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Wits Physiotherapy Research

Welcome to the Wits Physiotherapy Research webpage!

Disability rehabilitation

Although disability rehabilitation is addressed across all areas of physiotherapy, this niche area focusses on rehabilitation of patients following a neurological illness or trauma. This covers conditions such as, but not limited to, acquired brain injury, spinal cord injury, demyelinating and other neurologically degenerative conditions. This field of physiotherapy research addresses the continuum of patient care through the rehabilitation process: establishing the prevalence and incidence of conditions and their risk factors; using the International Classification of Functioning, Disability and Health (ICF) to conceptualise health, function  and the degree of disability by  measuring impairments, activity limitation, participation restriction and the underlying contextual factors. In addition this niche will focus on evaluating the therapeutic effects of different interventions including health promotion interventions and health education in disability rehabilitation and influence policy relevant to disability. Through this research we strive to align to the Department of Physiotherapy’s vision of being locally responsive and internationally competitive and to the Framework and Strategy for Disability and Rehabilitation services 2015-2020 (South African Department of Health 2015) which outlines the model of care for managing disability based on the Community based rehabilitation (CBR) approach.

HIV across the lifespan

Research in HIV disability is an area of research that contributes to understanding rehabilitation for a condition that affects 25% of South Africa’s population. This field of physiotherapy research focuses on understanding the full spectrum of the HIV trajectory through a rehabilitation conceptual lens from epidemiology of disability, prevention, treatment care, support and policy implications in line with the national approach to HIV management. The research area includes basic clinical research of the impact of HIV on body systems such as cardiovascular system, muscle, skeletal and nerves of patients’. Additionally, impairments, functional status and testing the effect of treatment interventions such as exercise on rehabilitation outcomes to mitigate functional limitations and quality of life fall out.  This area of research involves understanding the involvement and role of family and community and the service delivery models to ensure accessible affordable applicable and acceptable rehabilitation services that are evidence based and appropriate. This area of research aims to influence policy and clinical practice and daily life of people living with HIV to impact their quality of life.

A related area of research is that or understanding service delivery models  for all high burden of disease conditions and thus understanding the service components of service delivery, how to monitor, evaluate and  improve efficiency and effectiveness. Within rehabilitation this includes models of community based rehabilitation, outreach and related concepts of management and monitoring and evaluation.

Musculoskeletal health and wellbeing

This research niche area focuses on the musculoskeletal health and wellbeing of the population across the lifespan and on different levels of participation in society. It includes research in/ an integration of research in the fields of sports, motion analysis, orthopaedic conditions, pain, musculoskeletal therapy, and women's health.  The focus is mainly on locally responsive and internationally competitive research in epidemiology, association and predictive factors of dysfunctions, refining of clinical assessment tools, efficacy of interventions (manual and behavioural therapy, as well as exercise), and translation of findings into clinical practice and education, in all of the stipulated areas.

The vision is therefore to synthesise evidence-based practice in each of the areas to improve musculoskeletal health, mainly in a South-African population, by identifying and effective management of the impairments, activity limitations, and participation restrictions, including the interactions with contextual factors.

Acute illness

Acute illness arises as a result of infectious diseases (including TB, HIV, and other bacterial, viral or fungal infections), acute or chronic cardiac or pulmonary conditions, disorders of the endocrine system, gastrointestinal diseases or disorders, renal disease, traumatic injury, or cancer. This field of physiotherapy research focuses on rehabilitation provided to patients in the intensive care unit, high care and hospital ward setting, as well as reporting on patient outcomes after discharge from an acute care setting. This includes measurement of patients’ impairments, functional status and testing the effect of treatment interventions on clinical outcomes to mitigate activity limitations and participation restrictions.

Another field of research in this area involves reporting on the role of physiotherapy inpatient management in an acute care setting. This includes reporting on the scope of physiotherapy practice and setting of minimum standards of clinical practice for physiotherapists in acute cate settings in the South African healthcare system.

Our vision is therefore to promote the role of physiotherapy in the management of patients in acute care settings and to optimise patient recovery from acute illness.

Paediatrics

Paediatrics is a very broad field and the research in this niche area is diverse. The main focus thus far has been the impact of HIV on the long term neurodevelopmental and physical outcomes of children infected with the disease. This has spanned the timeline of childhood from premature infants to adolescents.

Further research has been done to evaluate the impact of various chronic and acute conditions on the activities and participation of children. This has included, amongst others, congenital cardiac conditions, prematurity, haemophilia, burns, cerebral palsy and traumatic brain injury. By understanding the impact these conditions have on the health and wellbeing of infants and children we are better able to plan and deliver appropriate cost effective services.

Digital innovation and technology in rehabilitation research

Through digital innovation and technology in rehabilitation research, we use technologically advanced methods to analyse human movement objectively. We determine which movement components are contributing factors to injury or ineffective movement. Based on these determinants, rehabilitation programmes are formulated. An individualised rehabilitation programme aims to mitigate impairments (e.g. to improve the joint range of movement or muscle strength), activity limitations (e.g. independent personal hygiene, performing the cricket fast-bowling action) and participation restrictions (e.g. participating as a member of a soccer team or of the church choir).

The analysis of human movement is a valuable investigative tool used in many research applications. Human movement can be analysed in terms of the following: kinematics (displacement, velocity, angular change and angular acceleration), kinetics (forces and moments, mechanical free-body analysis), energy analysis, gait and activity analysis, computer simulation, inverse dynamics and forward dynamics.

Our vision is therefore to prevent and remediate impairments, activity limitations and participation restrictions through research in the analysis of human movement and intervention using human movement. We strive towards the creation of both basic and applied science that ultimately has an impact on and translates into change in real life situations within the South African context and beyond.

Education

The focus of this area is to develop and refine educational methods in order to improve teaching and learning and thus revolutionise the scholarship of our students. We aim to meet student’s learning styles and provide them with high quality learning experiences. Refining and enhancing pedagogy through research provides the platform to deliver high quality teaching and learning experiences. Pedagogical approaches researched are diverse including current trends such as e-learning and simulation-based learning, to facilitate the adoption of new ways of understanding and developing learning. This area also considers the personal, social and environmental factors that influence student learning and strategies to overcome these perceived barriers.

Health systems and policies

Mr Kganetso Sekome - Kganetso.Sekome@wits.ac.za

Service delivery in the health sector is influenced by policies and the system in which it functions. This niche area focuses aspects that influence policy and service delivery through studies that examine, develop and test policies and service delivery models in physiotherapy service and the implementation thereof. It also focuses on research related to the different approaches in service delivery, monitoring and evaluation of physiotherapy programmes. Service delivery research  is interdisciplinary and  applies a number of principles including those of public health, epidemiology, management, and clinical management  underpinned by the  determinants of health that influence health and rehabilitation outcomes.   Health policy and systems research can be employed at several points in the policy cycle, which involves establishing a socially relevant health policy problem, policy formulation, policy implementation, policy monitoring and evaluation. Service delivery and policy research focuses on the organisational, contextual and social determinants of health rather that clinical research.

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