Scielo RSS <![CDATA[South African Journal of Occupational Therapy]]> vol. 43 num. 3 lang. es <![CDATA[SciELO Logo]]> <![CDATA[<b>Editorial Comment</b>]]> <![CDATA[<b>Towards evidenced-based practice - A systematic review of methods and tests used in the clinical assessment of hypotonia</b>]]> BACKGROUND: There is much contention about the measures used for the assessment of hypotonia in children and in order to determine what is available within the scientific literature, a systematic review to provide a critical appraisal of the studies describing the methods and tests used in the clinical assessment of hypotonia in children was undertaken. METHODS: A systematic process in searching and identifying relevant literature was followed. An analysis and synthesis of the literature was undertaken by two reviewers, with a specific review question, search strategy and inclusion criteria. RESULTS: A hierarchy of the levels of evidence is reported in this paper Twelve studies met the inclusion criteria, and were evaluated according to the critical review form for quantitative studies developed at McMaster University Occupational Therapy Evidence-Based Practice Research Group. A quality score was also provided in addition to the important characteristics of the included studies. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: There appeared to be a paucity of scientific literature that documented the objective assessment of hypotonia in children. This review has thus identified the need for more studies with greater methodological rigour in order to determine best practice with respect to the methods used in the assessment of low muscle tone in the paediatric population. <![CDATA[<b>Quality management in occupational therapy</b>]]> Although quality management is used in occupational therapy in South Africa, no comprehensive description or standardisation of it exists and literature in the context of this topic is scarce. As a consequence of this, the purpose of this study was to describe the extent of occupational therapists' involvement in quality management. A quantitative study in the form of a survey was carried out. A convenience sample of 80 occupational therapists was surveyed, using a structured questionnaire. Results of the study indicated that most occupational therapists have some knowledge of quality frameworks. Standardisation of documentation and its auditing appear to be one of a number of problems. Another challenge is that occupational therapists may work in relative professional isolation making it problematic to implement quality management. Recommendations were made for occupational therapy practice and further research, as well as a proposed quality management framework for occupational therapy in South Africa. <![CDATA[<b>The rehabilitation programme and functional outcomes of persons with lower limb amputations at a primary level rehabilitation centre</b>]]> The study aimed at evaluating the rehabilitation programme offered to clients who had undergone a lower limb amputation at an outpatient rehabilitation centre and to determine the functional outcomes of the clients who participated in the programme. Amputations have a severe physical, psychological and socio- economic impact. Effective rehabilitation can assist the individual in dealing with these. A quantitative, descriptive design was implemented in the study. Thirty clients with lower limb amputations who received rehabilitation and the two therapists working at the centre participated in the study. A questionnaire based on the International Classification of Function, Disability and Health, folder audit form and interviews were used for data collection. No programme vision, mission or objectives for the programme could be identified. Rehabilitation focussed on impairment. The impact of prosthetic rehabilitation on outdoor activities requiring mobility was statistically significant, with p values ranging from 0.00069 to 0.037.'Lack of indoor mobility training' significantly decreased participants ability to lift and carry objects (p 0.011), stand up (p = 0.042), get around inside the house (p = 0.00023), pick up objects from the floor (p = 0.00068), get up from the floor (p = 0.0072), get out of the house (p = 0.0016) and move around in the yard (0.0013). The 'Failure to address community mobility" had a statistically significant negative impact on all aspects of community mobility scores except transfers and driving. Recommendations include that a service vision and objectives be developed. In addition services should be evaluated and monitored on an ongoing basis and mentorship provided to therapists. <![CDATA[<b>The effect of a two-week sensory diet on fussy infants with regulatory sensory processing disorder</b>]]> This study investigated the effectiveness of a two-week programme of parent education and a sensory diet to reduce signs of fussiness in infants identified with Regulatory Sensory Processing Disorder (RSPD). The sensory diet was viewed as a complementary programme and was based on the Sensory Integration theory of Jean Ayers. The sample consisted of twelve infants who met the diagnostic criteria for RSPD. Data were gathered using the Infant Toddler Symptom Checklist and a parent interview. Infants were divided into two combined age bands as prescribed for the administration of the Infant Toddler Symptom Checklist. One group fell into the age band of 7-12 months of age and the other into the 13-24 months age band. Pre and post intervention measures allowed for comparison of data to determine the effect of the programme. Findings for this sample indicated a significant reduction in signs of fussiness in both groups (p<0.00), with a greater change evident in the 7-12 month group. The most significant changes were seen in self-regulatory and attachment behaviours. Difficulties with tactile, vestibular and auditory sensitivities related to sensory processing persisted indicating the need for further sensory integrative therapy. Parents reported a lack of knowledge and recognition of Regulatory Sensory Processing Disorder in infants by health professionals and as a result, there had been no referral to occupational therapists for sensory integration therapy in this sample group. Despite the small sample size, the results contribute to the emerging understanding of the influence of sensory modulation on dysfunctional infant behaviour. <![CDATA[<b>The sensory profile: Comparative analysis of children with Specific Language Impairment, ADHD and autism</b>]]> The Sensory Profile is useful in assisting with diagnosis of certain conditions which present with different sensory processing patterns. The purpose of this study was to compare the Sensory Profile for children with Specific Language Impairment (SU) (n=22) to a typical pattern, as well as the reported profiles of samples with autism and Attention Deficit/Hyperactive Disorder (ADHD). The SU sample had significantly more sensory processing difficulties than the typical population in all aspects. The Sensory Profile for both the autism and ADHD samples differed significantly from that of the SLI sample for H. Modulation Related to Body Position and Movement and Factor 6: Poor Registration. The SU sample showed fewer sensory processing problems except for J. Modulation of Sensory Input Affecting Emotional Responses, M. Behavioural Outcomes of Sensory Processing and Factor 9: Fine motor/perceptual indicating that this small sample of children with SLI did present with a unique Sensory Profile pattern. <![CDATA[<b>A Clinical Skills Unit: Addressing the need for Continued Professional Development (CPD) in Allied Health Professions</b>]]> INTRODUCTION: The Health Professions Council of South Africa (HPCSA) monitors compulsory continuing professional development (CPD) to ensure that healthcare professionals update their knowledge and skills to the benefit of their clients. One of the objectives of the Clinical Skills Unit (CSU) in the School for Allied Health Professions at the University of the Free State (UFS) was to use it for CPD as part of a responsibility towards alumni. This study investigated the needs of qualified dieticians (DT), occupational therapists (OT) and physiotherapists (PT) to assist in the provision of relevant CPD activities at the Unit. METHODS: A descriptive, comparative study was conducted. Two hundred and fifty-eight questionnaires were distributed in the Free State and Northern Cape provinces, to members of the professional groups mentioned above. To ensure reliability, 10% of the sample was re-tested after one month. RESULTS: One hundred and twenty-seven professionals responded to the questionnaire, with 55.6% being from the Free State. CPD activities were attended in Bloemfontein by 65.9%. Most of the CPD activities (70.6%) attended prior to the study were theoretical in nature and 85% of respondents would have prefered to observe experts and learn by doing. Differences between the groups were significant for some of the questions, for example, dieticians preferred a large group didactic approach while the other professional groups prefered to observe experts and be involved in the learning process. All the professionals prefered CPD activities to be presented by an expert in their specific field of practise. CONCLUSIONS: Taking into consideration the views of professionals and the results of international studies, the CSU at the UFS will be able to address the CPD needs of allied health professionals in the Free State and Northern Cape.