Background. Limitations in physiotherapy curricula have been reported. Work-based experiences, especially during compulsory community service, could inform curricula. Objective. To develop a model of community service physiotherapy to guide curriculum reform. Methods. In this appreciative inquiry, trained physiotherapy students conducted tele-interviews with newly graduated physiotherapists. Twelve recently graduated community-service physiotherapists -heterogeneous in gender, mother tongue, university attended and work setting -were purposively recruited. Two coders applied Tesch's coding technique to the transcripts; one did paper-based work and the other used AtlasTi software. Consensus was reached and a member check done. Results. Four themes identified were: (i) the essence of community physiotherapy; (ii) the collaborative nature of community physiotherapy; (iii) prerequisites for a positive practice environment; and (iv) community physiotherapy as a gateway to personal growth and professional development. Physiotherapists consult clients from varied cultural backgrounds, ages and health and disease profiles. Health education is a key intervention, but clients emphasised therapeutic touch. Team work enhances services, especially within a context of poverty, and prevents isolation. New graduates have to deal with inefficient management, lack of transport, inadequate equipment and needs resilience. They want discipline-specific supervision. Conclusion.Community physiotherapy makes specific demands, especially for novice therapists. Service-learning in authentic diverse contexts would foster professional development and cultural competence. Clinical competency should remain the backbone of the curriculum, complemented by competency in health education. Different ways of reflection would facilitate lifelong learning and growth in attributes such as resilience, which is necessary for dealing with sub-optimal practice environments.

The exercise intervention failed to reduce the HbA1c to a greater extent than in the relaxation control group. Both groups improved significantly from baseline, probably due to the study effect.

Urbanisation,  a  sedentary  lifestyle  and  increasing  obesity  due  to westernization and changed eating habits have been identified as independent risk factors for diabetes in the South African population. To establish the effectiveness of a daily walk and diet education intervention program. A randomized controlled trial was performed. The study population consisted of men and women of all races, ages 40 to 65 with Type 2 Diabetes Mellitus (DM) of duration at least one year attending the Steve Biko Diabetes Outpatient clinic. Patients of all weights were considered. Patients who had an HbA1c > 8 – 9.5% were included in the sample group.Four  weekly  group  classes  consisted  of  education  considered  essential  for  ongoing  nutrition  self-management  and physical activity. Yamax pedometers and walk prescriptions based on the average number of steps walked in three days were used. The participants had a follow-up assessment at 16 weeks and one year. The intervention and control groups were compared with respect to changes from baseline, using analysis of covariance (ANCOVA) with baseline values as covariates.The  difference  between  the  intervention  and  control  groups  in  the  change  in  HbA1c  from  the  baseline  was significant at the 16-week follow-up assessment (p=0.041) and in the total cholesterol and LDL-cholesterol at the  one-year follow-up assessment (p =0.047; p =0.014). These results suggest that HbA1c can be improved over a period of four months. More frequent contact with the patients is necessary.

The aims of the study were to establish in a cohort of female patients with Type Diabetes the knowledge and perceptions of exercise, personal and environmental barriers to doing exercise and the outcome expectations of performing physical activity.The sample consisted of 28 patients between the ages of 48 and 70 (mean = 60.2, SD = 6.6) years and 11 ethnic groups, attending the Mamelodi Hospital Diabetic Outpatient Clinic. The duration of the disease ranged from 1 to 22 years and 82% of the patients were using oral hypoglycaemic agents. Demographic and qualitative data were captured by means of focus group interviews. Demographic data were summarized with descriptive statistics. Qualitative data were analysed by means of well described principles of qualitative data analyses. A percent agreement was performed, and data were re-coded until the inter-rater reliability was 85%. All 28 subjects reported that they saw doing household chores and walking as ways of exercising. Sixty one percent of the subjects indicated relief from arthritis as a benefit of exercise. The main environmental barrier was the absence of a convenient venue (61%). Tiredness (36%) and arthritis (36%) were the main personal barriers to doing exercise. All subjects indicated a better quality of life and improvement of functional capabilities as outcome expectations of taking part in an exercise program. Subjects had positive attitudes towards exercise, wanted to have control in the program and also expressed the need for social support.

Background. Successful extubation of mechanically ventilated patients is essential for the physiotherapist to succeed in respiratory rehabilitation of the patient. Delay in the weaning process increases the complication rate of mechanical ventilation. A variety of parameters are used as predictors of extubation readiness, but the association between muscle strength (deltoid, neck flexor muscle group and trapezius), endurance and extubation readiness has not been determined. Objectives. The aim of the study was to determine if muscle strength and endurance can be used as possible predictors of successful extubation in mechanically ventilated patients. The objectives were to determine if muscle strength measured with the Oxford grading scale can be used as a possible predictor, and if muscle endurance measured with the MOTOmed letto2 cycle ergometer can be used as a possible predictor. Methods. During the pilot study, 37 subjects were recruited. Deltoid, neck flexors and trapezius muscle strength was tested using the Oxford grading scale and respiratory muscle strength using maximum inspiratory and expiratory pressures. Endurance was determined by riding the MOTOmed letto2 cycle ergometer for 5 minutes with the upper limbs. Results. Muscle strength of the deltoid and the neck flexor muscle group tested with the Oxford grading scale was associated with successful extubation respectively, (p=0.022; p=0.019). Muscle endurance tested with the MOTOmed letto2 cycle ergometer also demonstrated an association with successful extubation (p=0.014). Conclusion. Future studies with larger sample sizes are recommended.