Self-care and functional mobility outcomes of patients diagnosed with tuberculosis of the spine in Kwazulu Natal

Hannington, Michelle
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There is a lack of research available on the functional outcomes achieved by patients with Tuberculosis (TB) of the spine, which is relevant for occupational therapists (OTs) to set diagnosis-specific outcomes. The aim of the study was to determine the self-care and functional mobility outcomes achieved by TB spine patients, in KwaZulu Natal, and the factors impacting on these outcomes. A quantitative cross-sectional descriptive design was used and sampling included all TB spine patients accessing the hospitals included in the study. Data collection occurred over a nine month period. The outcome measures used included: a demographic and medical questionnaire, the American Spinal Injury Association classification scale, and the self-care and mobility sections within the Spinal Cord Independence Measure III. TB spine showed a good prognosis for functional independence, with the majority of the population performing well in self-care and functional mobility outcomes, with lower limbs activities the most affected. Factors associated with good functional outcomes included no other TB history, incomplete neurological fallout, and a lesion in the lumbar spine. Back pain, paraplegia and a lesion in the thoracic spine were associated with poorer functional outcomes. Only a small percentage of patients were referred to OT. Patients diagnosed with TB spine have a good prognosis for self-care and functional mobility outcomes, however there was poor referral of TB spine patients to OT which indicates a need for further education around the role of occupational therapists in TB spine. Key Words: TB spine, self-care, functional mobility, functional outcomes, non-traumatic spinal cord lesion, occupational therapy.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Science in Occupational Therapy