Faculty of Health Sciences
Permanent URI for this communityhttp://ir-dev.dut.ac.za/handle/10321/11
Browse
8 results
Search Results
Item The prevalence, selected risk factors and burden of primary headaches in lecturers at a University of Technology (UoT) in KwaZulu-Natal during the COVID-19 pandemic(2024) Chetty, Deidre; Orton, Penelope Margaret; O’Connor, LauraBackground: Headaches are a common disabling condition that affect many people worldwide. Headaches have been under-studied in developing countries and there is a paucity of literature documenting headaches in lecturers. The COVID-19 pandemic has forced lecturers to adapt to online teaching, which may have resulted in headaches. It is envisaged that this research will be beneficial to chiropractors, other healthcare providers and lecturers. Aim of Study: The aim of this study was to determine the prevalence, selected risk factors and burden of primary headaches in lecturers at a university of technology (UoT) in KwaZulu Natal during the COVID-19 pandemic. Methodology: A quantitative, descriptive cross-sectional design, where 685 lecturers employed at the Durban University of Technology, through self-selection, were selected to participate, using consecutive sampling. A minimum sample size of 247 was calculated, using a confidence level of 95% and confidence interval of 5%. Lecturers from all six faculties were invited to participate. The headache-attributed restriction, disability, social handicap and impaired participation (HARDSHIP) questionnaire was administered electronically via QUESTIONPRO®. Each participant was required to initial a consent form prior to answering the questionnaire. The diagnostic algorithm was utilised to diagnose headaches according to the diagnostic questions in the HARDSHIP questionnaire. All data were captured on an Excel spreadsheet and subsequently analysed using SPSS version 28. Results: There was a total of 255 completed questionnaires. The mean age of respondents was 45.66 years old. Of the total sample (n=255), 51.8% were headache sufferers. Most respondents suffered from probable tension-type headache (41.9%; n=54), followed by migraine-type headache (27.9%, n=36). Social risk factors revealed a significant relationship between alcohol and headaches, and sleep deprivation and headaches. Medial risk factors revealed a significant relationship between a head injury and headache and sinusitis and headache. Although there was a relationship between psychological risk factors and headache, it was not significant. Many work-related risk factors were significantly related to headache. There was a greater number of headache sufferers who tested positive for COVID-19. Many respondents experienced loneliness and their workload increased during the pandemic. Most of the respondents’ headaches interfered with work, and they usually took medication to treat their headache. Conclusion: Headaches are common in lecturing staff with, tension type headaches being most prevalent. There are many risk factors which are strongly associated with headaches and its impact caused an interference with work and negatively affected the suffers mental health. Family, social or leisure activities are also neglected when a headache occurred. This study adds to the current literature on headache prevalence in the lecturer population and increases awareness.Item Perception of chiropractic students in their preparedness in the diagnoses and management of headache disorders at a selected University of Technology(2024) Abrahams, Tamia; Abdul-Rasheed, AshuraA headache is defined as “pain found in the head above the orbito-meatal line and or nuchal ridge” and widely affects both males and females globally. Chiropractic treatment and the management of headaches is substantial, with one in five new patients’ chief complaint being a headache and, thus, the use of chiropractic care in the management and treatment of headaches is popular. The term “self-perceived preparedness” refers to how people view themselves in terms of confidence and competency with regard to certain skills. Self-perceived preparedness is essential as it relates to one’s confidence and the ability to accurately diagnose and manage headache disorders. There is a definite scarcity in South African literature as to the self-perceived preparedness of students in the diagnosis and management of headache disorders. In a South African chiropractic context, the literature, with regard to students’ confidence, awareness and self-assessment of skills is lacking. There are a number of advantages that can come from exploring the concept of self-perceived preparedness. The benefits include, but are not limited to, the assessment of whether or not the curricula goals have been achieved, the readiness of chiropractic students to confidently and correctly diagnose and manage patients sufficiently, and the different aspects that can lead to one feeling unprepared. Aim The aim of this study was to explore and describe the self-perceived preparedness of the chiropractic students’ in the diagnosis and management of headache disorders. Methodology This study design employed a qualitative, explorative and descriptive design. Purposeful sampling was utilised and individual, semi-structured interviews were conducted with 13 Master’s degree students in the chiropractic programme. These interviews took place “in person” and an interview guide was utilised in each interview. The interviews were conducted over a week from the 18th to the 23rd of September 2023. The questions surrounded the topics of self-perceived preparedness, confidence, challenges (whether educational or personal) and the effect of clinical exposure on one’s confidence and skills. The interviews were analysed and themes were extracted utilising Tesch’s eight-step approach of data analysis. Results The chief themes that emerged from the data collection included the level of preparedness, educational and environmental challenges, as well as the positive role that clinical exposure had on students’ views of their self-perceived preparedness. The participants felt largely unprepared to deal clinically with headache disorders. This stemmed from the feeling of isolation within academia, lack of support from staff and clinicians, lack of practical aspects within the curriculum and the COVID-19 pandemic, which resulted in a lack of in-person interaction. Conclusion The findings of this study highlighted the lack of confidence and feeling of under-preparedness to deal with headache disorders within a clinic setting by chiropractic Master’s students. This was mainly attributed to educational and environmental challenges. However, the exposure students gained within a clinical environment greatly improved their feeling of overall self-perceived preparednessItem The effectiveness of an electromechanical adjusting instrumental compared to cervical spine manipulation in the treatment of cervicogenic headaches(2018) Whittaker, Russell; Varatharajullu, DesireeBackground: Cervicogenic headaches are usually chronic, debilitating and tend to be unresponsive to common headache medications. Manual therapy has been shown to be an effective form of management for cervicogenic headache. The Electromechanical Adjusting Instrument is a hand-held device offered as an alternative to manual therapy for musculoskeletal treatment. Aim: The aim of this study was to determine the effectiveness of the Electromechanical Adjusting Instrument compared to cervical spine manipulation in terms of subjective and objective measures in the treatment of cervicogenic headache. Methodology: This study was a randomised single-blinded clinical trial. There were 41 participants between the ages of 18 and 59 years who were randomly divided into two groups of 21 and 20 respectively by means of a randomisation table drawn up by the statistician. Participants in Group A received cervical spine manipulation while those in Group B received the Electromechanical Adjusting Instrument. Subjective headache intensity was determined using a Numerical Pain Rating Scale. The effect of neck pain on the participants’ activities of daily living before and after treatment was assessed using the Neck Disability Index. The effect of the headache on the participants’ activities of daily living before and after treatment was assessed using the Headache Disability Index. Objective cervical range of motion in all six planes of motion was assessed using a CROM goniometer. Participants in both groups received six interventions over a three-week period with a minimum interval of 48 hours between each intervention. The subjective and objectives assessments were taken at baseline, post-third and post-sixth interventions. The data was analysed using the IBM SPSS version 24.0. Repeated measures ANOVA was used to examine the effect on each outcome measure separately of time and treatment group interaction. Profile plots were generated to show the rates of changes in outcomes over time by the intervention group. A p value <0.05 was considered statistically significant. Results: For most of the outcomes, there was no clinical or statistical interaction present, i.e. the intervention effect was similar in both groups irrespective of the intervention. Conclusion: The trends in each of the outcomes suggest that the Electromechanical Adjusting Instrument is as effective as cervical spine manipulation for the treatment of cervicogenic headacheItem A clinical trial to investigate the relative effectiveness of acetaminophen with caffeine as opposed to cervical manipulation in the treatment of tension-type headache(2000) Thomson, Deborah Anne; Penter, C. S.Tension-type headache is generally accepted as the most common form of headache and has been shown to have a great impact on work and social activities (Shwartz et al. 1998). Tension-type headache occurs in 39% of people who suffer from headache symptoms with a higher incidence among females, and a peak in the 25-44 year old age group (Wong et al. 1995). The purpose of this study was to investigate the relative effectiveness of 1000mg acetaminophen (paracetamol) combined with 130mg caffeine as opposed to cervical manipulation as a treatment for tension-type headache.Item The relationship of myofascial trigger points of the pericranial musculature and episodic tension-type headache(2007) Forsyth, Juliette Faye; De Busser, Nikki LaurenThe purpose of this study was to determine the relationship between Myofascial Pain Syndrome (MPS) of the pericranial musculature and the clinical presentation of episodic tension-type headache (ETTH). It set out to determine the extent to which MPS is related to the nature of the ETTH. ETTH is a very prevalent disorder, common to individuals in their third decade, and particularly females. Current literature suggests a multi-factorial aetiology, combining psychological and neuromusculoskeletal mechanisms, to name a few. Due to the many facets of this disorder, it has, for a long time, provided a challenge to the practitioner with regard to patient treatment and management. MPS is a condition that may affect any number of muscles, resulting in motor, sensory and autonomic symptoms. MPS of the pericranial muscles, namely the upper Trapezius, Sternocleidomastoid, Temporalis and Suboccipital muscles, produces a referred pain pattern similar to the pain pattern experienced during an ETTH. The literature states that the pain produced by MPS has been somewhat overlooked and it was thus necessary to further investigate the myofascial component of ETTH. This study was a quantitative, pilot, non-intervention, clinical assessment study, which required forty participants residing in the province of Kwa-Zulu Natal suffering from ETTH. The clinical assessment included a case history and physical and cervical examinations. The participants were requested to complete a headache diary over a period of 14 days. Following this, they returned to the Chiropractic Day Clinic for a second consultation. Data was collected at both consultations and the participant was offered one free treatment. The headache diary and Numerical Pain Rating Scale provided the subjective measurements, while the algometer and Myofascial Diagnostic Scale were used to gather the objective measurements.Item An investigation into the diagnosis and management of patients presenting with selected headaches by chiropractors in the greater Durban area(2016) Kleingeld, Stefan; Matkovich, GrantIntroduction There is a worldwide need for research into headaches in order to improve and add to the current model of literature to develop more efficient management strategies for headaches. Headaches can present clinically similarly and present a diagnostic challenge. Currently it is not known what the clinical accuracy of headache diagnosis is or which management strategies chiropractors prefer to use in practice to manage certain headaches. The aim of this study was to investigate the diagnosis of certain headaches by chiropractors in the greater Durban area and to determine how certain headaches commonly treated by chiropractors were managed. Methodology Based on the quantitative paradigm, this is a descriptive questionnaire based study involving a population of 88 chiropractors practicing in the greater Durban area. The final sample size was 63, a response rate of 72%. The questionnaire was developed specifically for this study and was validated by an expert group and tested by a pilot study to ensure construct and face validity. Data regarding demographic information, diagnostic approach to cervicogenic headache (CEH), intracranial haemorrhage, meningitis, migraine (MEH) and tension type headache (TTH) and management of CEH, TTH and MEH was collected from the sample. SPSS version 22 was used to analyse the data. Descriptive statistics were reported in frequency tables. Continuous variables were compared between independent categories using one way ANOVA tests. Trends were shown in cross tabulations and interpreted descriptively where Chi square tests could not be calculated. Results The sample size consisted of 63 chiropractors in the greater Durban area, South-Africa, of which 49.2% (31) were male and 50.8% (32) were female. The mean age was 37 years (range 25 to 71 years). The majority of the sample had between six- to nine years of practice experience, with the majority being in full time practice (82.5% (52)). The majority (92.1% (58)) of the sample had graduated from DUT. Seventeen point five percent (11) of the sample had additional tertiary qualifications, the most common of which was a Master’s degree of Medical Sciences (Sports Medicine), with a total of 19 additional short courses being reported by 79.4% (50) of the sample. Seventy five point one percent (41) of the sample indicated usage of chiropractic specific journals, with 38.1% (24) of the sample indicating that these journals had an impact on the way they manage headaches in practice. Seventy seven point eight percent (49) of the sample attended health related conferences on a regular basis, with 38.1% (24) of the sample indicating that these conferences influenced their management of headaches in practice. Seventeen point five percent (11) of the sample had practiced internationally, with a range of international practice from one month to 12 years. The majority of the sample indicated that they practiced according to a combination of mixer and evidence based philosophy. The accuracy of diagnostic outcome for meningitis was 98.4% (62), TTH was 47.6% (30), MEH was 82.5% (52), CEH was 82.5% (52) and intracranial haemorrhage was 30.2% (19). The results for the management of CEH, TTH and MEH indicated that a minimum of 98.6% (62) would adjust a patient with these headaches; the sample predominantly preferred application of specific adjustments to fixated segments in the cervical and thoracic spine. A minimum of 66.7% (42) regarded spinal manipulative therapy (SMT) as the primary focus of treatment across all three headaches. The most commonly selected modality to be used in conjunction with SMT was massage therapy (with a minimum selection frequency of 68.3% (43) across CEH, MEH and TTH). Massage therapy was the most commonly selected modality to be used when SMT is contra-indicated (minimum selection frequency of 61.9% (40) across CEH, MEH and TTH). A minimum of 98.4% (62) of the sample indicated that they would treat MFPTs if associated with headaches, most commonly using dry needling. For the majority of the sample, the interval of choice for a second appointment was two to three days and the number of treatments expected for relief of symptoms was two to three treatments. Further investigations were considered necessary by the majority of the sample after seven days without any relief of symptoms. The majority of the sample recommended pain free care. Regarding patient advice and education, there was agreement on postural and ergonomic advice, home stretching, stress management techniques and proprioceptive exercises. If treatment goals were not obtained, the majority of the sample agreed to change the treatment plan, reassess all of the previous findings and if necessary refer the patient to another non-chiropractic health care provider. Conclusion Based on the case scenarios used in this study, meningitis, CEH and MEH were accurately diagnosed by the majority of the sample. There appeared to be some confusion with regard to the diagnosis of TTH as nearly half of the sample confused it for CEH. The accuracy with regard to the diagnosis of intracranial haemorrhage was concerning as the minority of the sample correctly diagnosed this condition. A relatively similar approach was used by chiropractors to treat headaches, with relatively little change in the treatment options between CEH, TTH and MEH. Most of the treatment methods, used by most of the sample, have moderate evidence for efficacy in treatment of musculoskeletal conditions. The management options chosen by the majority of the sample could be of potential benefit for the management of the respective headaches. Few differences were noted with regard to the impact of demographic information on the diagnostic outcome and management approaches. Some, but not enough, evidence indicates that the older participants provided less accurate diagnoses. The headaches which were less accurately diagnosed possibly due to an age difference were meningitis, TTH and MEH. With regard to management of headaches the only statistically significant differences were noted for the management of TTH for which age appeared to influence the specificity of adjustments used in TTH.Item The prevalence and impact of primary headaches on students at the Durban based campuses of the Durban University of Technology (DUT)(2016) Basdav, Jyotika; Puckree, Threethambal; Haffejee, FirozaBackground Headaches affect different proportions of many populations and are experienced by any age, gender or ethnicity group. There is a paucity of data on the prevalence of headaches in South Africa, particularly amongst the university student population. Previous studies have suggested that headaches impact on daily activities as well as family and/or social activities. Studies on the impact of headaches on students are limited. Aim of Study The aim of this research study was to determine the prevalence and impact of primary headaches amongst students at the Durban University of Technology (DUT). Methodology A quantitative descriptive cross sectional survey was used to determine the prevalence of primary headaches in the student population at DUT. A minimum sample size of 384 was calculated using a confidence level of 95% and confidence interval of five percent. All six faculties were included. The course programmes and levels were chosen by multi-stage sampling. Each willing participant was required to sign a written consent form prior to enrolment in the study. Subsequently a self-administered questionnaire was filled out. The International Classification of Headache Disorder Criteria was used to classify primary headaches. All data was captured on an Excel spreadsheet and subsequently analysed using SPSS version 23.0. Results The total of 471 completed questionnaires was received. The prevalence of primary and secondary headaches was similar (50.2%; n = 222 versus 49.8%; n = 220, p = 0.92). More participants suffered from tension type (68.5%; n = 152) headaches compared to migraines (16.2%, n = 36) and mixed migraine and tension type headaches (15.3%, n = 34; p < 0.001). None of the study participants suffered from cluster headaches. Poor vision and stress increased the risk of a headache occurrence. The main relieving factor identified was the use of medication. Other relieving factors reported were sleep and relaxation. There was no correlation between suffering from headaches across the different faculties (p = 0.65), age of the participant (p = 0.77), ethnicity (p = 0.40), marital status (p = 0.84) and gender (p = 0.35). Headaches had a negative impact on the academic activities of the affected participants, including limited concentration and a complete halt to studies. Conclusion Tension type headaches were more prevalent amongst the study population. The impact of headaches limited concentration during tests and examination periods. An increased frequency and intensity of headaches was reported during this period. Family, social or leisure activities were also neglected when a headache occurred. This study adds to the current literature on headache prevalence in the student population. It also highlights that chiropractors are not consulted for headaches by students in the South African context. The chiropractic profession can benefit by tapping into this population.Item An investigation into the role of forward head posture as an associated factor in the presentation of episodic tension-type and cervicogenic headaches(2010) Duani, Victor; De Busser, Nikki Lauren; Nell, JacobForward head posture (FHP) is a common postural abnormality, often associated with myofascial trigger points which can result in head and neck pain. The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting C7 spinous process to the tragus of the ear. The smaller the angle the greater the FHP. Cervical musculoskeletal abnormalities have often been linked to headache types, most especially episodic tension-type headache (ETTH) and cervicogenic headaches (CGH). Objectives: To determine whether an association exists between FHP, distance of the external auditory meatus (EAM) from the plumbline and cervical range of motion and the presentation of ETTH and CGH. Method: This was a quantitative comparative study (n=60) comparing three equal groups, one with ETTH, CGH and healthy controls. The FHP of the Subjects FHP was assessed by measuring the CV angle. A lateral digital photograph was taken to assess the distance of the external auditory meatus from the plumbline. Lastly, cervical range of motion was measured. The two symptomatic groups also received a headache diary for a fourteen day period monitoring frequency, intensity and duration of their headaches. Result: The two symptomatic groups had a smaller CV angle and a greater distance from the plumbline (p<0.05) than the asymptomatic group. The asymptomatic group had a significantly greater flexion (p=0.009), extension (p=0.038) and left rotation (p=0.018) range of motion than the two symptomatic groups. The CGH group had a significant positive correlation between the distance of the EAM from the plumbline and the intensity of headaches. The ETTH group had a significant positive correlation between the right craniovertebral angle and the mean duration of headaches. Conclusion: Therefore, it can be concluded that patients presenting with ETTH and/or CGH may have associated postural abnormalities that may act as a trigger or a contributory factor to the presenting headache.