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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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Start date: 2020Subject: search.filters.subject.Musculoskeletal pain

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    An exploration into the self-reported experiences of musculoskeletal pain in females diagnosed with long Covid within the eThekwini Municipality
    (2024) Pillay, Karisa; Abdul-Rasheed, Ashura
    BACKGROUND The COVID-19 pandemic caused a worldwide health crisis that prompted an increase in the output of research targeted at expanding the knowledge available about COVID-19, the symptoms experienced and its consequences. Post-acute sequelae of SARS-CoV-2 infection is described as the persistence of symptoms since the initial diagnosis of COVID-19 for more than four weeks and, in most cases, lasting for months at a time. It is also referred to as Long COVID. Musculoskeletal pain (MSP) in relation to this condition is associated with tenderness, discomfort and stiffness of the joints, bones or muscles. Amidst the various reports of symptoms experienced by those affected by Long COVID, MSP has been identified as the most prevalent and debilitating manifestation, common in patients diagnosed with Long COVID. Despite current literature detailing the prevalence of various symptoms associated with Long COVID, a gap in the literature remains in the understanding of the experiences of individuals affected by MSP. Research has identified that women are more likely to endure symptoms of Long COVID, especially MSP, as compared to males. Given that women share a disproportionate burden of Long COVID, it is imperative to get a better understanding of the unique difficulties and lived experiences of women suffering from MSP. A thorough exploration into the various factors that play a role in the onset, development, persistence, and consequences of this symptom is required to fully grasp the experiences women have had whilst enduring MSP. Various factors play a vital role in the influence of an individual’s experiences of MSP throughout their Long COVID journey; these include pre-existing musculoskeletal conditions, the severity of the illness itself, biological changes because of COVID-19, psychological stresses, social determinants of health and health seeking approaches. This qualitative investigation aimed to address this gap in the literature by conducting in depth interviews amongst women with Long COVID experiencing MSP. This approach was to capture the rich perspectives of the participants, detailing daily life experiences, and methods of coping and challenges associated with MSP as a result of Long COVID. The benefits of a deeper understanding of the MSP experiences in women with Long COVID include interventions and support services specifically designed to address the unique challenges and needs that women encounter, resulting in a better quality of life and overall well-being. AIM OF STUDY The aim of this study has been to explore the experiences of MSP as a clinical manifestation of long COVID in women. METHODOLOGY A qualitative, exploratory, descriptive approach was utilised in this study(McLeod 2017). The purpose of a qualitative approach is to obtain a greater understanding of the experiences and perspectives of individuals who provide rich data without the use of quantitative and statistical methods. The sampling strategy utilised in this study was purposive sampling with the snowball method to obtain data. In this study, MSP was explored through the first-hand experiences of women with Long COVID to further understand how this clinical manifestation has affected their quality of life. This study involved conducting individual in-person interviews with a sample size of 12 women with Long COVID, with the purpose of providing personal, engaging interactions to obtain rich, reliable data. The benefit of conducting personal interviews is that it gathers the personal perspectives of individuals and explores responses to questions, which adds reliability to the study. Data was collected until saturation was attained. Data saturation was reached after interviewing the eighth participant, but four additional participants were interviewed thereafter to confirm saturation was reached. RESULTS The data were analysed using Tesch’s method to identify themes and subthemes. This involved the transcription and review of the participant responses, coding the responses according to themes and further categorizing similar themes into subthemes. The main themes that were identified in this study were the common clinical presentation of MSP experience due to Long COVID, negative effects of MSP on the quality of life and the varied and limited choice of healthcare treatment options. The participants shared a commonality with regard to the clinical presentation MSP, as most of them experienced back pain, neck pain, shoulder pain and headaches. The participants reported that they led a poor quality of life due to the extent of MSP which negatively affected their ability to perform daily tasks and resulted in constant fatigue. A high prevalence of anxiety, depression and frustration was experienced by the participants as they were exhausted from trying to find an effective treatment to resolve their pain. Most participants were highly reliant on pain medication to find some type of relief. Others sought alternate methods of care in the form of chiropractic treatment and lifestyle changes. This helped them better manage their pain and improve their general well-being. CONCLUSION The results of this study revealed that MSP is a prevalent and debilitating symptom amongst women with Long COVID. It affects various major aspects of lives, such as physical functioning, socialisation and mental health. A multi-disciplinary approach is imperative to provide efficient and effective health care to patients. Therefore, it is imperative that not only chiropractors but all health care practitioners who come into contact with affected women are able to create well-rounded treatment plans for those patients and converse easily with them to find a solution to their pain.
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    An investigation into musculoskeletal pain associated with primary dysmenorrhea in students at a University of Technology : a descriptive study
    (2022) Chapman, Heidi Michaela; Abdul-Rasheed, Ashura
    Primary dysmenorrhea (PD) is the most frequent gynaecological complaint affecting women across different backgrounds. Growing evidence has demonstrated a strong link between PD and comorbid musculoskeletal pain (MSK), carrying significant impact for the lives of sufferers. Despite this, few studies have isolated and investigated this association, particularly in a South African context. Aim: The aim of this study was to determine the prevalence, risk factors, management, and impact that MSK pain associated with PD has on female university students. Methodology: A quantitative, descriptive cross-sectional survey was conducted at a university of technology in KwaZulu-Natal, South Africa. Data were obtained through voluntary self-administered surveys from 324 participants. The surveys consisted of six parts: demographic characteristics, menstrual history, MSK pain characteristics, risk factors, management approaches and impact. Data were analysed using IBM SPSS version 27. Results: A total of 300 participants were included. A high prevalence of MSK pain was noted. Clinical characteristics showed that the pain was moderate and distributed across anatomical regions, with low back pain being most affected. There was a high prevalence of headaches and myofascial pain. The mode of transportation, as well as heaviness of menstrual flow were significant risk factors. Various management approaches, including home remedies, allopathic and complementary healthcare, were utilised by participants. Overall impact was high across personal, social, and academic domains. Conclusion: This study showed a strong correlation between PD and comorbid MSK pain among female university students, with various management approaches for participants. Pain appeared to carry significant impact across all aspects of life.
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    An exploration into the utilisation of the biopsychosocial model by chiropractors in the eThekwini Municipality
    (2022-09-29) Williamson, Rosanne Louise; O’Connor, Laura
    Background: The biopsychosocial (BPS) model is one of the many models of healthcare and its utilisation has been encouraged when treating and managing musculoskeletal conditions, especially neck and low back pain. Chiropractors are viewed as primary care providers, focused on the treatment and management of musculoskeletal conditions, most of which are spine related. This study aims to explore the utilisation of the biopsychosocial model by chiropractors in the eThekwini Municipality. Method: A qualitative, exploratory, descriptive study was conducted, in which twelve chiropractors within the eThekwini Municipality were interviewed to explore their understanding, attitudes, utilisation and challenges when utilising the BPS model. Semi-structured interviews were conducted in English, and later transcribed verbatim. Transcripts were analysed using Tesch’s method to form codes, themes and subthemes. Results: Female and male chiropractors were interviewed. They displayed knowledge of and a positive attitude towards the BPS model and its constituents. The chiropractors’ felt that chiropractic institutions should implement further practical training in the model to adequately prepare students for practice as many of the interviewees felt that addressing psychosocial factors was beyond their scope of practice and that they did not have the required skills. The most mentioned challenge was time, and how it resulted in constraints when utilising the model. This impacted them being able to implement the model effectively. Few used screening tools citing a lack of training or that they added to the time constraints. Conclusion: Chiropractors had positive attitudes towards and knew about the BPS model. They used the model in their practices to varying degrees with time and skills being the biggest challenges to effective implementation. It is recommended that chiropractic associations and training institutions provide additional practical training to teach students and practitioners how to implement the model in a clinical setting.
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    Upper body musculoskeletal pain associated with remote working of academics at the Durban University of Technology during the COVID-19 pandemic
    (2022-09-29) Narainsamy, Nevinia
    BACKGROUND The world-wide pandemic COVID-19, which initiated international lockdowns and varied degrees of work considerations, enforced remote working to reduce the spread of infection. Ergonomic support for effective remote working during this rapid transition received little consideration. Musculoskeletal disorders (MSDs) associated with musculoskeletal pain (MSP) are frequently linked to poor ergonomic support at the workplace and compromises the quality of life of those affected. MSP may be aggravated by prolonged, repetitive, and awkward movements, poor posture and ergonomics, or a fast-paced workload. Additionally, the onset of upper body MSP contributes to workrelated MSDs, resulting in decreased work productivity. It is believed that the current shift to remote working may result in an increase in MSP. This study, therefore, aims to determine the prevalence and effects of upper body musculoskeletal pain (head, neck, shoulder and back) associated with the ergonomic changes of remote working during the current COVID-19 pandemic. OBJECTIVES 1. To determine the prevalence of musculoskeletal pain among those working remotely during the COVID-19 pandemic. 2. To determine the selected risk factors predisposing to upper body musculoskeletal pain as an ergonomic effect of remote working. 3. To identify the extent to which remote working has impacted the occurrence of musculoskeletal pain with particular reference to ergonomic aspects. 4. To determine the effects of musculoskeletal pain and its impact on work performance/productivity. 5. To provide guidelines/recommendations and future considerations to support the prevention of MSP during remote working. METHOD A quantitative, descriptive cross-sectional study was conducted on all Durban University of Technology (DUT) academic staff members, to obtain relevant data regarding the onset of musculoskeletal pain and ergonomical factors, whilst working remotely during the COVID19 pandemic. Data were collected through the use of an online questionnaire, administered through DUT’s electronic platform. The Dutch Musculoskeletal Questionnaire was adapted to focus more on ergonomics and working remotely. Descriptive statistics were used to provide summarised questionnaire data. All data were analyzed using the IBM SPSS version 25 software package. Bivariate analyses, such as the Pearson’s chisquared test, ANOVA, and T-tests, where appropriate, were done. A p<0.05 was considered statistically significant. Findings of similar studies, both locally and internationally, provided generalised and more contextualised recommendations related to the ergonomic effects of working remotely. RESULTS In summary, 87.2% of participants reported to having musculoskeletal pain (MSP) prior to COVID-19. However, there was a massive increase in MSP while remote working, with 81.8% of participants reporting MSP during COVID-19. A great number of academic staff members (52.7%) reported to have worked remotely and having suitable equipment (59.1%) to facilitate remote work. With a reported increase in workload (89.1%), there was also an increase in productivity (53.6%). The most severe location of pain while remote working was the back (25.5%). Ergonomic factors that were noteworthy were that 64.5% participants sat without their back supported; shoulders were not relaxed in neutral (68.2%); wrists were not in a neutral position (51.8%) and the neck was not in a neutral position while remote working (63.6%). These factors remained consistent before and during COVID-19, indicating a minute change in the statistical significance of ergonomic factors. The p-value was less than 0.001. Regarding the emotional states of the respondents, it has been revealed that there was an association between the emotional status before and during COVID-19. All corresponding p-values were less than 0.001, indicating a statistically significant relationship. CONCLUSION The COVID-19 pandemic has placed unprecedented pressures on governments, economies, and families, posing what many observers consider the largest global peacetime challenge since the Great Depression a century ago. In South Africa, the government moved swiftly after the first confirmed case of COVID-19 on 5 March 2020, which subsequently led to a national lockdown by 27 March 2020. This placed huge challenges on the population, especially for the poor and those working from home. The exponential rise in COVID-19 infections rapidly transformed how and if people would return to the traditional way of working. Working from home during the nationwide lockdown led to poor quality of work and a lack of efficiency, which ultimately led to poor work productivity. Many employers worldwide chose to protect both the health and job security of their employees by implementing remote working. The average household lack the components of a functional office setup such as a simple desk and good quality chair. This consequently predisposed many to work hunched over coffee tables or on kitchen stools without proper neck and back support. It is possible that many working individuals will emerge with increased incidence of MSP after the coronavirus crisis. Ergonomic support for effective remote working may have been ignored amidst the more disastrous effects of the pandemic, but the crisis becoming a major contributor to an increased onset of MSP. This is likely to remain as the norm, even after the shifting of lockdowns, for millions of workers. The adverse effects of the pandemic thus appear to extend beyond its direct consequences into an increased onset of ergonomical concerns that warrants some investigation. This study therefore aimed to determine the prevalence and effects of upper body (head, neck, shoulder and back) musculoskeletal pain associated with ergonomic changes experienced with remote working during the COVID-19 pandemic. It is hoped that the results of this study will inform interventions to redress such effects in remote working climates.