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Background: Patients who sustain chest wall trauma e.g. blunt or penetrating are at increased risk of developing musculoskeletal and pulmonary dysfunction. Physical therapy services are often included during hospital stays to assist with patient outcomes such as lung expansion, increasing oxygenation, pain management, optimization of joint range of motion and early mobility. Objectives: This protocol describes the proposed systematic review that aims to determine the physical therapy treatment interventions and the effects thereof on clinical outcomes when used in the management of adult patients with intra-pleural abnormalities following chest wall trauma. Methods: The research team will conduct an effectiveness systematic review using the PICO approach. A three-step search strategy of seven databases will be undertaken: Pubmed, CINAHIL Plus, The Cochrane Library, Physiotherapy Evidence Database (PEDro), Scopus, Science Direct and Google Scholar from conception of the databases. No limitations will be placed on language. The inclusion criteria are publications that focus on adults who sustained chest wall trauma, who had a diagnosis of an intra-pleural abnormality and managed with an intra-pleural drain, and who received physical therapy interventions during their stay in an acute care hospital. If participants had diagnoses that limit ambulation, such publications will not be included in the review. Two independent reviewers will do the critical appraisal and data extraction. Results: Results are unknown. Conclusions: This review will contribute to the understanding of physical therapy offered to patients and the clinical outcomes achieved when used in the management of adult patients with intra-pleural abnormalities following chest wall trauma. [ABSTRACT FROM AUTHOR]

Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students.

BACKGROUND AND AIMS: Unilateral Spatial Neglect (USN) affects the rehabilitation process and leads to poor outcomes after stroke. Factors that influence USN recovery following prism adaptation therapy have not been investigated. This study investigated predictors of USN recovery after prism therapy at the sub-acute phase of recovery. METHODS: This study was a randomized controlled trial. USN was assessed with the Behavioural Inattention Test and Catherine Bergego scale. Seventy-four patients with USN were divided into control and intervention group (prism). The prism group used 20 dioptre prism lenses for repeated aiming for 12 sessions while the control group used neutral lenses for aiming training. Regression analysis was conducted to establish clinical and sociodemographic factors that influence USN recovery. RESULTS: Gender, age, years of education, race, employment status, handedness, type of stroke, time since stroke and site of stroke (p > 0.005) showed no significant influence on USN recovery following PA treatment. Higher Cognitive function (OR = 1.52, CI = 1.08–2.14, p = 0.016) and group allocationng (being in the prism group) (OR = 63.10, CI = 9.70–410.59, P < 0.001) were found to significantly influence USN recovery following PA treatment session. CONCLUSIONS: A significant modulating effect on general cognitive ability was found in this study. This suggests that prism adaptation therapy's effect on neural activity and spatial neglect depends on the cognitive function of stroke survivors. Trial registration: Pan African Clinical Trial Registry identifier: PACTR201903732473573. [ABSTRACT FROM AUTHOR]

Patients with life-threatening illnesses in intensive care receive management that improves their chances for survival. The physical outcomes of individuals infected with HIV who survive an intensive care unit (ICU) stay are not well known. The purpose was to describe the physical outcomes of ICU survivors in a high HIV prevalent area and highlight challenges as it relates to study feasibility. A pilot study at a tertiary-care university-affiliated hospital was done. Participants were assessed at ICU and ward admission, hospital discharge, three and six months following discharge. The profile and physical function, assessed with the ICU Mobility Scale, Karnofsky Performance Status Scale and six-minute walk test, of participants was determined. The EQ-5D-3 L provides information on participants' health-related quality of life (HRQOL). The pilot study consists of five patients (n = 173 screened). All were independently mobile and on antiretroviral therapy prior to hospital admission. Respiratory and peripheral muscle weakness were present with variable performance in physical function across participants. Improvement in function occurred over time but participants still had physical dysfunction at six months. Pain/physical discomfort and anxiety/depression were common complaints influencing HRQOL. ICU survivors, who are HIV-positive, present with significant physical dysfunction who require rehabilitation to reduce disability. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to explore the current treatment approaches for patients with post-stroke unilateral spatial neglect. A three-step search strategy using the Johanna Briggs Institute (JBI) guidelines, was undertaken. PubMed, CINAHL, The Cochrane Central Register of Controlled Trial, SCOPUS, PROSPERO, JBI, Sport Discus, and Google Scholar databases were searched. Searches were limited to publications from January 1, 2008, to May 1, 2020. Critical appraisal was undertaken by two independent reviewers using a standardized critical appraisal instrument developed by JBI. Data were extracted using a study-specific charting table. A total of 3,648 articles were identified, 311 full-text articles were screened and 86 articles were critically appraised, with 83 articles included in the review. Intervention approaches for post-stroke unilateral spatial neglect symptom amelioration were identified and categorized as prism adaptation and visual scanning, mental practice and mirror therapy, electrical stimulation and robotics, combination therapy, pharmacological therapy, and other interventions. Both positive and negative results across identified interventions were identified without specific reference to the phase of recovery. This review provides insight into current interventions for post-stroke unilateral spatial neglect. A plethora of intervention studies have been explored to ameliorate neglect symptoms post-stroke. Prism adaptation (PA) and combination therapy are most commonly investigated intervention for unilateral spatial neglect (USN) and showed promise in ameliorating USN symptoms. No single treatment approach seems optimally superior in the rehabilitation of USN post-stroke. Evidence for the selection of treatment at a specific phase of recovery is not conclusive as both positive and negative outcome on neglect measure were observed across all treatment approaches without specific reference to the phase of recovery. Evidence for the long-term use of PA in USN rehabilitation appears to be modest. [ABSTRACT FROM AUTHOR]

The promotion of physical activity is encouraged in people living with HIV and AIDS (PLWHA) as a means of promoting wellness and health. Adherence to programmes that promote exercise is often reduced, and home-based programmes are suggested to improve adherence. This study investigated the personal and environmental factors that cause barriers and facilitators of physical activity in a home-based pedometer walking programme as a means of highlighting adherence challenges. An observational study nested in a randomised controlled trial was conducted in a cohort of South African PLWHA on antiretroviral therapy over a six-month period. Descriptive analysis and qualitative content analysis of 42 participants who underwent physical activity modification assisted with data review. The mean age of the sample was 38.7 (±8.9) years, consisted mostly of women (n= 35; 83.3%) who were employed (n= 19; 45.2%) but earning very little (less than R500 per month) and often single or widowed (n= 23; 54.8%). Barriers to physical activity identified included physical complaints, e.g., low-energy levels; psychological complaints, e.g., stress levels; family responsibility, e.g., being primary caregivers; the physical environment, e.g., adverse weather conditions; social environment, e.g., domestic abuse and crime; and workplace, e.g., being in a sedentary job. Facilitators of physical activity included support and encouragement from friends and family, religious practices during worship and community environment, e.g., having access to parks and sport fields. The study is of benefit as it highlights personal and environmental factors that need to be considered when developing or implementing a home-based walking programme in PLWHA. [ABSTRACT FROM AUTHOR]

Objective: People infected with the human immunodeficiency virus are at an increased risk of developing ischemic heart disease (IHD); however, the effects of an education and home-based pedometer walking program on risk factors of IHD are not known., Methods: We conducted a 12-month randomized study of an education and home-based pedometer walking program in 84 human immunodeficiency virus-infected individuals with risk factors of IHD., Results: Pedometer step count of the control and intervention groups improved significantly (P = 0.03 for both groups) at 6 months but was not significant at 12 months (P = 0.33 and 0.21, respectively). Significant between-group effects were observed in 6-minute walk test distance (P = 0.01), waist to hip ratio (P = 0.00), glucose (P = 0.00), and high-density lipoprotein (P = 0.01) over the 12-month period. The program did not result in change in high-sensitivity C-reactive protein as it was associated with perceived stress (r = 0.23; P = 0.03), weight (r = 0.28; P = 0.01), body mass index (r = 0.35; P < 0.00), waist (r = 0.28; P = 0.01) and hip circumference (r = 0.28; P = 0.01). Multivariate generalized estimation equation analysis demonstrated an inverse association between interaction and perceived stress (logB = -0.01; 95% confidence interval: -0.02 to -0.01; P <0.00) and body mass index (logB = -0.02; 95% confidence interval: -0.03 to -0.002; P = 0.02) at group level., Conclusion: An education and home-based pedometer walking program improves physical activity levels, and beneficial changes in other IHD risk factors were noted.