Table 4.
Effectiveness studies from Africa by field of practice and level of evidence.
| Area of practice | |||||||
|---|---|---|---|---|---|---|---|
| Authors | Study aim | Level of evidence | Sample size | Name of intervention | Outcome measures | Effective | Size of effect |
| Community development | |||||||
| González-Bernal et al. [46] | The aim of this research was to verify the effectiveness of a community-based OT intervention in the volition, quality of life, and perceived self-stigma of people with disabilities in the Moroccan city of Azrou. | III-3 | 94 | Community occupational therapy | Volitional questionnaire, WHOQOL-BREF, the stigma consciousness questionnaire, attribution questionnaire, ad hoc interview (Likert scale) | Yes | Not reported |
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| Hands | |||||||
| Naudé and de Klerk [76] | To explore aspects of feasibility related to the recruitment, consent, and retention rates in consideration of a future definitive randomised control trial. In addition, preliminary results of an early active therapy protocol compared to an early passive therapy protocol were reported on, together with patient satisfaction and demographics. | II | 31 | Early active mobilisation | Total active motion, Jamar hand dynamometer, Michigan Hand Questionnaire, Smith Hand Function Evaluation | Yes | Not reported |
| Spark, et al. [59] | To determine the range of movement (ROM), power, and pinch grip strength post-FTR and to establish factors that may affect these | III-3 | 126 | Passive motion, controlled active motion, or early active motion protocols | Bilateral hand ROM, bilateral grip strength, and pinch strength | No | Not reported |
| Young et al. [60] | To report on the rehabilitation and functional outcomes of a patient who had his hand replanted at the distal forearm in a private practice setting in Umhlanga, South Africa | IV | 1 | Early active mobilisation | ROM—goniometer; sensation—monofilaments and disk criminator; muscle strength—hydraulic dynamometer, B&L pinch gauge, and manual muscle testing; hand function—nine hole peg test, Jebsen-Taylor Hand Function Test, and DASH | Yes | Not applicable |
| Devan [57] | To describes a technique that utilizes a combination of an orthosis and Kinesio tape, thereby creating a treatment protocol that shortens the immobilisation phase for these patients | IV | 16 | Early active mobilisation | Goniometer | Yes | Not reported |
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| Mental health | |||||||
| Gandawa [45] | To determine whether participation in an eight-week volunteer program for learners was more effective than an eight-session life skill training program in improving alcohol use behaviour and perceptions | II | 34 | Volunteer program vs. life skill group | Alcohol expectancy questionnaire—adolescents, alcohol timeline follow-back | No | None |
| Strauss et al. [40] | To determine the effect of the tempo of music on the activity participation of the inhibited and agitated mental healthcare users with acute psychosis | II | 160 | Music tempo | Researcher developed their own assessment of participation because “there are no assessments to measure participation”; included attention, following of instructions, directedness towards activity, and willingness to participate | Yes | Not reported |
| Van Rensburg et al. [42] | To determine the short-term effect of a group drumming intervention program on aggression among adolescent girls at a school for girls diagnosed with conduct disorder in Bloemfontein in the Free State | II | 26 | Drumming program | Demographic questionnaire, aggression scale | Yes | Not reported |
| De Villiers [41] | To determine the effect of a 90-minute online intervention, to improve knowledge of individualized sensory processing preferences and associated modulation strategies on the occupational performance of adults with major affective disorders | II | 27 | Education on individualized sensory processing styles and associated modulation strategies | Canadian Occupational Performance Measure, WHODAS 2.0, PHQ-9, and GAD-7 | Yes | Not reported |
| Crouch [44] | To make an effective stress management program available to the impoverished rural community of the Acornhoek area of the Limpopo province | II | 120 | Stress management program | Questionnaire 1, questionnaire 2—both developed from literature and contextualized | Yes | Not reported |
| Engelbrecht et al. [36] | To determine whether attendance at an occupational therapy-led day treatment centre for mental healthcare users affects the use of inpatient services in South Africa | III-2 | 44 | Occupational therapy-led day treatment centre | Number of admissions, days in hospital | Yes | Medium to large |
| Ramano and de Beer [39] | To compare the outcomes of the proposed new occupational therapy (SCO) group program, with the existing occupational therapy (SCN) group program | III-2 | 100 | New occupational therapy (SCO) group program | Bay Area Functional Performance Evaluation-Revised (BaFPE-R) | Yes | Very small to medium |
| Grobler [37] | To compare an activity program with an outcome-based program for optimal functioning and reintegration of mental healthcare users into the community | III-3 | 102 | Activity-based occupational therapy vs. outcome-based occupational therapy | International Classification of Functioning, Disability and Health | Yes | Not reported |
| Plastow et al. [38] | To examine the effects of an occupational therapist-led African drumming group on mental well-being among adult psychiatric inpatients with mood disorders | IV | 13 | Occupational therapy-led African drumming | Stellenbosch Mood Scale (STEMS), Enjoyment of Interaction Scale, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) | Yes | Large |
| Silaule and Casteleijn [43] | To evaluate the change in activity participation of mental healthcare users attending an occupational therapy program | IV | 64 | Occupational therapy program | Activity Participation Outcome Measure (APOM) | Yes | Not reported |
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| Paediatrics | |||||||
| Vlok et al. [25] | To investigate the effect of ocular motor exercises, in combination with a visual perceptual program, on the visual perception of seven-year-old learners with visual perceptual problems | II | 32 | Visual perceptual intervention program | The Developmental Test of Visual Perception, 2nd edition, by Hammil, Pearson, and Voress 15 (DTVP-2) was used as the pre- and postprogram measurement | No | Small |
| Ramugondo et al. [26] | To describe the playfulness in children with HIV and PHE on HAART living in challenging socioeconomic areas in South Africa, and to evaluate the feasibility and preliminary effectiveness of a play-informed, caregiver-implemented, home-based intervention (PICIHBI) for improving play | II | 24 | Play-informed, caregiver-implemented, home-based intervention (PICIHBI) | Test of playfulness, background information questionnaire | No | Small |
| Hughes et al. [22] | To determine the effect of a soft neoprene thumb abductor splint on upper limb function in children with CP with a thumb-in-palm deformity | II | 28 | Neoprene thumb abduction splints and home program | Quality of Upper Extremity Skills Test | No | Very small to large |
| Buckle et al. [27] | To determine whether learners with attention deficit hyperactivity disorder (ADHD) and definite difference in sensory processing would be able to improve their in-seat behaviour, task completion speed, and attention-to-task as a result of a weighted vest | II | 30 | Weighted vests | Time seated per 20 minutes (in-seat behaviour), time in seconds (task completion), Conners' Continuous Performance Test II (CPT II) (attention to task) | Yes | Not reported |
| Hewson [61] | To design and evaluate a postural control program for infants, in which defined stimulatory activities are embedded into the everyday activities of the parents | II | 50 | Infant postural control program (IPCP) | Screening Questionnaire, Baby's Day Diary©, Peabody Developmental Motor Scales–2nd Edition (PDMS-2) | Yes | Not reported |
| Lecuona et al. [30] | To investigate the effect of Ayres Sensory Integration (ASI) on the development of premature infants in the first 12 months of life | II | 24 | Ayers Sensory Integration (ASI) | the Infant/Toddler Sensory Profile (ITSP), the Test of Sensory Function in Infants (TSFI), and Bayley III Scales of Infant and Toddler Development (BIII) | Yes | Not reported |
| Van Heerden et al. [34] | To establish whether a life skill program would have a short-term effect on the emotional intelligence of children in Grade R | II | 88 | Life skills | Cilliers Emotional Intelligence Test | Yes | Not reported |
| Russell et al. [64] | To assess the effectiveness of the Developmental Resource Stimulation Programme for children with DS younger than 42 months | III-2 | 30 | Developmental Resource Stimulation Programme | The Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley Scales III) | No | Not reported |
| Levin [29] | To identify whether Stetro pencil grips, inclined surfaces, and splints are effective in enhancing writing speed and legibility in grade two children with learning disabilities | III-2 | 22 | Assistive devices for pencil grasp | Author-developed handwriting assessment including speed and legibility (letter formation, spacing between words, letter spacing between lines, accuracy, and general appearance) | No | Not reported |
| Chedzey [31] | To determine the level of efficacy of the CTP on the development of three-to-four-year-old children in the rural Mahikeng areas | III-2 | 49 | The cross-trainer program (CTP) | ECDC (Early Childhood Development Criteria) consisting of Section A: Cognitive SRRA (School Readiness Risk Areas), Section B: Fine Motor Coordination, and Section C: Gross Motor Coordination | Yes | Not reported |
| Salzwedel [33] | To determine the effect of the SEMOSTI sensory-motor program, on the gross motor proficiency of four-to-six-year-old children | III-2 | 73 | SEMOSTI (sensory motor stimulation program) | Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), questionnaires: physical activity (frequency, duration, type in domains of vigorous, low to moderate, and sedentary) | Yes | Not reported |
| Smit [35] | To determine the effect of a classroom-based program on handwriting for children with pencil grasp problems | III-2 | 45 | Pencil grip provided | Lyytinen-Lund (1998) observation schedule, pinch meter, Minnesota Handwriting Assessment | Yes | Large |
| Hamer-Rohrer et al. [21] | To establish whether a CIMT (constraint-induced movement therapy) course in the home environment will result in improved hand function and performance in functional skills (activities of daily living) in a young child with asymmetrical cerebral palsy | III-3 | 1 | Constraint-induced movement therapy | Pediatric Evaluation of Disability Inventory | Yes | Not reported |
| Du Plessis et al. [23] | To determine the effect of 12 hippotherapy sessions on physiological effort and walking speed over 60 m | III-3 | 10 | Hippotherapy | Physiological cost index (PCI) and walking speed | Yes | Not reported |
| Russell et al. [24] | To establish the effect of combined therapy approaches (CTA) on the intervention of four children aged 48.1 months to 60 months with cerebral palsy (CP) | IV | 4 | CTA (combined therapy approaches) | PEDI-CAT, gross motor function measure, and goal attainment scale | No | None |
| Demopoulos [28] | To investigate the relationship between a sensory diet and in-seat behaviour of a learner in the classroom | IV | 12 | Sensory diet | Daily behaviour assessment scale | No | None |
| Bastable et al. [20] | To determine the effect of a nonpowered, self-initiated mobility program on the engagement of young children with severe mobility limitations | IV | 4 | Self-initiated mobility program | The Individual Child Engagement Record—Revised (ICER–R)2, Gross Motor Functioning Classification Level (baseline only) | Yes | Medium to large (Per participant) |
| Jorge et al. [63] | To explore whether 7-to-24-month-old infants with fussy behaviour would respond to an intervention program consisting of a two-week sensory diet and parent education | IV | 12 | Parent education and sensory diet | Demographic questionnaire, survey questions about the parents' knowledge of RSPD, parent self-report Infant-Toddler Symptom Checklist | Yes | Large |
| Delgado [56] | To investigate the effect a supination splint on the upper limb function of children with cerebral palsy for six months after they were injected with botulinum toxin A | III-3 | 10 | Supination splint | Modified Ashworth scores; goniometry measurements of the elbow, forearm, wrist, and thumb; the Quality of Upper Extremity Skills Test (QUEST) and a subjective hand assessment | Yes | Not reported |
|
| |||||||
| Physical rehabilitation | |||||||
| Jansen and Casteleijn [52] | To investigate whether occupational therapy, tailored to the level of motivation for patients with diabetic foot complications, has more positive treatment outcomes than occupational therapy that is not | III-1 | 10 | Occupational therapy program using Vona du Toit Model of Creative Ability | Reintegration to normal living index, wound tracing, creative participation assessment | Yes | Not reported |
| Kamwesiga et al. [48] | To evaluate the feasibility of (i) a mobile phone supported family-centred ADL intervention F@ce™ and (ii) the study design for evaluating the effects of the intervention on the perceived impact of stroke, perceived participation in everyday life, and self-efficacy in everyday activities among persons with stroke and their families in Uganda | III-2 | 30 | F@ce | COPM, Self-Efficacy, Stroke Impact Scale 3.0 Uganda version, Barthel Index, Occupational Gaps Questionnaire Ugandan version | Yes | Varies, but favours F@ce |
| Msengana et al. [51] | To establish the profile of the dysfunction with which stroke survivors present as well as the recovery their upper limb movement and independence in personal management on referral, at discharge and for two months postdischarge | III-3 | 59 | Occupational therapy | The Fugl-Meyer Assessment Upper Extremity (FMA UE) and the South African Data Functional Medicine (SADFM) Beta Scale® | Yes | Not reported |
| Mamabolo et al. [50] | The aim of this study was to establish the degree of functional independence of patients with stroke at discharge and more than six weeks postdischarge | IV | 68 | Stroke group and home-based intervention | Barthel Index | Yes | Not reported |
| Haffejee et al. [53] | To determine the functional mobility outcome and the factors that influence it post-TBI at discharge from hospital | IV | 60 | Occupational therapy | Functional Mobility Outcomes from the Rivermead Mobility Index Score | Yes | Not reported |
| Cawood and Visagie [47] | To describe the functional outcomes achieved by stroke survivors in an urban Western Cape province | IV | 53 | Occupational therapy | Stroke Impact Scale (SIS) Version 3.0, Modified Barthel Index (MBI) | Yes | Not reported |
| Graham [62] | To determine the value of CBR training, undertaken by the Department of Occupational Therapy | IV | 20 | Child care course | Questionnaire on knowledge gained from each workshop, retention of knowledge over one month, and skills learned used in daily handling of children | Yes | Not reported |
| Kloppers [49] | To describe the outcomes achieved by clients after participating in rehabilitation at the Bishop Lavis Rehabilitation Centre (BLRC) over a three-month period | IV | 78 | Rehabilitation (occupational therapy, physiotherapy, and limited speech and language therapy) | Adapted Zambian Activity and Participation questionnaire, Barthel Index, Oswestry Back Pain questionnaire, AIMS2-SF Arthritis Impact Scale, DASH (Disability of the Arm, Shoulder, and Hand), clinical mobility scale, carer stress scale, and CRALM | Yes | Not reported |
|
| |||||||
| Work practice | |||||||
| Van der Linde [54] | To determine the impact of a staff development program to increase knowledge, skills, and attitudes to work with PIMD on their perceived job satisfaction over time | IV | 12 | Staff training | Job satisfaction questionnaire | No | Not reported |
| Soeker [55] | To determine whether MOOSE is an effective model to enhance the cognitive skills of individuals with brain injury | IV | 10 | MOOSE (Model of Occupational Self Efficacy) program | Montreal Cognitive Assessment | Yes | Not reported |