Correlation of self-reported Leeds assessment of neuropathic symptoms and signs, clinical neurological examination and MRI findings in diagnosing lumbo-sacral radiculopathy

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Funding acknowledgements: (1) the Belgium Development Co-operation (VLIR-UOS) between the University of Limpopo and the Flemish Universities, (2) an Erasmus Mundus scholarship. Ethics approval: Ethical clearance from the MREC at University of Limpopo (MREC10/8/20). Written informed consent and confidentially form signed by all participants. http://dx.doi.org/10.1016/j.physio.2015.03.1468 Research Report Poster Presentation Number: RR-PO-05-21-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 A MODEL FOR INTEGRATION OF HEALTH PROMOTION IN PHYSIOTHERAPY PRACTICE WITHIN THE SOUTH AFRICAN CONTEXT N.P. Taukobong 1 , H. Myezwa 2 , J.-P. Van Geertruyden 3 , S. Pengpid 4

necessity for the physiotherapy practice to adopt a health promoting treatment approach. Implications: A need for post-professional education to improve knowledge and understanding of the health promotion for a long term perspective on improving health promotion in physiotherapy is required. Keywords: Health promotion; Integration; Physiotherapy practice Funding acknowledgements: (1) The Belgium Development Co-operation (VLIR-UOS) between the University of Limpopo and the Flemish Universities, (2) Erasmus Mundus scholarship. Ethics approval: Ethical clearance from the MREC at University of Limpopo (MREC10/8/20). Informed consent and a confidentially form signed by all participants. http://dx.doi.org/10.1016/j.physio.2015.03.1469 Research Report Poster Presentation Number: RR-PO-10-04-Sat Saturday 2 May 2015 13:00 Exhibit halls 401–403

1 Limpopo

– Medunsa Campus, Physiotherapy, Pretoria, South Africa; 2 Witwatersrand, Physiotherapy, Johannesburg, South Africa; 3 Antwerp University, International Health, Antwerp, Belgium; 4 Mahidol University, Salaya Campus, ASEAN Institute for Health Development, Mahidol, Thailand Background: A health-focused practice is inevitable in the 21st century and physiotherapy practice has to change the approach in patient treatment to reflect emphasis on health and well-being. Purpose: The purpose of the study was to attain consensus among health promotion experts on the components and elements that could be contained in a model for health promotion in physiotherapy practice within the SA context. Methods: In this study a Delphi method was used to validate health promotion components for physiotherapy practice in SA. The SPSS version 20 was used to analyse the data. Statements with mean scores of 3.0 and above were retained for the second round stage whereas those statements rated with mean scores less than 3.0 were struck through to indicate that they are deleted. The added statements under the different subsections were also included for the second round. Results: In the Delphi study 14 out of 20 experts agreed to participate and 12 constituted the final panel for achieving the consensus. The panel of experts confirmed that a pool of health-promotion components was considered essential for health promotion in physiotherapy education and practice. The initial components were informed by literature and recommended by the first physical therapy summit on global health. Of the initial 44 components identified 33 remained after the third Delphi round. Conclusion(s): The study reinforced the importance of health promotion in physiotherapy and also demonstrated the

CORRELATION OF SELF-REPORTED LEEDS ASSESSMENT OF NEUROPATHIC SYMPTOMS AND SIGNS, CLINICAL NEUROLOGICAL EXAMINATION AND MRI FINDINGS IN DIAGNOSING LUMBO-SACRAL RADICULOPATHY N. Tawa 1 , I. Diener 2 , A. Rhoda 2 1 Jomo

Kenyatta University of Agriculture & Technology, School of Medicine, Department of Physiotherapy, Nairobi, Kenya; 2 University of the Western Cape, Physiotherapy, Cape Town, South Africa Background: Lumbo-sacral radiculopathy (LSR) is clinically defined as low back and referred leg symptoms accompanied by objective sensory and/or motor deficit due to nerve root compromise. LSR is a common condition encountered by physiotherapists and diagnosis in daily practice remains a challenge. Moreover, LSR impose a significant impact on patients’ health, socio-economic status, level of activity and participation and quality of life. Options available for diagnosing LSR include neuropathic pain screening questionnaires, clinical neurological tests and imaging. In embracing evidence-based practice, the diagnostic utility and correlation of these tests ought to be empirically explored. Purpose: To determine a correlation between S-LANSS scale, CNE and MRI findings in diagnosing LSR among patients with low back and referred leg symptoms referred for physiotherapy in selected Kenyan hospitals. Methods: The study consisted of, firstly, two systematic literature reviews to establish the evidence-based accuracy of CNE, and then of MRI in diagnosing LSR. Secondly, clinical validation of an adopted S-LANSS scale and MRI reporting

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642

protocol was established, and a standardized evidencebased CNE protocol developed. Finally, a cross-sectional blinded validity study was conducted in six different physiotherapy departments. Participants were recruited using strict inclusion criteria and data was collected using a researcher-developed pain and demographic questionnaire, the S-LANSS scale, CNE protocol, ODI and the MRI reporting protocol. Data was captured and analysed using SPSS version 21. Descriptive analysis was done using frequencies, means and percentages, while inferential analysis was conducted using Spearman’s correlation coefficient test r to establish the correlation between the diagnostic tests. Cross tabulations, receiver operating curves (ROC) and scatter plots were used to establish the sensitivity and/or specificity of S-LANSS scale and CNE tests as defined by MRI. Results: A total of 102 participants were recruited in this study with a gender distribution of females 57%, males 43%. Majority (67%) had neuropathic pain according to S-LANSS and their pain intensity ranged from moderate (4–6) to severe (7–9) as classified by NPRS and was more common among manual workers. Patients whose pain was neuropathic had moderate to severe disability. Lower limb neuro-dynamic tests and S-LANSS were the most sensitive tests, 0.79 and 0.75 respectively. Tendon reflexes were the most specific tests (0.87). S-LANSS and CNE correlated fairly but significantly (r = 0.36, P = 0.01) with MRI findings. Conclusion(s): LSR is common and its diagnosis remains a challenge among physiotherapists. MRI is a high-cost diagnostic tool but is being referred by many clinicians in making decisions regarding patients’ management. Rapid and low-cost neuropathic pain screening using S-LANSS scale together with evidence-based CNE correlate fairly with MRI and thus may be used in diagnosing LSR. Implications: Both S-LANSS and CNE are low risk, rapid and cost-effective tests in diagnosing LSR. With their reported sensitivity and correlation with MRI, they could be used in deciding whether to manage a patient conservatively using pharmacological agents, manual physiotherapy and therapeutic exercise or consider surgery in the initial management of patients with clinical suspicion of LSR. This is especially valuable in resource-poor settings where MRI is costly or unavailable. Keywords: Radiculopathy; S-LANSS; Clinical neurological examination and MRI Funding acknowledgements: National Research Foundation, Republic of South Africa. Department of Research and Production, Jomo Kenyatta University of Agriculture & Technology. Ethics approval: Senate Higher Degrees, University of the Western Cape, Republic of South Africa. Ethical clearance number: 11/10/32. http://dx.doi.org/10.1016/j.physio.2015.03.1470

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Research Report Poster Presentation Number: RR-PO-13-03-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 NORMATIVE GAIT SPEED AND ITS RELATION TO FALLS IN THE COMMUNITY DWELLING ELDERLY IN SINGAPORE M.A. Tay 1 , M. Poh 1 , L.H. Tee 1 , N.H. Ismail 2 1 Tan Tock Seng Hospital, Physiotherapy, Singapore, Singapore; 2 Tan Tock Seng Hospital, Department of Continuing & Community Care, Singapore, Singapore

Background: Slow gait speed has been demonstrated to be associated with hospitalization, mortality, functional decline and higher risks of falls (Atkinson et al., 2005; Montero-Odasso et al., 2005; Verghese et al., 2009). Faster and slower gait speeds have been associated with higher risks of falls (Quach et al., 2011). Gait speed is a simple and quick screening test for falls screening in the community. However, to date, there is no local data collected for the normative values of gait speed for the community dwelling elderly in Singapore. The relationship between gait speed and falls is also still unclear. Purpose: The aims of the study are to: (1) establish normative values of gait speed among community dwelling elderly with and without fall history and (2) explore the relationship between gait speed and fall history among local community dwelling elderly. Methods: Participants were recruited at two community events to promote awareness on falls and vestibular dysfunction in May 2014. Data was collected and analyzed retrospectively from 305 participants above 60 years old. Gait speed was calculated by measuring the time taken for participants to ambulate the middle 4 m of a 6 m walkway at a comfortable and at a fast pace. Results: There were 56 fallers (18.4%), of which 32 (10.5%) were single fallers and 24 (7.9%) were recurrent fallers. The average gait speed was 1.01 m/s and 1.36 m/s for comfortable and fast pace respectively. Gait speed at comfortable and fast pace decreased with increasing age. Using a ROC curve, the cut-off values for comfortable gait speed at was >1.06 m/s (4 m walk time = 3.75 s) for fallers versus non-fallers, with a sensitivity and specificity of 0.55. Gait speed for fallers versus non-fallers at both comfortable and fast pace were significantly different in the 60–69 age group (comfortable speed non-faller = 1.10 m/s vs. faller = 0.94 m/s p = 0.031, fast speed non-faller = 1.48 m/s vs. faller = 1.25 m/s p = 0.042) but not in the 70–79 or above 80 age groups. Conclusion(s): Gait speed may be a quick and easy measure to predict past fallers in the 60–69 year old age group among community dwelling elderly. However, as the