Browsing by Author "Limakatso, Katleho"
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- ItemOpen AccessPatient satisfaction at the chronic pain management clinic at Groote Schuur hospital(2022) Majangara, Munyaradzi Blessing; Parker, Romy; Limakatso, KatlehoBackground: Chronic pain is a costly and debilitating ailment with an estimated global prevalence of 20%. The evaluation of patient satisfaction with pain management is crucial to ensure that care provided remains fit for purpose, and it helps to identify opportunities for improvement. Groote Schuur Hospital has one of the few functional interdisciplinary pain clinics in South Africa with more than 900 patients seen per year. To date we have no data informing us about patient satisfaction at the clinic. The aim of our study was to survey patients being treated at the pain clinic to determine their level of satisfaction with the service. Methods: A descriptive cross-sectional study was conducted with a sample of 67 patients who had been attending the Chronic Pain Management Clinic for more than 3 months. Data were collected telephonically using the patient demographics form and internationally validated Pain Treatment Satisfaction Scale. Data were analysed using descriptive statistics. Results: The mean age of the 67 participants was 56.5yrs (SD: 12.9; Age range: 18-83). Eighty-one percent of the sample identified as female, and 70% had not completed 12 years of schooling. Most patients were referred from orthopaedics (48%) followed by referrals from day clinics (13.5%). The median pain severity score was 7.5 (IQR: 7-9) a week prior to data collection. The majority (70%) of participants reported that they were able to ask the staff questions and were provided with adequate support and care. Results indicate that 6 in every 10 patients are satisfied with their pain management at the GSH chronic pain management clinic. One aspect of care which was less than satisfactory related to receiving information about their condition and treatment. In general, participants would have liked more information about their illness or injury (51%), causes and treatments for pain, as well as side effects of pain medication (60%). Conclusions: Most participants were somewhat satisfied or very satisfied with all aspects of care they were asked about. It is clear that patient-satisfaction is not only driven by pain relief but can be enhanced by good patient-provider relationships and shared decision making. It is important to continually train health care providers to improve their communication skills.
- ItemOpen AccessThe prevalence and risk factors for phantom limb pain in people with amputations: A systematic review and meta-analysis(2020-10-14) Limakatso, Katleho; Bedwell, Gillian J; Madden, Victoria J; Parker, RomyBackground: Phantom limb pain (PLP)-pain felt in the amputated limb-is often accompanied by significant suffering. Estimates of the burden of PLP have provided conflicting data. To obtain a robust estimate of the burden of PLP, we gathered and critically appraised the literature on the prevalence and risk factors associated with PLP in people with limb amputations. Methods: Articles published between 1980 and July 2019 were identified through a systematic search of the following electronic databases: MEDLINE/PubMed, PsycINFO, PsycArticles, Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Health Source: Nursing/Academic Edition, SCOPUS, Web of Science and Academic Search Premier. Grey literature was searched on databases for preprints. Two reviewers independently conducted the screening of articles, data extraction and risk of bias assessment. The meta-analyses were conducted using the random effects model. A statistically significant level for the analyses was set at p<0.05. Results: The pooling of all studies demonstrated a prevalence estimate of 64% [95% CI: 60.01-68.05] with high heterogeneity [I2 = 95.95% (95% CI: 95.10-96.60)]. The prevalence of PLP was significantly lower in developing countries compared to developed countries [53.98% vs 66.55%; p = 0.03]. Persistent pre-operative pain, proximal site of amputation, stump pain, lower limb amputation and phantom sensations were identified as risk factors for PLP. Conclusion: This systematic review and meta-analysis estimates that six of every 10 people with an amputation report PLP-a high and important prevalence of PLP. Healthcare professionals ought to be aware of the high rates of PLP and implement strategies to reduce PLP by addressing known risk factors, specifically those identified by the current study.
- ItemOpen AccessThe effects of graded motor imagery and its components on phantom limb pain and disability in upper and lower limb amputees: a systematic review protocol(BioMed Central, 2016-09-01) Limakatso, Katleho; Corten, Lieselotte; Parker, RomyBackground: Phantom limb pain (PLP) is characterized by the anatomical shifting of neighbouring somatosensory and motor areas into a deafferented cortical area of the brain contralateral to the amputated limb. It has been shown that maladaptive neuroplasticity is positively correlated to the perception of PLP in amputees. Recent studies support the use of graded motor imagery (GMI) and its component to alleviate the severity of PLP and disability. However, there is insufficient collective empirical evidence exploring the effectiveness of these treatment modalities in amputees with PLP. This systematic review will therefore explore the effects of GMI and its individual components on PLP and disability in upper and lower limb amputees. Methods: We will utilize a customized search strategy to search PubMed, Cochrane Central register of Controlled Trials, MEDLINE, Embase, PsycINFO, PEDro, Scopus, CINAHL, LILACS, DARE, Africa-Wide Information and Web of Science. We will also look at clinicaltrials.gov (http://www.clinicaltrials.gov/), Pactr.gov (http://www.pactr.org/) and EU Clinical trials register (https://www.clinicaltrialsregister.eu/) for ongoing research. Two independent reviewers will screen articles for methodological validity. Thereafter, data from included studies will be extracted by two independent reviewers through a customized pre-set data extraction sheet. Studies with a comparable intervention and outcome measure will be pooled for meta-analysis. Studies with high heterogeneity will be analysed through random effects model. A narrative data analysis will be considered where there is insufficient data to perform a meta-analysis. Discussion: Several studies investigating the effectiveness of GMI and its different components on PLP have drawn contrasting conclusions regarding the efficacy and applicability of GMI in clinical practice. This systematic review will therefore gather and critically appraise all relevant data, to generate a substantial conclusion and recommendations for clinical practice and research on this subject.
- ItemOpen AccessThe prevalence and characteristics of chronic musculoskeletal pain in adult triathletes in South Africa(2022) Francis, Glenda Chantelle; Parker, Romy; Limakatso, KatlehoBackground Chronic pain, a growing problem globally, affects 11% to 55% of the world's adult population. The prevalence of chronic musculoskeletal pain amongst adult triathletes is unclear due to conflicting prevalence reports. The rise in sport participation at professional, amateur, and recreational levels, has led to an increase in the incidence of sports-related injuries among athletes and suggests that the prevalence of musculoskeletal injuries amongst triathletes, in particular, could also be increasing. However, pain and injury don't always go hand-in-hand. There is consistent support for exercise induced analgesia and pain perseverance in athletes. The lack of prevalence studies of chronic musculoskeletal pain in adult triathletes does not provide a definitive estimate of prevalence, and therefore leaves a gap in our understanding of chronic pain, and the characteristics thereof, in this population group. Therefore, two studies were conducted: (i) a systematic review of the literature to determine the prevalence of chronic musculoskeletal pain in adult athletes competing in the sports of swimming, cycling and running and adult triathletes and (ii) a cross-sectional survey of South African triathletes to determine the prevalence of chronic musculoskeletal pain in this group. Methods Phase 1 : Systematic review A systematic review was developed according to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) guidelines (Shamseer et al., 2015) and registered on PROSPERO [ID: CRD42020214094]. A customized search strategy containing relevant words and terms was used to search the following databases: MEDLINE/PubMed (via EBSCOhost), Cochrane Library, SCOPUS, SCIENCEDIRECT and AFRICA-WIDE INFORMATION (via EBSCOhost), Academic Search Premier, CINAHL, PsycArticles and PsycINFO. The risk of bias tool for prevalence studies was used to evaluate risk of bias in eligible studies. Studies were pooled for meta-analysis using the random effects model to determine a summary estimate of the prevalence of chronic musculoskeletal pain in triathletes across included studies. Statistical significance was set at a level of p < 0.05. Phase 2: Cross-sectional survey A cross-sectional study was conducted online via the social media platforms of Triathlon South Africa (TSA) and all other triathlon and multisport clubs in SA who gave approval. A password protected online survey using Microsoft Forms was created making use of a consent form, demographic questionnaire as well as the Brief Pain Inventory (BPI), Pain Catastrophising Scale (PCS) and the Tampa Scale for Kinesiophobia (TSK). The sampling frame consisted of adult South African triathletes over the age of 18 years and currently participating in triathlon in SA in either the Sprint, Olympic, Half Iron Man or Iron Man distances. Sample size was calculated based on the estimated number of registered triathletes with TSA and its affiliated clubs. With a confidence level of 95% and a sampling of error of 5%, a sample of 333 would make our findings generalisable to the sampling frame. Ethical approval to conduct this study was granted from University of Cape Town, Faculty of Health Sciences, Human Research Ethics Committee. Results Phase 1: Systematic review The initial literature search returned 590 records of which 588 remained after removal of duplicates. Initial screening of titles and abstracts identified 48 studies eligible for full-text review. Chronic musculoskeletal pain is experienced by athletes and triathletes with a pooled prevalence of48.96% and is consistent with global prevalence rates for chronic pain of between 11% and 55%. None of the literature reviewed reported on the effects of gender, culture, and level of income as possible contributing factors for chronic pain and none of the studies reported on whether the participants were disabled by their pain. Phase 2: Cross-sectional survey 297 triathletes responded to the survey, a sample size sufficient for 89.19% confidence. The prevalence of chronic pain was 29.29%. The association between the presence of chronic pain, sociodemographic characteristics, training and injury history were explored by comparing each variable in those with chronic musculoskeletal pain to those reporting without chronic musculoskeletal pain. Triathletes reporting chronic pain were significantly older than their counterparts. Apart from swimming, where those with pain were spending significantly longer training, the respondents showed no significant differences in training history or training characteristics. Respondents with chronic pain had sustained significantly fewer triathlon related injuries in the past 6 weeks than those without chronic pain. Conversely, respondents with chronic pain sustained more triathlon related injuries in the past 12 months . Respondents with chronic pain lost fewer training days due to injury in the last 6 months but lost more training days due to injury in the last 12 months. Conclusion The aim of this study was to determine the prevalence and characteristics of chronic musculoskeletal pain in adult triathletes in South Africa. The results of the systematic review and the cross-sectional survey offer substantial support for the hypothesis that chronic musculoskeletal pain is prevalent among adult triathletes. Notably, even with our small sample size, the results of the cross-sectional survey show a significant level of chronic pain without disability in this athletic population. We hope that future studies will explore the differences between chronic pain and high impact chronic pain (chronic pain with associated disability) and the effect thereof on participation on meaningful life roles in athletes. The role of physiotherapy in treating people with chronic pain is to minimise disability associated with pain, in both athlete and non-athlete populations.
- ItemOpen AccessThe prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol(2019-01-10) Limakatso, Katleho; Bedwell, Gillian J; Madden, Victoria J; Parker, RomyBackground The prevalence of phantom limb pain (PLP) in people with amputations is unclear because of the conflicting reports across the literature. It is proposed that the conflicting reports on the prevalence of PLP are a consequence of variations in the time period during which the studies were undertaken, countries in which the studies were conducted and recruitment processes implemented during collection of epidemiological data. In consideration of these factors, we aim to gather and critically appraise relevant literature to determine the prevalence estimate of and risk factors for PLP in people with amputations. Methods We will use a customised search strategy containing relevant words and terms to search the following databases: MEDLINE/PubMed (via EBSCOhost), PsycINFO (via EBSCOhost), PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL) (via EBSCOhost), Africa-Wide Information (via EBSCOhost), Health Source: Nursing/Academic Edition (via EBSCOhost) SCOPUS, Web of Science and Academic Search Premier (via EBSCOhost). The risk of bias assessment will be conducted using a risk of bias assessment tool for prevalence studies, and data will be extracted using a piloted customised data extraction sheet. Data extracted from individual studies will be entered into Review Manager 5 and assessed for clinical and statistical heterogeneity. Studies will be pooled for meta-analysis using the random-effects model to determine a summary estimate of the prevalence of PLP across included studies. A statistically significant level will be set at pā<ā0.05. Discussion As far as we know, a systematic review and meta-analysis on the prevalence of, and risk factors for PLP in people with amputations has not been conducted. Given the varying reports in the literature, it is necessary to determine an estimate of the prevalence of PLP to generate an informed conclusion on this subject. The results of this review will be published in an internationally accredited journal and used to inform researchers, clinicians, policy-makers and the public about the burden of, and risk factors for PLP. This will be done with a further aim to improve the quality of pain management in society. Systematic review registration PROSPERO CRD42018094821