Centre for Disability and Rehabilitation Studies

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Browsing Centre for Disability and Rehabilitation Studies by Subject "Amputation -- South Africa"

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    Bridging the gap for transtibial prosthetic rehabilitation : analysis for the development of a pro bono application
    (Stellenbosch : Stellenbosch University, 2023-03) Van Vuuren, Susanna Catharina; Visagie, Surona; Pienaar, Elzbeth; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH SUMMARY: Background: In South Africa, people with lower-limb amputations face challenges accessing rehabilitation services. The reasons for poor access to rehabilitation are multifaceted. In rural settings of South Africa, referral pathways and coordinated rehabilitation by a multidisciplinary team are rarely available. It is well known that prosthetic rehabilitation leads to improved outcomes. Currently, there are few evidence-based best practice protocols applied in transtibial prosthetic rehabilitation internationally. Mobile health technologies can reach underserved populations, improve clinical outcomes, promote attendance and adherence, and improve health-related quality of life. However, currently, only 1% of mobile health applications are grounded in scientific evidence and is evidence-based-driven. Aim: This study aimed to identify rehabilitation interventions that can inform a rehabilitation application for transtibial prosthetic users in South Africa. Study design: The study was executed in two distinct phases, namely a systematic literature review and a qualitative descriptive study. Methods: The objective of the systematic literature review was to evaluate current literature on transtibial prosthetic rehabilitation interventions globally. The literature review was executed according to the PRISMA 2020 statement. The literature search was conducted between May 2021 and February 2022 and explored rehabilitation interventions as part of transtibial prosthetic rehabilitation. Nine articles adhered to the inclusion criteria and were reviewed. The analytical studies were assessed using the Cochrane Collaboration Risk of Bias tool. The overall quality of evidence was assigned using the Cochrane Grading of Recommendations, Assessment, Development and Evaluations system. The literature probe conceptualised five themes for exercise interventions to be included in transtibial prosthetic rehabilitation. The objective of the descriptive qualitative design was to explore transtibial prosthetic users’ rehabilitation needs and experiences. In addition, it determined prosthetists’ and physiotherapists’ opinions on interventions that should be included in transtibial prosthetic rehabilitation in South Africa. Non-probability sampling techniques were used to select participants among each population group consisting of prosthetic users (n=8), prosthetists (n=8) and physiotherapists (n=10). Qualitative data were collected through telephonic interviews and were analysed using a content analysis approach. The findings from the two phases and four sources were triangulated to identify rehabilitation interventions to be included in a pro bono rehabilitation application. Findings: Through data triangulation, two main concepts were identified to be incorporated into an application. The first concept was exercise interventions that focus on balance and weight bearing, joint mobility, muscle strength and gait. The findings also suggest that a rehabilitation roadmap, patient education and peer support should be included in the application. Conclusion: It was recommended that exercise interventions should focus on balance, weight bearing, muscle strength, joint mobility and gait. Prosthetic users should be able to practise at home and must not require additional equipment to execute the exercises. It was concluded that additional factors should be included in the application. These factors include a rehabilitation roadmap, functional prosthetic rehabilitation, patient education and support as well as to incorporate a social platform into the application.