The prevalence and rehabilitation needs of individuals with locomotor disability in Mitchell's Plain
Locomotor disability is a problem, reported prevalence ranging from 1% to 8.6%. Only a limited number of studies have been done in South Africa. They used different methodologies and definitions, thus leading to the variation in prevalence reported. A further factor influencing prevalence is that some locomotor disabilities are area-specific. This study aimed to determine the prevalence and rehabilitation needs of individuals with locomotor disability in Mitchell's Plain, for planning intervention strategies as part of this community based rehabilitation service. A cross sectional study design was employed. A stratified proportional cluster sampling technique was used to select 36 clusters resulting in a sample size of2424 people. Screening questions recommended by the WHO were used to identify people with impairments (Phase I). Further screening (Phase II), of those identified with impairments, using a questionnaire based on the ICIDH categories, identified people with disabilities. People with locomotor disabilities were grouped together and qualitative analysis through case studies was done on sub-groups where common themes manifested. 12.9% reported some form of impairment; 3.9% adults could be classified as having disabilities. Amongst adults with disabilities, 2.7% had locomotor disabilities. Consistent with the literature, disability increased with age, was more frequently reported amongst females, and was associated with lower socio-economic class. Multiple impairments were frequently reported, with the most common impairment being musculo-skeletal conditions. Use of health services occurred in the public sector with the local Day Hospital used as frequently as more distant tertiary hospitals. The study revealed the need for improved and accessible medical and rehabilitation services in the community. Their poor ability to integrate functionally and economically into the community, was reflected in the high proportion of people with mobility and occupational handicap categories. Low levels of education worsened the impact on occupational handicap. It was further evident that multiple impairments amongst the elderly lead to greater dependence of people with locomotor disability on their care-givers. Even though the need for assistive equipment was high, much of assistive equipment owned was not being used. A further handicapping factor for the disabled using assistive equipment was their environment which restricted the use of assistive equipment. High locomotor disability prevalence was confirmed in this study. Major unmet needs were identified in the handicap categories of physical mobility and economic self-sufficiency. Domiciliary based intervention was recommended as the most appropriate rehabilitative intervention for the severely physically disabled persons.
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