Browsing by Author "Nadasan, Thayananthee."

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Investigating occupational risk factors of low back pain and related disability among patients attending a private physiotherapy practice in Gaborone, Botswana.
(2018) Chihumbiri, Noreen Vimbiso.; Nadasan, Thayananthee.
Globally, low back pain (LBP) is regarded as the most common cause of occupational illness, job- related disability and absenteeism from work. The presence of LBP in the working age is a great cause for concern, as it is this population that contributes greatly to the productivity and economic viability of a country. However, in order to effect meaningful changes, such as formulating primary prevention and subsequent management strategies aimed at curbing the rising burden of occupational LBP, it is necessary to understand the physical activities that workers are frequently exposed to in the work place that put them at risk of developing LBP. Botswana is largely dependent on the working age population to drive its economy therefore necessitating introductory research, as reported in various industries on occupational risk factors that may hamper optimal worker participation. This research therefore aimed to determine the occupational risk factors and the resulting back-related disability in patients presenting with LBP to a private physiotherapy practice in Gaborone, Botswana. The objectives were fulfilled by using a structured, self–administered questionnaire to describe the demographics of the individuals, determine the extent of sickness absenteeism from work owing to LBP and to establish the resulting back-related disability through the Roland-Morris Disability Questionnaire (RDQ). Furthermore, the relationship between occupational risk factors and the level of back-related disability as well as the demographic profile of the study participants and the level of back-related disability were determined based on statistical analysis. The study was successful in establishing that the slight majority were females (52%) and the mean age of participants was 41 years. 35.3 percent of the study participants had between 10 to 19 years of work experience while 43.7 percent were classified as overweight. The results also reflect that minor LBP disability level was reported by 79.8% while 57.2 percent had missed between three to seven days of work in the previous year because of LBP. The occupational risk factors dynamic loads, static loads, repetitive loads, ergonomic environmental conditions, vibrations, prolonged standing, prolonged sitting, prolonged walking were significantly associated with LBP. The odds of having severe back-related disability are increased approximately 163 % for females (p-value= .043613). The presence of LBP and its associated disability in the working age, a population that drives the commercial hub of a nation, calls for recognition of this growing burden as a liability to the economic growth of Botswana. Investigating occupational factors of LBP would assist in making policies that address the different risk factors of LBP particularly in females and the 30 to 39 years age group as these are the commonly affected. In addition, emerging industries with increased risk of back-related disability can be prioritised in terms of ergonomic interventions as well as implementing health policies to help curb the escalating burden of LBP and facilitate optimal worker participation whose indefinite benefits would go a long way in enhancing the economy. Keywords: Low back pain, Risk factors, Disability, Occupational Health, Health Promotion
Primary health care delivery : a case study of KwaZulu-Natal with special reference to physiotherapy.
(2009) Nadasan, Thayananthee.; Penceliah, Yoganandee.
The delivery of primary health care (PHC), as promulgated by the World Health Organization (WHO) and in South Africa, is of fundamental importance. Physiotherapy is an essential component of the health care delivery system and must promote PHC during clinical training and practice. In KwaZulu-Natal (KZN), PHC service delivery has been a problem for various reasons such as the history of the country (apartheid era pre- 1994), financial constraints, lack of human resources, physical infrastructure and time constraints. Service delivery within the health sector is reported frequently in the media as physiotherapists and radiographers embarked on a strike latter part of 2009 in KZN due to a discrepancy in the Occupation Specific Dispensation (OSD). Physiotherapists have highlighted that they were overworked, carrying the strain of vacancies, due to frequent resignations to migrate to the private sector. The aim of the research was to explore the promotion of PHC delivery in KZN. The objectives explored the empowerment of students and staff in the Health Science Disciplines to PHC service delivery. In addition, managers at provincial and local levels were included in the study. Barriers and factors that enhance the promotion of PHC were identified. The research design comprised of a survey, a quantitative and qualitative case study of KZN, using questionnaires or semi-structured interviews. The findings indicated that the physiotherapy staff lacked PHC training (p=0.000) and 48.7% of the Disciplines in Health Sciences indicated that the rural needs were not being addressed with regards to PHC service delivery (p=0.018). Each discipline operated within its own silo, without any consultation and inter-disciplinary collaboration, to the detriment of effective delivery of PHC services. Fragmentation and duplication of PHC services existed between Provincial and Local Governments as indicated by 46% of the managers, which is disconcerting post 15 years of democracy in South Africa. The main objective of the National Health Plan and Reconstruction and Development Programme (RDP) was to readdress the inequalities and fragmented health services. Numerous recommendations are made which will improve the journey towards transformation, comprehensive PHC service delivery, and the quality of life of all citizens
Rehabilitation service in the northern KwaZulu-Natal, uThungulu and service providers’ knowledge and attitudes towards public private partnerships.
(2018) Mazibuko, Senzelwe Mfihlakalo.; Nadasan, Thayananthee.; Olagbegi, Oladapo Michael.
Rehabilitation assists persons with disabilities attain physical independence and self-determination. In South Africa, the distribution of rehabilitation services is largely poor. Rehabilitation services in uThungulu District, KwaZulu-Natal are covered by the public sector. The uThungulu public health sector provides limited rehabilitation services, with physiotherapists working in multidisciplinary teams. Consequently, achieving rehabilitation goals of functional independence is affected. Public and private rehabilitation service providers working together can help to combat this problem. Furthermore, rehabilitation services are unevenly distributed in rural uThungulu. This study explores current rehabilitation service provision practices in uThungulu and the possibility of Public Private Partnerships (PPPs). A sample of 50(37 public and 13 private) rehabilitation service providers were interviewed; using a mixed methods exploratory case study. Through the use of focus groups, individual interviews and questionnaires, participants were requested information on their perception of the availability, accessibility and equitability of rehabilitation services in uThungulu district. The knowledge and attitude service providers had towards PPPs were also explored. Rehabilitation practitioners reported poor rehabilitation service provision in uThungulu due to the poor socio-economic circumstance of uThungulu, limited multidisciplinary rehabilitation service providers and poor delivery of rehabilitation services. Sixty-four percent of the participants reported that their rehabilitation was not sufficient. Ninety-two percent of the participants reported working in a multidisciplinary team however human resource shortages were also reported resulting in institutions being constantly short-staffed. Sixty-nine percent of the participants reported the non-availability of designated rehabilitation units in their institutions. Professionals working at institutions with designated rehabilitation units evaluated the effectiveness of the rehabilitation programme significantly more positively than those working at institutions without such designated units (U= 98.5, p=0.01). Participants stated that they receive an average of 5.37±4.79 rehabilitation referrals per day. Forty percent of the participants stated that rehabilitation sessions occur daily, with 38% of respondents reporting rehabilitation sessions lasting between 30 to 45 minutes. A moderate, positive correlation was found between participants’ perceptions of managerial support and perceived rehabilitation programme effectiveness (rs= 0.45, p=0.01). A weak, positive and statistically significant correlation between perceived effectiveness of rehabilitation programme and ease of administrative process was found (rs= 0.29, p= 0.04). Two thirds (66%) of the participants did not know about PPP and only a third (34%) knew about it. Rehabilitation service in uThungulu is provided predominantly in hospital departments and less so at community-based centres such as clinics. UThungulu’s rehabilitation services are multidisciplinary, but often with an incomplete quota of rehabilitation practitioners. Rehabilitation services were perceivednegatively by providers in the uThungulu District. These negative perceptions were due to a lack of equipment, the absence of designated rehabilitation units, human resource shortages, a lack of managerial support and cumbersome administrative processes. Furthermore, rehabilitation service providers perceived rehabilitation as insufficient and ineffective. Rehabilitation service providers in uThungulu were not aware of PPPs. The possible utilisation of PPPs as tools for adequate rehabilitation service provision thus could not be ascertained sufficiently. The few providers who were aware of PPPs reported a positive potential for PPPs as vehicles of rehabilitation service provision.
A study of the effects of exercise therapy on the comorbidity of attention deficit hyperactivity disorder (ADHD) and developmental co-ordination disorder (DCD).
(2019) Dawson, Pamela Marie Therese.; Nadasan, Thayananthee.; Govender, Preesha.
Background: The literature suggests a high prevalence of comorbid ADHD and DCD in South Africa and worldwide. Specific figures of the suspected high prevalence are not available and the link between the two conditions are poorly understood. Medical treatment relies on neurostimulant drugs, which have little or no effect on the motor symptoms and have significant side effects. An intervention that addresses both motor co-ordination and attention/concentration impairments is essential in the overall management of children presenting with these comorbid conditions. This study aimed to document prevalence figures and demographic profile of children aged 8 to 9 years diagnosed with comorbid ADHD and DCD; and to design and develop and test efficacy of an exercise intervention that addresses symptoms of the comorbid conditions. Methodology: The study was located at remedial units within mainstream schools in KwaZulu-Natal, South Africa. Children aged 8 to 9 years diagnosed with ADHD were assessed using the modified Conners’ Teacher Rating Scale and the Copeland’s Symptom Checklist, the Development Co-ordination Disorder Questionnaire (DCDQ) and the Motor Assessment Battery for Children, edition 1 (MABC-1). A three round Delphi technique assisted in the development of an exercise intervention. The efficacy of the exercise intervention was tested via a quasi-experimental study. Children that were assessed were divided into four groups namely: Group (A) that were administered neuropharmacological medication prescribed by a medical practitioner; Group (B) were exposed to the exercise intervention only; Group (C) included children on neuropharmacological medication that were exposed to the exercise intervention and Group (D) served as the control, receiving routine care. All participants were grouped, according to parental preference. Effectiveness of each intervention was assessed using Wilcoxon Signed Ranked Test. Results: 151 children were tested. 74% were diagnosed with comorbid ADHD and DCD. The male to female ratio was 2:1. The combined subtype of ADHD was most commonly diagnosed with comorbidity. Consensus on structure and content in an exercise intervention was achieved in three rounds of the Delphi technique. The programme comprised 12 exercises. ADHD scores were as follows: Group A and B showed significant deterioration in these scores, Group C demonstrated a significant improvement and Group D showed no significant change. Results of motor scores: Group A and D showed a significant deterioration, while Group B and C demonstrated a significant improvement. Conclusions: The combination of medication plus exercises are effective in addressing and improving the symptoms of comorbid ADHD and DCD in children aged 8 to 9 in KZN, SA. Practitioners are cautioned to screen children with ADHD for DCD, following which treatment should be administered to address symptoms of both conditions, hence, providing a more effective and holistic form of management.