Masters Practice Projects

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http://hdl.handle.net/10292/10895
The Masters Practice Projects collection contains digital copies of AUT masters practice projects deposited with the Library since 2017 and made available open access.

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Now showing 1 - 5 of 34
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    What is the Efficacy of Existing Interventions for Reducing the Impact of Post-Traumatic Osteoarthritis Following Anterior Cruciate Ligament Injury? A Systematic Review
    McIntosh, Catherine
    Introduction. Anterior Cruciate Ligament (ACL) injury has been identified as a risk factor for developing post-traumatic osteoarthritis (PTOA). The individual and societal burden of ACL injuries and PTOA are considerable in Aotearoa New Zealand (AoNZ). This burden is predicted to increase if there is no change in how these injuries are managed. A variety of ACL injury management options exist in AoNZ. Rehabilitation is a recognized component of ACL injury management. The efficacy of different ACL rehabilitation interventions on reducing the impact of PTOA is unknown. Objective. This systematic review aimed to identify, synthesise and critique the findings of research that has evaluated the effectiveness of ACL injury management on the development of PTOA. This review will appraise the quality of the identified literature, to answer the research question, what is the efficacy of existing interventions for reducing the impact of PTOA following ACL injury? Methods. A systematic search of electronic databases CINAHL, SPORTDiscus MEDLINE (via EBSCO) and Scopus was completed and studies relevant to the objective were identified. A quality critique of the selected studies was undertaken using a modified Downs and Black appraisal tool. Data central to the study objective were extracted and analysed. Results. Six articles were retained for final review, quantified as good quality. Five studies compared the effect of surgical anterior cruciate ligament repair (ACLR) with non-surgical management of ACL injuries on the development of PTOA. Only one study investigated the effect of different ACL rehabilitation protocols on the development of PTOA. The incidence of PTOA following ACL injury was comparable regardless of the management interventions compared in each of the studies. Conclusion. Current research shows the risk of PTOA after ACL injury is not changed by ACL injury management. Further research is required to inform ACL injury management to reduce the long-term impact of ACL injury and optimise the wellbeing of the growing ACL-injured population. In the meantime, the evidence supports physiotherapists to implement programmes for ACL injury prevention and promoting knee joint health following ACL injury.
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    Experiences of Rangatahi Māori with Mental Health Services in Aotearoa
    Rihari, Teina
    Currently, there is a distinct lack of research on rangatahi Māori and mental healthcare in Aotearoa. Research on mental healthcare in Aotearoa has predominantly explored Pakeha and adult experiences. This present research pursued to fill this gap in the literature by investigating the experiences of rangatahi Māori with experiences with mental healthcare in Aotearoa. From these interviews, information will be extracted to add to the limited available research and uncover prospective topics for future research with rangatahi Māori. Māori-centric qualitative methodology was employed in the current study. Data was collected through semi-structured interviews with rangatahi Māori who have experiences with mental healthcare in Aotearoa. Thematic analysis was used to examine the data collected. Two overarching themes were identified: barriers and enablers. These overarching themes comprise eight emergent themes: 1a) Health literacy, 1b) Stigmatism, 1c) Time, 1d) Financial and socioeconomic factors, 2a) Whakawhānaungatanga, 2b) Transparency, 2c) Satisfaction with service, 2d) Incorporation of Māori culture/models. The findings from these themes provided recommendations for service providers and future research into rangatahi Māori mental health
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    Beginning the Journey of Becoming a Tiriti-partner: A Critical Reflection
    (Auckland University of Technology, 2023) Melville, Anton Jack
    Te Tiriti o Waitangi is a contractual agreement between Māori and the Crown promising kāwanatanga, rangatiratanga, ōritetanga and wairuatanga. Despite these promises, extensive breaches of Te Tiriti o Waitangi have occurred since its inception creating significant health inequities for Māori which continue to this day. Within the health system, the dominant biomedical model of practice prioritises Western views of health which continues to reinforce colonial systems and reduce equity for Māori. There is a critical need for healthcare practitioners to work alongside Māori, working as Tiriti-partners. This practice project aims to explore Māori experiences of health services within the literature through the lens of Te Tiriti o Waitangi and use these understandings to critically reflect on my practice and to use this knowledge to help me work as a Tiriti-partner in my physiotherapy practice. A literature search was completed exploring Māori experiences of hospital and rehabilitation services. The articles of te Tiriti o Waitangi were used as a framework for analysis. Utilising the key learnings which came from the framework analysis, a case was chosen from my practice to undergo analysis through critical reflexivity. This practice project has demonstrated how clinicians and hospital services influence the experience of Māori. These are influenced by how clinicians interact with Māori during the healthcare encounter and clinicians’ previous experiences through their training and own values or beliefs. Systemic structures also contribute to health and well-being through increasing financial and social constraints, institutional racism and bias. Through critical reflexivity, I propose ways of thinking and working that can support clinicians to reduce health disparities by creating space, prioritising, and being an equal participant in whanaungatanga, acknowledging Māori kāwanatanga and rangatiratanga, and supporting wairuatanga using te reo Māori and knowledge of tikanga. By acting in these ways, clinicians can begin to reduce inequities experienced by Māori in healthcare. However, acting in this way is just the first step in becoming a Tiriti-partner and only one of the pieces required to reduce inequities. To fully achieve pae ora, healthy futures, for Māori, we must make critical reflexivity and challenging our personal assumptions a life-long journey.
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    The Efficacy of Repeat Botulinum Toxin Injections in the Management of Spasticity in Children and Young Adults with Cerebral Palsy: A Systematic Review
    (Auckland University of Technology, 2022) Marlowe, Brittney Lee
    Background: Botulinum toxin (BT) is a common treatment intervention for the management of spasticity in children with Cerebral Palsy (CP). There are no national or internationally recognised clinical guidelines that provide clear information about the recommended frequency of repeat doses of BT and there are inconsistencies in clinical practice. The primary aim of this review was to determine the efficacy of repeat BT injections in the management of clinical outcomes in children with CP. The secondary aim was to compare the efficacy findings with the current National Institute for Health and Care Excellence (NICE) clinical guidelines to determine if the guidelines incorporate evidence-based recommendations concerning the timing and frequency of botulinum toxin injections. Method: A systematic literature search was conducted across five databases to identify relevant articles. Eligibility criteria included participants aged between birth to 21 years old at time of enrolment, clinical diagnosis of CP, presence of spasticity, treatment intervention of two or more BT treatments, and a comparison intervention of either a different frequency of BT, other interventions, or no BT treatment. Three independent reviewers identified eligible studies. Nineteen randomised controlled trials (RCTs) and 17 observational studies met the inclusion criteria, and the 19 RCTs were analysed in this project. Study characteristics and findings were extracted, and methodological quality was assessed using Version 2 of the Cochrane risk-of-bias tool for randomised controlled trials (RoB 2). A descriptive analysis was performed to assess outcomes and determine the efficacy of i) different frequencies of repeat BT injections, ii) repeated BT versus no BT, and iii) repeated BT versus other interventions. Results: A higher frequency of BT (4-monthly versus 12-monthly) resulted in significant short-term improvements in gait and adverse events were found to be twice as frequent. Reduced frequency of BT was found to improve outcomes in occupational performance when compared to OT only. Repeated BT compared with placebo injection resulted in improvements in gait and active ROM. Repeated BT compared with other interventions such as BT only, OT only or surgical intervention resulted in significant improvements in ROM and spasticity. Implications: The findings of this review provide evidence to support repeated BT improves spasticity, ROM and gait in the short-term only when compared to physiotherapy (PT) only, OT only or placebo injection. The recommended treatment frequency of BT is 12-monthly when the goal is to improve ROM and spasticity and 4-monthly when goal is to improve gait in the short-term only. Seven future recommendations suggest additional guidelines and changes to current NICE guidelines for translation to clinical practice. Future studies to investigate the long-term effectiveness of repeated BT in children with CP is required ensuring findings capture health related quality of life (HRQL) as a measure of participation.
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    A Critical Review Of The Task Related Training (TRT) Mobile App Prototype And Its Suitability For The Delivery Of TRT Locomotor Circuit Class Training For People With Stroke In An Inpatient Hospital Setting In Singapore: A Physiotherapy Perspective
    (Auckland University of Technology, 2022) Mohamed Noor, Nurzahidah
    Background: Stroke is the leading cause of adult disability worldwide (Tetzlaff et al., 2020), and can result in locomotor disability, impacting functional independence and participation (Knox et al., 2018). As a result, identifying interventions that reduce locomotor disability while increasing functional independence is critical. The rise of digital health has resulted in a plethora of mobile technology-based innovations that open up new avenues for stroke rehabilitation (Henson et al., 2019). By facilitating physical, cognitive, and social activity, the use of tablet technology and mobile apps provides a platform for increasing the variety (Rinne et al., 2016), dose (Stütz et al., 2017) and intensity (Norouzi-Gheidari et al., 2012) of stroke rehabilitation in the hospital and community setting (White et al., 2015). Mobile apps have the potential to support the delivery of evidenced based interventions like task-related circuit class training (CCT) which has been shown to be more effective than conventional physiotherapy in improving walking speed, walking endurance and some aspects of balance in people with stroke (English et al., 2017). The physiotherapy department at Jurong Community Hospital (JCH), National University Health System in Singapore, wanted to see if their current stroke CCT programme could be delivered digitally to keep up with technological advancements. The purpose of this critical review was to determine the suitability of Task Related Training (TRT), an app in its early prototype stage, to support locomotor CCT for stroke patients at JCH. Method: This critical review used 1) a think-aloud usability method to assess the usability and suitability of the TRT app prototype from a physiotherapy perspective, and (2) comparator methods that critiqued the app's content using motor learning and task-related training principles, and tasks reported in the CCT literature for people with stroke. Results: Initial user testing revealed that the TRT app was well-received in terms of usability and suitability. Examining the app's content revealed that it is closely aligned with motor learning and TRT principles, as well as the tasks in the CCT evidence base. From the perspective of a physiotherapy user, the TRT App has the potential to support the delivery of the JCH CCT programme. Conclusion: Future directions should see designers of rehabilitation technology consider the recommendations outlined in this review and conduct future iterative user testing with physiotherapists, therapy associates and people with stroke in Singapore. Near-live encounters with the device over extended periods of time in the CCT context would also be important. Future research should also look at validating the device's efficacy for delivering locomotor CCT programmes in people with stroke.
Practice projects are protected by the Copyright Act 1994 (New Zealand). The research projects may be consulted by you, provided you comply with the provisions of the Act and the following conditions of use:
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