Background: Cystic fibrosis transmembrane conductance regulator modulator (CFTRm) therapy has transformed cystic fibrosis (CF) outcomes in high-income settings, yet access remains severely limited in South Africa. Patient-reported outcomes of CFTRm are underexplored. Objectives: To describe the lived experiences of South African people living with cystic fibrosis (PLwCF) following CFTRm initiation, focusing on respiratory symptoms, treatment burden, physical activity, social and recreational participation, and well-being. Method: A convergent mixed-methods design incorporated an online survey (n = 37; 48% response rate) and semi-structured interviews (n = 6) with PLwCF aged > 6 years. Chi-square and Fisher’s exact tests compared pre- and post-CFTRm responses; qualitative data underwent inductive thematic analysis. Results: Participants reported dramatic improvements from pre- to post-CFTRm: daily distressing respiratory symptoms decreased from 73% to 6% (p < 0.0001); perceived therapy burden shifted from predominantly high (78%) to predominantly low burden (87%), with a similar decline in duration of respiratory treatment: before CFTRm, 63% of participants spent > 1 h per day on respiratory treatment compared to 14% after CFTRm (p < 0.0001); regular exercise increased from 62% to 92% (p = 0.04); frequent social participation from 22% to 49% (p = 0.006); and perceived excellent health increased from 5% to 65% (p < 0.0001). Ten qualitative themes emerged: (1) respiratory health transformation, (2) reduced treatment burden, (3) normalisation of daily life, (4) enhanced physical capacity and participation, (5) profound psychosocial and (6) family impact, (7) improved nutrition, (8) reduced hospitalisations, (9) improved energy, and (10) altruistic hope for universal access. Conclusion: Cystic fibrosis transmembrane conductance regulator modulator profoundly transforms the lived experiences of South African PLwCF providing compelling evidence to advocate for equitable access in resource-limited settings. Clinical Implications: National funding and rollout of CFTRm for all eligible PLwCF in South Africa are urgently needed, together with interdisciplinary support to navigate modifications to existing care regimens.
Background:Kinesiophobia hampers positive outcomes in patients with non-specific chronic lower back pain (NSCLBP). Graded exposure therapy is a psychosocial approach aimed at increasing patients' functional capacity by challenging their fears and negative expectations. Objectives:Our study aimed to evaluate the effect of a graded exposure therapy programme on patients with NSCLBP, with primary outcomes assessing changes in pain intensity (Brief Pain Inventory - Short Form [BPI-SF]) and kinesiophobia (Tampa Scale of Kinesiophobia-11 [TSK-11]) from baseline to post-intervention and secondary outcomes assessing changes in pain interference (BPI-SF). Method:A quasi-experimental pre-test and post-test design was used. Twenty-eight participants with NSCLBP for more than 3 months and a TSK-11 score ≥ 22 were recruited. Outcome measures included the TSK-11, BPI-SF and Fear of Daily Activities Questionnaire (FDAQ). The intervention included a 4-week graded exposure programme and pain neuroscience education in the first session only. Data were analysed using the parametric paired t-test and Cohen's d. Results:Out of 28 participants, most were female (96.4%) with a mean age of 45 (± 8.2) years and reported pain for more than 12 months. Significant improvements were observed on both the TSK-11 and BPI-SF (p < 0.001). Large effect sizes were observed for both kinesiophobia and pain severity (TSK-11: d = 1.73, 95% confidence interval [CI 1.14, 2.32]; BPI Pain Severity: d = 1.21, 95% CI [0.72, 1.70]). Conclusion:Graded exposure therapy was effective in reducing pain and kinesiophobia in patients with NSCLBP in the short term. Clinical implications:Future considerations should be given to implementing the graded exposure therapy in conjunction with other physiotherapy modalities.
Background: Mental illness (MI) is a leading cause of global ill health and disability, with nearly half of the population affected by mental health (MH) conditions at some point in their lives. Consequently, all healthcare professionals, including physiotherapy students, will inevitably encounter patients with MI in clinical practice. However, their preparedness and ability to manage these patients remain unclear. Objectives: To explore physiotherapy students’ perceptions of their preparedness and ability to manage patients with co-existing (undiagnosed or known) MH conditions alongside a primary physical health presentation in clinical practice. Method: A qualitative, exploratory, descriptive design was employed. Sixteen fourth-year physiotherapy students from the University of the Western Cape (mean age 22.8 ± 1.32 years) participated in semi-structured individual interviews conducted either face-to-face or online. Data were thematically analysed using Braun and Clarke’s six-phase method. Results: Four themes emerged from the data: (1) Evolving understandings of MI: knowledge, sources, and lived experiences; (2) Negotiating care within personal and clinical realities; (3) Insufficient alignment between theory and practice; and (4) Making sense of physiotherapy’s contribution to MH care. Conclusion: The findings highlight the need to strengthen both theoretical and practical components of MH curricula and training within undergraduate physiotherapy programmes. Clinical implications: Improved curricular integration may enhance students’ preparedness, ability, confidence and competence when managing patients with MI, while supporting more holistic and effective patient care.
his Table of Contents reflects the print compilation of peer-reviewed articles published in the journal. Each article listed was originally published online under the journal’s open access model and remains individually accessible and citable. This compilation has been created solely for print distribution, reference, and archival purposes. No new research content is introduced. The publisher affirms that all articles included in this compilation have undergone the journal’s standard editorial and peer-review processes.
Background: To improve motor impairment in stroke survivors, physiotherapists are encouraged to structure exercise sessions in such a way that motor learning is optimised in stroke survivors. No studies have described the knowledge, attitudes or practices of South African physiotherapists regarding motor learning in stroke rehabilitation. Objectives: To describe the knowledge, attitudes and practices of South African physiotherapists regarding motor learning in stroke rehabilitation. Method: Convenient and snowball sampling techniques were used. Self-compiled questionnaires were sent to members of the South African Society of Physiotherapy (SASP) via an electronic survey platform. Results: Forty physiotherapists completed the survey. Respondents’ main area of interest was spread widely: the most indicated area was neuromusculoskeletal physiotherapy (n = 16, 40%), followed by adult neurological rehabilitation (n = 7, 17.5%). Fifty per cent of respondents treated between 1 stroke survivor and 10 stroke survivors with motor impairment over the past year. Most respondents (n = 36, 90%) had moderate knowledge of motor learning in stroke rehabilitation. However, study findings indicate knowledge gaps in several areas. Most respondents (n = 37, 92.5%) considered the application of motor learning principles to be an important tool to improve motor impairment in stroke survivors. Respondents inconsistently applied motor learning recommendations from the literature into stroke rehabilitation. Conclusion: The study revealed knowledge and practice gaps in several motor learning areas and inconsistent application of motor learning recommendations from the literature into stroke rehabilitation. Clinical implications: Findings highlight the need for further post-graduate training to allow physiotherapists to confidently apply motor learning principles in stroke rehabilitation.
Background: Major depressive disorder (MDD) is a global cause of disability, with many patients experiencing suboptimal response to conventional treatments. Mindful breathing exercises, a simple and scalable technique, have emerged as a promising non-pharmacological intervention for alleviating depressive symptoms and improving quality of life. Objectives: To evaluate the effectiveness of mindful breathing exercises on symptom reduction and quality of life in individuals diagnosed with MDD. Method: A systematic search of Cochrane Library, MEDLINE (PubMed), PEDro, Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and BioMed Central databases was conducted from inception to September 2025. Our review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible criteria were intervention studies examining the effects of mindful breathing on depressive symptoms and quality of life in individuals diagnosed with MDD. Two reviewers independently screened the studies, extracted the data and assessed the methodological quality using the Cochrane risk of bias tool. A narrative synthesis was conducted because of heterogeneity in outcome measures and intervention protocols. Results: Two studies involving 179 participants met the inclusion criteria. One study combined cognitive behavioural therapy with breathing exercises, demonstrating improvements in sleep quality, psychiatric symptoms and heart rate variability. Another study demonstrated a significant reduction in anxiety. Conclusion: Mindful breathing exercises are beneficial in alleviating symptoms of depression and anxiety, as well as enhancing physiological indicators in people with MDD. Clinical Implications: Our review highlights breathing techniques as an affordable, non-pharmaceutical option to conventional treatment; however, more research with rigorous outcomes is needed.
Background: A shift from biomedical towards biopsychosocial approaches is increasingly recommended in literature for the management of non-specific low back pain (LBP). The knowledge, attitudes and beliefs of clinicians may, however, serve as a barrier to effective management. Objectives: Our study investigated the impact of an online education programme on the knowledge, attitudes and beliefs of physiotherapists about chronic LBP. Method: Qualified physiotherapists (n = 536) attended a webinar series based on risk stratification and the biopsychosocial model of care for LBP. Participants completed the Pain Attitudes and Beliefs Scale for Physiotherapists and Neurophysiology of Pain Questionnaire before and after. Data were compared using descriptive analysis, dependent t-tests and Pearson correlation analyses. Results: Post-intervention, biomedical orientation decreased significantly (53.74 ± 12.80 to 43.04 ± 11.63; p 0.001), while biopsychosocial orientation increased (35.52 ± 4.65 to 39.62 ± 4.70; p 0.001). Pain neurophysiology knowledge improved significantly (NPQ: 10.19 ± 1.78 to 11.04 ± 1.64; p 0.001). Improvements in the biopsychosocial orientation of participants were found to correlate with a notable reduction in biomedical orientation post-intervention (r = −0.234, p = 0.000). There was also a significant positive correlation between improvements in biopsychosocial beliefs and pain neurophysiology knowledge post-intervention (r = 0.152, p = 0.031). Conclusion: Online educational interventions may enhance physiotherapists’ knowledge and shift attitudes and beliefs towards a biopsychosocial treatment orientation for LBP. Clinical implications: Incorporating concise, theory-informed online educational modules into continuing professional development may bridge knowledge gaps and facilitate the translation of biopsychosocial pain management strategies into routine physiotherapy practice.
Background: The prevalence of polytrauma is increasing globally and in South Africa, contributing to the reported rates of disability. Early physiotherapy intervention in the acute care setting reduces the risk of complications and facilitates functional recovery of patients who sustained polytrauma injuries. There is minimal evidence exploring patients’ perceptions of their recovery of physical function following polytrauma injury in an acute setting and after hospital discharge. Objectives: To explore patients’ perceptions of their recovery of physical function after polytrauma. Method: A qualitative single-case study was carried out at a private trauma facility in Johannesburg, drawing on eight semi-structured interviews gathered through purposive sampling. The interview transcripts were examined using an inductive analytical approach, with MAXQDA assisting in generating the codes and themes. Results: Six central themes emerged, capturing patients’ views on the factors that hindered or supported their recovery of physical function following polytrauma. These broad themes included satisfaction with the care received, experiences with rehabilitation after discharge, mental health and resilience, degree of disability, pain and physical functioning, and the influence of support systems. Conclusion: Multiple factors shape how patients perceive their physical recovery after experiencing polytrauma. Notably, the quality of interpersonal interactions played a prominent role in shaping their views of the care they received. Clinical implications: Our study may inform practice in the clinical setting in the management of patients recovering from polytrauma injuries to address barriers and promote facilitators identified.
Background: Football is a complex team sport with high physical, tactical and technical demands, exposing players to a high risk of both contact and non-contact injuries. Objectives: To map the range of preventative strategies used to reduce non-contact lower limb injuries among male footballers. Method: Our study was conducted as a scoping review. The review was guided in five stages: (1) defining the research question; (2) identifying relevant studies; (3) selecting the topic; (4) charting and collecting data; and (5) summarising and reporting the results. The research was guided by the population, concept, context framework, focusing on professional and amateur male soccer players across various age groups. It examined a range of preventative strategies targeting non-contact lower limb injuries, recognising their critical role in reducing player exclusion because of injury. The literature search was conducted across eight electronic databases: PUBMED, CINAHL, PEDro, EBSCOhost, Cochrane Library, SPORTDiscus, Scopus and ScienceDirect. Results: Twenty-five (out of 617) studies met the inclusion criteria, and their outcomes have been presented. Outcomes revealed various injury inhibition programmes implemented for non-contact lower limb injuries among male footballers, which were: Nordic hamstring exercises, Copenhagen adduction exercise, muscle strengthening, stretching exercises, ankle taping, FIFA 11, FIFA 11+ warm-up programme, preseason preparation, running mechanics, high chronic training loads, bounding exercises and a multicomponent exercise programme. Conclusion: The study identified a range of preventative strategies commonly employed to reduce the risk of non-contact lower limb injuries among male football players. Clinical implications: Considering the varying dynamics across teams and competitive levels, these strategies can serve as a valuable framework for developing injury prevention programmes.
Background: Clinical education is central to physiotherapy training, yet many students enter their first placements with limited experience in holistic clinical reasoning. The International Classification of Functioning, Disability and Health (ICF) provides a biopsychosocial framework for understanding functioning, yet its use in early clinical education remains underexplored. Objectives: This study aimed to investigate second-year physiotherapy students’ self-reported understanding and application of the ICF following first time clinical exposure within a redesigned clinical course. Method: A quantitative cross-sectional descriptive study was conducted. All second-year physiotherapy students completing their first clinical placements in 2023 and 2024 at a South African university were invited to complete a self-developed survey. The survey assessed perceived understanding and application of ICF components using Likert-scale and categorical items. Descriptive statistics were used for analysis. Results: Of the 138 eligible students, 106 responded (76.9%). Students reported improved perceived understanding of the ICF, with retrospective ratings increasing from a mean of 6 before placement to 9 after placement. Confidence in applying the ICF was high (mean = 8). Conclusion: Early clinical exposure structured around the ICF may support the development of holistic reasoning and encourage students to move beyond impairment-focused thinking. Clinical implications: Embedding the ICF into early placements may strengthen patient-centred clinical reasoning.
Background: Clinical reasoning in the intensive care unit (ICU), a complex, high-acuity and stressful environment, may require a different set of critical thinking and decision-making approaches to undergraduate physiotherapy student training in this setting that needs to be explored. Objectives: To explore clinical reasoning processes of undergraduate physiotherapy students (novices) and clinicians (experts) in ICU settings in the Western Cape. Method: A qualitative exploratory study using semi-structured interviews with purposively sampled participants: seven final-year physiotherapy novices and four physiotherapy clinicians with over 5 years of ICU experience. Data were analysed using Braun and Clarke’s six-phase thematic content analysis. Results: Both novice and expert physiotherapists described using information gathering, assessment planning, and hypothesis formulation from medical folder reviews and objective assessments to guide critical thinking and decision-making in ICU care. Experienced clinicians relied on the International Classification of Function framework and extensive ICU exposure to strengthen their reasoning. Novice physiotherapists reported that theory and its application supported their clinical reasoning, but their effectiveness was limited by the complex, high-pressure ICU environment, emotional burden of critically ill and end-of-life care, and feelings of overwhelm, fear, stress, anxiety and limited experience. Conclusion: The study highlights shared foundations but clear differences in the depth of clinical reasoning between novice and expert physiotherapists, with clinicians’ greater experience and situational familiarity enabling more advanced reasoning in ICU care. Clinical implications: Structured ICU exposure, emotional support and guided reasoning frameworks are needed to help novice physiotherapists apply theory effectively in high-pressure ICU settings.
Background:Health professions education is undergoing a paradigm shift from a predominantly curative focus towards prevention and health promotion, in line with global health priorities such as Sustainable Development Goal 3 (SDG3). Physiotherapy curricula, however, often still devote limited attention to preventative competencies. Objectives:The objectives of this study are to identify risk factors for shoulder pain in amateur fast bowlers and illustrate how such evidence can inform the integration of preventative competencies into undergraduate physiotherapy curricula. Method:A prospective, longitudinal cohort study was conducted during the 2018-2019 amateur cricket season. Thirty-nine male fast bowlers completed baseline musculoskeletal screening and weekly online questionnaires documenting injury incidence. Physical assessments included shoulder range of motion, scapular control, muscle strength, endurance and stability tests. Data were analysed using t-tests, Mann-Whitney U tests, chi-square and/or Fisher's exact tests. Results:Nine participants (23%) sustained shoulder pain during the season. Risk factors associated with injury included scapular dyskinesia, decreased internal rotation, increased external rotation, glenohumeral internal rotation deficit, poor endurance and reduced isometric muscle strength. These factors demonstrated moderate-to-large effect sizes. Conclusion:The identification of modifiable risk factors for shoulder pain demonstrates the value of embedding screening skills into undergraduate physiotherapy curricula. Teaching students to assess and address risk factors fosters a preventative orientation that extends beyond sports injuries to broader health contexts. Clinical implications:Incorporating risk factor screening into training equips physiotherapy graduates with practical skills for early detection and prevention, thereby reducing the burden of preventable conditions and aligning education with the objectives of SDG3.
Background: The rehabilitation experience can influence the transition back to home and community life. With impending National Health Insurance reform and limited rehabilitation guidelines in South Africa, there is a need to understand the current state of rehabilitation services. To the authors’ knowledge, no other South African study has explored inpatient rehabilitation experiences and their influence on the readiness to transition home in spinal cord injury (SCI). Objectives: To explore the experiences of inpatient rehabilitation among people with SCI, to examine how the experience influenced their transition out of inpatient rehabilitation, and to identify the needs of people with SCI when transitioning out of inpatient rehabilitation. Method: A phenomenological, qualitative design was used. Semi-structured interviews were conducted with 11 patients with SCI in their final week of inpatient rehabilitation from October 2023 to February 2024. The interview guide was developed from similar studies in New Zealand. Interviews were transcribed verbatim and inductively analysed to identify themes. Results: Three themes emerged: overall rehabilitation experience, factors influencing the experience and transition readiness, and needs impacting the transition to home. Participants reported a positive experience overall, although some negative elements were noted. Key needs for a smoother transition included bridging the gaps in the approach to care, more realistic home environment simulations and individualised psychological support. Conclusion: Rehabilitation experiences highlight the need for a specialised, patient-centred approach to SCI care. Addressing unmet needs can enhance preparedness for reintegration, especially in contexts without a structured SCI model of care. Clinical implications: Ongoing professional development, improved rehabilitation environments and structured psychological support during rehabilitation are needed.
Background:Speech-language pathology (SLP) students in South Africa often face persistent challenges in transferring theoretical learning to authentic clinical contexts. This theory-practice divide is compounded by limited placement opportunities, multilingual classrooms, and broader structural inequities, all of which contribute to a significant theory-practice divide. Addressing these contextual realities requires innovative pedagogical approaches that extend beyond traditional teaching methods. Objectives:This article presents the conceptual and theoretical foundations of a low-cost, online escape room aimed at enhancing clinical reasoning skills in third-year SLP students, grounded in the contextual realities of South African higher education. Method:The design was informed by social constructivism, self-determination theory, and simulation-based learning. Implemented via the Genial.ly platform, the escape room integrated authentic case-based tasks, facilitator-mediated feedback, progress-dependent sequencing, and multimedia layering. These features created an interactive, psychologically safe space where students could apply theoretical knowledge to contextually relevant clinical challenges. Results:The design foregrounds social learning, motivation, and contextual responsiveness - core dimensions of capability building in resource-limited systems. It demonstrates how theoretically informed, technology-enhanced learning can promote autonomy, competence, and relatedness, supporting the development of confident and reflective practitioners in multilingual and under-resourced environments. Conclusion:This article proposes a scalable and contextually responsive model for developing clinical reasoning in the Global South healthcare education contexts. By foregrounding theoretical grounding and contextual adaptability, it contributes to the broader conversation on how technology-enhanced learning can support capability development in resource-limited settings. Clinical implications:The online escape room illustrates the potential of low-fidelity, technology-enhanced simulations to improve clinical reasoning, learner engagement, and confidence in diverse, resource-constrained training contexts, providing an equitable, scalable means to bridge theory and practice.
Background: Shoulder pathologies are common causes of pain and functional limitation, often requiring physiotherapeutic interventions. Evidence comparing the effectiveness of manual therapy and exercise-based approaches in non-traumatic shoulder conditions remains limited. Objectives: To compare the effectiveness of Maitland mobilisation (MAIT) versus kinesiotherapy (KINE) in improving pain, function, quality of life, and range of motion (ROM) in patients with non-traumatic shoulder pathology. Method: Fifty-nine patients (63 shoulders) were randomly assigned to KINE (KINE; n = 32) or MAIT (MAIT; n = 31) over 15 sessions (three per week for 5 weeks). Both groups also received shortwave diathermy, transcutaneous electrical nerve stimulation, and exercises. Outcomes included the Disabilities for the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons (ASES) scale, Visual Analogue Scale (VAS) for pain, Short Form Health Survey, and ROM assessed with a Qualisys motion capture system. Assessments were performed at baseline, post-treatment, and 2-week follow-up. Results: While both groups showed significant improvements in pain, function, and quality of life after treatment, maintained at 2-week follow-up, MAIT also improved all outcome measures across all ROMs. Percentage changes from baseline were significantly greater in the MAIT group for most variables at both time points. A greater proportion of patients in the MAIT group exceeded the minimal clinically important difference (MCID) for DASH, ASES, and VAS. Conclusion: Although both approaches produced positive outcomes, MAIT demonstrated superior effectiveness compared with KINE. Clinical Implications: Maitland mobilisation may be recommended as a preferred intervention for non-traumatic shoulder pathology in clinical practice, offering broader improvements in function, pain, and mobility without additional treatment burden.
Background: A large part of physiotherapy clinical training is situated in the workplace. Learning in an authentic environment is supported by facilitators. Objectives: This study focussed on the perceptions and understanding of physiotherapy students and facilitators while learning on the clinical platform. Method: A qualitative methodology within an interpretivist paradigm was followed using convenience sampling. Results: Physiotherapy students (n = 45) in their fourth and final year of study and clinical facilitators of this student group (n = 13) were invited to participate in a focus group discussion (FGD) for the students (n = 7) and semi-structured interviews for the facilitators (n = 7). An inductive data analysis approach was followed. Three themes were generated: Learning as a Shared, Active Process; Relationships, Role Modelling and Power Dynamics in Clinical Learning; and the Clinical Environment as Both Constraint and Catalyst. Conclusion: Across themes, learning was shaped by how students and facilitators understood and enacted their roles, the degree to which student agency was recognised and supported, and how relational safety and environmental constraints mediated engagement. Implicit and sometimes misaligned expectations between students and facilitators influenced whether learning opportunities were taken up or constrained. Clinical learning emerged as a co-constructed, relational process rather than a unidirectional transfer of knowledge. Clinical Implications: Supporting meaningful learning in the clinical environment requires greater attention to implicit expectations, relational dynamics and the conditions under which student agency can be enacted.
Background: The national cancer strategy includes guidelines for rehabilitation as part of a collaborative team for cancer care. Interprofessional engagement is a critical attribute of a rehabilitation team. Thus, exposing students to live case scenarios in physiotherapy (PT), occupational therapy (OT) and speech-language pathology (SLP) provides development of Interprofessional Education Collaborative (IPEC) core competencies. Objectives: To evaluate students’ acquisition of interprofessional competencies (Values and Ethics; Roles and Responsibilities; Interprofessional Communication; and Teams and Teamwork) in cancer rehabilitation and explore their qualitative experiences of interprofessional engagement. Method: A cross-sectional survey design with open-ended questions was administered to final year rehabilitation students (PT, OT and SLP) post interprofessional education (IPE) session with a cancer survivor (CS). Results: Of 140 enrolled final year students, 64 completed the IPEC survey on Redcap. Descriptive and qualitative data analysis were conducted. High levels of agreement across all IPEC domains were observed, with the highest seen in Teams and Teamwork. Three themes, (1) Scope of practice, (2) Teamwork, (3) Experience of the IPE activity, emerged from the open-ended questions. Conclusion: High agreement across IPEC domains indicates enhanced collaborative attitudes and role clarity, despite limited exposure to oncology in participants’ undergraduate curricula. The presence of a CS added authenticity, fostering empathy and ethical practice. Students gained insight into professional boundaries, effective communication strategies and teamwork in complex care settings. Findings support integrating authentic, condition-specific IPE into curricula to strengthen collaboration and professional identity formation. Clinical implications: Undergraduate Health Sciences students can gain exposure to national cancer policies through IPE sessions. Future research can explore if the skills learnt translate to clinical teamwork post-graduation.
Background: Physiotherapy clinical education in South Africa faces persistent challenges related to equity, relevance and sustainability, compounded by resource constraints and workforce pressures. Policy, as a tool for shaping undergraduate clinical training, remains underutilised despite its potential to drive transformative educational practices. Objectives: This study explores how policy can inform and strengthen undergraduate physiotherapy clinical education, drawing on findings from a doctoral evaluation of the Framework and Strategy for Disability and Rehabilitation (FSDR) in South Africa. Method: An explanatory mixed-methods design was employed, guided by implementation science frameworks, to evaluate barriers, enablers and outcomes of FSDR implementation. Data were analysed to identify implications for clinical education, including curriculum design, clinical placements and supervisory practices. Results: Key barriers identified included limited funding, insufficient resources, weak intersectoral collaboration and workforce shortages. Enablers included active disability advocacy, alignment with international rights-based frameworks and community-based rehabilitation initiatives. Applying these findings to clinical education highlighted strategies for optimising clinical placement resources, building supervisor capacity, integrating disability-inclusive and community-based approaches and developing robust monitoring and evaluation systems to ensure training is relevant and socially accountable. Conclusion: Policy-driven transformation of physiotherapy clinical education is essential to equip graduates with the competencies required to meet societal and health system needs. Clinical implication: Embedding policy into clinical training fosters socially accountable graduates who can advance disability rights, contribute to equitable rehabilitation services and translate national health priorities into practical clinical practice.
Background: Physiotherapy management is a necessary core aspect in spinal cord injury (SCI) rehabilitation, and undergraduate preparation for adequate application is imperative. Objectives: To determine physiotherapy students’ self-perceived competence and readiness in treating patients with SCI. Method: This study included 48 fourth-year students enrolled in a Bachelor of Physiotherapy degree in South Africa. Students completed a QualtricsXM online survey consisting of 32 questions self-compiled from the Assessment of Physiotherapy Practice (APP) tool and the Dundee Ready Education Environment Measure (DREEM) questionnaire to determine self-perceived competence and readiness to treat SCI patients. Descriptive (frequencies and means) and inferential data (independent t-test and Fisher’s exact test) were analysed using SPSS v26 at a 0.05 level of significance. Results: Students reported 70% self-perceived competence and 73% readiness to treat SCI patients. Theoretical knowledge was perceived as adequate (p 0.01), and students who completed their SCI clinical block perceived themselves as more competent in treating patients with SCI (p 0.01). They were able to clinically reason and adequately differentiate between diagnoses (p 0.01) and safely perform treatment techniques (p 0.01). Conclusion: Students who completed their SCI clinical block had higher self-perception of competence to differentially diagnose SCI and to treat SCI patients safely, compared to those who had not. Clinical implications: Hands-on experience of SCI patient care is encouraged before SCI clinical block rotation. In cases where there are limited clinical placements, universities are recommended to augment written case scenarios with finite supervised patient exposure.
