Stellenbosch University
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More thought into pain and rehabilitation
Author: Afdeling Navorsingsontwikkeling, Division for Research Development
Published: 12/11/2019

Fourteen years ago, Prof Quinette Louw wrote her own bit of history at Stellenbosch University (SU) when she became the institution’s first ever associate professor in physiotherapy. In 2010, she became a full professor – again the first to hold the position. These days, she is executive head of the Department of Health and Rehabilitation Sciences and the Division of Physiotherapy and in 2018 was appointed as the South African Research Chair (SARChI) in Innovative Rehabilitation.

Since her student days in the 1990s, Louw has spent much of her time treating and investigating matters related to different kinds of musculoskeletal pain, such as knee, hip or back pain, which peaks when the affected body part is moved. For her talk as part of the Forward with Research Impact series of the Division of Research Development, Louw will place the spotlight on back pain. The public lecture takes place on 13 November at 13:00 at the SU Museum in Rhyneveld Street, Stellenbosch.

Louw was the only African researcher invited to provide input and data to a 2018 review series in the medical journal The Lancet about the global prevalence of back pain. Globally, the occurrence of the condition has doubled over the past 25 years, at great cost to economies because of work absenteeism.

The prevalence of back pain is higher in low-income countries than in high-income ones. We don’t yet fully understand why this is so,” notes Louw. “Managing the condition remains a problem. Many approaches are simply not evidence-based.”

She too often sees how patients are unnecessarily put on long-term medication that has no real effect on their pain or the causes of their discomfort. For her, the answer more often than not lies putting into practice transdisciplinary rehabilitation techniques that focus on the crux of the problem.

All about movement

Louw grew up in in Richmond in the Northern Cape. At the age of ten, she moved to Cape Town with her parents, both teachers, and two siblings. In 1991 Louw matriculated from Bishop Lavis Secondary as one of its star pupils.

Louw did ballet and contemporary dancing for 13 years of her life and loves the movement at its heart. On advice from a family friend, she studied towards a BSc in Physiotherapy at the University of the Western Cape.

“It is all about movement too,” she summarises the profession in a few words.

After graduating in 1994, she gained valuable practical experience at a community health centre in Athlone. Louw describes herself as an “eternal student” and therefore has pursued postgraduate studies through a master’s degree from the University of South Australia in 1998. A lectureship at UWC followed, which also provided her with the opportunity to build up her own private practice and keep honing her clinical skills. She completed her PhD in 2004, again from the University of South Australia, by doing most of her research on the biomechanics of knee injuries in South Africa.

In 2005 she joined Stellenbosch University as an associate professor with the daunting task of building up the research profile and postgraduate programme of the Division of Physiotherapy. At the time, universities’ funding models were changing, with greater emphasis being placed on research outputs along with teaching and training responsibilities. The year 2005 also saw the birth of the first of her two children. Her now teenage son is a gifted classical pianist, and her ten-year old daughter old is emerging as an avid baker with a talent for designing and decorating cakes.

“For the first ten to 12 years of my career in the Faculty I had to build a research profile. My strategy was to optimise output that was gained through every investment.  For every cent we received we produced an output. By doing that, we could improve our research outputs, and build strategic networks with Germany, Ireland and Australian collaborators,” she explains the strategy that she followed. “When I started, we published one or two papers per year, but these days it is more in the line of 35 a year. With the new Chair, we might be able to push it up to 50.

Over the course of fourteen years, Louw has seen 76 postgraduate students from 15 countries in Africa, the Middle East, Europe and the US graduate – a most valuable extension to the pool of expertise in physiotherapy. Of these, four were honoured as the best postgraduate students in the Faculty in their respective years.

Louw’s office is close to the Biomechanics Facility in the Faculty of Medicine and Health Science Building on the Tygerberg campus. The facility was opened in 2008 and has since been used by a multidisciplinary team of mechatronic and industrial engineers, medical specialists and others working in the health sector.  These days it is being run as part of the University’s Central Analytical Facility.  

Louw thrives on the challenges and opportunities of working in an academic setting such as that of the Division of Physiotherapy, and the prospect of learning from her colleagues and students daily. She sees the value in being ready when opportunity knocks, and of transdisciplinary collaboration.

“The one thing I have done well is to be focused on Africa, our local issues and looking for strategies that will work and are feasible for us,” she believes.

School furniture

Louw is very realistic about a career in research: “It takes a long time to get to a place where you have a profile and are able to research topics that have an impact. And can access substantial funding.”

A newspaper clipping on her office wall tells the story of a project that she hopes will have an impact on the lifestyle of school children. KUZE is an affordable, adaptable and robust school desk and chair with many health and social benefits. It allows learners to either sit or stand and work. It is the result of years of research into good posture, ergonomics and the influence of sedentary lifestyles by Louw and fellow SU researchers Dr Sjan-Mari Brown and Dominic Fisher.

Louw says it is “very exciting” to see research taking shape into something very tangible, to something beyond mere “research output on a graph”. The prototype was tested in the real-life environment of schools in Gugulethu and Kensington and it has since been taken up in some schools.

It is not yet available for sale, but the team has recently decided to invest in commercialisation of the prototype. A German exchange student is currently studying whether its use could improve scholars’ concentration levels, which could be a key selling point to get it into more classrooms. The application for an international patent was submitted in 2018, thanks to support by Innovus, the SU interaction and innovation company.

Next phase

In recent years Louw has been involved in a number of national projects, such as drafting sorely needed national guidelines for the rehabilitation of stroke patients. These are currently being put through their paces at Baragwanath Hospital in Soweto, before endorsement by the National Department of Health. The World Health Organisation will apply some of their methods developed for South Africa for the stroke guideline to develop minimum packages for rehabilitation for low and middle income countries. It forms part of the WHO - Rehab 2030 drive that advocates for the inclusion of rehabilitation as a key health strategy.

When it was announced in 2018, Louw describes being awarded the SARChI Chair in Innovative Rehabilitation as “the realisation of a long-term goal and the pinnacle of her career path to date”. 

She sees it as acknowledgement that research into rehabilitation is being taken seriously at institutional, national and government levels. It also endorses the need for more research into matters related to rehabilitation, and its uses as a strategic tool to improve the health of South Africans. The Chair’s endeavours focus on providing scientific and clinical evidence about the type of transdisciplinary cost-effective rehabilitation efforts that will improve the functioning of people with different ailments – from stroke victims to people who have been injured in road accidents or who suffer from chronic diseases.

Fostering relationships with the Departments of Health, community groups, non-government organisations and clinicians is key to Louw’s endeavours to do research that can have the greatest potential to influence people’s lives. To this end, this member of the SU Senate since 2006, adds: “Researchers produce research output but to impact the lives of people you need partners who will use the research output to make meaningful changes.”