Vaneshveri Naidoo

Background: Rehabilitation remains an unmet need and a neglected health service in South Africa. To address the country’s complex burden of disease, a skilled rehabilitation workforce is needed. Aim: This study aimed to identify prevalent medical conditions and disease trends among patients treated by rehabilitation therapists over a six-year period. It further examined whether these prevalent health conditions are represented in the rehabilitation health education curricula. Setting: The study was undertaken in public healthcare facilities within Gauteng province, South Africa. Methods: Secondary data on provincial rehabilitation data from April 2019 to March 2024 were analysed and categorised into non-communicable diseases (NCDs), children-specific conditions, injuries, and communicable diseases. Data were analysed descriptively. Lastly, the undergraduate rehabilitation health training curriculum (Occupational therapy, Physiotherapy, Speech therapy and Audiology) was reviewed to assess whether it covers the medical conditions treated by rehabilitation therapists. Results: The most treated conditions were NCDs (44.1%), injuries (36.4%) and children-specific conditions (15.6%). All health conditions decreased during the coronavirus disease 2019 pandemic, followed by an increase in NCDs and injuries between 2022 and 2024. The undergraduate rehabilitation health training curriculum covers the most prevalent conditions treated by public sector rehabilitation therapists. Conclusion: The burden of diseases treated in public healthcare rehabilitation departments aligns with the national burden of diseases. The impact of the COVID-19 pandemic on rehabilitation services is evident in the trend analysis over the years. Continual review of the curriculum is needed to ensure local health responsiveness. Contribution: This study highlights the burden of disease treated by the public health sector rehabilitation therapists, the trends over time and the importance of ensuring that the curriculum is locally responsive.

Background: The national cancer strategy includes guidelines for rehabilitation as part of a collaborative team for cancer care. Interprofessional engagement is a critical attribute of a rehabilitation team. Thus, exposing students to live case scenarios in physiotherapy (PT), occupational therapy (OT) and speech-language pathology (SLP) provides development of Interprofessional Education Collaborative (IPEC) core competencies. Objectives: To evaluate students’ acquisition of interprofessional competencies (Values and Ethics; Roles and Responsibilities; Interprofessional Communication; and Teams and Teamwork) in cancer rehabilitation and explore their qualitative experiences of interprofessional engagement. Method: A cross-sectional survey design with open-ended questions was administered to final year rehabilitation students (PT, OT and SLP) post interprofessional education (IPE) session with a cancer survivor (CS). Results: Of 140 enrolled final year students, 64 completed the IPEC survey on Redcap. Descriptive and qualitative data analysis were conducted. High levels of agreement across all IPEC domains were observed, with the highest seen in Teams and Teamwork. Three themes, (1) Scope of practice, (2) Teamwork, (3) Experience of the IPE activity, emerged from the open-ended questions. Conclusion: High agreement across IPEC domains indicates enhanced collaborative attitudes and role clarity, despite limited exposure to oncology in participants’ undergraduate curricula. The presence of a CS added authenticity, fostering empathy and ethical practice. Students gained insight into professional boundaries, effective communication strategies and teamwork in complex care settings. Findings support integrating authentic, condition-specific IPE into curricula to strengthen collaboration and professional identity formation. Clinical implications: Undergraduate Health Sciences students can gain exposure to national cancer policies through IPE sessions. Future research can explore if the skills learnt translate to clinical teamwork post-graduation.

The South African Journal of Physiotherapy is the official scholarly refereed journal of the South African Society of Physiotherapy. It aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions both nationally and internationally.

Background: Kinesiophobia hampers positive outcomes in patients with non-specific chronic lower back pain (NSCLBP). Graded exposure therapy is a psychosocial approach aimed at increasing patients’ functional capacity by challenging their fears and negative expectations. Objectives: Our study aimed to evaluate the effect of a graded exposure therapy programme on patients with NSCLBP, with primary outcomes assessing changes in pain intensity (Brief Pain Inventory – Short Form [BPI-SF]) and kinesiophobia (Tampa Scale of Kinesiophobia-11 [TSK-11]) from baseline to post-intervention and secondary outcomes assessing changes in pain interference (BPI-SF). Method: A quasi-experimental pre-test and post-test design was used. Twenty-eight participants with NSCLBP for more than 3 months and a TSK-11 score ≥ 22 were recruited. Outcome measures included the TSK-11, BPI-SF and Fear of Daily Activities Questionnaire (FDAQ). The intervention included a 4-week graded exposure programme and pain neuroscience education in the first session only. Data were analysed using the parametric paired t-test and Cohen’s d. Results: Out of 28 participants, most were female (96.4%) with a mean age of 45 (± 8.2) years and reported pain for more than 12 months. Significant improvements were observed on both the TSK-11 and BPI-SF (p < 0.001). Large effect sizes were observed for both kinesiophobia and pain severity (TSK-11: d = 1.73, 95% confidence interval [CI 1.14, 2.32]; BPI Pain Severity: d = 1.21, 95% CI [0.72, 1.70]). Conclusion: Graded exposure therapy was effective in reducing pain and kinesiophobia in patients with NSCLBP in the short term. Clinical implications: Future considerations should be given to implementing the graded exposure therapy in conjunction with other physiotherapy modalities.

Background: Social accountability represents the social contract between medicine and society, encouraging healthcare professionals (HCPs) to address social and health-related issues. The importance of integrating social accountability into curricula is widely recognised, but there is a lack of comprehensive mapping of the specific elements that should be included. Objectives: To identify the key elements of social accountability that should be integrated into undergraduate health sciences curricula to develop socially accountable HCPs. Method: The scoping review was conducted following the Joanna Briggs Institute Reviewers’ Manual 2015 for scoping reviews. A comprehensive search was employed using various keyword combinations and search strings, inclusive of published and grey literature from the past 15 years. Studies were systematically charted and analysed. Results: A rigorous screening process resulted in 47 studies being included in the review. Majority of the studies were qualitative, with the highest number of studies originating from Canada, South Africa, and the United States, as well as several multi-country studies. Equity emerged as the most frequently mentioned value, while cost-effectiveness was discussed the least. Conclusion: The scoping review demonstrates that embedding equity-driven approaches, community engagement, interprofessional collaboration and transformative learning in healthcare systems and tertiary institutions is vital. Addressing these priorities through undergraduate health sciences training can foster more inclusive, responsive and effective healthcare delivery, and improve health outcomes. Clinical implications: Integrating the identified elements of social accountability into undergraduate health sciences curricula may lead to improved patient outcomes, reduced health disparities, and more effective, patient-centred care.

Background: Post-operative rehabilitation is key to successful outcomes in anterior cruciate ligament (ACL) surgery. This study aimed to determine the management strategies (accelerated vs. non-accelerated protocols) and treatment modalities used by physiotherapists for post-operative ACL rehabilitation in Gauteng, South Africa. Objectives: This study determined the frequency of accelerated and non-accelerated protocols, identified rehabilitation objectives, commonly used physiotherapy modalities and exercise recommendations within the first 6 weeks of post-operative ACL rehabilitation. Method: A cross-sectional study was carried out between 15 December 2021 and 27 May 2022, using a custom-designed questionnaire. The survey was initially distributed to members of the South African Society of Physiotherapy (SASP) and Physiotherapy Association of South Africa (PASA), as well as shared on social media platforms. Data collection was completed in 6 months. Descriptive statistics (frequencies means and percentage

The South African Journal of Physiotherapy is the official scholarly refereed journal of the South African Society of Physiotherapy. It aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions both nationally and internationally.

Background: Patients with mental health disorders (MHDs) often present with chronic illness and complain of pain and poor physical health. They present with a high burden of disease and poor quality of life. Significant associations between MHDs and chronic illness have been found. Lifestyle interventions are cost-effective strategies, which seem to be effective in managing comorbid mental and physical health disorders. Therefore, a summary of the evidence and clinical practice guidelines is needed in South Africa.Objectives: Our study will aim to determine the effectiveness of lifestyle interventions on health-related quality of life, in patients with comorbid mental and physical health disorders.Method: The systematic review will be conducted using the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness. MEDLINE (Ovid), CINAHL (EBSCO), LiLACS, Scopus, Physiotherapy Evidence Data Base (PEDro) and Cochrane Central Register of Controlled Trials will be searched. A three-step search strategy will identify published literature in all languages from 2011 to 2022. Critical appraisal of all included studies will be performed, and the relevant data will then be extracted. Where possible, data will be pooled in a statistical meta-analysis.Results: The results will provide the best available evidence regarding lifestyle interventions in the management of patients with comorbid mental and physical health disorders.Conclusion: Our review will provide evidence on the effectiveness of lifestyle interventions in the management of patients with comorbid mental and physical health disorders.Clinical implications: The results may assist in determining the best use of lifestyle interventions in the management of patients with MHDs and comorbidities.

Background: Physiotherapy clinical education is complex. The dynamic learning milieu is fluid and multidimensional, which contributes to the complexity of the clinical learning experience. Consequently, there are numerous factors which impact the clinical learning experience which cannot be measured objectively – a gap which led to the development of our study.Objectives: To develop, validate, and test the reliability of an assessment tool that evaluates the effectiveness and quality of physiotherapy clinical education programmes.Method: A mixed methods approach in three phases included physiotherapy academics, clinical educators, and clinicians throughout South Africa. Phase One was a qualitative study: focus group discussions determined items and domains of the tool. Phase Two established the content and construct validity of the tool, a scoring system and a name for the tool, using the Delphi method. In Phase Three, factor analysis reduced the number of items, and the feasibility and utility of the tool was determined cross-sectionally.Results: The Vaneshveri Naidoo Clinical Programme Evaluation Tool (VN-CPET) of 58 items and six domains was developed and found to be valid, reliable (α = 0.75) and useful. The six domains of VN-CPET include governance; academic processes; learning exposure; clinical orientation; clinical supervision and quality assurance and monitoring and evaluation.Conclusion: The Vaneshveri Naidoo Clinical Programme Evaluation Tool is a valid, reliable and standardised tool, that evaluates the quality and effectiveness of physiotherapy clinical education programmes.Clinical implications: This tool can objectively evaluate the quality and effectiveness of physiotherapy clinical education programmes in South Africa, and other health science education programmes, both locally and globally, with minor modification.

Background: Learning styles of health care professionals are unique and tend to be profession- specific. This study aimed to compare the learning styles of undergraduate occupational therapy and physiotherapy students and to determine the relationship between preferred learning styles, demographic factors, and academic performance.Method: The study design was a cross-sectional, descriptive study. Undergraduate occupational therapy and physiotherapy students completed a self-developed questionnaire and the Grasha-Reichmann Learning Style Inventory.Results: A total of 313 students with a mean age of 19.6±1.58 years participated in this study. The results showed that students preferred the collaborative (75%) learning style, with the first-year students scoring significantly higher in the collaborative style (3.97±0.48; p<0.001). The male students (2.67±0.65) scored higher in the competitive learning style than female students (2.20±0.62; p=0.001, d=0.757). The competitive learning style, when controlling for sociodemographic variables, is a significant predictor of an increase in academic performance in English language (B=2.28, [0.60-3.96]), physics (B=3.62, [0.22-7.02]) and overall academic performance (B=2.12, [0.34-3.90]).Conclusion: The predominant preferred learning styles are the collaborative and participant styles. The application in the teaching space should be carefully considered for the selection of teaching approaches and activities. This study points to the Physiotherapy and Occupational Therapy programmes need to align to the collaborative style and respond with a variety of teaching methods. The associations shown between preferred learning styles and demographic variables point to the need to pay attention to diversity when selecting teaching approaches and activities.