OpenUCT :: Browsing by Department "Division of Physiotherapy"

Browsing by Department "Division of Physiotherapy"

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Open Access
A systematic review investigating measurement properties of physiological tests in rugby
(BioMed Central, 2017-12-28) Chiwaridzo, Matthew; Oorschot, Sander; Dambi, Jermaine M; Ferguson, Gillian D; Bonney, Emmanuel; Mudawarima, Tapfuma; Tadyanemhandu, Cathrine; Smits-Engelsman, Bouwien C M
Background: This systematic review was conducted with the first objective aimed at providing an overview of the physiological characteristics commonly evaluated in rugby and the corresponding tests used to measure each construct. Secondly, the measurement properties of all identified tests per physiological construct were evaluated with the ultimate purpose of identifying tests with strongest level of evidence per construct. Methods: The review was conducted in two stages. In all stages, electronic databases of EBSCOhost, Medline and Scopus were searched for full-text articles. Stage 1 included studies examining physiological characteristics in rugby. Stage 2 included studies evaluating measurement properties of all tests identified in Stage 1 either in rugby or related sports such as Australian Rules football and Soccer. Two independent reviewers screened relevant articles from titles and abstracts for both stages. Results: Seventy studies met the inclusion criteria for Stage 1. The studies described 63 tests assessing speed (8), agility/change of direction speed (7), upper-body muscular endurance (8), upper-body muscular power (6), upperbody muscular strength (5), anaerobic endurance (4), maximal aerobic power (4), lower-body muscular power (3), prolonged high-intensity intermittent running ability/endurance (5), lower-body muscular strength (5), repeated high-intensity exercise performance (3), repeated-sprint ability (2), repeated-effort ability (1), maximal aerobic speed (1) and abdominal endurance (1). Stage 2 identified 20 studies describing measurement properties of 21 different tests. Only moderate evidence was found for the reliability of the 30–15 Intermittent Fitness. There was limited evidence found for the reliability and/or validity of 5 m, 10 m, 20 m speed tests, 505 test, modified 505 test, L run test, Sergeant Jump test and bench press repetitions-to-fatigue tests. There was no information from high-quality studies on the measurement properties of all the other tests identified in stage 1. Conclusion: A number of physiological characteristics are evaluated in rugby. Each physiological construct has multiple tests for measurement. However, there is paucity of information on measurement properties from high-quality studies for the tests. This raises questions about the usefulness and applicability of these tests in rugby and creates a need for high-quality future studies evaluating measurement properties of these physiological tests. Trial registrations: PROSPERO CRD 42015029747.
Open Access
A systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS)
(BioMed Central, 2018-05-02) Dambi, Jermaine M; Corten, Lieselotte; Chiwaridzo, Matthew; Jack, Helen; Mlambo, Tecla; Jelsma, Jennifer
Background Social support (SS) has been identified as an essential buffer to stressful life events. Consequently, there has been a surge in the evaluation of SS as a wellbeing indicator. The Multidimensional Perceived Social Support Scale (MSPSS) has evolved as one of the most extensively translated and validated social support outcome measures. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, there is a paucity of systematic evidence of the psychometrics of adapted and translated versions of the MSPSS across settings. Objectives To understand the psychometric properties of the MSPSS for non-English speaking populations by conducting a systematic review of studies that examine the psychometric properties of non-English versions of the MSPSS. Methods We searched Africa-Wide Information, CINAHL, Medline and PsycINFO, for articles published in English on the translation and or validation of the MSPSS. Methodological quality and quality of psychometric properties of the retrieved translations were assessed using the COSMIN checklist and a validated quality assessment criterion, respectively. The two assessments were combined to produce the best level of evidence per language/translation. Results Seventy articles evaluating the MSPSS in 22 languages were retrieved. Most translations [16/22] were not rigorously translated (only solitary backward-forward translations were performed, reconciliation was poorly described, or were not pretested). There was poor evidence for structural validity, as confirmatory factor analysis was performed in only nine studies. Internal consistency was reported in all studies. Most attained a Cronbach’s alpha of at least 0.70 against a backdrop of fair methodological quality. There was poor evidence for construct validity. Conclusion There is limited evidence supporting the psychometric robustness of the translated versions of the MSPSS, and given the variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error and cut-off values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions of the MSPSS. Trial registration PROSPERO-CRD42016052394.
Open Access
Arnica and the treatment of soft tissue trauma
(2002) Bauer, Cynthia Moira
Word processed copy. Bibliography: leaf 42.
Open Access
The association between prematurity, motor fuction and health related quality of life among learners in the foundation primary phase
(2017) Oosthuizen, Henriëtte; Ferguson, Gillian D; Jelsma, Jennifer
Introduction and Aims: Children born prematurely (≤ 36 weeks gestation) are at risk of poor developmental outcomes and are more likely than their full-term (FT) peers to have behavioural, physical and/or cognitive limitations. In order to deliver effective interventions, therapists need to have a sound understanding of the problems experienced by children who were born prematurely. Presently, very little is known about the functional problems of young school aged children, living in the Free State province of South Africa, who were born prematurely. Methodology: This study was conducted in 15 randomly selected schools located within in a 100 km radius of Bloemfontein. Two groups of children in grades R, 1 and 2 (age range: 5-8 years) were recruited, the first group (PREM group) consisted of children having a history of premature birth (≤ 36 weeks). The second group consisted of full term children (FT group) who were matched for age and gender to the first group. The PREM group was categorised into three subgroups according to prematurity status: late premature (34-36 weeks, LP), moderate (MP) to very premature (29-33 weeks, VP) and extremely premature (≤ 28 weeks, EP). A self-designed questionnaire was used to record demographic and medical information obtained from parents. The questions were related to antenatal factors, birth and medical history of the child. The Movement Assessment Battery for Children second edition (MABC-2) and MABC-2 Checklist were used to evaluate functional motor problems in children. The European Quality of Life Dimension Scale- Youth version (EQ-5D-Y) was used to determine the Health Related Quality of Life of the children and the Strengths and Difficulties Questionnaire (SDQ) was used to describe the behavioural and emotional status of each child according to their parents and teachers. Ethical approval was obtained from the University of Cape Town Research Ethics Committee (HREC REF: 694/2014) and permission to conduct the study within schools was granted by the Free State Education Department. Informed consent and assent was obtained. Parents were interviewed by a research assistant using the self-designed questionnaire. A different researcher then tested all children using the MABC-2 and assisted each child to complete the EQ-5D-Y. The parents and teachers each completed the SDQ and teachers completed the MABC-2 checklist. Statistical analysis was conducted using SAS® Version 9.4 and STATISTICA 10. The data were summarized using descriptive statistics (i.e. number of available data (n), mean, and standard deviation, minimum, median and maximum). The Mann Whitney U test was used to compare groups (PREM vs FT groups) and the Chi-square test was used to determine any association between groups and 5 descriptive variables. Comparisons between prematurity subgroups were conducted using the Kruskal- Wallis ANOVA. Results: 122 children participated in this study: 61 FT children and 61 PREM children. The PREM group consisted of 23 children who were classified as late premature, 27 who were moderate to very premature and 11 children who were extremely premature There were no differences between groups in terms of age (U = 1760, z = -0.51, p = 0.610), gender (Chi = 0.03, df = 2, p = 0.86), grade level (Chi = 0.386, df = 3, p = 0.98) and socioeconomic status [as defined by mothers level of education (Chi = 3.79, df = 2, p = 0.15) and school quintile (Chi = 5.22, df =2, p = 0.07)]. Differences were found in terms of maternal age at delivery (PREM = 31.9 years [SD=5.2] vs. FT = 29.02 years [SD = 3.5] df = 120, t = -3.61, p < 0.001). As expected, the PREM group had a significantly lower birthweight compared to the FT group (PREM = 2201g [SD = 748] vs. FT = 3132g [SD = 406], df = 120, t = 8.54, p < 0.001). 96.7% of those in the PREM group were born via C/section (p < 0.0001). Apart from one case of respiratory distress, the FT group reported no neonatal complications. As expected, more candidates in the PREM group were more frequently hospitalised (Chi = 34.605, df = 2), and cases of CP were reported. The APGAR scores were significantly different between FT and PREM groups at 1min (p<0.0001) and 5min (p<0.0001) Regarding motor performance, there was a significant difference in MABC-2 Total Standard Scores (MABC TSS) (U = 1425.0, z = 2.23, p = 0.026) and the MABC-Checklist Total Motor Scores (U = 1016.5, z = -4.32, p < 0.0001) with FT group performing better and reporting less functional motor problems than the PREM group. Regarding HRQoL, we found that groups were also significantly different in terms of the Mobility domain of the EQ-5D-Y with the Prem group reporting more problems than the FT group (Chi = 6.31, df =1, p = 0.012). No differences were found between groups with regard to the Looking After Myself (Chi = 2.03, df =1, p = 0.153), Usual Activities (Chi = 0.00, df = 1, p = 1.0), Worried/Sad/Unhappy (Chi = 1.22, df =1, p = 0.541), and Pain/Discomfort (Chi = 3.59, df = 1, p = 0.165) domains. In terms of emotional-behavioural status, we found no differences between the two groups in terms of Parent Total Difficulties scores (U = 1791.50, z = -0.351, p = 0.725) as well as Teachers Total Difficulties Scores (U = 1518.0, z = -1.751, p = 0.08). However, the FT group scored lower than the PREM group on the emotional domain (U = 1404.0, z = -2.33, p = 0.02) indicating less problems and higher on the prosocial domain (U = 1335.0, z = 2.68, p = 0.007) indicating more positive factors in this group. On examination of the PREM sub groups, we found no differences in Parent Total Difficulties Score between groups (p = 0.377). When we compared parent versus teacher SDQ scores, 45 (73.8 %) cases where the parent and teacher were in agreement with the "normal" assigned score. In addition, there were 2 (3.3 %) cases were the parent and teacher respectively assigned a score of "abnormal" and "borderline". Regarding the Impact scores, parents/caregivers reported that the difficulties (emotional, conduct, hyperactivity, peer and prosocial problems) did not have an impact on a child's friendship (p = 0.2889), classroom learning (p = 0.2325), leisure activities (p = 0.3585) or their home life (p = 0.1248). In contrast, teachers' responses indicated that the difficulties had an influence on classroom learning (p = 0.0030) but not friendships (p = 0.2374). Discussion: The late premature group made up a bigger proportion of the premature group. This correlates with the PPIP report, where the same trend was noted for the South African premature population (Pattinson, Saving Babies [PPIP], 2012-2013; Kalimba & Ballot, 2013). Findings from this study correlated with literature on PREM children being more at risk of decreased motor function when compared to FT peers (Hack et al., 2002; Chyi et al., 2008; Stephans & Vohr, 2009; Van Baar et al., 2009; Hornby & Woodward, 2009; Van Baar et al, 2013). Fine motor skills is essential in a child's daily activities and very important to function at school. This study indicated a deficiency within fine motor and balance domains within the PREM group. Maternal age surfaced as predictor of motor performance as younger mothers (< 19 years) have an increased risk of low birth weight and premature infants (very and extremely premature) (Schempf, Branum, Lukacs & Schoendorf, 2007; Gibbs, Wendt, Peters & Hogue, 2012; Kalimba & Ballot, 2013; Fall, Sachdev, Osmond, Restrepo-Mendez, Victora, Martorell, Stein, Sinha, et al., 2015; Benli, Benli, Usta, Atakul, Koroglu, 2015). Literature on older mothers (≥ age 35) also showed an increased risk towards premature birth (moderate and very premature) with more medical conditions (such as hypertension and diabetes)-this was not the case in this research (Schempf et al., 2007; Gibbs et al., 2012; Kalimba & Ballot, 2013; Fall et al., 2015; Benli et al., 2015), however it is reported that PREM infants from older mothers show somewhat better outcomes of infants later in life (Schempf et al., 2007; Gibbs et al., 2012; Kalimba & Ballot, 2013; Fall et al., 2015; Benli et al., 2015). Other findings from this research indicated that, from the teachers' perspectives, PREM children showed a greater tendency towards emotional and prosocial behaviour impairments, than the FT population. This align with literature where premature infants are mentioned to be more susceptible to behaviour performance problems at school-age (Kerstjens et al., 2012; Bos et al., 2013; Moreira et al., 7 2014). In this research, the extremely premature group had more behavioural problems which had an impact on theses children's leisure activities, peer, and classroom learning. Conclusion: Our findings suggest that PREM children have more motor problems than FT children and that the very preterm group showed the highest risk for motor problems. Maternal age also indicated to be an influencing factor where mothers younger than 19, as well as mother over 35, both indicated a risk for premature birth, resulting in low birth weight. Other risk factors influencing function in the PREM, apart from low birth weight, indicated by the results were factors like respiratory distress, apnoea, haemorrhaging and the exposure to post-natal steroids. According to teacher's perceptions, the children in the PREM group, tended to show more behavioural and emotional problems that those of the FT sample.
Open Access
Bone stress injuries in the lower back of cricket fast bowlers
(2003) Millson, Helen; Lambert, Mike
Open Access
Cervico-mandibular muscle activity in females with chronic cervical pain a descriptive, cross-sectional, correctional study
(2012) Lang, Patricia; Parker, Romy; Burgess, Theresa
Chronic musculoskeletal conditions of the spine and periphery are a burden both internationally and in South Africa. There is a socio-economic burden as a consequence of the severity, duration and recurrence of chronic cervical musculoskeletal conditions among information technology and sedentary office workers. However, the precise mechanisms behind chronic cervical disorders remain unclear. It is theorised that the pathophysiological mechanisms in chronic cervical musculoskeletal conditions share a similar theoretical framework to chronic pain itself. The biopsychosocial model of chronic pain accepts the dynamic nature of pain. This model accepts the dual biological and psychosocial components that enhance the experience and maintenance of chronic pain, through central sensitisation. There appears to be a neurophysiological, biomechanical and psychological link between the cervical area and the temporomandibular area. Although numerous studies have implied that individuals with temporomandibular disorders have concurrent cervical dysfunction, there is currently no evidence that individuals with cervical dysfunction exhibit altered muscle activity in the masseter and cervical erector spinae muscles or report teeth clenching habits. Consequently, identification of factors that may contribute to chronic cervical musculoskeletal conditions, stemming from the temporomandibular area, may potentially be lost. The aim of the present study was to explore the activity levels of the cervicomandibular muscles in females with chronic cervical musculoskeletal conditions, who showed no symptoms of temporomandibular disorders. This study had a descriptive cross-sectional correlational design with single-blinding. The telephonic screening process was followed by the signing of informed consent forms. Validated questionnaires were used for categorisation and comparison of the socio-demographic and biopsychosocial profiles of the pain group (n = 20) and the no pain group (n = 22). The screening, informed consent and questionnaires were completed by an assistant. The first of five questionnaires, the adapted Research Diagnostic Criteria History questionnaire, was used as an instrument for exclusion of temporomandibular disorders and the recording of a daytime parafunctional teeth clenching habit. The remaining four questionnaires, listed as the Neck Disability Index, the Computer Usage Questionnaire, the Brief Pain Inventory, and the EuroQol-5D were used for determining levels of cervical disability for categorisation and comparison between groups, as well as for determining levels of pain-related disability, occupational and sporting activity, and health related quality of life.
Open Access
A comparative study of the effects of meclofenamate, diclofenac and placebo, in combination with physiotherapy, on the healing of acute quadriceps and hamstring muscle tears
(1991) Reynolds, Jonathan F; Bowerbank, Patricia; Noakes, Timothy D
A double-blind, placebo controlled research technique was used to determine the effects of two non-steroidal anti-inflammatory drugs, meclofenamate and diclofenac, in combination with physiotherapy treatment, on the rate and extent of healing of acute hamstring muscle tears. Sixty patients were recruited and treated at No's 1 and 2 Military Hospitals in Voortrekkerhoogte and Wynberg, Cape Town, respectively. Patients were randomly allocated to one of three treatment groups: meclofenamate, diclofenac and placebo. Patient assessments were performed on days 1, 3 and 7 of the 7-day study period. These assessments included pain assessment (visual analogue scale), swelling measurement (thigh circumference measurement at the site of the muscle tear) and muscle performance test (Cybex isokinetic dynamometer and data reduction computer). All patients received physiotherapy treatment on all 7 days of the study. This comprised early rest, ice, compression and elevation (RICE), and later, ultrasound and deep transverse friction massage. An intensive regime of strengthening and stretching exercises was used throughout the study, beginning with stretching and isometric exercises gradually moving onto isotonic exercises and aerobic exercise including swimming, running and cycling. No competitive sport was allowed during the study period. Statistical significance was determined using the analysis-of-variance (ANOVA) test with an acceptance level of p<0.05. No differences in pain, swelling or muscle performance were demonstrated between the three treatment groups. In terms of the pain and swelling assessments, the injuries did not appear to be very severe. Accordingly, the groups were divided into severe and non-severe sub-groups and statistical significance was determined using the ANOVA test with an acceptance level of p<0.05. A significant difference was found in the severe hamstring injury sub-group. In this group, pain reduction was greater in the placebo group than in the meclofenamate group on day 7. There were no other significant differences found in this sub-group analysis. Relatively few side effects were encountered, and those encountered were mild. No patients were withdrawn from the study as a result of these adverse events. Drowsiness and gastro-intestinal disturbance were the most common side effects reported. In conclusion, the study found that no benefit was gained from the use of meclofenamate or diclofenac in combination with physiotherapeutic modalities as compared to the use of physiotherapeutic modalities on their own. Thus, the widespread use of NSAIDs in the treatment of acute muscle injuries may not be justified.
Open Access
A comparison between the effects of hamstring static stretching and active warm-up on range of motion and performance
(2006) Beukes, Phillo; Schwellnus, Martin; Lambert, Mike
Includes bibliographical references.
Open Access
A comparison of hospital-based and community-based models of cerebral palsy rehabilitation
(2013) Dambi, Jermaine Matewu; Jelsma, Jennifer
Cerebral palsy is a disabling and permanent condition which requires sustained rehabilitation over a long period of time. There is much debate as to which model of service delivery is most appropriate for children with cerebral palsy and their mothers. The aim of this study was to compare the efficacy and effectiveness of two models of service delivery currently offered in Harare, Zimbabwe. One of these is a hospital-based and the other a community-based service. A quasi-experimental study was done to determine the efficacy of two service delivery models from the perspective of caregivers and functional gains in children. Questionnaires were distributed to caregivers of children with CP at baseline and after three months. The caregivers were 46 in total, with twenty caregivers having children receiving rehabilitation services under an outreach program and 26 receiving services as outpatients at a central hospital. The caregivers’ health- related quality of life was assessed using the EQ-5D, the burden of care was measured using the Caregiver Strain Index, satisfaction with physiotherapy was assessed using the modified Medrisk satisfaction with physiotherapy services questionnaire and compliance was measured as an index of the met appointments from the scheduled appointments. Additionally, motor functional changes in children with CP were assessed at baseline and after three months using the Gross Motor Function Measurement (GMFM-88). Children receiving community based treatment children were significantly older than children in the hospital based group. However, the two groups were comparable in terms of sociodemographics of both children and caregivers at baseline. The correlation between age and change in score was tested and found to be non-significant (r=-.103, p=.497). Spearman’s rho indicated that as the level of severity increased in terms of GMFCS level, so the amount of improvement decreased (rho=-568, p<;.000). However, as age was significantly different between the two groups and there were more severely affected children in the community based treatment group, regression analysis was done to establish which factors predicted the amount of change in the GMFM Score. Dummy variables were created for the categorical variable of the group and the ordinal variable of GMFCS was dichotomised into level 3 and above and level 4 and below. The resulting model accounted for25% of the variance (adjusted R²= .25) after the score of one child was removed after residual analysis indicated that he/she had improved more than two standard deviations from the mean residual. The results indicate that, once age and category were controlled for, children in the community based treatment group improved 3.5 points more than children receiving hospital based services. Children who were more severely disabled showed 4.7 points less improvement, and for each month of age, children showed .04 less improvement, although this was not significant.
Open Access
A comparison of treatment protocols for infants with motor delay
(2012) Olivier, Odette; Ferguson, Gillian; Jelsma, Jennifer
Purpose: Early intervention (EI) strategies are reported to have positive results on decreasing the extent of motor delay in children. However, most studies regarding treatment of infants with motor delay as a result of psychosocial/environmental factors have taken place in developed countries where resource constraints are not as severe as in the South African context. The aim was thus to determine which intervention protocol (standard vs. intense group orientated therapy) was the most feasible and efficacious for infants with motor delay, primarily due to psychosocial/environmental factors. Methodology: A cross sectional, descriptive, correlational research approach was used to identify infants with motor delay using the Bayley Infant Neurodevelopmental Screener III (BINS) at three Well Baby clinics. After a baseline assessment, infants who met the criteria to participate entered an experimental study consisting of a single blinded randomized control trial. The final sample included 24 infants aged 3 to 12 months. Participants were randomly divided into two groups and a repeated measures design was followed to conduct this study. The Bayley Scales of Infant Development II (BSID II) was used to evaluate motor progress over a three month intervention period. The standard group received treatment once a month for three months compared to a weekly treatment session attended by dyads in the intense group. Care-giver compliance along with their level of satisfaction was investigated using self-structured questionnaires. Results: Twenty four participants were recruited with a mean age of 5.69 months (SD= 2.36; range 3-10.4). Both monthly and weekly treatment groups showed significant motor developmental progress over the intervention period. The overall difference between the groups was not significant (p=.78) and by the final assessment, during the intervention period, both groups displayed similar psychomotor developmental indices (monthly: mean= 87.92, SD= 10.87, range 73-109; weekly: mean= 94.18, SD= 7.63, range 85-109). However there was a medium to large effect size ( d = 0.65) in favour of the weekly treatment group and they also showed better initial developmental progress after 1 month compared to the gradual trend of progress illustrated by the monthly group. After treatment sessions were withheld for six weeks, an assessment of motor performance showed the monthly group retained their skills better than the weekly group. This difference had a medium effect size of d = 0.58 in favour of the monthly group. Care-givers generally showed a high level of satisfaction with no significant differences between groups (p= .64). Similarly, no statistically significant difference was found between the groups in terms of compliance to the home programme. Conclusion: Both the intense and standard group orientated treatment protocols had significantly positive results after treatment. The intense group showed rapid initial progress compared to the monthly group. However, the monthly group better retained their skills after treatment was discontinued. Therefore, in a South African, low socio-economic context, the monthly protocol might be more practical and cost effective.
Open Access
Content validity and test-retest reliability of a low back pain questionnaire in Zimbabwean adolescents
(BioMed Central, 2017-02-28) Chiwaridzo, Matthew; Chikasha, Tafadzwa Nicole; Naidoo, Nirmala; Dambi, Jermaine Matewu; Tadyanemhandu, Cathrine; Munambah, Nyaradzai; Chizanga, Precious Trish
Background: In Zimbabwe, a recent increase in the volume of research on recurrent non-specific low back pain (NSLBP) has revealed that adolescents are commonly affected. This is alarming to health professionals and parents and calls for serious primary preventative strategies to be developed and implemented forthwith. Early identification initiatives should be prioritised in order to curtail the condition and its progression. In an attempt to be proactive in minimising the prevalence of recurrent NSLBP, this study was conducted to evaluate the content validity and test-retest reliability of a survey questionnaire with the aim of proffering a valid and reliable questionnaire which can be used in non-clinical settings to identify adolescents with recurrent NSLBP in Harare, Zimbabwe and determine the possible factors associated with the condition. Methods: The study was conducted in two parts. The first part assessed content validity of the questionnaire using four experts derived from academia and clinical practice. The second part evaluated the reliability of the questionnaire among 125 high school-children aged between 13 and 19 years in a test-retest study. Results: Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. Overall, the Scale Content Validity Index for the questionnaire was 0.97. Item completion for the reliability study was satisfactory. The questionnaire items had kappa values ranging from 0.17 (slight agreement) to 1 (perfect agreement). High levels of reliability were found for the questions on school bag use (k=0.94), sports participation (k=0.97), and lifetime prevalence (k=0.89). Conclusion: Excellent content validity and slight to perfect test-retest reliability was found for the Low Back Pain (LBP) questionnaire. These results are comparable to findings of other studies evaluating the psychometric properties of LBP questionnaires. Cognisant of the limitations of the study, the results of this study suggest that the LBP questionnaire could be used in local studies investigating LBP among adolescents although questions enquiring on functional limitations and sciatica may need further consideration.
Open Access
Cross sectional study to determine whether there are central nervous system changes in rugby players who have sustained recurrent ankle injuries
(2017) Rawlinson, Alice Jane; Parker, Romy; Burgess, Theresa
Background: Rugby is a popular game played around the world and has one of the highest recorded injury rates in sport. The literature exposes ankle injuries as one of the most common areas injured in sport and this trend carries through in rugby too, with lateral ankle sprains predominating. Recurrent ankle injuries are commonly reported in the literature and account for high economic and social burden. There are many intrinsic and extrinsic risk factors credited with causing lateral ankle injuries but to date the literature does not show conclusive evidence for management and prevention of recurrent injuries. A new area of research that has not previously been explored is the neurological influence on recurrent injury. Central processing is a recognised form of learning seen in adults and children during normal development and training and more recently acknowledged in injury settings. This phenomenon has also been seen in abnormal states of development such as neglect and chronic pain. Central Nervous System Changes In Recurrent Ankle Injuries In Rugby Player 2 Aim: The purpose of this study was to investigate whether there are changes in the central nervous system of rugby players with recurrent ankle injuries. Methods: An experimental and control group was used for this cross sectional study. Participants were recruited from the Golden Lions Rugby Union. Forty-six players in total were recruited. The control group consisted of 22 players, and the recurrent injury group consisted of 24 players. Medical and Sports History Questionnaire was administered as well as a battery of four physical test procedures. The questionnaire asked participants to provide information regarding demographics, playing position, training and playing history, current general health, current and previous injury history, and specifically ankle injury history. The four testing procedures were: body image testing, laterality testing, two point discrimination testing and pressure-pain threshold testing. Results: The results were collected and recorded. Between group and within group comparisons were made for the control and recurrent injury groups. From the Medical and Sports History Questionnaire the results indicated that the recurrent injury group participated in a significantly shorter preseason training period compared to the control group. The laterality testing within group analysis had a significant difference, the injured side had a slower recognition time [1.4(1.3-1.6)] compared to the uninjured side [1.3(1.15-1.5) Central Nervous System Changes In Recurrent Ankle Injuries In Rugby Player 3 p<0.01]. Pressure pain threshold testing produced a significant difference for the control group on the ATFL test site and the PTFL site. The PTFL site also demonstrated significant difference in the between group comparison analysis. The results from the two point discrimination testing and the body image testing produced interesting results. The two point discrimination tests performed on the both the recurrent injury group and the control group using within group comparison showed significant differences on the anterior talofibular ligament between the affected and nonaffected limbs. The between group test result were also significant for the injured vs control side at the ATFL site. The affected side showed a poorer ability to differentiate between one and two points, needing a bigger area before two points were distinguished from one. Similarly, body image testing showed significant differences in the within group comparison of total area drawn for the recurrent injury group only. In the recurrent injury group, the drawing of the affected foot was significantly larger than the drawing of the unaffected side. The control group showed no differences between sides. Conclusion: The study recommends that there is a relationship between central nervous system changes in recurrent ankle injuries in the sample group of professional rugby players. The data indicates that preseason length is a factor to be considered in recurrent ankle injuries. The clinical tests focussed specifically on central nervous system changes also produced some illuminating results. The recurrent injury group demonstrated significant difference between injured and uninjured sides in both two point discrimination testing of the ATFL ligaments and in the body image drawing of the foot and ankle. The control group in contrast didn't yield any differences between sides for these same tests. The pressure pain testing and laterality testing producing significant results also indicate the central nervous system involvement in recurrent injury.
Open Access
The development of posture in very low birthweight infants (<1500 grams)
(1993) Magasiner, Vivien Adele; Molteno, Christopher D; Malan, A
The aims of the study were to examine postural development in very low birthweight and normal birthweight infants and to determine whether deviant postures were predictive of adverse neurodevelopmental outcome. In the first part of the study the 7 postural responses selected by Vojta to evaluate neuromotor development were applied to 69 very low birthweight (VLBW < 1 500 grams) infants and to 28 healthy full-term infants of normal birthweight (> 2500 grams). Of the 69 VLBW infants, 43 were small for gestational age and 26 appropriate for gestational age. All infants were examined at term and 4 months corrected age. They were all later assessed on the Griffiths Mental Development Scale at 12 and 18 months corrected age. There were significant differences in postural reactions between the 2 groups which confirmed the lower tone and greater extension previously described in VLBW infants. An important finding in the study was that poor head and trunk righting noted at 4 months corrected age in VLBW infants, was associated with less developed locomotion at 12 and 18 months as assessed by the Griffiths Mental Development Scale. Thus, a delay in maturation in VLBW infants which was apparent from the assessment of postural responses was still identifiable on the locomotor sub-scales at 12 and 18 months. Five of Vojta's responses were shown to be useful as part of the neurological assessment of high risk infants. In the second part of the study, the 5 useful Vojta responses were incorporated into the Infant Neurodevelopmental Assessment (INA) which was used to assess 76 high risk VLBW infants. The 76 infants consisted of 34 infants with intracranial lesions on ultrasound and 42 without intracranial lesions. All infants were assessed at term and 4 % months corrected age using the INA. At 12 months corrected age they were all assessed on the Griffiths Mental Development Scale. Six infants were diagnosed as having cerebral palsy, all of whom had intracranial lesions. Several clinical signs indicative of cerebral palsy were significant at 4 % months corrected age and will be useful in future studies to diagnose cerebral palsy early. The association between lack of head and trunk control at 4 % months corrected age and a lower locomotor score at 12 months corrected age proved to be significant again and reinforces the finding that early delay in maturation is identifiable on the locomotor scale at 12 months corrected age.
Open Access
Difference in the prevalence of lower limb injuries in classical ballet dancers with and without lumbar-pelvic stability
(2005) Swart, Michelle; Lambert, Mike
The grace and ease with which a dancer entertains an audience is deceptive with respect to the sweat and tears shed to achieve such elegance of movement. Ballet demands great flexibility and strength. This is showcased as a story told through movement, full of emotion and expressed to music. As a physiotherapist on watches a ballet in absolute awe of the stresses the human body has to endure. What adaptations are necessary within the musculoskeletal system to allow such movement? Do these adaptations lead to injury?
Open Access
Differences in five kilometer time trial performance during the recovery period after an ultramarathon race
(2013) Benney, Tamlyn; Burgess, Theresa; Lambert, Mike
Athletes require an appropriate balance between training, competition stress and recovery to achieve maximal performance. Previous studies have shown that exercise induced muscle damage has a negative influence on endurance running performance, and that these negative effects may be mediated by an increased perception of effort. There is a lack of evidence regarding the effects of ultramarathon distance races on running performance, and the optimal duration of the recovery period before returning to competitive running. The aim of this study was to determine the changes in running performance during the recovery period after an ultramarathon race. The specific objectives were: (a) to determine differences in running performance between the experimental group (runners participating in the 2011 Comrades Marathon) and a control group (distance runners not taking part in the 2011 Comrades Marathon) during the recovery period after an ultramarathon race; (b) to determine the differences in muscle pain, heart rate and perception of effort during a 5 km time trial between groups and over time before, and during the recovery period after an ultramarathon race; and (c) to determine if there were any relationships between prior experience, training history, and running performance during the recovery period following an ultramarathon race.
Open Access
The effect of a community based pulmonary rehabilitation programme on the quality of life of patients with pulmonary tuberculosis
(2011) De Grass, Donna; Manie, Shamila
The purpose of this study is to determine whether a community based rehabilitation exercise programme had an effect on pulmonary function, exercise tolerance and Health Related Quality of Life (HRQoL) in patients diagnosed with Pulmonary Tuberculosis (PTB). The prevalence of PTB in South Africa is one of the highest in the African continent. Assessing the effectiveness of the programme could provide further methods in improving compliance to pharmaceutical medication as well as an improvement in the morbidity experienced after diagnosis of PTB.
Open Access
The effect of a teacher-based intervention programme for primary schools on learner's health-related quality of life, body mass index and physical fitness: a randomised control trial
(2017) Bowers, Jodie; Naidoo, Nirmala
Background: Childhood obesity, a rising problem world-wide and within South Africa, has been negatively linked with both physical fitness (PF) and health-related quality of life (HRQoL). The school environment is the ideal setting for children to obtain the skills and knowledge to increase physical activity (PA) levels and healthy diets. PA and school-based nutrition intervention programmes have been shown to have positive effects on diet and PA behaviours in children. However, there is minimal literature reporting on the effectiveness of school-based interventions in a South African setting. Aim: The primary aim of the first phase of the study was to provide a contextual background regarding the provision of PA in school-based PE programmes within a small sample of schools from which the learners in the intervention study were drawn. The primary aim of the second phase of the study was to determine the effect of a teacher-based intervention programme after six weeks for primary schools with less than the mandated amount or no specific amount of PE on learner's HRQoL, Body Mass Index (BMI) and PF. Methodology: Ten schools were randomly selected from the circuit lists within the Port Elizabeth Education District. Ten staff members from the selected schools completed the School Environment Questionnaire in order to provide a situational analysis regarding the provision of PA in school-based PE programmes. A sample of 300 learners (aged nine to eleven) from four randomly selected schools participated in the pre-testing measures in order to establish the weight status (using BMI and waist circumference (WC)), HRQoL (using the EQ-5D-Y), and PF (using the Eurofit test battery). Class teachers, from schools with less than the mandated amount of PE or no specific amount of PE, who were part of the experimental group, implemented the intervention. In order to implement the intervention, they received training and were given a PE programme booklet. The PE intervention programme was in line with the Curriculum and Assessment Policy Statement teaching plan for life skills, and was based on targeting the deficiencies found in the pre-testing fitness measurements. Post-testing measures, using the same learners, were conducted six weeks later. The obtained results were analysed using STATISTICA version 12. Results: Phase one of the study revealed that PE was provided at all schools. The curriculum was followed by 90% of schools, but only 30% had teachers with PE qualifications. PE policies and practices were being developed and/or implemented in 70% of schools, and 50% had no specific amount of time mandated to PE, or less than the mandated amount. Soccer was offered at all schools, and 80% of schools had access to an outdoor sports field and an outdoor paved area. Phase two of the study found that the control and experimental groups were not equivalent at baseline with regard to gender distribution, BMI Z-scores and interpretations, the EQ-5D-Y "looking after myself" variable, and the sit-up test. No positive significant differences were noted in BMI Z-scores, WC, HRQoL, or PF components in the experimental group after the six-week intervention. Discussion: The average duration of PE at 70% of the participating schools was longer than the national average, despite half of the schools not implementing the mandated amount of PE. Gaps in the curriculum content and unqualified PE teachers may have prevented learners from developing the necessary skills associated with PE, including the various components of PF. The six-week teacher-based intervention was found to be ineffective. Similar results were seen in other South African studies. Insignificant intervention findings may be the result of poor intervention implementation or compliance, time constraints experienced by participating teachers, and the short six-week duration of the intervention. Teachers mainly commented on the enjoyment of the intervention programme by the learners. Conclusion: This study concludes that the effects of the six week teacher-based intervention, on primary school learners' HRQoL, BMI, and PF, was insignificant. Nevertheless, all schools provided PE, despite half of the schools not implementing the amount mandated. This study provides a platform for future studies in the attempt to reduce the occurrence of obesity in school children; thereby reducing its increasing national burden on health and the economy.
Open Access
The effect of functional electrical stimulation on abdominal muscle strength and gross motor function in children with cerebral palsy a randomised control trial
(2014) Joffe, Jessica Robyn; Jelsma, Jennifer
Includes abstract. Includes bibliographical references.
Open Access
The effect of high intensity training on the angle-torque relationship of the quadriceps and hamstring muscles in a group of well-trained cyclists
(2008) Rösemann, Christel; Lambert, Mike
Includes abstract. Includes bibliographical references (leaves 69-74).
Open Access
The effect of medial patellar taping on pain, strength and neuromuscular recruitment in subjects with and without patellofemoral pain
(2003) Brown, Janet; Gray, Janine; Harley, Yolande
Patellofemoral disorders are amongst the most common clinical conditions encountered in the sporting and general population [8, 33, 68]. Patellofemoral pain (PFP) is usually described as diffuse, peripatellar, anterior knee pain [8, 61].