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Evans R.1
1University of Cape Town, Exercise Science and Sports Medicine, Cape Town, South Africa
Background: South Africa holds one of the highest traumatic spinal cord injury (TSCI) incidence rates in the world, where the annual crude incidence of TSCI was found to be 75.6 per million persons, compared to the global incidence rates estimated at 23 per million. As a result of this high incidence rate, prevention and rehabilitation of SCI in South Africa should be of key importance. Less than 20% of South Africans have medical aid, indicating that more than 80% of the population depends on government funding for healthcare. South Africa is capable of providing high quality in-patient care, but the demand from poor, uninsured communities is overwhelming. Without outpatient rehabilitation post-discharge, individuals do not reach the full potential of their functional capacity. Lowered functional capacities reduce independence and increase the burden placed upon the community.
Purpose: The Therapy & Beyond rehabilitation programme has been developed to move South Africa closer to the international standard of outpatient neurological rehabilitation. The programme focuses on innovative rehabilitation that is targeted to strengthen and improve the neuromuscular system as well as reduce the likelihood of secondary complications.
Methods: The rehabilitation centre from which the programme operates is located in Newlands, Cape Town and is lead by a team of Biokineticists (exercise specialists). The programme is a six-stage process that is complemented by gait training using a robotic exoskeleton (Ekso Bionics). The six stages are as follows:
1. Pre-habilitation
2. Muscle Recruitment
3. Posture & Joint Stability
4. Resistance & Endurance Training
5. Pre-Gait Training
6. Advanced Gait Training
The programme is available to private patients as well as those from disadvantaged backgrounds. An application process to a registered NPO, The Walking with Brandon Foundation, is used to determine the financial need and required level of funding for disadvantaged individuals.
Results: A growing referral network has been established with Physiotherapists and Occupational Therapists supporting the role of the Biokineticist in the long-term rehabilitation of those with SCI. Initial clinical findings have demonstrated promising functional improvements in those enrolled in the Therapy & Beyond Programme.
Conclusion(s): The current South African health system is not equipped to satisfy the long-term physical needs of all individuals with SCI. The Therapy & Beyond rehabilitation programme has been created to fill this void and offer advanced outpatient rehabilitation to individuals from all socio-economic backgrounds.
Implications: Biokineticists are likely to become increasingly involved in the multi-disciplinary team of health professionals treating individuals with SCI and other neurological conditions. The Therapy & Beyond programme illustrates a successful model where the burden placed upon acute care facilities in South Africa can be reduced through referral to an advanced outpatient rehabilitation facility.
Funding acknowledgements: No sources of funding
Topic: Disability & rehabilitation
Ethics approval: No ethics approval required.
All authors, affiliations and abstracts have been published as submitted.
