Theses and dissertations (Health Sciences)

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Exploring the perceptions and experiences of chiropractors in the eThekwini Municipality regarding interprofessional referrals
(2026-01-21) Kolia, Amina; Varatharajullu, Desiree
Background Interprofessional collaboration refers to the collaboration among various healthcare practitioners with the intention of providing patients with the most effective and appropriate form of care. These collaborations can be defined as interactions and relationships formed among various healthcare practitioners. This collaboration allows for improved patient outcomes, cost effective healthcare, allocation of resources, and improved satisfaction for the patient and practitioner. A referral among various healthcare practitioners can enable and facilitate interprofessional collaboration. The perceptions and experiences of South African chiropractors needed to be explored and understood. Many studies have focused on how other healthcare practitioners view chiropractors and their perceptions and experiences from the collaboration. Referrals occur when healthcare practitioners interact with one another to provide their patient with the best possible care. Understanding interprofessional referral networks requires a comprehensive analysis of all parties involved in the referral process. The perspectives and experiences offer valuable insights into barriers and challenges encountered in the interaction and collaboration among healthcare practitioners. In South Africa, chiropractors are trained to diagnose any physical defect, illness or deficiency. The treatment for these conditions may be outside chiropractors’ scope of practice, necessitating the use of the referral network. Exploring the perceptions and experiences of South African chiropractors facilitates the identification of potential barriers and challenges, as well as the development of solutions to address them. Aim of the study The aim of this study was to explore the perceptions and experiences of chiropractors with respect to their interprofessional referrals to healthcare practitioners. Methodology This study entailed a qualitative design, using an explorative study design. The study population was qualified chiropractors registered with the Allied Health Profession Council of South Africa, in the location of the eThekwini Municipality, KwaZulu-Natal, South Africa. Purposive and snowball sampling strategies were used to recruit participants. A sample size of 13 participants was used and one-on one interviews were conducted using a semi-structured interview guide. The interviews were approximately 30 to 40 minutes long and were transcribed verbatim. The transcripts were analysed and a list of topics were made. The topics were abbreviated into codes and these were arranged in alphabetical order. The codes that were similar and regular were grouped to form categories. Themes or concepts were made from the categories and a theoretical construct was formed. Thematic analysis was conducted using Tesch’s method of thematic analysis. Results The study identified four main themes, namely interprofessional collaboration and referral dynamic, patient perspectives on referral and continuation of care, challenges encountered in the referral process, and enhancement of the referral network. The participants expressed reasons for patient referrals in the chiropractic profession, as well as other professions. They emphasised their personal networks and expressed shared values on interprofessional interactions, with noted positive outcomes. The participants noted a correlation among patient preferences and their healthcare decisions. Obstacles encountered by patients impacted their referrals and the participants emphasised the relevance of these obstacles to patient care. A variety of obstacles encountered by the participating chiropractors were discussed, including stereotypes, misconceptions surrounding the chiropractic scope of practice, geographical location, communication barriers, chiropractic jargon, other practitioners age and sense of ownership, as well as the exclusion of chiropractic from the public healthcare system. Methods to improve interprofessional referrals and collaboration were then outlined and discussed in detail. Conclusion This qualitative study explored the perceptions and experiences of chiropractors in eThekwini Municipality regarding interprofessional referrals and collaboration. This study emphasised the importance and value of referrals when patient care falls outside the scope of chiropractic and emphasised that positive working relationships facilitate evidence-based and patient-centred care. Several challenges to collaboration were found to be stereotyping, communication barriers, and exclusion from the public healthcare system. This study outlined the need for better communication, new graduate guidance and clinical training to facilitate and improve the collaborative relationships among chiropractors and other professions. It offers insights from the perspective of South African chiropractors and recommends further investigative studies in other municipalities.
The value of the strengths-based approach at residential child and youth care facilities in eThekwini, KwaZulu-Natal
(2025-06-20) Khumalo, Nkosingiphile; Dewan, Fathima
The child and youth care profession has always existed to provide services for children and youth who are vulnerable, orphaned or at risk, as well as for their families. However, there is insufficient information on the approaches utilised by child and youth care professionals to ensure optimum growth and development in residential child and youth care facilities. The findings of this study intend to provide knowledge about the application and challenges child and youth care professionals may encounter when using the strengths-based approach, which is an approach that seeks to empower children by focusing on their existing capabilities and resources, rather than solely focusing on their deficits or problems. The study’s aim was to explore the value of the strengths-based approach at residential child and youth care facilities and provide recommendations to enhance and inform strengths-based work in child and youth care. The study adopted a phenomenological research approach using eighteen locally based child and youth care workers from three child and youth care centres in the eThekwini region, Durban, KwaZulu Natal. The study participants were purposively chosen to participate in semi-structured in-depth interviews. Data was analysed using thematic analysis. All the ethical considerations, such as voluntary participation, anonymity, informed consent, and confidentiality, were thoroughly followed and adhered to. The research study results highlighted the significant value of strengths-based work in residential child and youth care settings. Notably, this approach has been instrumental in promoting language and age-appropriate programmes, interventions, and assessments tailored to the unique needs of young people. Moreover, strengths-based work has fostered growth and development in the lives of young people, yielding positive outcomes. Participants emphasised that the strengths-based approach is a valuable tool in child and youth care because it governs the way they think about children and young people and the way they go about their life-space work daily. This approach is responsible for meaningful behavioural changes in young people which is the core objective for child and youth care work. Participants in the current study also highlighted the disadvantages of employing this approach stating that strengths-based work is time-consuming, requiring significant investment in building relationships and implementing individualised plans. Additionally, participants reported difficulties in the implementation of the strengths-based approach, highlighting the negative behaviours and attitudes they encounter from children, which hinders progress and create challenges for practitioners. There is also inadequate emotional and financial support offered by the organisation. According to the study results, it was established that many problems in the strengths-based approach can be solved by training, support or education. A better understanding of strengths-based work and the value of this approach may strengthen and improve strengths-based services, broaden knowledge, and enable child and youth care workers to provide thorough treatment and appropriate interventions for children’s developmental needs. It is therefore recommended that future studies evaluate the effectiveness of strengths-based approaches from the perspectives of children and young people in residential care and compare outcomes across different settings and populations to further inform best practices.
The prevalence and risk factors of muscle dysmorphia in amateur male bodybuilders in the eThekwini Municipality
(2025-07-18) Govender, Sachin; Pienaar, Cindy; Van Heerden , Kirsten; Prince, Cleo
Background Muscle dysmorphia (MD), which falls within the spectrum of Body Dysmorphic Disorder, is an increasingly common psychological condition worldwide. Within the bodybuilding community, “bigorexia” manifests when bodybuilders perceive themselves as having much less muscle mass than they actually do, which resorts to the use of performance enhancing drugs (PEDs). Although PEDs are prescription based, illegal use/excessive use can result in physiological and mental complications. Furthermore, the lack of research on MD in developing countries, such as South Africa, warrants investigations pertaining to the development of certain risk factors as well as the pathogenesis of the preoccupation of muscularity in MD. This will assist medical practitioners, such as chiropractors, in identifying and understanding MD risk factors and lead to improved patient management. Methods: The research utilised a quantitative, descriptive, cross-sectional survey approach. The study targeted enrolling at least 196 amateur male bodybuilders from five chosen gymnasiums within the eThekwini Municipality area. Following the acquisition of informed consent, participants completed the modified Adonis Complex Questionnaire (ACQ). The collected questionnaire data were analysed using IBM SPSS version 25. Results: The main findings of this study showed that most participants (65.8%) reported a minor concern of MD, 32.1% reported a moderate concern of MD and only 2% reported a serious concern for MD in the eThekwini Municipality. The prevalence of MD in amateur male bodybuilders showed a weak positive correlation with selected self-reported risk factors (low self-esteem, childhood victimisation, anxiety, perfectionism, eating disorders, PEDs and social media. The regression analysis revealed that unhealthy eating behaviours accounted for 19% of the variance, followed by anxiety, victimisation, and social media influence, which accounted for 10.4%, and self-esteem and perfectionism, which accounted for 3.9%. Only 2% of participants expressed having a serious concern of body image dissatisfaction, therefore, MD was found to not have any influence on the quality of life of majority of the selected participants in this study. The quality of life of the 2% of participants with a serious concern of MD may have been influenced psychosocially and physically. The aim, objectives one, two, three as well as the alternate hypothesis, which states that MD is present in some amateur male bodybuilders in the eThekwini Municipality were achieved in this study. Conclusions: The key findings showed that there was a 2% prevalence of MD amongst the participants in this study. There was a weak positive correlation of self reported risk factors for developing MD which included low self-esteem, anxiety, depression, childhood victimisation, perfectionism, social media influence and an unhealthy relationship with food. In terms of quality of life, MD did not have a significant influence on the participant’s perception of their quality of life. Chiropractors play an essential role in patient care due to injuries caused by over-exertion/over-training as a result of MD. Therefore, collaborative treatment plans with other healthcare professionals, such as psychologists, nutritionists and physicians is necessary to provide full comprehensive care for individuals with MD. By working together, healthcare professionals can create integrated treatment plans that consider all aspects of an individual’s health. This holistic approach can improve overall treatment outcomes as it ensures that all contributing factors to MD can be addressed.
Detection of potentially pathogenic bacteria on emergency care personnel's safety protective footwear and evaluation of infection, prevention, and control procedures in the uMgungundlovu district of KwaZulu-Natal
(2025-10-16) Gengan, Jerry Devraj; Sobuwa, Simpiwe; Reddy, Poovendhree
Emergency Care Personnel (ECP) within KwaZulu-Natal Emergency Medical Services (KZN EMS) consistently respond to medical, trauma, and disaster emergencies. Emergency care personnel often serve as primary responders responsible for providing specialised care and life-saving interventions, which may increase their risk of exposure to healthcare-associated infections. Emergency care personnel are equipped with official attire and Safety Protective Footwear (SPF), which are part of their Personal Protective Equipment (PPE) for duty. Working in the pre-hospital setting presents challenges due to the lack of patient history provided to ECPs’ upon initial contact, increasing the risk of Healthcare-Associated Infections (HAIs). Emergency care personnel may unintentionally facilitate transmission of diseases. In the pre hospital setting, there is a scarcity of information regarding disease transmission. Emergency care personnel are restricted in their ability to sanitise and disinfect their vehicles and SPF because of high-priority cases and limited turnaround times. In the absence of an Infection Prevention and Control (IPC) policy regarding cleaning procedures for EMS personnel, there is a potential risk of HAIs. KZN EMS does not possess an adequate IPC system, in contrast to hospitals. The purpose of this study was to evaluate ECPs' SPF for the presence of microorganisms related to bacterial infections and to determine whether EMS KwaZulu-Natal uMgungundlovu district has any infection prevention and control procedures or policies. This study employed a prospective cross-sectional quantitative approach and was conducted in two phases. The initial phase involved swabbing of 53 selected ECPs’ SPF at the EMS Grey’s Hospital base to identify bacterial contamination. This was followed by data collection using a questionnaire distributed to all EMS bases in the uMgungundlovu District, aimed at assessing ECP's ICP awareness and practices among 165 staff members. After distributing the questionnaire to all bases in the uMgungundlovu district, a total of 303 participants were surveyed, with 165 (54%) responding. A considerable proportion of participants were uninformed of EMS policies and practices due to the absence of an EMS IPC policy. Inadequate ICP awareness, insufficient disinfection practices, unavailable PPE, and inaccessible cleaning supplies were all prevalent issues. The study employed an aerobic culture-based method consisting of 53 samples. The bacterial analysis revealed six pathogens (11.3%) in seven (13.2%) SPF samples. Pasteurella canis, Enterococcus faecium, Enterococcus casseliflavus, Escherichia coli, Pantoea agglomerans, and Acinetobacter radioresistens were all identified as potential pathogenic organisms. This study demonstrated the prevalence of microbial contamination on ECPs’ SPF, which may act as a reservoir for transmitting potential infections to patients and healthcare personnel. Emergency medical service personnel showed significant non compliance in cleaning and disinfecting practices. KwaZulu-Natal EMS uMgungundlovu District lacks an effective cleaning protocol for decontaminating SPF. Further research is necessary to determine whether contaminated SPF contributes to the transmission of infectious pathogens in pre-hospital settings. Additionally, KZN EMS must address the insufficient supply of cleaning materials, inadequate IPC training, and poor procedural guidelines.
The epidemiology of musculoskeletal pain in dressage riders in KwaZulu-Natal : a cross sectional study
(2026-04-07) Alberts, Jessica; Chetty, Sean; Varatharajullu, Desiree
Background: Previous studies indicate that horse riders experience a high prevalence of equestrian related injuries and back pain; however, these studies have combined different horse-riding disciplines, assessed back pain only in elite dressage riders, or reported on the prevalence of equestrian-related injuries. There is a scarcity of research on dressage horse riders in South Africa and on musculoskeletal pain in this population. Therefore, this study addresses the prevalence of musculoskeletal pain in dressage riders in South Africa, thus bridging the gap between research done on horse riders in other countries and horse riders in South Africa. Aim: To investigate the prevalence of musculoskeletal pain in dressage horse riders in KwaZulu Natal. Objectives: To determine the point and period (one year) prevalence of musculoskeletal pain in dressage riders in KwaZulu-Natal. To investigate the selected risk factors (the velocity of horse riding, the time spent horse riding, the type of saddle being used, the number of horses being ridden, the mechanical differences in the horse’s movement, history of previous horse-riding injury) on the prevalence of musculoskeletal pain in dressage horse riders in KwaZulu-Natal. To determine the impact of musculoskeletal pain in dressage riders in KwaZulu Natal. To determine the association between the prevalence of musculoskeletal pain and selected risk factors. Results: A total of 89 participants completed the questionnaire, resulting in an 81.65% response rate. The majority of riders (83%) had a history of experiencing musculoskeletal pain at some point during riding, with low back pain being the most common region (65%). A majority of 89% of riders were currently experiencing musculoskeletal pain, with low back pain being reported as the most common region (48%), followed by neck pain, mid-back pain and knee pain (25%). The musculoskeletal pain was most described as being sharp (62%) and tight/spasm (57%). Strenuous riding (28%) and riding multiple horses a day (28%) were reported to be the most contributing factors for aggravating musculoskeletal pain. Conclusion: This study has revealed the prevalence of musculoskeletal pain in the different anatomical regions in dressage horse riders, adding to the body of literature on musculoskeletal pain in horse riders. The study emphasised the different biomechanical demands on dressage riders and how the rider is impacted, adding to the importance of adequate treatment methods for the different sporting disciplines.
A study on the management of hyperpigmentation in skin types IV to VI AT aesthetics clinics in eThekwini, KwaZulu-Natal
(2026-02) Memela, Simphiwe Nokwanda; Ghuman, Shanaz
Hyperpigmentation is a skin disorder caused by the increase of melanin production in the skin, caused by different internal (e.g. hormones) and external (e.g. UV exposure) stimuli. Different types of hyperpigmentation, namely melasma, post-inflammatory hyperpigmentation and solar lentigines, may be found amongst individuals. Persons with darker skin tones (greater melanin production) are more susceptible to hyperpigmentation due to their melanocytes being slightly larger and easily triggered by internal and external stimuli, compared to individuals with the skin type I-III. In relation to the treatment of hyperpigmentation in skin of colour, extra precautions should be taken due to the skin being easily irritated, resulting in the increase of pigmentation as a mechanism of the skin protecting itself from further damage. Therefore, professional treatments would include micro-needling and gentle chemical peels, which have been explored in this study during treatment, in addition to tyrosinase inhibitors which were used during treatments, as well as a home supportive treatment regime. With the use of an appropriate treatment plan and home-care regime, the individual noticed improvement in their skin with reduced pigmentation, an evened-out skin tone and reduced fine lines and wrinkles as an additional benefit. The tool used for data analysis was a semi-structured questionnaire and open-ended statements. Questions were developed by the researcher in line with the objectives employed to gather qualitative data. The questions were based on the hyperpigmentation typologies, current skin treatment, as well as homecare. These were distributed to the participants to complete during Phase (1), and Phase (2) entailed the researcher conducting the qualitative component. The study was conducted within eThekwini, in KwaZulu-Natal. The study constituted 30 participants who were undergoing hyperpigmentation management programs, who consented to participate in the study. Census sampling was implemented as every participant’s responses were utilised during data collection and analysis. The study explored the different hyperpigmentation treatment approaches that were offered to individuals with Fitzpatrick Skin Types IV to VI. The treatment approaches proved to be a success as participants were satisfied with their results. The participants did point out that it is a gradual process that needs patience from the professional as well as from the individual that is on the journey.
A probabilistic and epidemiological assessment of health risks associated with recreational exposure to contaminated surface water : a case of the uMsunduzi River
(2026-02) Mdluli, Zinhle Pearl; Sibiya, Maureen Nokuthula; Amoah, Isaac Dennis; Pillai, Sheena Kumari Kuttan
Water quality degradation and scarcity have become prominent global concerns. In South Africa, poorly treated effluent from wastewater treatment facilities has contributed to the deterioration of river water quality, often exhibiting elevated levels of microorganisms. This study evaluated the microbial water quality of the uMsunduzi River and established a correlation between exposure to the river and the incidence of diarrheal infections among Dusi Marathon participants. In addition, the study conducted a theoretical assessment of the pre-and post-exposure risk reduction interventions that have the potential to safeguard participants of the canoe race The study employed a comprehensive approach, which included a water quality analysis using Escherichia coli, Pseudomonas aeruginosa, and Cryptosporidium spp. as reference pathogens. The detection of E. coli and P. aeruginosa was conducted using IDEXX Colilert-18 and Pseudolert detection and enumeration kits, and digital droplet Polymerase Chain Reaction (ddPCR) for Cryptosporidium spp. An exposure and diarrheal incidence assessment through a prospective survey methodology and a Quantitative Microbial Risk Assessment (QMRA). Data analysis and interpretation for the exposure and incidence assessment were accomplished using the most recent IBM® SPSS® VERSION 27. The probability analysis for the QMRA was conducted using the distribution fitting capability included in the @Risk 7.5 program developed by Palisade Corporation. The study detected elevated levels of E. coli, Pseudomonas aeruginosa, and Cryptosporidium spp. in the river water, exceeding acceptable limits set by World Health Organization and Department Water Affairs and Forestry. The exposure diarrheal incidence assessment revealed a significant association between river exposure and diarrheal infections, with a 97% increased risk of developing diarrhea among those who ingested water from the river. The QMRA indicated a significant risk of infection for populations who depend on the uMsunduzi River for recreational activities, primarily associated with Cryptosporidium spp. The conclusions drawn suggest that regular monitoring is crucial to ensure the safety of water for leisure activities such as swimming, boating, and fishing. Monitoring systems may identify possible health threats and apply appropriate mitigation actions by testing for pathogens, biological contaminants, and chemical pollutants. Recreational bodies of water may act as a reservoir for waterborne infections, offering significant health risks to persons. This primary data analysis provided a comprehensive overview of the incidence of diarrhea among Duzi Canoe Marathon participants in 2022. We identified participant demographics and exposure assessments, key factors contributed to this health concern. As the Duzi Canoe Marathon continues to attract diverse participants, understanding and addressing health challenges is paramount. This analysis is a valuable resource for future event planning and underscores the commitment to participant welfare.
The treatment practices of homoeopaths, phytotherapists and traditional healers with regards to female infertility in the KwaZulu-Natal province
(2026-01-28) Mtolo, Xoliswa Princess; Hall, Cornelia Maria
Background David Hoffmann (1997: 97) writes: "More than any of the other systems, the reproductive system shows the miracle of life at work. It is a miracle that we can wonder at, can analyse in terms of tissue and hormone function, write poetry about, but which in the end will leave us speechless." Reproduction is an important biological event in human beings, so anything that threatens reproduction, for example infertility, will trigger a significant response. Infertility is a disorder of the reproductive system and is defined as an inability to achieve and keep a pregnancy after a year or more of consistent, non-contraceptive and unprotected sexual intercourse involving a biological male and female of reproductive age. There are different treatment approaches to female infertility depending on several factors including the aetiology and the duration of the infertility. South Africa has different healthcare approaches, comprising allopathic medicine, complementary medicine and traditional medicine. Homoeopathy and phytotherapy fall under complementary medicine, while traditional medicine is also a recognised form of medicine that is culturally very accepted and popular. Aim of the study The study aimed to explore different treatment practices of homoeopaths, phytotherapists and traditional healers with regards to female infertility, with the objective of expanding the treatment options that are available for women diagnosed with infertility. Methodology A qualitative and explorative study design was utilised. Twelve participants were selected by virtue of their capacity to provide precise information, with the aim of increasing the efficiency of the study. Respondents were interviewed individually using an interview guide and each of the interviews were audio recorded and transcribed. The transcripts were analysed using Tesch's (1992) 8-step approach to qualitative research, whereby specific recurring themes are extracted from the data. Results After the 12 participants were interviewed, data was analysed, and four major themes emerged. The participants demonstrated a strong understanding of female infertility, including its causes, contributing factors and diagnostic procedures. The practitioners interviewed in the study described various treatments or management strategies for female infertility. Findings were that the main treatments of three modalities were: homoeopathy – Natrum muriaticum, Sepia officinalis and Pulsatilla pratensis; phytotherapy – Agnus castus, Actaea racemosa (black cohosh), and Asparagus racemosus (shatavari); traditional medicine – imbiza and isihlambezo. All participants confidently stated that their treatment methods were safe and had a high success rate in helping women achieve pregnancy and eventually parenthood. Conclusion The salient themes of this study strongly suggest that homoeopaths, phytotherapists and traditional healers have an in-depth understanding of female infertility with a wide range of trusted and safe treatment methods that have proven to help females achieve a longed-for pregnancy and parenthood. Based on these findings the researcher recommends that interprofessional interaction and referrals between conventional and CAM practitioners be broadened so that treatment practices evolved from this study can be pursued.
An in vitro study on the physiological actions of Carbolicum acidum 5CH, 9CH, 15CH, 30CH, 200CH on granulocytes and T-cells chemical mediators in cellular allergic responses
(2025-10-21) Mzimela, Mnqobi Victor Khayelihle; Mkhize, Brenda Thabisile; Nokhuthula Hloniphani, Mavela
With allergic diseases on the increase globally, alternative and complementary methods of treatment need to be investigated for the management of allergic conditions. Homoeopathy is an alternative system of medicine that works by stimulating the body’s vital force, which is the unique energy of each individual, to cure illnesses. This study investigated the physiological effects of a homoeopathic remedy, Carbolicum acidum 5CH, 9CH, 15CH, 30CH, and 200CH, on chemical mediators associated with allergic reactions by conducting an in vitro experimental study using granulocytes and T-cells isolated from human whole blood. The study was based on the hypothesis that higher potencies will have inhibitory effects on the expression of allergic chemical mediators, while lower potencies will have a stimulatory effect. This hypothesis was founded on the homoeopathic principle of infinitesimals which indicates that the higher the homoeopathic potency, the greater the curative power of the remedy . This study further observed the concept of hormesis, which states that the effects of an agent on biological systems will have stimulatory functions in low doses, whereas higher doses are inhibitory, thereby showing a dose-response relationship. To evaluate the effects of this homoeopathic anti-allergy remedy, human whole blood was aliquoted with potencies of Carbolicum acidum. The cell suspensions were then stimulated with a BD leukocyte activation cocktail, which induced the activation of cells and chemical mediator release. The levels of chemical mediator release were quantified by measuring the upregulation of activation markers on the cell surfaces of granulocytes and T-cells using a BD FACSymphony A5 flow cytometer. The activation markers that were investigated included HLA-DR, CD203c, CD63, and CD69. The effects of treatment on the expression of these markers were also investigated using flow cytometric analysis. The key findings of this study, first of its kind in South Africa, demonstrated that Carbolicum acidum had significant effects on the expression of activation markers HLA-DR (p = 0.005), CD203c/CD63 (p < 0.001), highlighting its physiological effect in modulating chemical mediator release.
The effectiveness of active release technique and the combination of active release technique and muscle energy technique in the treatment of hamstring tightness associated with chronic lower back pain
(2025-04-25) Chen, Ching-Hsuan; Ally, Fazila; Prince, Cleo
Background: Chronic lower back pain (CLBP) is one of the top ten causes of daily disability that affect large population globally. Musculoskeletal disorders account for 80% of lower back pain and in particular, hamstring tightness has been identified as one of the causative factors of chronic lower back pain. Massage, needling and cupping therapy have been proven to be effective treatment options. However, these treatments are prohibited for patients with contraindications such as pregnancy, cancer, sunburn, rash, deep vein thrombosis and diabetes mellitus. Therefore, it is important to establish treatment options that can be administered to patients who present with low back pain due to hamstring tightness, but who also present with contraindications to established treatment options. Techniques such as active release technique (ART) and muscle energy technique (MET) have been investigated in conditions like tension headache, chronic neck pain, tennis elbow, carpel tunnel syndrome, sciatic nerve pain and plantar fasciitis. However, these techniques have not been investigated in the treatment of chronic lower back pain caused by hamstring tightness. Aim: This study aimed to identify the effectiveness of active release technique alone versus the combination of muscle energy technique and active release technique in the treatment of chronic lower back pain due to hamstring tightness. Method: The proposed research study utilised a quantitative study design consisting of an experimental single blinded randomised and comparative clinical trial. The target population included participants between the ages of 18-55 years who reside in the eThekwini region of KwaZulu-Natal. A total sample size of 40 patients underwent a randomised controlled trial and took place with 2 groups of 20 participants each. Group A, received active release technique alone in the treatment of hamstring tightness causing chronic lower back pain, and Group B, received the combination of active release treatment and muscle energy technique in the treatment hamstring tightness of chronic lower back pain. Each group received 2 interventions and the results from group A and group B were compared to identify the effectiveness from the outcome. Throughout, a p-value of 0.05 was used to indicate significance levels. The analysis carried out using IMB SPSS Statistics 27 software. Result: The findings of this study revealed that there was a significant difference between the group receiving ART alone compared to the combination of ART and MET. Conclusion: In conclusion, this study revealed that the use of combination of ART and MET is more effective than the use of ART alone.
A qualitative inquiry on the physical, psychological and social effects of the 2022 floods on individuals, families and communities’ in eThekwini, KwaZulu-Natal
(2025-08-13) Singh, Vikesh; Bhagwan, Raisuyah
In April 2022, eThekwini metropolitan, situated in the Province of KwaZulu-Natal experienced one of the most devastating floods events in recent history. The heavy rains caused landslides, mass destruction of homes, damages to infrastructure and the displacement of thousands of people. Many communities were affected and homes and businesses washed away, particularly those in informal settlements and homes in low lying areas. The flooding disaster also affected the transport systems causing businesses to become affected and disrupting people’s access to healthcare and schools. Thousands of people were displaced into temporary and long term shelters with limited resources. Whilst the number of floods that have affected human societies has increased globally each year, little empirical research related to how it was experienced in South Africa has been done. This study sought to explore the physical and psychosocial effects of the April 2022 floods on individuals, families and communities, in South Africa as well as the role of faith based organizations within the disaster response and recovery efforts. A qualitative case study design was used to inform the study process. Non-probability purposive sampling techniques were used to recruit a total of forty-three participants. Four samples were recruited. The first three were community members affected by the floods and residing within an urban area, semi-rural area and an informal settlement. The fourth sample included participants from a Christian, Hindu and Muslim faith-based organisation. Semi-structured interviews were used to gather data which was then analysed using thematic analysis. The key findings show that participants suffered significant physical hardship including injury, illness and exposure to poor living conditions in the aftermath of their displacement. Families reported the loss of their homes, essential belongings and items of sentiment. The study highlighted that those living in disadvantaged spaces, such as informal settlements, endured the largest losses as their homes were most vulnerable to the heavy rainwaters, as they were built from poor building materials. The floods also damaged community infrastructure and utilities such as electricity and sanitation, placing community members at risk of health issues. The psychological effects on the participants were also widespread and participants described experiencing substantial levels of sadness, fear, anger and anxiety. Families were displaced and community support was weakened, further affecting the mental health of participants. Faith-based organizations were found to play a significant role in the response and recovery activities. They mobilized quickly to provide shelter, food, clothing and bedding for those who were displaced. They created safe spaces for weeks and months not only by providing material assistance, but also through offering counselling, prayer and spiritual support, thereby helping individuals and families to process their losses and fostering resilience. The data also showed that the early warning signs associated with weather forecasting were not well communicated to those most vulnerable, as most people were unaware of the impending flood and its dangers. In conclusion, this study offered rich and insightful perspectives into the lives of those affected by the floods. It reflected the interconnected nature between the physical, psychological, social and spiritual effects of the flood, by showing how damages to homes, livelihoods and the displacement were intertwined with mental health struggles and social isolation. Faith based organizations filled a critical gap in service provision and contributed meaningfully to the disaster response and recovery. This study will contribute to the disaster management policies and strategies in eThekwini and South Africa, through its holistic findings, on how individuals, families and communities were affected and the role played by local government and community organizations in responding to the disaster.
Cervical spinal manipulation for neck pain-effect on muscle recruitment patterns, spinal kinematics, pain and disability in participants in KwaZulu-Natal
(2025-08-25) O'Connor, Laura Maié; Pillay, Julian David; Murphy, Bernadette
Background Neck pain is a common disabling condition that can become chronic, leading to economic and personal burdens. A small pool of research highlights variations in motor control in neck pain, where alterations in spinal kinematic and/or muscle activation patterns, have been found during head, neck and unilateral arm tasks. Bilateral arm tasks have not been assessed, despite their common use in occupational settings and daily life. Few studies have simultaneously assessed spinal kinematics and muscle recruitment patterns in those with neck pain. The combined assessment allows a more holistic view of how neck pain may impact motor control which can lead to more effective interventions to target these processes. A common treatment for neck pain is spinal manipulative therapy (SMT). Although well utilised, the specific mechanism through which it exerts its reported clinical effects are not well understood. Mechanistic studies suggest that it activates neurophysiological processes which in addition to inducing pain relief activate reflexogenic, spinal and supraspinal structures involved in motor control. Little is known regarding the effect of SMT on spinal kinematics and muscle recruitment patterns and if changes in these motor variable correlate with pain and disability in those with neck pain. Thus, this study aimed to determine the effect of cervical SMT on pain, disability, cervicothoracic spinal kinematic and muscle activation patterns while performing a cervical range of motion (ROM), a unilateral and bilateral arm task when comparing to a control intervention. Methods Prior to the implementation of a randomised, controlled trial (RCT), a case controlled cross-sectional study was undertaken to determine the presence of cervicothoracic spinal kinematic and muscle activation patterns in adults with chronic, non-specific neck pain (n=20) compared to age and sex matched controls (n=20). Pain and disability measures and were obtained from those with neck pain; with health status being collected from all the participants. Spinal kinematics were obtained via motion capture and surface electromyography was utilised to obtain muscle recruitment patterns from six pairs of cervicothoracic muscles. Data were collected during seated cervical ROM, a seated unilateral and standing bilateral upper limb lifting task. Statistical analysis was performed with a p-value less than 0.05. A randomised, controlled trial (RCT) was then utilised to collect data from adults with chronic, non-specific neck pain (n=39), who were allocated to receive either cervical SMT or a control intervention. Four treatments were administered over 2 weeks with a one week follow up. Pain, disability and health status were measured. The same methodology as utilised in the case-controlled study was employed to obtain cervicothoracic spinal kinematics muscle recruitment patterns from six pairs of cervicothoracic muscles. Participants undertook 3 tasks: cervical range of motion, a unilateral and bilateral upper limb lifting task. Measurements were taken at baseline, the fourth visit and at a one-week follow-up. Statistical analysis was performed with a p-value less than 0.05. Results When comparing those with neck pain to those without, during cervical ROM the participants with neck pain took longer to complete right lateral flexion (p = 0,018, r = 0.35), no differences between the groups were found for peak displacement, peak and mean velocity and jerk (p ˃ 0.05). Those with neck pain had reduced left posterior cervical muscle activation time during cervical extension (p = 0.026, r = 0.34), peak activation during left and right away lateral flexion (p = 0.030, r = 0.32; p = 0.047, r = 0.29) and in the left anterior scalene during right rotation (p = 0.049, r = 0.29). Increased activation time was found in right lateral flexion in the left paraspinal muscle during the away and return phase (p = 0.042, r = 0. 0.27; p = 0.026, r = 0.34), for rotation in the left paraspinal on right rotation during the away and return phase (p = 0.042, p = 0.002), for peak and mean activation in the away and return phases (p ˂ 0.05, medium effect sizes). The unilateral arm task resulted in those with neck pain having less peak displacement in upper thoracic spine rotation (p = 0.017, r = 0.35), greater displacement in lateral flexion (p = 0.006, r = 0.40) and rotation (p = 0.038, r = 0.31) in the lower thoracic spine. During lifting and lowering those with neck pain had a greater lower thoracic spine rotation range (p = 0.036; p = 0.004). Muscle activation showed a greater percentage activation time in the right upper trapezius (UT) and left paraspinal at T4 (p = 0.039, r = 0.30; p = 0.039, r = 0.30) and lower peak activation in the left paraspinal at T4 (p = 0.032, r = 0.32) in lifting. During lowering the left paraspinal muscle at T4 had a greater activation time percentage (p = 0,005, r = 0.34), lower peak (p = 0.019, r = 0.42) and mean (p = 0.044, r = 0.24) activation in those with neck pain. The bilateral task showed greater cervical lateral flexion velocity (p = 0.024, r = 0.34) in those without neck pain, and an increased rotation range in the upper and lower thoracic spines (p = 0.024, r = 0.34; p = 0.016, r = 0.37) in those with neck pain while lifting. During lowering, those without neck pain had increased average velocity in cervical lateral flexion (p = 0.012, r = 0.34) and rotation (p = 0.022, r = 0.35). No significant differences between the groups were found for muscle activation patterns in the bilateral arm task. When comparing the effect of cervical SMT to a control group, those receiving SMT had greater pain reduction by visit four (p = 0.010; η2= 0.22), with no between group difference by the one-week follow up. The SMT had improved disability by one-week follow when compared to the control p = 0.006, η2= 0.24). At the fourth visit, the SMT group had an improvement in pain (p = 0.010, η2= 0.22), with no difference between the groups at the one week follow up (p = 0.340, η2=0.03). Greater improvements in disability occurred at the one week within the SMT group (p = 0.006, η2= 0.24). No between group differences were found for the global impression of change scale or level of satisfaction (p ˃ 0.05) between the groups, except for the SMT group reporting improved emotions (p = 0.001) and quality of life (p = 0.025). For cervical ROM assessment after one treatment, increased velocity in left rotation (p = 0.040, η2 = 0.119) and jerk in flexion (p ˂ 0.05), right (p = 0.023, η2 = 0.148) and left (p = 0.025, η2 = 0.144) lateral flexion and left rotation (p = 0.043; η2=0.115) was found in the SMT group. The control group had greater activation in the left posterior cervical (PC) (p = 0.012, η2 = 0.180) in flexion, left anterior scalene (AS) (p = 0.007, η2 = 0.215), left sternocleidomastoid (SCM) (p = 0.019, η2 = 0.164) in extension and the left paraspinal at T9 (LT9) during right lateral flexion (p = 0.049, η2 = 0.116). Less activation occurred in the control group for peak (p = 0.041, η2 = 0.128) and mean (p = 0.045, η2 = 0.123) activation in the LAS and the left LUT (p = 0.008, η2 = 0.192) in right lateral flexion; peak (p = 0.029, η2 = 0.145) and mean (p = 0.025, η2 = 0.151) activation in the right AS and in the LT9 for away time percentage (p = 0.019, η2 = 0.145) in left lateral flexion and the right PC (p = 0.024, η2 = 0.146), LT4 (p = 0.021, η2 = 0.147) and right SCM (p = 0.038, η2 = 0.127) for right rotation. After three treatments the SMT group had increased return peak jerk in flexion (p = 0.034, η2 = 0.146) and return peak (p = 0.028v) and away average jerk (p = 0.008, η2 = 0.191, η2 = 0.175) in left rotation. Muscle activation was less in the control group in the right AS during flexion (p = 0.024) and greater for right PC for peak (p = 0.034, η2 = 0.149) and mean activation (p = 0.002, η2 = 0.179) and LUT (p = 0.015, η2 =0.187) in extension, left AS in away (p = 0.048, η2 = 0.142) and return (p = 0.042, η2 = 0.042) right lateral flexion and in the LPC away (p = 0.029, η2 = 0.159) and mean (p = 0.029, η2 = 0.134) activation in left lateral flexion. The intervention group had greater activation in the left paraspinal at T4 during the return phase of flexion (p = 0.035, η2 = 0.149). When assessing the effect of the interventions on the unilateral arm task there were no differences between the groups for spinal kinematics following one treatment (p ˃ 0.05), with greater peak (p = 0.038, η2 = 0.13) and mean (p = 0.031, η2 =0.14) muscle activity in the right paraspinal muscle in the intervention group during the lowering phase. At the fourth visit the intervention group had a greater upper thoracic spine rotation range (p = 0.021, η2 = 0.17) during lifting, and increased flexion/extension range in the lower thoracic spine (p = 0.037, η2 = 0.141) during lowering. The right upper trapezius muscles had greater mean activity in the intervention group (p = 0.026, η2 = 0.141) during lifting. In the bilateral arm task, greater flexion/extension jerk occurred in the lower thoracic spine (p = 0.038, η2 = 0.13) during lowering in the control group, with the intervention group having greater jerk in lateral flexion (p = 0.014, η2 = 0.13) and rotation (p = 0.019, η2 = 0.17) and greater rotation range (p = 0.041, η2 = 0.13) and velocity (p = 0.006, η2 = 0.22) in the lower thoracic spine. The intervention group had less peak activity in the right PC muscle during lifting (p = 0.049, η2 = 0.119), with greater peak activation in the right paraspinal T4 (p = 0.026, η2 = 0.151) and activation time percentage in the right SCM during lifting (p = 0.029, η2 = 0.148) and lowering (p = 0.015, η2 = 0.186). At the fourth visit, the intervention group had greater upper thoracic spine flexion/extension jerk (p = 0.045, η2 = 0.14) during lowering, with lower left PC peak muscle activation during lifting (p = 0.029, η2 = 0.16) and mean activation during lowering (p = 0.006, η2 = 0.237). Mean activation of the left (p = 0.039, η2 = 0.154) and right (p = 0.034, η2 = 0.157) SCMs during the lowering phase was greater in the intervention group. No differences were found between those receiving SMT and the control for perceived global impression of change categories (p=0.500) or level of satisfaction (p ˃ 0.05), except that the SMT group reported improved emotions (p = 0.001) and quality of life (p = 0.025). Conclusion People with neck pain presented with an altered pattern of motor control reflected by changes in cervicothoracic spinal kinematic and muscle recruitment patterns. This presentation was influenced by the activity, which was undertaken, often involving the thoracic spine more than the cervical spine. When treated with cervical SMT there was a decrease in pain and disability with increased rotation velocity and jerk in flexion, lateral flexion and left rotation immediately after one treatment and in the short term when performing cervical ROM. This was associated with increased activation patterns of cervicothoracic muscles during lateral flexion and rotation after one treatment with lower activation levels occurring after three treatments. In the upper limb tasks, the intervention effects were few and variable. This study showed that cervical SMT had a more favourable impact on muscle recruitment patterns than spinal kinematics. Highlighting the potential role of cervical SMT to bring about changes in motor control.
An exploratory study of resilience building strategies in community based child and youth care in Inanda Kwa-Zulu-Natal
(2025-09-18) Ntlokwana, Sinolizwi; Dewan, Fathima
Resilience building has been widely studied, yet there is limited literature on its practical implementation, particularly in the South African context. In community based care settings, resilience plays a crucial role in helping children and youth overcome adversity, enabling them to lead meaningful lives despite challenging circumstances. This study explores resilience-building strategies used in community based care in Inanda Durban, KwaZulu-Natal, with a focus on the experiences of child and youth care workers (CYCWs). The study underpinned by ecological systems theory and the strength-based approach, which provided a lens to understand how CYCWs draw on both internal and external resources to support resilience. Using a qualitative research approach, the study employed purposive and convenience sampling to recruit twenty CYCWs for semi-structured interviews. Participants shared their experiences and the strategies they used to foster resilience among children in their care. Through thematic analysis, five key themes emerged: CYCWs’ understanding of resilience, the importance of resilience building in child and youth care, effective resilience-building strategies, challenges faced in resilience building, and suggestions for improvement. The findings reveal that resilience building involves strategies such as encouraging and building children up, facilitating behaviour change, promoting positive coping skills, ensuring academic success, and fostering participation in sports. A strength based approach, spirituality, and mentorship programs were also identified as key resilience-building methods. However, resilience efforts are constrained by contextual challenges such as lack of parental and community support, emotional strain on CYCWs, inadequate services, and limited access to basic resources. In addition, children in their care are often exposed to poverty, violence and the effects of HIV/AIDS, which exacerbate their vulnerabilities. The study also highlights the need for continuous professional development, training, and improved reunification processes with families. These insights contribute to the growing body of knowledge on resilience in community-based care and also provide practical recommendations for strengthening resilience-building strategies among vulnerable children not only in South Africa but around the world.
The prevalence and associated risk factors of musculoskeletal disorders in students who utilise public transport at a University of Technology in South Africa
(2025-11-02) Hlongwa, Mayibongwe Thandokuhle; Varatharajullu, Desiree
Musculoskeletal disorders are injuries affecting the musculoskeletal system, which includes muscles, bones, tendons, joints, and ligaments. These disorders are experienced from childhood to old age have a higher frequency of complaints by working age individuals to health care practitioners. Musculoskeletal disorders can affect individuals’ capacity to work and in more severe cases, can limit their capability to participate in activities of daily living. Transportation is an important part of everyday life within our modern society. In South Africa, public transport comprises the use of minibus taxis, buses and the metro railway system. The national household travel survey of 2020 demonstrated that public transport is the most accessible means of travel, with minibus taxis dominating with 25.7%, followed by buses with 4.5% and lastly the metro railway with 0.7%. In contrast private transport had 25.9%. 41.7% walked as a mode of travel and 1.5% of respondents used other modes of transport. Students have a high travel demand such as Rhodes University recording an estimated 11660 trips in 2014. A large number of students at the Durban University of Technology, South Africa, commute to and from campus using public transport. These students are placed at risk for further exacerbation of current musculoskeletal disorders or the onset of them. A gap in the literature with respect to musculoskeletal disorders among university students who travel using public transport exists and, therefore, this study aimed to fill the gap in that literature. Aim The aim of this study was to determine the point prevalence and risk factors of musculoskeletal disorders among students who utilise public transportation at a university of technology. Methodology This study was designed as a quantitative, descriptive, cross-sectional survey, and was conducted online with registered students at the Durban University of Technology who commute using public transport. The online questionnaire was administered via a link to QuestionPro to the university students in order to determine the point prevalence and associated risk factors of musculoskeletal disorders. The questionnaire included demographic information, transport routine factors, factors of musculoskeletal disorder and the impacts of musculoskeletal disorders. The captured data were sent to a statistician for statistical analysis. Results A total of 382 completed online questionnaires were analysed, giving a response rate of 72.8%. The results showed a moderately high prevalence (62.3%) of musculoskeletal disorders among the students. The most affected areas of pain were the lower back (39.95%), neck (27.8%), shoulder (27.8%) and upper back (27.4%), while the least prevalent region was the elbow (5.0%). Factors that were considered statistically significant among the students included stress, excessive alcohol consumption, and previous history of trauma. Transport related factors such as the duration of transport (time) were also statistically significant. Conclusions and Recommendations This study highlights the point prevalence and risk factors of musculoskeletal disorders among university students using public transportation. To mitigate these risks, future research should adopt longitudinal design, incorporate objective clinical assessments, and compare different transport modes. Preventative strategies, including student awareness programmes on posture and physical activity, reduced carrying loads through digital learning and ergonomic improvements in public transport seating and suspension, are recommended. Collaboration among educational institutions, transportation authorities, and healthcare professionals is essential to reduce musculoskeletal disorders, ultimately enhance students’ well being, academic performance, and quality of life.
The effectiveness of transcutaneous electrical nerve stimulation on adhesive capsulitis : a systematic review
(2025-09-29) Goorchuran, Genista; Chiliza, B.; Van der Meulen , A.
Background: Adhesive capsulitis, commonly known as frozen shoulder, is a common condition associated with pain, stiffness and reduced mobility. The pathology affects between 2 to 8% of the general population, primarily females aged 40 years and older. Patients diagnosed with diabetes mellitus, hypothyroidism and cardiovascular disease carry a higher risk of the development of adhesive capsulitis. Transcutaneous electrical stimulation (TENS) is a conservative treatment option, the evidence supporting its effectiveness remains inconsistent and varied in methodological quality. Therefore, this systematic review aimed to critically appraise the available literature and summarise the evidence to determine the level of support of the use of TENS in the management of adhesive capsulitis. Methods: The researcher searched eight electronic databases (Google Scholar, CINAHL, Cochrane databases, Cochrane review databases, PubMed, and SCOPUS). The search terms used were namely, “adhesive capsulitis”, “shoulder adhesive capsulitis”, “frozen shoulder”, “shoulder pain”, “transcutaneous electrical nerve stimulation”, “TENS” and “electrical stimulation”. The inclusion criteria included randomised controlled trials (RCTs), non-randomised controlled trials (nRCTs), and observational studies focused on adhesive capsulitis following the use of TENS as a part of the intervention. The citations and abstracts were filtered based on the relevance to keywords and the full text articles identified based on the inclusion criteria. The final list of articles was reviewed by seven reviewers using PEDro, Newcastle Ottawa and the Liddle Scales (the scales used to evaluate the articles were based on the study design), to establish the methodological rigor of the studies. Once the data collection concluded (viz., full text articles), each article was screened and reviewed by the reviewers. Therefore, the article was evaluated based on the outlined criteria, specified scales, and the limitations of the study reported. The primary outcomes were the effectiveness of TENS in the management of adhesive capsulitis either as a single treatment and/or in combination with other modalities. The data was summarised and presented in tables, illustrating the data found. Results: The initial database search yielded 4 282 studies (after 148 duplicated articles were removed), of which 23 articles fulfilled the eligibility criteria for inclusion in this systematic review. The studies provided mixed results specifically, with only one study utilized TENS as a single treatment modality, while the majority (n=22) examined TENS as part of a multimodal treatment approach. In addition, one study did not specify whether the evidence was related to TENS as the intervention was broadly described as electrical stimulation. The included studies reported improvements in pain, shoulder range of motion and functional outcomes following the interventions that incorporated TENS. However, these improvements were noted when TENS was used in combination with other treatment interventions, rather than a standalone treatment. There is limited evidence supporting the use of TENS as a single modality in the management of adhesive capsulitis, whereas the evidence supporting the use of TENS in combination therapy was deemed favourable, but the evidence was limited in respect to the contribution of TENS in the multimodal protocols. Conclusion: The evidence in support of combination therapy with the addition on TENS in the management of adhesive capsulitis was favourable as participants reported improvements in terms of pain, range of motion and in some cases functionality. Considering the current evidence, it is recommended that future studies investigate the use of TENS in combination therapy and its long-term efficacy.
Exploring the perceptions of chiropractors in the eThekwini municipality on the role of chiropractic care in the management of post-surgical lumbar pain
(2026-01-23) Fourie, Johan Carel; Abdul-Rasheed, Ashura; Padayachy , Keseri
BACKGROUND Lumbar pain is the leading cause of disability worldwide with an increasing prevalence. There are several interventions for lumbar pain, with surgery usually considered as the last resort. Chiropractic treatment is an intervention associated with management of spine pain; therefore, it stands to reason that chiropractors would encounter patients suffering from post-surgical lumbar pain in practice. The perceptions of chiropractors on the role of chiropractic management in post-surgical lumbar pain (PSLP) can therefore assist further development in this field. AIM This study aimed to explore the perceptions chiropractors in the eThekwini municipality have about their role in the management of patients who suffer from post surgical lumbar pain. METHODOLOGY A qualitative, exploratory and descriptive design, utilising the linear snowball sampling technique, was used. Individual, semi-structured interviews were conducted with 12 qualified chiropractors in the eThekwini municipality of KwaZulu-Natal in South Africa. The interviews were recorded, transcribed and then analysed. RESULTS Four main themes were extracted: informed and competent understanding of PSLP, shared recognition of the chiropractor’s role and utilisation in post-surgical lumbar spine care, shared perceptions of the therapeutic value of chiropractic treatment for managing PSLP, and uniform practice patterns and challenges in post-surgical lumbar spine management. CONCLUSION Chiropractors believe that, chiropractic care plays a role in restoring movement, improving function and reducing pain in the management of PSLP through the application of various modalities available to them within their wides scope of practice.
An epidemiological study of Medial Tibial Stress Syndrome Type II in club hockey players in the eThekwini Municipality
(2026-01-26) Blackburn, Jonathan; Pillay , Julian David; Ally, Fazila
Background: Field hockey is a high intensity sport that exposes players to intrinsic, extrinsic, and overuse injuries. An overuse injury that appears to be neglected in field hockey epidemiological research is Medial Tibial Stress Syndrome (MTSS TII). Objectives: This study aimed to determine the self-reported prevalence of MTSS TII in club hockey players within the eThekwini Municipality, any potential contributing possible risk factors that may contribute to its development, and identify the treatment-seeking strategies employed by these players. Methods: A quantitative, cross-sectional study was conducted to determine the prevalence and potential risk factors of MTSS TII among club hockey players in the eThekwini Municipality, KwaZulu-Natal, South Africa. An online self-administered questionnaire was distributed via the Durban Hockey Association to registered adult players (older than 18 years old) competing for clubs within the municipality. The questionnaire explored the demographics, potential risk factors contributing to MTSS TII, a MTSS TII assessment tool, MTSS TII history and education, and management of the condition. Results: Among the 137 participants, 10.9% (n=15) were self-diagnosed with MTSS TII. A higher prevalence of MTSS TII was found in women (60%) compared to men. A significant association was found between MTSS TII and duration of shoe use (Fisher’s exact test = 12.328, p=0.007), with 40% of those with MTSS TII used their hockey shoes for less than six months compared to 9% of those without MTSS TII. A total of 55 participants (40.1%) had a history of MTSS TII or had been diagnosed by a licenced practitioner. Physiotherapy was the most frequently consulted medical service (85%), with stretching (88.9%), massage (88.9%), and strapping (74.1%) reported as the most frequently used treatments. Notably, only 13.1% of participants reported receiving any education about MTSS TII from coaches or team staff (p<0.01). Discussion and conclusions: MTSS TII is a relatively common occurrence in field hockey players, particularly among women. This study clarifies the prevalence, potential risk factors, education, and management of MTSS TII in field hockey players. The results of this study, particularly the high percentage of players with a history of shin splints, indicate the need for injury prevention strategies.
The immediate effect of long-axis talocrural manipulation and sham laser on sagittal motion of the ankle joint and bowling speed of club cricket pace bowlers in the eThekwini Municipality
(2025-12-15) Vermaak, Jason; Currie, Shereen; Shaik, Junaid
Purpose: The purpose of this study was to determine the immediate effect of talocrural long-axis manipulation and sham laser on sagittal ankle motion and bowling speed in club cricket pace bowlers in the eThekwini Municipality. Method: Fifty-four club-level pace bowlers were randomly assigned into two equal groups, Groups A and B (n = 27 each). Participants in Group A received a talocrural long-axis manipulation (TLAM) intervention, while participants in Group B received a sham laser intervention (placebo). All participants bowled six maximum-effort deliveries both before and after the intervention. Bowling speed (km·h⁻¹) was measured using a SpeedTrac X Radar Gun (EMG Companies Inc., Prescott, USA). Both front and back foot ankle sagittal range of motion (ROM) (°), namely, dorsiflexion and plantarflexion, were assessed using an analogue goniometer (Hitech Therapy, Durban, South Africa). For each participant, the mean of the three fastest deliveries was recorded for the pre- and post-intervention. Data were analysed using SPSS version 31. Paired sample t-tests were used to compare pre- and post-intervention means for ankle sagittal motion and bowling speed to determine statistical significance. To evaluate the collective influence of the intervention type (Group A: talocrural manipulation; Group B: sham laser) on changes in ankle joint ROM and bowling speed, with age as a covariate, a GLM multivariate analysis was conducted. A follow-up univariate ANOVA test was performed to determine which individual variables contributed to the overall intervention effect. The correlation between the ankle sagittal ROM and bowling speed was assessed using Spearman’s correlation. An alpha level of 0.05 was set to determine statistical significance; therefore, a p-value of <0.05 was considered statistically significant. Results: The mean ± standard deviation (SD) of the age of participants was 31.7 ± 8.0 years in Group A (intervention) and 32.8 ± 7.4 years in Group B (control). In the intervention group, front foot dorsiflexion improved significantly from 110.9° ± 5.7 to 101.9° ± 7.7 (-9.0°, 95% CI: −11.6 to −6.4, p < 0.001), and plantarflexion improved significantly from 152.9° ± 9.1 to 160.0° ± 7.3 (+7.1°, 95% CI: 4.5 to 9.9, p = 0.001). A smaller but significant improvement was also observed in back foot plantarflexion from 154.1° ± 8.2 to 155.8° ± 7 (+1.7°, 95% CI: 0.2 to 3.1, p = 0.025), with an insignificant improvement in back foot dorsiflexion (-1.3°, 95% CI: −3.3 to 0.6, p = 0.173). In contrast, no significant changes in front foot or back foot ROM were observed in the control group. Bowling speed in Group A increased significantly from 112.8 ± 12.5km·h⁻¹ to 118 ± 11.3km·h⁻¹ (+5.4km·h⁻¹, 95% CI: 2.6 to 8.3, p < 0.001). In contrast, no significant change in bowling speed was observed in Group B. A multivariate analysis confirmed that the intervention had a significant collective effect on ankle sagittal ROM and bowling speed (Pillai’s Trace = 0.488, F (5,47) = 9.0, p < 0.001, partial η² = 0.50), independent of age. A statistically significant, moderate negative correlation (r = -0.484, p = 0.049) was observed between increases in ankle dorsiflexion ROM and bowling speed in the intervention group. Conclusion: TLAM of the front foot resulted in a significant increase in ankle sagittal ROM and bowling speed in club-level cricket pace bowlers, with no adverse effects reported. This provides the first evidence that front foot ankle manipulation can improve a key performance metric in pace bowling, reinforcing the ankle’s crucial biomechanical role in generating bowling speed. These findings suggest that TLAM could support the performance enhancement of pace bowlers, offering a safe and non-invasive intervention that manual therapists can use within a cricket team. While improvements in ankle sagittal motion and bowling speed were observed, the effect of TLAM on other pace bowling performance metrics, such as accuracy and bounce, remains unexplored. Future research should explore these performance metrics, assess the combined impact of TLAM with upper body manipulation, and investigate the effect of TLAM in different population groups, such as female pace bowlers.
Evaluating the ratio of mature oocytes to immature oocytes in oocyte cohorts aspirated from HIV seropositive and HIV seronegative females post-controlled ovarian hyperstimulation
(2024-08) Ndlela, Nombuso Felicia; Prakaschandra, D. R.; Gabriel, E.
A woman’s reproductive potential can be threatened by disrupting normal oocyte development, often associated with advancing maternal age, chronic viral infections, medical conditions/interventions, pharmaceutical and recreational drugs, and an individual’s Body Mass Index (BMI). Often, these factors affect the outcomes of assisted reproductive techniques (ART); however, they are not always addressed well, especially in developing countries such as South Africa. Research Aim and Objectives: This study aimed to provide a comparative analysis of the mature and immature oocyte yields in oocyte cohorts obtained from HIV-infected females against HIV-uninfected women of reproductive age, post-controlled ovarian hyperstimulation (COH). Additionally, the study examined the potential influence of factors associated with HIV infection, infertility, and ART, such as age, BMI, viral load, CD4+ lymphocyte counts, antiretroviral medication intake, ovarian stimulation protocols, and ovulation trigger injections on oocyte maturation outcomes. Methodology: This study evaluated n=80 women aged between 18-39 years attending ART between 2021 and 2023. GnRH-Antagonist protocol (Cetrotide® antagonist) for COH was used on all patients, and the exogenous gonadotropins for follicular stimulation were initiated on day 2/3 of the menstrual cycle. Ovitrelle® at 250mcg or Lucrin® at 40IU or 80IU were the ovulation triggers used. The oocytes were aspirated 36 hours after administration of the ovulation trigger. Oocyte denudation and assessment were done 2 hours after the TVOA, after which insemination using the ICSI technique was conducted 2 hours after incubation. Only the mature (MII) oocytes were inseminated at Day 0/Day 1, the appearance of 2 pronuclei (PN) and 2-Polar bodies (PB) at 16-18hours signified successful fertilisation, and single embryo culture in one-step media (under oil) was carried out for the next 3-5 days in a benchtop incubator. Results: The means for MII oocytes (p-value= 0,264), MI oocytes (p-value= 0,352), and GV oocytes (p-value= 0,258) between the HIV-infected population and HIV uninfected controls showed no statistical differences (all p-values> 0.05). Furthermore, when the total population was matched by age, BMI, ovarian stimulation protocol, ovulation trigger injection, and serum AMH, outcomes (follicle number, oocyte retrieval rates, and MII oocyte number) were comparable (all p-values> 0.05). Age was, however, positively associated with the relationship between AMH, follicle number, and MII oocyte number in the entire population. In this study, the quantities of mature (MII) oocytes in oocyte cohorts from the HIV positive females against the HIV negative females were similar. Furthermore, there were no significant differences in ART outcomes between the two groups after matching patients by age, BMI, ovarian stimulation protocol, and ovulation trigger.
An exploration of the role of child and youth care workers during the April 2022 floods in eThekwini, KwaZulu-Natal
(2026-01-29) Ngcobo, Nonkululeko Princess; Bhagwan, Raisuyah
Flooding has become a global issue, affecting countries worldwide, leading to significant humanitarian crises. This disaster occurs when excessive water overflows onto land, often due to intense rainfall, melting snow, or powerful storms along coastlines. They rank among the most common and destructive catastrophic events, posing significant threats to human settlements, infrastructure, and ecosystems. Natural disasters such as floods significantly impact the lives and environments of people, leading to substantial socio-economic and environmental repercussions. They also threaten the well-being and safety of children and families, exacerbating existing vulnerabilities and creating new ones. In addition, the growing frequency and impact of flood events underscore the need for enhanced preparedness measures and adaptive response strategies to mitigate vulnerability. Social service professionals can make a substantial contribution to facilitating recovery and stability among affected populations. This study seeks to examine the specific contributions of professionals in child and youth care work in aiding young people and their families affected by floods. Although research has explored the responsibilities of these practitioners in various life contexts, there has been limited investigation into their significant contributions to providing support and assistance during flooding to affected populations. The study focuses on investigating the involvement of these workers during the April 2022 floods. A qualitative approach was taken to understand the perspectives of fifteen child and youth care professionals. This study aimed to gain a deeper understanding of the roles played by child and youth care workers during the KwaZulu-Natal (KZN) floods, particularly regarding their services during and after the floods. Participants were identified and recruited through the National Association of Child and Youth Care Workers (NACCW). Non-probability sampling methods, purposive sampling was used to select a minimum of fifteen (15) participants. Data was collected until saturation. Semi-structured interviews were utilised to obtain data. Data collection involved using an interview guide for this research. The raw data from the samples was analysed using thematic analysis. The researcher took great care to uphold ethical considerations, maintaining research integrity and validity. The data collected revealed five significant themes, which led to the emergence of twelve sub-themes. The five (5) significant themes were as follows: (1) the impact and effects of floods, (2) the destruction of child and family life, (3) children and family protection, (4) response and intervention strategies and (5) training and preparedness. The study highlighted the crucial role of child and youth care practitioners in enhancing the well-being and stability of young individuals and families. Findings highlighted their vital role in advocating for and meeting the needs of young people during a flood disaster. This research also revealed that these professionals provided crucial psychosocial support, fostering resilience and the coping mechanisms of victims and their families.

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