Faculty of Health Sciences
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Item An epidemiological investigation into low back pain in schoolteachers within the Greater Tzaneen Municipality in Limpopo, South Africa(2022-09-29) Prinsloo, Imé Mari; Docrat, Aadil; Prince, Cleo KirstyBackground: Low back pain (LBP) is a common and significant disease found in the entire population but increased among the working population. Studies have shown that prevalence among LBP in schoolteachers are increased, yet there has been limited studies looking at urban and rural schoolteachers simultaneously. Objectives: To determine the incidence and lifetime prevalence of low back pain among schoolteachers within the Greater Tzaneen Municipality, South Africa; to determine the risk factors (in terms of demographics, lifestyle, and occupational factors) of developing LBP; and to determine the management strategies sufferers of LBP use to get relief. Methods: This was a quantitative, descriptive, cross-sectional study conducted within schools of the Greater Tzaneen Municipality. Teachers working in both the urban and rural school setting were approached to partake in the study. Those who met the criteria were invited to complete the selfadministered questionnaires, online or hard copies. In total 345 questionnaires were completed. Results: Of the 345 completed questionnaires 67% reported having LBP. Significant associations were made between the prevalence of LBP and increased mental stress (51.5%). Similarly, LBP sufferers had a higher BMI (p=.010); have been teaching for longer, (p=.049); and spend more time working at a computer, p<.001. Aggravating factors of LBP included bending/twisting the body, lack of sleep, reaching overhead, sitting, standing, and stress/tension. The strongest corresponding factor being stress and tension (p<.001). Conclusion: In this specific community there was no significant difference in prevalence of LBP between urban and rural schoolteacher. Notwithstanding previous research, this study highlights that global statistics is not always appropriate in South African context. This draws attention to the need for research specifically based on our diverse country.Item The epidemiology of low back pain in radiographers working in the eThekwini Municipality(2018) Erasmus, Mynhardt; Maharaj, Praveena; Ally, FazilaBackground Low back pain (LBP) is one of the most common causes of occupational disability in healthcare professionals, including radiographers. Radiographers experience several difficulties at work, which include continuous radiation exposure, long working hours; shift work; high physical work load; inadequate staffing; heavy weight of the mobile x-ray machine; wearing a lead apron; bending and lifting patients. There is a paucity in the literature on the epidemiology of LBP in radiographers working in the public and private sectors of South Africa. To date no study has been performed which determines the risk factors for developing LBP in diagnostic radiographers within the eThekwini Municipality. Aim The aim of the study was to determine the epidemiology of LBP in diagnostic radiographers working in the public and private sectors of the eThekwini Municipality, and to identify the risk factors for LBP to which diagnostic radiographers are exposed. Research methodology The research conducted was a quantitative study with a descriptive design which targeted diagnostic radiographers working in both the public and private sectors of the eThekwini Municipality. The research tool was an online survey administered through ‘SurveyMonkey’ which included questions and statements relating to the epidemiology of LBP in order to meet the study objectives. Results and discussion One hundred and thirty-one radiographers (55,0%) participated in this study, of which 43 had to be excluded as per the exclusion criteria. The final response rate was 37,0% (n=88), with 43,2% of the respondents from the public sector and 56,8% from the private sector. The point prevalence of LBP was found to be 42,1% and 36,0% in the private sector. The period prevalence rates of LBP in the public sector were i) 0-3 months 10,5%; ii) 3-6 months 2,6%; iii) 4-9 months 15,8%; and iv) 9-12 months 23,7%. The private sector LBP period prevalence rates were i) 0-3 months 6,0%; ii) 3- 6 months 0%; iii) 4-9 months 4,0%; and iv) 9-12 months 34,0%. The cumulative annual LBP prevalence rate was 52,6% in the public sector and 44,0% in the private sector. Lifetime prevalence for LBP in the public sector and private sector radiographers was 89,5% and 90,0% respectively. The participants were characterised with bilateral, intermittent LBP that was moderate in nature, described as stiffness, a dull ache or sharp/shooting pain that was worse at work, reduced on days off work and affecting their daily and leisure activities. Work-related LBP activities reported by radiographers included sitting for long periods; lifting heavy objects and patients; twisting; working at a computer; bending; continuous pulling; and working with forward positioned arms. Other activities included wearing a lead apron; transferring patients to a bed/chair; positioning of the overhead x-ray tube; sitting and standing for >3 hours; pushing hospital bed patients; carrying imaging cassettes; and working fast due to radiation exposure. Radiographers involved in these activities had an 80,0-100,0% risk of experiencing LBP. The were 45% of the participants who reported previously injuring their lower back at work. Female radiographers were more prone to LBP compared with male radiographers. High stress levels and smoking were associated with an increased incidence of LBP, and exercise was found to reduce the incidence of LBPItem Profile of lumbar spine conditions requiring surgical intervention in the Orthopaedic Department at a specialist public hospital in Kwa-Zulu Natal(2018) Hillermann, Jens; O'Connor, LauraPurpose: Low Back Pain (LBP) is a leading cause of activity limitation and absence from work globally, and the treatment is often complicated and multifactorial. There is little documentation about the types of conditions requiring lumbar spine surgery in the public health care sector in South Africa (SA). The aim of this study was to develop a profile of lumbar spine conditions requiring surgical intervention in the Orthopaedic Department at a specialist public hospital in KwaZulu-Natal (KZN). Methods: This study utilised a descriptive, retrospective, clinical audit design. A total of 112 patient files meeting the study inclusion criteria were analysed and data was extracted and recorded on a data template. Permission to conduct the study was obtained from the KZN Department of Health, the Manager of the King Dinizulu Hospital and ethical approval was obtained from the Institutional Research Ethics committee. The data was analysed using the Statistical Package for the Social Sciences (SPSS) (IBM Corporation). The data was described using means, standard deviations, percentages and count. Inferential statistical analysis was utilised to draw conclusions about populations from sample data. Chi-square and Fischer’s Exact test were used to compare categorical data with a statistical significance of p value ≤0.05. Results: The mean age of the patients was 41.7 years of age (range 3-76 years of age), with more females (55.4%, n = 62) than males (44.6%, n = 50) requiring surgery. More than half of the patients were Black Africans (55.4%, n = 62), with the majority (58%, n = 65) of all the patients being unemployed. Mechanical low back pain (MLBP) was the condition most often requiring surgical intervention (41.1%, n = 46) with lumbar stenosis being the most common diagnosis (17%, n = 19). This was followed by infective spondylitis (33.9%, n = 38). Frankel grading for neurological deficit was most often reported in patients with non-mechanical or infective causes of low back pain. Infective co-morbidity was (39.3%, n = 44) with 19.6% (n = 22) patients suffering from both tuberculosis (TB) and human immunodeficiency virus (HIV), 14.3% (n = 16) from TB alone and 5.4% (n = 6) with HIV/Acquired immunodeficiency syndrome alone. Most patients (91.1%, n = 102) received pre-surgical management consisting of medication either alone or in combination with other therapies such as physiotherapy, back braces, crutches and dietary intervention. The most common surgical procedure utilised was posterior spinal fusion (PSF) (43.8%, n = 49) either alone or in combination with other surgical procedures such as: decompression, biopsy and abscess drainage. This procedure alone was the favoured for non-mechanical LBP (NMLBP) (12.5%, n = 14), while PSF in combination with decompression was favoured the treatment for LBP of infective origin (15.2%, n = 17). Post-surgical management included medication (96.4%, n = 108) and physiotherapy (17%, n = 19); these were administered either individually or in combination. There were only six post- surgical complications; two were metal ware failure and four were infections. Of the four post- surgical infections, all of the patients had HIV/AIDS as a co-morbid condition. The trends suggest that the MLBP patients were predominantly older i.e. 40-69 years (82.6%, n = 38) and from the Indian race group (25.9%, n = 29). This was in contrast to the other types of LBP which predominately affected younger populations (i.e. 10-39 years) and Blacks. There were no differences in gender distribution for both MLBP and NMLBP. However, with LBP of infective origin, females were twice as much affected than males. Conclusion: The profile of lumbar spine conditions requiring surgical intervention at a public hospital is varied and there is a high prevalence of surgery for mechanical and infective cases of lumbar spine pain. Effective management of these conditions may reduce morbidity. Future studies should investigate the economic impact of lumbar spine surgery on health expenditure in South Africa.Item The relative effectiveness of spinal manipulation versus spinal manipulation in conjunction with low back strapping in the treatment of mechanical low back pain, in the dysfunctional phase(2000) Broughton, Amanda Lynne; Kretzmann, HeidiThe absence of tested theory has resulted in a continued variation in protocols for the treatment of mechanical low back pain. This study was designed in order to determine the relative effectiveness of spinal manipulation versus spinal manipulation in conjunction with a low back strapping in the treatment of mechanical low back pain in the phase of dysfunction.Item The role of essential oils in the management of mechanical low back pain(1994) Luders, Regina Gertrude; Liebenberg, H. S.The purpose of this study was to investigate the effects of essential oils, applied by means of effleurage massage, in the treatment of mechanical low back pain, in terms of the patient's physical and psychological responses to the essential oils, in order to determine the role of essential oils in the management of mechanical low back pain.Item A study of the effects of chiropractic therapy on the diameter of the spinal canal of patients with low back pain and radiculopathy(1996) Beira, Bradley Stuart; Peers, Anthony V.Focus during this investigation was directed towards determining alterations in the size of the lumbar intervertebral disc in patients symptomatic with low back pain and sciatic distribution pain, in response to chiropractic management of this condition. The efficacy of chiropractic management for low back pain with associated radiculopathy has been examined. Flexion distraction technique and side posture rotatory adjustment technique of the lumbar spine have been used during this trial.Item The value of isometric and stretch exercises in the management of mechanical lower back pain(1995) Deall, Ashleigh Jane; Kretzmann, Heidi MariseMechanical low back pain is a common clinical entity which needs professional treatment (Margo 1994). Due to the nature of mechanical low back pain, recurrence of pain is a common entity that can cripple a patient and the ~tate financially. It is for'this reason that the professionals need to establish a cost effective method of treatment that helps maintain the pain free state and prevent recurrencesItem A study to determine the usefulness of the Gonstead Listing System as an indicator of the direction of adjusting the sacroiliac joint in the treatment of sacroiliac syndrome(1997) Moorcroft, Rayne; Peers, Anthony V.The purpose of this study is to evaluate the usefulness of the Gonstead Listing System as a reliable indicator of the direction in which to adjust the sacroiliac joint in subjects with sacroiliac joint dysfunction, in terms of their subjective and objective clinical findings. The hypothesis is that the direction of manipulation is clinically insignificant in causing a decrease in the subject's clinical findings. This information is necessary in order for chiropractors to formulate a more cost-effective treatment protocol for their patients.Item The relative effectiveness of combined spinal manipulative therapy and action potential therapy versus combined spinal manipulative therapy and placebo action potential therapy in the treatment of mechanical low back pain(2000) Atkinson, Micah Justin; Myburgh, CorneliusLower back pain represents as a common disorder, with between 60% and 80% of the general population being affected (Kirkaldy-Willis 1992:2). This, apart from just the health aspects, has serious financial implications which are an ongoing concern to industry (Frymoyer 1991: 137). This study was designed to determine the effectiveness of combined spinal manipulation and "Action Potential" therapy versus spinal manipulative therapy and placebo "Action Potential" therapy in the treatment of mechanical lower back pain. It is currently accepted that spinal manipulation is of great benefit in the treatment of lower back pain (Di Fabio 1992), and it appears that "Action Potential Simulation" therapy, a new low-frequency electrical current therapy, would fit the criteria necessary to address the dysfunctional phase of low back pain as set out by the authors such as Kirkaldy- Willis (1988).Item A study of the relative effectiveness of the lumbar roll and the spinous push technique in the treatment of facet syndrome in the lumbar spine(1996) Jansen, Petrus C.; Till, A. G.Lower back pain due to mechanical dysfunction is a common cause of pain and disability in mankind. Lumbar spine facet syndrome is a major aetiology in mechanical lower back pain