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Purpose: Development of Physical Therapy (PT) services for people with disability is one of the urgent challenges in the health sector in Papua New Guinea (PNG). However, information on the current status of PT services in PNG is scarce, as also is the case for the hospital-based outpatient PT services. This study aimed to describe the characteristics of outpatients receiving PT services in a provincial hospital in West New Britain (WNB) Province, PNG and to compare them with the characteristics of inpatients.

Method: This was a retrospective case study using outpatient and inpatient records. The records of clients receiving PT services as either outpatients (413 records, outpatient group) or inpatients (350 records, inpatient group) were reviewed in relation to sex, age and diagnosis. Comparisons were made between the two groups on basis of quantitative data of the two patient groups .

Results: The final analysis comprised 404 records in the outpatient group and 344 records in the inpatient group. In the outpatient group, injury and musculoskeletal disease were forming the most dominant diagnosis groups with 52.5% and 22.0%, respectively. Injury was most common in the age group 20 to 39 years and musculoskeletal diseases was most common in the age group 40 to 59 years. These two diagnosis groups and congenital malformations were significantly more represented among outpatients than among inpatients.

Conclusions: Young to middle-aged clients with injury or musculoskeletal disease were predominant among outpatient PT services as compared to inpatient services. The study findings serve to provide information on the current situation and potential needs of hospital-based outpatient PT services in one provincial hospital of PNG. These findings could be the base for planning outpatient PT service in WNB Province and PNG.

Purpose: The study aimed to compare the effects of balance training on balance confidence and its relationship with social participation among clients with stroke.

Method: A pre- and post- experimental group design was used. Stroke survivors who met the inclusion criteria were consecutively assigned to two groups (task- oriented and biofeedback). Participants in the task-oriented group received task- oriented activities for 20 minutes and the biofeedback group received intervention in correckta (equipment used for balance training) for 20 minutes, along with conventional occupational therapy - 5 sessions per week, for 12 weeks. Balance Confidence Scale was used for measuring balance confidence, and Frenchay Activities Index (FAI) was used to measure social participation. Statistical calculations were performed with SPSS version 16.0 package. Statistical tests were carried out with the level of significance set at p≤ 0.05.

Results: The findings suggest that both the biofeedback and task-oriented groups showed significant improvement in balance confidence and there was no statistically significant difference between the groups. There was a moderate to good relationship between balance confidence and social participation.

Conclusions and Implications: There is evidence that many stroke survivors have low balance confidence. Therapists should assess the balance confidence of their clients and encourage them to participate in these beneficial interventions.

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus in both developed and developing countries. It is found in about 10% of diabetic clients at diagnosis, and in the majority of clients 25 years down the line. Clients with pre-diabetes may also develop neuropathies that are similar to diabetic neuropathies. Long-term hyperglycemia can cause peripheral nerve damage, resulting in distal-predominant nerve fibre degeneration. Loss of feeling in the lower limbs is a high risk for limb amputation. Despite efforts to make an early diagnosis and to halt the progression of diabetic neuropathy, currently there is no effective treatment available at a global level, except for strict control of blood glucose.

Physical therapy can improve the overall quality of life of diabetes mellitus clients with peripheral neuropathy and can alleviate the symptoms of neuropathy. This paper assesses the effectiveness of interventions used by physical therapists to minimise dysfunctions in people with DPN. It reviews the different treatment strategies and presents evidence and conditions for its applications.
 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Purpose: To assess the effects of Motor Imagery programme on upper extremity functional task performance and quality of life among stroke survivors.

Method: Thirty people who were diagnosed with stroke, were selected from the Department of Occupational Therapy, SVNIRTAR, Odisha, India, and consecutively assigned to control (n=15) and experimental (n=15) groups. The control group received conventional occupational therapy only, and the experimental group received conventional occupational therapy combined with Motor Imagery programme. Upper Extremity Motor Activity Log (UE-MAL) and Stroke Specific Quality Of Life Questionnaire (SSQOL) were used for assessment, before and after the intervention.

Results: The experimental group showed significant improvement compared to the control group (P<.004 & P<.001). The implication is that there is a good relationship between upper extremity functional task performance and quality of life (r= 0.928).

Conclusions: The Motor Imagery programme is a simple and very cost-effective treatment used in Occupational Therapy practice. It can be easily taught and learnt. The study concludes that Motor Imagery programme is effective in improving upper extremity functional task performance and quality of life among stroke survivors.

Purpose: Progressive deterioration of physical function occurs in persons with Type 2 diabetes and peripheral neuropathy. This study assessed the effects of multisensory training on balance and gait in persons with diabeticneuropathies.

Method: Thirty two persons with peripheral neuropathies were enrolled, randomised, and subdivided into 2 groups - an experimental group of 16 participants with diabetes (65 ± 2.12 years) and a control group of 16 participants with diabetes (68 ± 2.17 years). For 6 weeks, both groups were given health education on diabetes for 30 minutes a week. In addition, the experimental group practised a multisensory exercise programme for 30 minutes, 3 times a week over 6 weeks. Outcome measures used were ‘timed up and go’ test for assessing balance and ‘6-minute walk’ test for gait. Standard descriptive statistics were used to report means, standard deviation, and range for baseline characteristics. Paired and unpaired ‘t-tests’ were used wherever necessary, to determine significant differences in data among groups and between pre-test and post-test scores (p<0.05).

Results: By the end of the trial period, the intervention group showed a significant improvement in scores of the ‘timed up and go’ test (t= 14.7092), but there was no statistically significant difference in the ‘6-minute walk’ test scores (p=0.7206, t= 0.3644).There was no difference for both measures in the control group.

Conclusion: The study showed that multisensory exercises could improve balance in persons with Type 2 diabetes and peripheral neuropathy. The findings suggest that along with physiological sensory factors, cognitive-behavioural factors and strengthening of the lower limb muscles should be considered when treating diabetic persons with gait alterations.

Background: Cerebral palsy is a type of non-progressive central nervous system disorder with multiple impairments. As there are sensory, communicatory and intellectual impairments, providing care at home may be stressful and affect to the physical and mental health of the caregivers. This in turn could interfere with rehabilitation of persons with cerebral palsy.

Purpose: This study assesses the mental health status and quality of life of caregivers of persons with disabilities. The study group consisted of caregivers of 23 children with cerebral palsy and intellectual disability.

Method: The needs of the children with disabilities were assessed using a pre- tested interview schedule, while caregivers were administered GHQ-28 and WHO-QOL.

Results: Thirteen (56.52%) of the primary caregivers tested positive for GHQ. The psychological and environmental domains of QOL were found to be most affected, while the physical and social domains were relatively better.

Conclusion: There was a significant (p<0.05) correlation between the GHQ scores and quality of life.