Research Articles (Physiotherapy)

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Predictors of return to work among mine workers following on-duty injury : a scoping review
(AOSIS, 2025-06-30) Botha, Wilinda; Magida, Nontembiso; Mudzi, Witness; Bello, Bashir
BACKGROUND : Mining industry workers face substantial challenges returning to work after occupational injuries. Despite the critical importance of successful return to work (RTW) outcomes, there is limited understanding of specific predictors within the mining sector that influence these outcomes. OBJECTIVES : To systematically identify and analyse factors influencing RTW among mine workers following on-duty injuries and synthesise evidence to inform rehabilitation strategies. METHOD : We searched PubMed, CINAHL, Google Scholar and PsycINFO databases for literature published between 1996 and December 2024. Studies were screened using predetermined inclusion and exclusion criteria. Data from eligible studies were extracted and analysed thematically to identify key predictors of RTW outcomes. RESULTS : Three studies met the inclusion criteria. Negative RTW predictors (barriers) included physical complications (muscular atrophy, chronic pain), psychological factors (work avoidance, secondary gains) and workplace challenges (harsh conditions, job stress). Positive predictors (facilitators) encompassed supportive work environments, shorter rehabilitation periods, and financial stability. Demographic characteristics, particularly younger age and higher education levels, were associated with improved RTW outcomes. CONCLUSION : Return to work success among mine workers is influenced by multiple interconnected factors spanning physical, psychological, workplace and demographic domains. CLINICAL IMPLICATIONS : These findings emphasise the need for comprehensive rehabilitation programmes integrating medical care, psychological support and workplace modifications. Future research should focus on developing targeted interventions that address these multiple dimensions of RTW in the mining sector.
Health systems and quality of life : the situation of South Africans with spinal cord injury
(AOSIS, 2025-06-06) Nizeyimana, Eugene; Rhoda, Anthea; Mothabeng, Joyce Diphale; Theron, Francois; Joseph, Conran
BACKGROUND : Spinal cord injury (SCI) significantly impacts quality of life (QoL) through physical disabilities and reduced social participation. OBJECTIVES : This study compared health system indicators, social factors and self-reported QoL between individuals with SCI accessing public versus private healthcare in South Africa. METHOD : A cross-sectional survey using the International Spinal Cord Injury (InSCI) community survey questionnaire was conducted with 200 SCI individuals (156 public, 44 private sector) from Cape Town and Pretoria. Chi-square tests and correlation analyses were performed. RESULTS : Significant disparities were observed between cohorts. Public sector participants reported higher rates of disability pension receipt (82.1% vs 54.5%) and greater challenges accessing various services. Overall, self-reported QoL was 56%, with the private cohort reporting significantly higher satisfaction (64% vs 52%). Private sector participants also reported higher satisfaction with living conditions and personal relationships. Access to disability pension and healthcare negatively correlated with QoL, while access to public spaces, medication, transport and nursing care positively correlated with QoL. CONCLUSION : This study reveals significant disparities in health system performance, social factors and QoL between SCI individuals accessing public versus private healthcare in South Africa. CLINICAL IMPLICATIONS : Findings highlight the need to address systemic inequities in healthcare access and social support for individuals with SCI to improve QoL across sectors.
Correlations between pain, functioning, and quality of life in manual wheelchair users with spinal cord injury
(Public Library of Science, 2025-05) Mashola, Mokgadi Kholofelo; Korkie, Elzette; Mothabeng, Diphale Joyce
BACKGROUND : Pain after spinal cord injury (SCI) is one of the most important contributors to poor rehabilitation outcomes, reduced quality of life (QOL) as well as poorer physical, social, and psychological functioning. OBJECTIVE : To determine the correlation of overall and shoulder pain on functioning and QOL in community-dwelling people with SCI. METHODS : This quantitative correlational study included people with SCI with or without pain, who were discharged from five rehabilitation hospitals in Gauteng, South Africa. The presence of pain, wheelchair function, and QOL were investigated using the Numeric Rating Scale, Wheelchair Function Test Questionnaire, and the WHOQOL-BREF questionnaire. Pectoralis minor muscle (PMm) length was measured using a Vernier caliper and the Scapular Dyskinesis test was used to observe for scapular dyskinesis. Descriptive statistics; Independent t-tests, ANOVA tests, and Fisher's exact tests were performed using the SPSS v27 at a 0.05 level of significance. RESULTS : 85% of the 122 participants reported overall pain, mainly burning (32.7%) and below the level of injury (39.4%), with only 14.8% reporting shoulder pain. There was no overall difference in QOL between participants with and without pain, however, pain prevented individuals from doing what they needed to do (p < 0.05). Pain severity was negatively correlated with QOL (p < 0.001) and sleep satisfaction (p < 0.05). There were no correlations found between shoulder pain and PMm length, as well as scapular dyskinesis. However, there was a negative correlation between shoulder pain and wheelchair function in those who reported shoulder pain (p < 0.01). CONCLUSION : Pain is problematic after SCI and although shoulder pain is not as prominent, it has the potential to negatively impact an individual's ability to use their wheelchair effectively. CONTRIBUTION : Findings from this study emphasise the negative role of pain on life satisfaction and QOL. Stakeholders involved in SCI rehabilitation can consider including comprehensive pain management within the interprofessional model of care.
Parental perspectives on support for learners with physical disabilities at special schools
(AOSIS, 2025-08) Sibuyi, Makwena M.; Mathye, Desmond; Tshabalala, Muziwakhe D.; Mphahlele, Komane Matthews; Mshunqane, Nombeko
BACKGROUND : Inclusive education for learners with special education needs is challenged with a rigid curricula and inadequate policy monitoring. Parental perspectives are crucial for shaping inclusive policies. However, these are insufficiently examined in the existing research and hinder improvements in special education practices. OBJECTIVES : This study explored parents’ perspectives on how special schools met the unique needs of learners living with physical disabilities. METHOD : A descriptive, qualitative exploratory design utilising semi-structured interviews with 11 parents from three selected special schools was adopted. Participants were recruited using a purposive non-random sampling method through telephone calls and face-to-face interviews. Transcripts were audio recorded and transcribed verbatim. Data were analysed inductively using a six-step approach to thematic data analysis on ATLAS.ti version 9. Intercoder reliability was achieved with consensus agreement. RESULTS : Three themes emerged: (1) A lack of curriculum differentiation and its effects on the learners’ academic performance. (2) A lack of empathy and support in addressing the learners’ challenges. (3) Poor management of assistive devices. CONCLUSION : Parents perceived that special schools inadequately addressed their children’s needs, particularly in curriculum delivery. Insufficient assessments resulted in learners remaining in unsuitable academic stream instead of transitioning to vocational pathways. CONTRIBUTION : Parental insights highlight critical areas for improvement in informing policies to enhance support for learners with special education needs.
Prevalence of urinary incontinence in postpartum women and physiotherapy interventions applied : an integrative review
(Wiley, 2025-03) Koomson, Gifty; Mgolozeli-Mgolose, Siyabulela; Mshunqane, Nombeko
OBJECTIVE : This integrative review identified studies that reported the prevalence of physiotherapeutic interventions for urinary incontinence among postpartum women. METHODS : This is an integrative literature review study. We used the integrative literature review framework proposed by Whittemore and Knafl to search for relevant literature. SEARCH STRATEGY : The search strategy for electronic databases was developed from the research question and definitions of key concepts, assisted by the librarian. Databases that were searched include Google Scholar, Medline (PubMed), CINAHL, and the Joanna Briggs Institute databases. Both qualitative and quantitative studies that met the inclusion criteria were included. We used the CASP tool to assess the quality of selected papers. DATA COLLECTION AND ANALYSIS : The included articles were thematically analyzed. Thirty-six papers met the inclusion criteria for the review. Six themes emerged from the analysis: prevalence of postpartum UI; risk factors for postpartum UI; antenatal pelvic floor muscle training; conservative treatment and quality of life; experiences of postpartum women with UI; and possible coping strategies adopted by women. Most of the articles were quantitative studies (80.5%); 16.6% were qualitative and 2.7% adopted mixed methods. CONCLUSIONS : Urinary incontinence is common in postpartum women. Antenatal pelvic floor muscle training is protective against postpartum UI and should be the first-line treatment option.
Characterization and risk stratification of coronary artery disease in people living with HIV : a global systematic review
(Frontiers Media, 2025-08) Nweke, Martins C.; Ibeneme, Sam; Pillay, Julian D.; Mshunqane, Nombeko
BACKGROUND : Coronary artery disease (CAD) is a leading cause of mortality among people living with HIV (PLWH). Risk stratification remains inconsistent due to geographic disparities, ART-related metabolic effects, and overreliance on strength of association. This review synthesizes global evidence to classify CAD risk factors in PLWH, aiming to improve predictive models and preventative strategies. METHODS : Following the PRISMA 2020 guidelines, a systematic review was conducted across six databases: PubMed, Scopus, Web of Science, Medline, CINAHL, and African Journals (SABINET). Two independent reviewers screened studies and extracted data. Narrative synthesis and meta-analysis were conducted. Risk factors were classified using Rw, causality index (CI), and public health priority (PHP). FINDINGS : Twenty-two studies involving 103,370 participants were included. First-class risk factors (CI: 7–10) included hypertension (OR: 4.9; p < 0.05; Rw: 4.5), advanced age (≥50 years) (OR: 4.96, p < 0.05, Rw: 3.58), dyslipidemia (OR: 2.15, p < 0.04, Rw: 2.15), and overweight/obesity (OR: 1.81, p < 0.05, Rw: 1.36). Second-class risk factors (CI: 5–6) included family history of CVD (OR: 3.25, p < 0.05; Rw: 2. 24). Third-class risk factors (CI ≤4) included diabetes (OR: 2.64, p < 0.05, Rw: 1.32), antiretroviral therapy exposure (OR: 1.68, p < 0.05, Rw: 0.63), and homosexuality (OR: 1.82, p < 0.05, Rw: 0.62). Critical thresholds (cumulative Rw: 14.8 and 8.0) were set at 75th and 50th percentiles of cumulative Rw. At GTT value of 0.50, the parsimonious global clinical prediction model for HIV-related CAD included age, hypertension, dyslipidemia, family history of CVD, diabetes, and overweight/obesity (Rw: 15.5, GTT: 4.05). For primary prevention, the optimal model comprised hypertension, dyslipidemia, and obesity (Rw: 8.01, GTT: 2.07). Advanced age and hypertension were “necessary causes” of CAD among PLWH. CONCLUSION : Association strength alone cannot determine CAD risk. Cumulative risk indexing and responsiveness provide a robust framework. Prevention should prioritize hypertension and dyslipidemia management, with interventions for obesity, smoking, and virological failure. Age and hypertension should prompt cardiovascular screening. Standardized risk definitions, accounting for the role of protective factors and integrating evidence with domain knowledge are vital for improved CAD risk stratification and prediction in PLWH. Routine cardiovascular screening in HIV care remains essential.
Knowledge, attitude, practice and barriers of exercise among postpartum women in a low-resource setting
(Wiley, 2025-07) Adjabu, Dorothy Ekua; Quartey, Jonathan; Mohammed, Tawagidu; Abdul-Rahman, Mubarak; Mothabeng, Diphale Joyce
INTRODUCTION : Physical inactivity predisposes mothers to untoward physical and mental health outcomes. Acquiring requisite knowledge pertaining to postpartum exercise promotes a good attitude and facilitates participation in exercises in spite of the presence of barriers. This study aimed to determine the knowledge, attitude, practice and barriers to postpartum exercises among women within 6 weeks to 1 year after childbirth. METHODS : This is a quantitative, cross-sectional study involving 146 postpartum women at a tertiary hospital in Accra, Ghana. Respondents completed an adapted survey tool–Knowledge, attitude and practice of postpartum exercise. The Statistical Package for Social Sciences (SPSS) 27 was used to perform all analyses using descriptive and inferential statistics with significance at a p-value of 0.05. RESULTS : Sixty-five percent reported a low general knowledge of postpartum exercise, 63% had an average knowledge of the benefits of exercise whilst 94% had a high knowledge of contraindications of exercise. Eighty-four percent of the respondents revealed a good attitude, although only 36% participated in postpartum exercises. Fifty-two percent of the postpartum women indicated that lack of time was a barrier for them, whilst 42% reported that lack of information was a barrier. Significant associations were discovered between general knowledge of postpartum exercise and practice (𝛘2 = 14.157, p-value = 0.001) as well as attitude and barriers (𝛘2 = 9.114, p-value = 0.003). CONCLUSION : This study highlights a low knowledge and practice of exercise among postpartum women at a single tertiary centre in Ghana, although they exhibit a good attitude towards exercise amidst major barriers. Findings suggest that health professionals in maternal healthcare should provide information regarding postpartum exercises as an essential aspect of postpartum care plans in low-resource settings to promote health outcomes.
Association between socio-demographic and injury factors, and physical activity behaviour in people with spinal cord injury : a theory-informed systematic review and meta-analysis
(BioMed Central, 2025-07) Nweke, Martins C.; Van Vuuren, Megan; Bester, Kobus; Maritz, Andrea; Van Vuuren, Lane; Vilakazi, Yolanda; Dlamini, Ayanda; Ncedani, Andiswa; Mostert, Karien
BACKGROUND : Identifying the determinants of physical (in)activity behaviour among people with spinal cord injury (PWSCI) will aid the prediction of speed and extent of recovery and inform strategies to optimise physical activity participation during physical rehabilitation. This review examined the association between socio-demographics, injury factors, and physical activity in PWSCI. METHODS : The Preferred Items for Reporting Systematic Reviews and Meta-analysis Protocols (PRISMA-P) provided the structure for this review. The epidemiological triangle and Bradford criteria further informed the review, as well as Rothman's causality model and Nweke's viewpoints. The review outcomes included injury factors and socio-demographic (intrinsic and extrinsic) factors associated with physical (in)activity in PWSCI. We searched four databases: PubMed, Medline, the Cumulative Index for Nursing and Allied Health Literature (CINHAL) and Academic Search Complete. The review used predefined eligibility criteria and a data screening and extraction template. The first author verified the extracted data. We employed narrative and quantitative syntheses and used a comprehensive Meta-analysis 4 to answer the review question. RESULTS : We retrieved 4,129 articles, of which 16 (nine cross-sectional studies, six cohorts and one non-randomised clinical trial) with 2,716 participants were eligible. The mean age of participants in the included studies was 45 years, and about 14% were female. Physical (in) activity was statistically significantly associated with income (OR = 1.58, CI 1.23–2.04), completeness of lesion (OR = 0.86 CI 0.82–0.90), and mobility aid (3.12, CI 1.57–6.19). No statistically significant association existed between physical (in) activity and age (OR = 1.09, CI 0.46–2.58), sex (OR = 0.66, CI 0.43–1.03), education (OR = 0.66, CI 0.42–1.06), time since injury (OR = 0,971, CI 0,749–1,26), vertebral level of the lesion (OR = 0.92, CI 0.71–1.11), or mechanism of injury (OR = 1.48, CI 0.74–2.97) among PWSCI. CONCLUSIONS : Efforts to optimise physical activity participation among PWSCI should consider the completeness of injury, income and type of mobility aid during rehabilitation programs. Factors such as employment status, residence, and type of house were less underscoring, and most studies needed more robust conceptual and theoretical underpinnings. TRIAL REGISTRATION : The review was registered with PROSPERO (ID: CRD42024544295).
Development of a high-performing, cost-effective and inclusive Afrocentric predictive model for stroke : a meta-analysis approach
(BioMed Central, 2025-07) Nweke, Martins C.; Oyirinnaya, P.; Nwoha, P.; Mitha, S.B.; Mshunqane, Nombeko; Govender, N.; Ukwuoma, M.; Ibeneme, S.C.
BACKGROUND : Predicting stroke risk is critical for preventive interventions. Most validated prediction models do not include data from African populations and may not be appropriate for the region. Relying solely on statistical significance to identify predictors may compromise algorithm performance. Also, some of the existing models include expensive biomarkers that are unsuitable for resource-limited settings. This study aims to develop a cost-effective and inclusive Afrocentric predictive model for stroke (CAPMS). METHODS : We conducted a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and searched the PubMed, Scopus, African Journal, Medline, Cochrane Library, Web of Science, and Cumulative Index for Nursing and Allied Health Literature databases. We included case‒control and cohort studies reporting stroke risk factors and their estimates among African populations. Titles and abstracts were independently screened. Meta-analyses were performed using Comprehensive Meta-analysis version 3. RESULTS : More than 50% of the eligible studies examined both ischemic and hemorrhagic stroke. More than 20 stroke risk factors were identified in Africa, with 18 eligible for meta-analysis. Homocysteine (risk weight [Rw] = 13.9, risk stability index [Ri] = 0.67), hypertension (Rw = 5.6, Ri = 0.94), and cardiac events (Rw = 3.1, Ri = 0.8) were the strongest independent predictors. Low green vegetable consumption (Rw = 2.4, Ri = 1.0), stress (Rw = 1.76, Ri = 1.0), and hypertension were the most clinically responsive risk factors. All risk factors/biomarkers except homocysteine cost between $2.8 and 12.2, indicating cost-effectiveness. A critical risk point of 12.7 was set at the 90th percentile. The cumulative Rw and costs for CAPMS 1 (20 and $1.2–4.6) and CAPMS 2 (22.4 and $6.5–17.3) indicate high performance and cost-effectiveness. CONCLUSIONS : Targeted screening via the CAPMS 1 and CAPMS 2 models offers a cost-effective solution for stroke screening in African clinics and communities. Immediate validation of the CAPMS is needed to evaluate its performance, feasibility, and acceptability in the region. REGISTRATION : The study protocol is registered with PROSPERO (ID: CRD42023430437).
Trail running safety : a review of serious adverse events reported in online news articles
(Sage, 2025-09) Viljoen, Carel Thomas; Da Cruz, Monique; Matlala, Kgame; Groves, Megan; Du Toit, Kaylin; Fourie, Loria; Silva, Bruno; Scheer, Volker; MacMillan, Candice; Janse van Rensburg, Dina Christina; carel.viljoen@up.ac.za
Trail running is an endurance sport that entails running outdoors on natural terrain. Scientific literature provides minimal information on serious adverse events that occur during trail running. The objectives of this review were to identify and summarize the available information published in online worldwide news articles and to categorize the results in fatal, missing, and catastrophic events in trail running. Over a 14-wk period, online news articles were searched using Google Advanced Search and DuckDuckGo for reports on serious adverse events during trail running. Data were extracted and summarized from online news articles that met the inclusion criteria. Ninety-four online news articles reported on 127 runners involved in serious adverse events during trail running. Among the serious adverse events reported in this review, 82% (n = 104) were fatal trail running events; 29% (n = 37) were related to missing events, of which 54% (n = 20) of the missing events resulted in death; and 6% (n = 6) were catastrophic injuries. Most runners were males (73%) aged 16 to 75 y (41.5 ± 12.6 y). The most common intrinsic causes of death were cardiac arrest (58%) and collapse (38%), whereas the most common extrinsic causes of death were cold weather resulting in potential hypothermia (40%) and blunt trauma following falling/slipping (25%). Almost half the runners who went missing (41%) were found. The 6 runners involved in catastrophic events (6%) suffered severe burn wounds, brain damage, and frostbite. Serious adverse events in trail running seem to be rare. This review reports multiple serious adverse events during trail running. Although these events are rare, they highlight the need for further research and improved reporting. These findings can assist in developing future prevention strategies for trail running events and guide medical staff during race-day medical planning.
Screening for suicidal thoughts, attempts, and associated factors in endurance and ultra-endurance runners
(Edizioni Minerva Medica, 2025-07) Scheer, Volker; Valero, David; Knechtle, Beat; Valero, Encarna; Viljoen, Carel Thomas; Thuany, Mabliny
BACKGROUND : Suicide is one of the leading causes of premature death. Prevalence of suicidal thoughts in the general adult population is approximately 4%, with lifetime prevalence of 5.6%, and suicidal attempts of 2.7%. No data are available on endurance runners (ER) and ultra-endurance runners (UER). METHODS : Prospective cohort study of ER (distance of ≥21.1 km-42.2 km) and UER (≥42.2 km), collecting self-reported data on biometrics, social, psychological, medical, and training history. Suicidal risk was assessed via the Patient Health Questionnaire (PHQ-9) and open questions. Statistical analysis included descriptive, predictive techniques, and regression analysis. RESULTS : A total of N.=601 runners participated in the study (female N.=222; male N.=379; mean age [standard deviation (SD)] 42.8 (10.1) years). Suicidal thoughts were present in 8.0%, with a lifetime prevalence of 14.1% (P<0.001). Previous suicidal attempts occurred in 2%. Associated factors for suicidal thoughts included previous diagnosis of depression (P<0.001), anxiety (P=0.015), age (P=0.013), and participating in fewer (<9) competitions per year (P=0.026). Associated factors of lifetime risk of suicidal thoughts included previous diagnoses of depression (P<0.001) and age (P=0.015). Runners aged less <30 years of age presented with a higher risk of suicide (P<0.001) than older runners. Associated factors for previous suicidal attempts included previous diagnosis of depression (P=0.01) and stress (P=0.028). CONCLUSIONS : We present novel data on prevalence of suicidal thoughts in ER/UER, which were 2-2.5-fold higher than in the general population. Creating awareness among athletes, families, coaches, medical teams, and race organizers and providing education, screening and access to appropriate support are important to reduce the burden of suicide in this sport.
Efficacy of aerobic exercise for HIV-associated neurocognitive disorders receiving ART : an RCT
(AOSIS, 2024-12-11) Nweke, Martins C.; Mshunqane, Nombeko; u19394595@tuks.co.za
BACKGROUND : HIV-associated neurocognitive disorder (HAND) affects an individual’s capacity for independence and engagement in everyday activities, posing challenges in environments with limited resources and low social support. OBJECTIVES : To ascertain the efficacy of exercise (AE) for activity and participation (AP) level in people with HAND. METHOD : This is a randomised controlled trial that is parallel-group in nature, with intention-to-treat analysis and disguised allocation. Seventy-three people with HAND in total were randomised at random to the AE and control groups. Three 20 -60-min sessions of moderate-intensity AE training on a cycle ergometer were included of the 12-week intervention. Individual tolerability served as the basis for progression. Three months after the intervention, at the conclusion of the intervention, and at the baseline, outcomes were measured. The AP constitutes the main outcome variable. To investigate the impact of AE on AP level, rank analysis of covariance was performed after log-transformation. RESULTS : When comparing the AE to the control group, there were significant increases in social wellbeing AP (Cohen d = 0.550; p = 0.021), emotion AP (Cohen d = 0.641; p = 0.007) and overall AP level (Cohen d = 0.896; p < 0.001). There was no discernible variation in AP across the groups three months following AE (Cohen d = 0.437; p = 0.067). CONCLUSION : AE induces a small increase in AP among individuals with HAND. CLINICAL IMPLICATIONS : For people with HAND, regular AE is a good way to manage AP restriction. Increasing AE participation may improve AP restriction.
Physiotherapists transgressions lodged at the Health Professions Council of South Africa between 2010 and 2020
(AOSIS, 2024-11-29) Dantile, Nokuzola Doris; Mshunqane, Nombeko; Van Staden, Cornelius W.
BACKGROUND : Complaints of ethical and professional misconduct are lodged and processed by the Health Professions Council of South Africa (HPCSA) in accordance with their legal mandate. OBJECTIVES : This study describes the nature and frequency of transgressions by physiotherapists as concluded by the HPCSA for the period from 2010 to 2020. METHOD : A total sampling method was used to extract all records of transgressions lodged against physiotherapists between 2010 and 2020. In a quantitative retrospective records review design, data were captured with the objective to report these descriptively. Ethics approval was granted by the Faculty of Health Sciences Research Ethics Committee of the University of Pretoria and permission to use the records was granted by HPCSA. RESULTS : Twenty-one transgressions by physiotherapists during the study period were recorded at the HPCSA. Most transgressions were charging for services not rendered (n = 20 times), invoices drafted inaccurately (n = 17) and false claims submitted to the medical aid schemes (n = 15). Other transgressions included failure to obtain informed consent and patient identity prior to treatment, charging for an unkept appointment, overservicing, misleading advertisements, love relationship with a patient and treating an animal in the same practice as humans. CONCLUSION : The transgressions were unprofessional in nature with the most frequently reported being false claims and accounts submitted to the medical aid by physiotherapists for services not rendered. CLINICAL IMPLICATIONS : The knowledge of transgressions will influence decision making and restrain infringement to enhance sound ethical practice.
Namibian healthcare professionals’ knowledge, attitudes and practices regarding environmental sustainability in healthcare
(MDPI, 2025-05) Lister, Helga Elke; Mostert, Karien; Ramkilawon, Gopika Devi; Oelschig, Cathrine; Ntiyane, Olwethu; Richardt, Erika; Da Silva Rocha, Deonelia Paulo; Sheerin, Savannah; Phaahla, Tshepang; Ashipala, Daniel; Pretorius, Louise; Munangatire, Takaedza; Maric, Filip
Among the many actions required to avert further intensification of today’s social, ecological and health crises is also the improvement of healthcare’s environmental sustainability, including in countries particularly vulnerable to such crises. The present study aimed to identify Namibian healthcare professionals’ knowledge, attitudes and practices, along with barriers and educational needs, as a foundation for context-relevant interventions. The study used a non-experimental, descriptive quantitative research design with an existing validated cross-sectional questionnaire as its data collection tool. Both purposive and snowball sampling were used to select healthcare professionals (n = 71) to participate in the quantitative online questionnaire. R (version 4.2.1) software was used to analyse the data from the completed questionnaires. The results showed that the Namibian healthcare professionals participating in this study have basic knowledge of and positive attitudes toward environmental sustainability in healthcare. However, various barriers to implementing strategies towards environmental sustainability exist that currently prevent the implementation of relevant practices. These should be overcome by the Namibian health system by providing the necessary frameworks, policies, measures and resources to drive improvements in environmental sustainability. Additionally, future and current healthcare professionals must receive training across all professional education levels to enable implementation in practice and effective advocacy and planetary health promotion.
Perspectives on adherence to prescribed home exercises after polytrauma : a qualitative study
(AOSIS, 2025-06) Monaiwa, Keamogetswe; Yazbek, Mariatha; Magida, Nontembiso
BACKGROUND : Polytrauma can be life altering, requiring a holistic approach to reach the highest functional level. Physiotherapists prescribe home exercise programmes (HEPs) to prevent complications associated with immobility. Adherence to HEPs is crucial, yet factors influencing non-adherence remain underexplored. OBJECTIVES : Our study explored patients with polytrauma perspectives on adherence to prescribed HEPs. METHOD : A qualitative exploratory, descriptive design was used to recruit participants purposively from a rehabilitation unit in Tshwane district, South Africa. Participants diagnosed with polytrauma, aged 18 years or older, and prescribed a HEP were included, while those with cognitive impairments or language barriers were excluded. Consent was obtained while hospitalised, and participants were contacted 3 months post-discharge for telephonic semistructured interviews lasting 30–45 min. Ethical clearance (reference number: 595/2022) and institutional permission were granted. Interviews were audio-recorded and conducted until data were saturated. Data were verbatim transcribed and analysed thematically to identify key themes and sub-themes. RESULTS : Thirteen participants (8 male and 5 female participants) with a mean age of 43.77 (standard deviation = 10.45) were interviewed. The four major themes were physical, psycho-cognitive, social and environmental factors. Adherence barriers were more significant than facilitators. The most frequently reported facilitator was family support, whereas the most commonly reported barrier was pain. CONCLUSION : Polytrauma patients identified more barriers than facilitators affecting HEP adherence. Pain significantly hindered adherence, while family support was a key enabler. CLINICAL IMPLICATION : Physiotherapists should work collaboratively with patients to develop inclusive HEPs that consider their demographic, social, psychological, physical and environmental context.
Pectoralis minor index range of healthy 18–24-year-old students from a Kenyan public university
(AOSIS, 2025-02) Agweyu, Eugene C.; Matheri, Joseph M.; Olivier, Benita; Korkie, Elzette
BACKGROUND : The pectoralis minor muscle (PMM) length is critical for shoulder movement and stability, often implicated in dysfunction and pain. The pectoralis minor index (PMI) quantifies this muscle’s length relative to body dimensions. Typical PMI values range from 10.0 cm to 12.5 cm in healthy adults, with data for Kenyan populations. OBJECTIVES : This study aimed to establish baseline PMI values among healthy 18–24-year-old university students in Kenya, examining variations by side dominance and sex to support clinical assessments. METHOD : A cross-sectional descriptive study recruited 289 healthy young adults from Jomo Kenyatta University of Agriculture and Technology (JKUAT) using stratified and simple random sampling. Data were collected through a self-developed, interviewer-administered questionnaire, achieving a 93.4% response rate. PMI values were measured in three postures: supine, relaxed, and standing. RESULTS : In the standing relaxed position, the PMI mean was 10.6 cm on the dominant side and 11.2 cm on the non-dominant side, with significant variation indicated by a 95% confidence interval. A paired t-test revealed a significant difference between dominant and non-dominant sides (p < 0.0001). CONCLUSION : Baseline PMI values for Kenyan young adults show significant differences by dominance and sex. These findings provide a foundational reference for assessing PMI in clinical settings, supporting physiotherapists and clinicians in evaluating and treating shoulder dysfunction using precise muscle length data. CLINICAL IMPLICATIONS : Establishing baseline PMI values assists physiotherapists in identifying deviations, enabling targeted interventions for shoulder dysfunction.
Using complex systems to understand running-related injuries
(Taylor and Francis, 2025) Thuany, Mabliny; Vieira, Douglas; Viljoen, Carel Thomas; Weiss, Katja; Knechtle, Beat; Gomes, Thayse Natacha
This study aims to investigate anthropometric and training characteristics associated with injuries in runners using a complex approach. We conducted a cross-sectional study with 97 Brazilian runners of both sexes (age: 39.1 ± 11.5 years; body mass index: 24.2 ± 4.2 kg/m2). A web survey was used for data collection, including age, sex, body weight, body height, training volume/frequency, session duration, running pace and injury information (yes or no; the number of injuries). The partial correlation parameter was used for network estimation, considering both sexes. For women, injury occurrence was positively and strongly associated with training frequency (r = 0.57) and the number of competitions (r = 0.64), while for men, a negative and strong association was found with age (r=-0.69), and positive associations were observed with BMI (r = 0.89) and training volume (r = 0.82). Network centrality showed that training session duration and the number of competitions/year presented a higher expected influence value for women (−1.47) and men (−1.31). Using a non-linear approach with Brazilian non-professional runners, training characteristics had a stronger influence on running-related injuries.
The SCIEPR checklist : a tool for standardizing chest X-ray interpretation in resource-constrained settings – a pilot study
(Elsevier, 2025-05) Sethole, Khethiwe Margaret; Mshunqane, Nombeko; margaret.sethole@up.ac.za
INTRODUCTION : Checklists improve performance in specialized fields such as radiology. The SCIEPR (Standardization, Communication, Image Evaluation, and Pattern Recognition) checklist was developed to aid nonradiologists in interpreting chest radiographs in district hospitals with no radiologists onsite. This study aims to investigate the clinical utility of the SCIEPR checklist. METHODS : A descriptive cross-sectional pilot study included 103 participants, including 40 radiographers and 63 doctors from four district hospitals. Radiographers completed sections A and B regarding imaging protocols for chest radiographs, while doctors filled out section C for systematically searching for abnormalities. After four weeks of using the checklist, the participants completed a survey comprising 23 closed-ended and seven open-ended questions. Key measures included compliance in completing the checklist and evaluating the end-user's perceptions of the checklist. RESULTS : Seventy-four SCIEPR checklists were adequately completed. Sections A and B had 100 % compliance. Two items were omitted from Section C. Forty-one participants completed the survey tool (22 doctors and 19 radiographers). Participants had mixed opinions on the checklist's impact on time and workload. No item changes were suggested. Participants reported that the checklist enhanced patient care, improved service quality, reduced interpretation time, and reduced patient waiting time. CONCLUSION : Following the pilot study, we refined section C of the SCIEPR checklist, improving content and face validity. The SCIEPR checklist promotes interprofessional collaboration and may reduce omission errors by standardizing imaging protocols. IMPLICATIONS FOR PRACTICE : The SCIEPR checklist is designed to enhance collaboration between radiographers and medical doctors in chest imaging and interpretation. Its main goal is to improve the consistency and accuracy of chest X-ray interpretations, particularly in resource-limited settings with no radiologist onsite.
Characterization and stratification of risk factors of stroke in people living with HIV : a theory-informed systematic review
(BioMed Central, 2025-05) Nweke, Martins C.; Mshunqane, Nombeko
BACKGROUND : Identification and stratification of risk factors for stroke among individuals living with HIV (PLWH) will facilitate primary prevention and prognostication, as well as strategies aimed at optimizing neurorehabilitation. This review sought to characterize and stratify the risk factors associated with stroke in PLWH. METHODS : The review was structured in accordance with the preferred items for reporting systematic reviews and meta-analysis (PRISMA) checklist. The epidemiological triangle, Bradford criteria, and Rothman causality model further informed the review. The review outcomes encompassed cardiovascular factors, HIV-related factors, and personal and extrinsic factors associated with stroke in PLWH. We conducted searches in PubMed, Scopus, Medline, Web of Science, Cumulative Index for Nursing and Allied Health Literature, and African Journal (SABINET). Data screening and extraction were independently performed utilizing predefined eligibility criteria and a data-extraction template. Narrative synthesis and risk stratification were employed to analyze the results. RESULTS : Thirty studies (22 cohorts and eight case–control) with a sample size of 353,995 participants were included in this review. The mean age of the participants was 45.1 ± 10.7 years. The majority of the participants (72.4%) were male. Risk factors for stroke in PLWH include cardiovascular factors (advanced age, tobacco use, hypertension, diabetes, atrial fibrillation, etc.), HIV-related factors (high viral load and low nadir CD4 count), personal factors (advanced age and female sex), and comorbidities (hepatitis C virus infection, chronic kidney disease, coronary artery disease, and liver fibrosis or cirrhosis). Diabetes, atrial fibrillation, smoking habits, hypertension, age, and viral load demonstrated a high likelihood of association with stroke in PLWH and should be prioritized when constructing clinical prediction algorithms for HIV-related stroke. CONCLUSIONS : The most important factors were hypertension and chronic kidney disease, followed by smoking, dyslipidemia, diabetes, HCV, HBV, CD4 count, use of ART, TB, and substance use (cocaine). The least important factors were age, sex, ethnicity, obesity, alcohol use, ART duration, and viral load. The predictive significance of these factors is still evolving, given the average moderate certainty of evidence. Predictive and preventative models should target factors with a high causality index and low investigative costs. TRIAL REGISTRATION : The review is part of a larger review registered with the PROSPERO (ID: CRD42024524494).
Burden and distribution of chronic kidney disease in sub-Saharan Africa : a systematic review with meta-analysis
(Faculty of Medicine, Makerere University, 2025) Nweke, Martins C.; Ado-Aghughu, Theresa; Daniels, Tobi; Imo, Uzunma
BACKGROUND : Chronic kidney disease (CKD) is fast becoming a leading non-communicable disease in sub-Saharan Africa. Efforts directed at mitigating CKD will thrive on precise and accurate estimation of CKD burden, which often varies widely owing to study characteristics like methods of estimating Glomerular Filtration Rate (GFR) and study population. OBJECTIVE : To determine the burden of CKD and distribution of this burden in sub-Saharan Africa based on study characteristics. METHODS : Involved systematic review of articles peer-reviewed literature published in English. Review was conducted consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources for review include MEDLINE, PubMed, CINAHL, Academic Search Complete, African wide information and articles that reported prevalence of chronic kidney disease in sub-Saharan Africa. Bias risk assessment was conducted using mixed-method appraisal tool. Random-effect model of meta-analysis was employed to quantify effects of variation study characteristics on burden of chronic kidney disease in sub-Saharan Africa. RESULTS : Showed statistically significant difference in CKD prevalence by study population (F=2.547, p=.019) and epidemiological significance difference in GFR estimate method with Schwartz approach (35%). Conclusion: CKD remains a public health issue in sub-Saharan Africa and the distribution varies widely according to region, study population and method of estimating GFR.

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