ETD Collection

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Subject: search.filters.subject.Upper Extremity

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Now showing 1 - 4 of 4
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    Children with cerebral palsy living in a resource constrained community: the efficacy of a thumb opponens splint - a case study
    (2018) Lachenicht, Michelle
    Cerebral Palsy is a common diagnosis in childhood and is often associated with upper limb impairments affecting hand function and participation in daily activities including personal management. A case study based research design was used with a sample of five children with spastic hemiplegic CP at Tambo Memorial Hospital to evaluate the efficacy of a thumb abductor splint for thumb in palm deformity in a resource constrained environment. The children involved in the study continued to receive their typical monthly occupational therapy service as well as any other therapy services they were involved in the time of the study. They were all splinted with a soft neoprene thumb abductor splint which they were advised to wear during participation in functional activities. A range of outcome measures were used to assess their hand function and functional performance before and after splint application over the three month data collection period including the Movement ABC and the Pediatric Evaluation of Disability Impairment scale. In spite of the small sample size and the limited clinically significant findings of the study - a potential benefit to wearing the splint during functional activity participation was highlighted in a resource constrained environment.
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    The effectiveness of lycra compression garments on the upper limb in patients with stroke
    (2017) Naubereit, Carene
    Introduction: Lycra compression garments have been documented as beneficial in affecting spasticity in children with cerebral palsy but there is little research on the use of Lycra compression garments in adults with neurological conditions. Thus, the purpose of this study was to explore the effectiveness of Lycra compression garments on motor function and functional use of the upper limb, in patients with stroke. Methods: A randomised control design with a control or intervention group was used. Both groups received routine upper limb rehabilitation while the experimental group also received a custom Lycra compression garment worn for a minimum of six hours a day. Results: Change between an initial assessment and assessment at six weeks, was measured on the Fugl-Meyer Assessment of Motor Recovery (FMA) and The Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH). While both groups had significant improvement in upper limb movement, statistically significant differences for change in total motor function, wrist and hand movement and coordination were found when the experimental group and the control group were compared. Small differences in measurements of pain, passive range of motion, sensation and functional use of the upper limb were found between the two groups. Conclusion: Results indicate that Lycra compression garments may be beneficial in facilitating the return of movement in the upper limb in individuals with stroke.
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    Informed consent for peripheral nerve blocks in patients presenting for upper limb surgery: documentation and patients' knowledge
    (2016) Buitenweg, Adriaan Willem
    Peripheral nerve blocks for upper limb surgery are commonly performed procedures that are considered very safe but may be associated with significant distress, serious and life threatening complications. The informed consent process, including its documentation, is an ethical and legal requirement to ensure that patients have full knowledge of the possible consequences, risks and benefits of the procedure for which they are granting permission. Numerous previous studies have shown that informed consent is often not obtained and that if attained is often inadequate and poorly documented. The aim of this study was to evaluate the adequacy of the informed consent process among patients receiving peripheral nerve blocks for upper limb surgery at the Chris Hani Baragwanath Academic Hospital Hand Unit. Patients receiving peripheral nerve blocks for upper limb surgery between September 2014 and March 2015 were approached for inclusion in the study. Patients were asked to complete a survey questionnaire and the patients' records were then reviewed to determine if consent was documented. It was found that only 20% of patients had adequate knowledge of the peripheral nerve blocks they had received, and only 44% of these patients had documented consent. None of the patients in the study had documented consent that was adequate according to the standard set out by the HPCSA. This study revealed that patients receiving peripheral nerve blocks for upper limb surgery at the CHBAH Hands Unit currently do not have adequate knowledge regarding the blocks and that documentation of informed consent is inadequate if present at all. 68% of patients requested that an information leaflet be developed and provided to them as part of the informed consent process.
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    The use of standardized assessments by occupational therapists in the management of the upper extremity after stroke in South Africa
    (2016) Phieros, Despina
    Occupational therapists worldwide are under pressure to provide evidence for the effectiveness of their intervention in managing stroke; with South African therapists facing additional challenges. In managing stroke, one of the most significant aspects the occupational therapists must focus on is the effects of the lesion on the upper extremity and how this has an influence on participation in occupations. The use of standardized upper extremity assessments can provide objective information and can guide the most effective intervention. The extent to which these are used in stroke rehabilitation in South Africa has not been explored until now. The results of this study depict how occupational therapists working in the neurological field are not making use of the available standardized upper extremity assessments. Their described barriers or limitations include: lack of time, resources and familiarity. There is a need for improved education and training regarding all aspects of standardized upper extremity assessments. Occupational therapists in all settings must start using standardized upper extremity assessments in practice to ensure they are joining the evidence based practice movement.