Browsing by Author "Stander, Jessica"

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    Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency : a systematic review
    (BioMed Central, 2018-01-16) Morris, Linzette; Stander, Jessica; Ebrahim, Wardah; Eksteen, Stephanie; Meaden, Orissa Anna; Ras, Ane; Wessels, Annemarie
    Background: Methamphetamine (MA) is a highly addictive psychostimulant used by approximately 52 million people worldwide. Chronic MA abuse leads to detrimental physiological and neurological changes, as well as increases in anxiety and depression, and decreases in overall fitness and quality of life. Exercise has been reported to possibly reverse physiological and neurological damage caused by previous MA use, and to reduce anxiety and depression in this population. The aim of this systematic review was to identify, clinically appraise and synthesise the available evidence for the effectiveness of exercise, compared to cognitive behavioural therapy (CBT), standard care or no intervention, on decreasing anxiety and depression and improving fitness and quality of life in previous MA users. Methods: Seven computerised databases were searched from inception to May 2017, namely Scopus, Cochrane Library, PubMed/MEDLINE, PEDro, CINAHL, and ScienceDirect. Search terms included exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. Randomised and non-randomised controlled- or clinical trials and pilot studies, published in English, were considered for inclusion. Methodological quality was critically appraised according to the PEDro scale. Heterogeneity across studies regarding control groups and assessment intervals rendered meta analyses inappropriate for this review and results were thus described narratively using text and tables. Results: Two hundred and fifty-one titles were identified following the initial search, and 14 potentially-relevant titles were selected and the abstracts reviewed. Three studies (two randomised controlled trials and one quasi-experimental pilot) were included, with an average PEDro score of 6.66. Exercise resulted in significantly lower depression and anxiety scores versus CBT (p = 0.001). Balance also significantly improved following exercise versus standard care (p < 0.001); as did vital capacity, hand-grip and one-leg stand with eyes closed. There were significant changes in all subdivisions of the Quality of Life Scale Questionnaire (p < 0.05), except psychology (p = 0.227). Conclusions: Level II evidence suggests that exercise is effective in reducing anxiety and depression and improving fitness in previous MA users, and Level III-2 evidence suggests that exercise is beneficial for improving quality of life in this population. Overall recovery in previous MA dependents might be significantly enhanced by including exercise in the rehabilitation process. Further research is required to strengthen these conclusions and to inform policy and health systems effectively.
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    Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency : a systematic review
    (BMC (part of Springer Nature), 2019) Morris, Linzette; Stander, Jessica; Ebrahim, Wardah; Eksteen, Stephanie; Meaden, Orissa Anna; Ras, Ane; Wessels, Annemarie
    Background: Methamphetamine (MA) is a highly addictive psychostimulant used by approximately 52 million people worldwide. Chronic MA abuse leads to detrimental physiological and neurological changes, as well as increases in anxiety and depression, and decreases in overall fitness and quality of life. Exercise has been reported to possibly reverse physiological and neurological damage caused by previous MA use, and to reduce anxiety and depression in this population. The aim of this systematic review was to identify, clinically appraise and synthesise the available evidence for the effectiveness of exercise, compared to cognitive behavioural therapy (CBT), standard care or no intervention, on decreasing anxiety and depression and improving fitness and quality of life in previous MA users. Methods: Seven computerised databases were searched from inception to May 2017, namely Scopus, Cochrane Library, PubMed/MEDLINE, PEDro, CINAHL, and ScienceDirect. Search terms included exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. Randomised and non-randomised controlled- or clinical trials and pilot studies, published in English, were considered for inclusion. Methodological quality was critically appraised according to the PEDro scale. Heterogeneity across studies regarding control groups and assessment intervals rendered meta analyses inappropriate for this review and results were thus described narratively using text and tables. Results: Two hundred and fifty-one titles were identified following the initial search, and 14 potentially-relevant titles were selected and the abstracts reviewed. Three studies (two randomised controlled trials and one quasi-experimental pilot) were included, with an average PEDro score of 6.66. Exercise resulted in significantly lower depression and anxiety scores versus CBT (p = 0.001). Balance also significantly improved following exercise versus standard care (p < 0.001); as did vital capacity, hand-grip and one-leg stand with eyes closed. There were significant changes in all subdivisions of the Quality of Life Scale Questionnaire (p < 0.05), except psychology (p = 0.227). Conclusions: Level II evidence suggests that exercise is effective in reducing anxiety and depression and improving fitness in previous MA users, and Level III-2 evidence suggests that exercise is beneficial for improving quality of life in this population. Overall recovery in previous MA dependents might be significantly enhanced by including exercise in the rehabilitation process. Further research is required to strengthen these conclusions and to inform policy and health systems effectively.
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    Learning styles of physiotherapists : a systematic scoping review
    (BMC (part of Springer Nature), 2019-01-03) Stander, Jessica; Grimmer, Karen; Brink, Yolandi
    Background: Understanding students’ learning styles, and modifying teaching styles and material accordingly, is an essential to delivering quality education. Knowing more about the learning styles of physiotherapy learners will assist educators’ planning and delivering of learning activities. The purpose of this scoping review was to explore what is published about physiotherapy learning styles. Methods: An adapted Arksey and O’Malley framework was applied to undertake this systematic scoping review. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PubMed, OTseeker, Scopus, ERIC) were searched using the keywords: ‘learning styles’ and ‘physiotherapy’. English-language, primary research articles that investigated physiotherapy learners’ learning styles were sought. Results: Of 396 potentially-relevant articles, 15 were included in this review. The studies mostly reflected undergraduate students (910 undergraduates, 361 postgraduates, 23 professionals), in developed countries. Nine articles used the Kolb’s experiential learning theory (ELT); one study applied Honey and Mumford’s approach; two studies used the Gregorc model of cognition and three studies did not specify an underlying theory. Outcome measures included different versions of Kolb’s Learning Style Inventory, the visual-aural-read/write-kinesthetic questionnaire, Gregorc style delineator, Felder Silverman’s Index of Learning Survey, and Honey and Mumford’s Learning Style Questionnaire. The preferred physiotherapy learning styles, according to the ELT, seem to be Converger (learns “hands-on” and applying previously attained knowledge) and Assimilator (gathers and organises information to make the most sense). Conclusions: Both physiotherapy learners and physiotherapists have specific learning styles of active participation, underpinned with practical examples of theoretical concepts. More research is needed in developing countries, and on postgraduate and professional physiotherapy learners’ learning styles. Also, further research should focus on defining and describing physiotherapy learning styles in a way to be used as an industry standard; and developing valid and reliable learning style outcome measures applicable across physiotherapy learners and settings.
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    A tailored training programme for South African physiotherapists on the use of evidence-based clinical practice guidelines when treating patients with acute and sub-acute low back pain
    (Stellenbosch : Stellenbosch University, 2020-12) Stander, Jessica; Brink, Yolandi; Grimmer, Karen Anne; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Introduction: Over the last 30 years there has been increasing international recognition of the importance of, and challenges involved in, applying best-available evidence to ensure consistent delivery of best-practice care to patients. This is called knowledge translation (KT). One KT vehicle is good quality clinical practice guidelines (CPGs), which summarise best-available evidence into concise recommendations for practice. This study was undertaken to fill a gap in knowledge about how best to educate South African physiotherapists (PTs) working in primary healthcare settings, about how to apply CPGs to inform diagnostic and management decisions. South African primary healthcare settings are generally resource-constrained, which can limit access to, and availability of, effective, and cost- and time-efficient care. This study focused on low back pain (LBP), the fourth-most common burden of disease in South Africa, and the most common primary healthcare condition treated by PTs. Methods: A multi-stage, mixed methods study was designed to develop and test a tailored training programme (TTP) that addressed factors influencing CPG uptake by South African primary healthcare PTs. The Implementation of Change model informed the study framework. Three set-up phases underpinned the draft TTP’s content and delivery method (two literature scoping reviews, and individual interviews exploring PTs’ perceptions of, and experiences with, CPG use). An expert validation study confirmed TTP content and delivery methods. The feasibility, acceptability and likely impact of the TTP was then piloted. Participants’ self-perception of CPG use and understanding of CPGs was captured pre-post TTP using surveys. Recorded discussions during the TTP, and after its completion were analysed descriptively for evidence of personal barriers and growth. Outcomes included knowledge, attitudes and behaviours. Results: The TTP content and delivery method was based on PTs’ learning needs and styles, and typical primary healthcare cases. The TTP consisted of a one-day interactive face-to-face KT session based on case studies, preceded by six podcasts (one-hour total), based on participants’ knowledge needs, attitudes and time constraints. The TTP was evaluated by 11 rural primary healthcare PTs. Pre-TTP evaluations demonstrated scepticism towards CPG-use in clinical practice, with most participants seemingly unaware of the nature, intent and construction of CPGs, or how to access or implement them. However, most participants identified areas of clinical practice where they required guidance, and all indicated an interest in learning more about providing evidence-based care. Immediate post TTP, evaluations showed improvements in knowledge, attitudes and skills in CPGs, and feedback was that the TTP was of unanticipated value in assisting PTs to use CPGs to better manage patients with LBP. Post TTP follow-up demonstrated significant behaviour change with PTs using CPGs more regularly, for patients with LBP, and other challenging conditions. Conclusion: The careful evidence based staged TTP development ensured that it addressed South African primary healthcare PTs’ needs and concerns. Its content and delivery methods were feasible and acceptable, and the TTP appeared to be effective in improving knowledge, attitudes and behaviours in the short and longer-term for rural PTs in one province of South Africa. The TTP is valid and ready for wider application to larger PT groups in primary healthcare settings.
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    Training programmes to improve evidence uptake and utilisation by physiotherapists : a systematic scoping review
    (BioMed Central, 2018-01-15) Stander, Jessica; Grimmer, Karen; Brink, Yolandi
    Background: Research training programmes are a knowledge translation (KT) intervention which aim to improve research evidence uptake by clinicians. Whilst KT training programmes have been reported to significantly improve evidence uptake by physiotherapists, it is unclear which aspects of training optimally assist KT into physiotherapy practice. The purpose of the review was to establish the body of evidence regarding KT training programmes to improve physiotherapists’ use of evidence-based practice (EBP) and clinical practice guidelines (CPG). Methods: A systematic scoping review was undertaken in line with the adapted Arksey and O’Malley framework. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PUBMED, OTseeker, Scopus, ERIC) were searched. Targeted keywords identified primary research articles of any hierarchy, that described the nature and impact of KT training programmes for physiotherapists. Where systematic reviews were identified, the component primary studies were considered individually for relevance. Critical appraisal was not undertaken due to the nature of a scoping review, and data was reported descriptively. Results: Ten systematic reviews were identified (yielding four relevant primary studies). Five additional primary studies were identified (two randomised controlled trials, two non-randomised controlled trials and one pre-post study) which were not included in the original systematic reviews. This provided nine eligible primary research studies for review. The KT strategies were all multi-faceted. Interactive sessions, didactic sessions, printed material and discussion and feedback were consistently associated with effective outcomes. When KT strategies addressed local barriers to EBP utilisation, there were better success rates for EBP and CPG uptake, irrespective of the outcome measures used. There were no consistent ways of measuring outcome. Conclusion: Multi-faceted KT strategies designed to address local barriers to knowledge translation were most effective in improving EBP/ CPG uptake among physiotherapists.