- (6 months) and long term (12 months). Conclusion: In patients with SIS only a short term significant improvement in shoulder function was found in favour of CSIs.
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    The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis : a systematic review and meta-analysis
    (AOSIS, 2019) Burger, Marlette; Coetzee, Wilna; Du Plessis, Lenka Z.; Geldenhuys, Larissa; Joubert, Francois; Myburgh, Elzanne; Van Rooyen, Chante; Vermeulen, Nicol
    Background: Adolescent idiopathic scoliosis (AIS) is one of the most common structural spinal deformities in adolescents, becoming apparent around the time of puberty. Schroth scoliosis-specific exercises have demonstrated promising results in reducing the progression of AIS. Objectives: The aim of this study was to identify, critically appraise and establish the best available evidence for the effectiveness of Schroth exercises in comparison to non-surgical management to reduce the progression of AIS. Methodology: Seven databases were searched in April 2018. Main key search terms included AIS, Schroth exercises, physiotherapy, exercise, electrical stimulation, yoga, Pilates, tai chi and bracing. The quality of the trials was critically appraised according to the PEDro scale. Revman© Review Manager Software was used to pool the quality of life (QOL) results. Results: Four randomised control trials with an average PEDro score of 6.75/10 were included in this study. Results indicated that Schroth exercises had a significant effect in decreasing the Cobb angle (p < 0.05) in comparison to non-surgical management. The pooled effect on QOL showed a significant result in favour of Schroth exercises at 12 weeks (p < 0.002) and at 24 weeks (p < 0.0004). Conclusion: Level II evidence suggests that Schroth exercises have a significant effect on reducing the Cobb angle and improving QOL in adolescents with idiopathic scoliosis. Clinical implications: This review’s findings should be considered with caution for physiotherapy practice because of the limited number of identified articles and their methodologic limitations. Based on the current available and limited evidence, clinicians could combine supervised Schroth exercises with conventional physiotherapy care (observation, exercise, bracing and manual therapy) when treating adolescents with idiopathic scoliosis.
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    Functional outcome of stroke inpatients according to human immunodeficiency virus status : a feasibility study
    (AOSIS, 2020) Hartley, Tasneem; Burger, Marlette; Esterhuizen, Tonya M.; Inglis-Jassiem, Gakeemah
    Background: Stroke in human immunodeficiency virus positive (HIV+) individuals is becoming an increasing concern. Being significantly younger than typical stroke patients, the impact of functional challenges on quality of life and burden on society becomes more eminent. Objectives: This feasibility study aims to determine the requirements for a large descriptive cohort, to adequately describe the functional outcome of stroke patients with varying HIV status. Method: All stroke patients meeting the inclusion criteria were recruited over a 6-month period at a South African inpatient rehabilitation centre. Data were collected on admission and discharge using outcome measures including the Barthel Index (BI), Berg Balance Scale (BBS) and the use of assistive devices used to describe independence with activities of daily living (ADL), mobility and safety post-stroke. Statistical analysis was performed using Stata version 14.2. Results: The feasibility study identified appropriate procedures and barriers to a successful study in addition to describing preliminary data on participant demographics, relevant medical history and functional outcomes post-stroke. Limitations that affected feasibility included minimal recruitment sites, length of data collection period, timely communication of participant discharge plans and dates, and confirmation of participant HIV status. An appropriate comparison between sub-groups could not be made because of disproportionate group sizes, median age differences and no assessor blinding. Conclusion: To increase generalisability and the understanding of the unique HIV+ stroke profile, multiple recruitment sites, longer data collection periods, assessor blinding and age-matched groups with HIV status confirmation are recommended.
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    General movements as a predictive tool of the neurological outcome in very low and extremely low birth-weight infants
    (Stellenbosch : Stellenbosch University, 2007) Burger, Marlette; Stellenbosch University. Faculty of . Dept. of .
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    Integrating evidence-based principles into the undergraduate physiotherapy research methodology curriculum : reflections on a new approach
    (Health & Medical Publishing Group, 2014-10) Burger, Marlette; Louw, Quinette Abegail
    Background. The research methodology module was reviewed as part of the overall revision of the undergraduate physiotherapy curriculum of Stellenbosch University. This created an ideal platform from which to assess how to align the principles of evidence-based practice (EBP) with research methodology. Fostering the principles of EBP provides students with research skills and attributes to be able to seek, evaluate and integrate new knowledge and to apply critical thinking in order to effectively facilitate professional growth and support lifelong learning. Objective. To describe the process of changing the undergraduate research methodology module from a primary research to a secondary research approach. Methods. We consulted international experts and searched the literature for ideas and concepts of how to incorporate the principles of EBP. The overall objective of the new research module was formulated to provide students with lifelong skills in obtaining, evaluating, synthesising and forming clinical recommendations, as well as applying research evidence to the clinical setting. Results. Structuring the research methodology module using an EBP teaching framework prepares students to formulate a research question, effectively search for and critically appraise the evidence and formulate clinical recommendations. The barriers and strategies of implementing the new undergraduate research methodology module, as well as lessons learnt, are presented. Conclusion. Utilising a secondary research approach in the form of a systematic review or meta-analysis in our undergraduate research methodology module provides the opportunity for students, as novice researchers, to be trained in the principles of EBP.
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    A systematic review of the effects of single- event multilevel surgery on gait parameters in children with spastic cerebral palsy
    (Public Library of Science, 2015) Lamberts, Robert P.; Burger, Marlette; Du Toit, Jacques; Langerak, Nelleke G.
    Background: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). Purpose: The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. Methods: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review. The Oxford Centre for Evidence-Based Medicine Scale and the Methodological Index for Non-Randomized Studies (MINORS) were used to appraise and determine the quality of the studies. Results: Except for one level II study, all studies were graded as level III according to the Oxford Centre for Evidence-Based Medicine Scale. The MINORS score for comparative studies (n = 6) was on average 15.7/24, while non-comparative studies (n = 18) scored on average 9.8/16. Nineteen kinematic and temporal-distance gait parameters were selected, and a majority of studies reported improvements after SEMLS interventions. The largest improvements were seen in knee range of motion, knee flexion at initial contact and minimal knee flexion in stance phase, ankle dorsiflexion at initial contact, maximum dorsiflexion in stance and in swing phase, hip rotation and foot progression angles. However, changes in 3DGA parameters varied based on the focus of the SEMLS intervention. Discussion: The current article provides a novel overview of a variety of SEMLS interventions within different SEMLS focus areas and the post-operative changes in 3DGA parameters. This overview will assist clinicians and researchers as a potential theoretical framework to further improve SEMLS techniques within different SEMLS focus groups. In addition, it can also be used as a tool to enhance communication with parents, although the results of the studies can’t be generalised and a holistic approach is needed when considering SEMLS in a child with spastic CP.
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    A systematic review of the effects of single-event multilevel surgery on gait parameters in children with spastic cerebral palsy
    (Public Library of Science, 2016-10-18) Lamberts, Robert P.; Burger, Marlette; Du Toit, Jacques; Langerak, Nelleke G.
    Background: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). Purpose: The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. Methods: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review. The Oxford Centre for Evidence-Based Medicine Scale and the Methodological Index for Non-Randomized Studies (MINORS) were used to appraise and determine the quality of the studies. Results: Except for one level II study, all studies were graded as level III according to the Oxford Centre for Evidence-Based Medicine Scale. The MINORS score for comparative studies (n = 6) was on average 15.7/24, while non-comparative studies (n = 18) scored on average 9.8/16. Nineteen kinematic and temporal-distance gait parameters were selected, and a majority of studies reported improvements after SEMLS interventions. The largest improvements were seen in knee range of motion, knee flexion at initial contact and minimal knee flexion in stance phase, ankle dorsiflexion at initial contact, maximum dorsiflexion in stance and in swing phase, hip rotation and foot progression angles. However, changes in 3DGA parameters varied based on the focus of the SEMLS intervention. Discussion: The current article provides a novel overview of a variety of SEMLS interventions within different SEMLS focus areas and the post-operative changes in 3DGA parameters. This overview will assist clinicians and researchers as a potential theoretical framework to further improve SEMLS techniques within different SEMLS focus groups. In addition, it can also be used as a tool to enhance communication with parents, although the results of the studies can’t be generalised and a holistic approach is needed when considering SEMLS in a child with spastic CP.
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    Workplace-based rehabilitation for upper limb conditions in the South African context
    (Occupational Therapy Association of South Africa, 2019-08) Hoosain, Munira; De Klerk, Susan; Burger, Marlette
    Workplace-based rehabilitation is a growing field of practice internationally and locally. This commentary discusses the current barriers and facilitators facing South African occupational therapists wanting to implement workplace-based rehabilitation with upper limb conditions. An overview is provided of current international practice in the field and relevant factors in the South African context. Recommendations are made for development in this field in clinical practice, research and education in South Africa.