Theses and dissertations (Health Sciences)

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An epidemiological investigation into musculoskeletal pain in KwaZulu-Natal orchestral musicians
(2024) Muhondo, Linley; Thandar, Yasmeen; Kell, Colette
Background Non-communicable diseases pose a significant health threat worldwide. Of those diseases, musculoskeletal diseases are most responsible for a significant portion of occupational injuries in all job-sectors, including the musical sector. Musicians are prone to suffering from musculoskeletal injuries, more so than other populations. These injuries are termed playing-related musculoskeletal diseases (PRMDs). There are several risk factors associated with acquiring PRMDs including being of the female gender, age, and the type of instrument played. While most literature on musicians’ has been documented in countries abroad, there is a paucity of literature looking at the risk factors and attributes of African, and specifically South African, musicians. This is notable, as African musicians may have different characteristics to their international counterparts. The aim of this research was to examine orchestral musicians in Kwa Zulu-Natal from all sections of the orchestra to determine the prevalence of musculoskeletal injuries and the potential risk factors for these injuries, as well as their musculoskeletal injury profile. Methodology This study was a quantitative, cross-sectional descriptive study based on a self administered questionnaire. The questionnaire was piloted electronically and the necessary alterations were made. The final questionnaire was administered to members of 2 orchestras in Kwa Zulu-Natal, namely the Pietermaritzburg City Orchestra (25 members) and the Durban City Orchestra (30 members), making the targeted sample 55 musicians in total. All musicians who met the inclusion criteria were invited to participate in the study. The anonymously completed questionnaires were placed into marked boxes after completion to ensure musician anonymity. The data was analysed using IBM SPSS version 28. Association between specific risk factors and 12-month prevalence of MSK was assessed using Fisher’s exact 2-sided tests for categorical risk factors, and t-tests for continuous risk factors. A p-value of <0.05 was taken as statistical significance. Results Of the 55 musicians targeted, 30 of them participated, resulting in a response rate of 54.5%. Majority of the respondents were female (n=20). The data showed that the annual prevalence of PRMDs in the two orchestras was 46.7%. The point and one month prevalence were both 40%. The most injured section of the orchestra were the strings, followed by the woodwind section. The string section also reported the highest number of average affected areas in the orchestra (n=4). The most frequently injured anatomical sites of the body were the shoulders and wrists. There was no statistical significance found between the risk factors and injuries acquired. However, the results showed that females were injured more than the males (55%). Most of the respondents that reported musculoskeletal injury fell within the 18-24 age range and majority of the injured musicians fell in the overweight BMI body category. Most of the music teachers and the single career musicians in the study reported suffering from PRMDs and playing instruments for more than 16 hours a week on average. Conclusion The prevalence of playing-related musculoskeletal disorders among musicians was relatively high among the orchestral musicians in Kwa Zulu-Natal. Though not statistically significant, factors such as instrument played, age, and female gender were the factors that had the greatest influence on injury rates. The pain experienced was mild in nature and felt worse after playing their instruments. While the pain did not affect their activities of daily living, it did cause a few to change their way of playing or stop playing entirely for a period of time due to their pain. Majority of the players were aware of musician’s playing related health problems, and acknowledged that they are a problem, but none of them had received formal methods of education regarding them. The COVID-19 pandemic was a phenomenon that also affected the musicians in various ways.
The injury profile of musculoskeletal injuries, and the impact thereof, in amateur pole sports athletes in eThekwini municipality
(2024) Worth, Kim; Pillay, Julian David
Background: Pole sport has gained popularity worldwide, especially in South Africa. Due to the nature of the sport, there is growing evidence of unique musculoskeletal injuries that accompany the sport. Despite this, there is little information regarding the specific musculoskeletal injuries that occur in pole sport athletes and, thus, the sport has been compared to gymnastics and circus arts which include certain similarities. Research in pole sports specifically is essential in order to assist healthcare professionals to manage the injuries specific to the sport appropriately. Aim: The aim of this study was to determine the prevalence, selected risk factors and types of injuries that amateur pole sport athletes experience, as well as the impact of the musculoskeletal injuries and the level of care used. Methodology: A quantitative, descriptive, cross-sectional method was utilised with the distribution of online questionnaires to five pole studios in the eThekwini municipality, KwaZulu-Natal, South Africa. The questionnaire consisted of the following sections: demographics; training history; risk factors; musculoskeletal injuries; consequence of injury on sport and performance, quality of life and the management approaches and impact thereof. The data was analysed using the IBM SPSS version 28. Results: A total of 59 female participants over the age of 18 years old were included in this study. A high prevalence of musculoskeletal injury was found, with a lifetime prevalence of 49.2% (n=29), and period prevalence over 12 months of 40.7% (n=24). The majority of injuries were found to affect the upper limb but injuries to the spine and lower limb were still common. The most commonly reported location of injuries was the shoulder (64.3%, n=18), followed by the hand and wrist (46.4%, n=13), and then the neck (35.7%, n=10) and thoracic back (35.6%, n=10). The most common type of injury was a strain type injury (48.1%, n=14), followed by contusions (11.1%, n=3). Significant risk factors included high skill level (p value of 0.005), increased strength (p value of 0.010), performing warm-ups for longer than 10 minutes (p value of 0.053) and performing static stretching cool-downs (p value of 0.005). The impact of pole sport injuries on the participants’ pole performance demonstrated that despite the athletes’ recovery from injury taking more than six weeks, the majority of the athletes either stopped pole sport and other activities for one week or less or did not stop the activities at all. The impact of pole sports injuries on the participants’ quality of life was significant, especially affecting their ability to perform daily activities, decreasing their ability to sleep and decreasing their mood as a result of injury. Various management approaches, including self-medication, home remedies and complementary healthcare were utilised by participants. Self-medication and home remedies were found to be utilised more commonly compared to seeking help from healthcare professionals. Conclusion: This study demonstrated that musculoskeletal injuries are largely present in pole sport athletes for which various management approaches were utilised. The injuries impacted multiple aspects of the participants’ lives. The uniqueness of this sport provides an interesting platform for new research, especially with regard to musculoskeletal injuries, as shown in this study.
The association between static biomechanical parameters and musculoskeletal injury in lower extremities in male recreational weight trainers
(2022) Makada, Fahmeeda; Matkovich, Grant
Background: Anatomical alignment of the lower extremity has been proposed as a risk factor for acute and chronic lower extremity injuries such as ACL injuries, patellofemoral syndrome, and plantar fasciitis. Lower extremity malalignment influences the load distribution on the joints, mechanical efficiency of the muscles and proprioceptive orientation and feedback from the hip and knee, resulting in altered neuromuscular function and control of the lower extremities. During recreational weight training, the weight trainer performs exercises with gradual load on machines or free weights, aimed to improve their muscular condition, fitness, power, or performance in other sports. The weight trainer uses his own bodyweight or specialised forms of equipment such as barbells, dumbbells and resistance training machines to target specific muscle groups and to perform specific joint actions. Various intrinsic and extrinsic factors contribute to injury. Anatomical alignment – amongst others - is regarded as an intrinsic factor. Studies state that suggested risk factors for injuries include heavy loads in extreme joint positions, training frequency, intensity, volume, muscle strength, stability and foot morphology. Several studies have examined musculoskeletal injuries in specific weight training populations such as powerlifters, weightlifters and bodybuilders. Very few studies have investigated the recreational weight training population. The purpose of this study is to identify whether associations exist between the relevant biomechanical parameters and injury, to prevent or correct these abnormalities. Objectives: This study aimed to establish lower extremity static biomechanical parameters of the hip (flexion, extension and Craig’s test), knee (quadriceps angle and tibial torsion test), ankle (dorsiflexion, Feiss line, hindfoot, and forefoot alignment) and leg length discrepancy, and to establish if an association exists between the above- mentioned parameters and musculoskeletal injuries in the lower extremities in male recreational weight trainers. Method: 30 Male recreational weight trainers were recruited from fitness centres within the greater Durban area to the DUT Chiropractic clinic, where the assessment took place. Each participant was assessed for injury and static biomechanical measurements were taken. The statistical analysis was performed using Stata version 16. For normally distributed continuous variable the mean and 95% CI was done. Shapiro Wilk test was used to test for normality. For not normally distributed variables, median and interquartile range was performed. 15 participants were diagnosed as injured and 15 participants as uninjured. As the sample size of this study is small, Fisher’s exact test was used to evaluate the association between two categorical variables. Results: The statistical analysis was performed using Stata version 16. For normally distributed continuous variables the mean and 95% CI were done and Shapiro Wilk test was used to test for normality. For not normally distributed variables, median and interquartile range were performed. As the sample size of this study is small, Fisher’s exact test was used to test the association between two categorical variables. Prevalence of injury was thus 50%. In the injured population, 46.67% were acute and chronic injuries. 16.67% of injuries were traumatic and 33.3% were non-traumatic. Fisher’s exact test was used to see the association between biomechanical measurement and existence of injury. Accordingly, Fisher’s exact test with p-value 0.036 indicated that there was enough evidence of association between right quadriceps angle and injury. The injured participants were more likely to have a low right quadriceps angle. However, the rest of the biomechanical measurements have no association with injury Conclusion: The injured participants were more likely to have a low right quadriceps angle. The rest of the biomechanical measurements have no association with injury.
Upper body musculoskeletal pain associated with remote working of academics at the Durban University of Technology during the COVID-19 pandemic
(2022-09-29) Narainsamy, Nevinia
BACKGROUND The world-wide pandemic COVID-19, which initiated international lockdowns and varied degrees of work considerations, enforced remote working to reduce the spread of infection. Ergonomic support for effective remote working during this rapid transition received little consideration. Musculoskeletal disorders (MSDs) associated with musculoskeletal pain (MSP) are frequently linked to poor ergonomic support at the workplace and compromises the quality of life of those affected. MSP may be aggravated by prolonged, repetitive, and awkward movements, poor posture and ergonomics, or a fast-paced workload. Additionally, the onset of upper body MSP contributes to workrelated MSDs, resulting in decreased work productivity. It is believed that the current shift to remote working may result in an increase in MSP. This study, therefore, aims to determine the prevalence and effects of upper body musculoskeletal pain (head, neck, shoulder and back) associated with the ergonomic changes of remote working during the current COVID-19 pandemic. OBJECTIVES 1. To determine the prevalence of musculoskeletal pain among those working remotely during the COVID-19 pandemic. 2. To determine the selected risk factors predisposing to upper body musculoskeletal pain as an ergonomic effect of remote working. 3. To identify the extent to which remote working has impacted the occurrence of musculoskeletal pain with particular reference to ergonomic aspects. 4. To determine the effects of musculoskeletal pain and its impact on work performance/productivity. 5. To provide guidelines/recommendations and future considerations to support the prevention of MSP during remote working. METHOD A quantitative, descriptive cross-sectional study was conducted on all Durban University of Technology (DUT) academic staff members, to obtain relevant data regarding the onset of musculoskeletal pain and ergonomical factors, whilst working remotely during the COVID19 pandemic. Data were collected through the use of an online questionnaire, administered through DUT’s electronic platform. The Dutch Musculoskeletal Questionnaire was adapted to focus more on ergonomics and working remotely. Descriptive statistics were used to provide summarised questionnaire data. All data were analyzed using the IBM SPSS version 25 software package. Bivariate analyses, such as the Pearson’s chisquared test, ANOVA, and T-tests, where appropriate, were done. A p<0.05 was considered statistically significant. Findings of similar studies, both locally and internationally, provided generalised and more contextualised recommendations related to the ergonomic effects of working remotely. RESULTS In summary, 87.2% of participants reported to having musculoskeletal pain (MSP) prior to COVID-19. However, there was a massive increase in MSP while remote working, with 81.8% of participants reporting MSP during COVID-19. A great number of academic staff members (52.7%) reported to have worked remotely and having suitable equipment (59.1%) to facilitate remote work. With a reported increase in workload (89.1%), there was also an increase in productivity (53.6%). The most severe location of pain while remote working was the back (25.5%). Ergonomic factors that were noteworthy were that 64.5% participants sat without their back supported; shoulders were not relaxed in neutral (68.2%); wrists were not in a neutral position (51.8%) and the neck was not in a neutral position while remote working (63.6%). These factors remained consistent before and during COVID-19, indicating a minute change in the statistical significance of ergonomic factors. The p-value was less than 0.001. Regarding the emotional states of the respondents, it has been revealed that there was an association between the emotional status before and during COVID-19. All corresponding p-values were less than 0.001, indicating a statistically significant relationship. CONCLUSION The COVID-19 pandemic has placed unprecedented pressures on governments, economies, and families, posing what many observers consider the largest global peacetime challenge since the Great Depression a century ago. In South Africa, the government moved swiftly after the first confirmed case of COVID-19 on 5 March 2020, which subsequently led to a national lockdown by 27 March 2020. This placed huge challenges on the population, especially for the poor and those working from home. The exponential rise in COVID-19 infections rapidly transformed how and if people would return to the traditional way of working. Working from home during the nationwide lockdown led to poor quality of work and a lack of efficiency, which ultimately led to poor work productivity. Many employers worldwide chose to protect both the health and job security of their employees by implementing remote working. The average household lack the components of a functional office setup such as a simple desk and good quality chair. This consequently predisposed many to work hunched over coffee tables or on kitchen stools without proper neck and back support. It is possible that many working individuals will emerge with increased incidence of MSP after the coronavirus crisis. Ergonomic support for effective remote working may have been ignored amidst the more disastrous effects of the pandemic, but the crisis becoming a major contributor to an increased onset of MSP. This is likely to remain as the norm, even after the shifting of lockdowns, for millions of workers. The adverse effects of the pandemic thus appear to extend beyond its direct consequences into an increased onset of ergonomical concerns that warrants some investigation. This study therefore aimed to determine the prevalence and effects of upper body (head, neck, shoulder and back) musculoskeletal pain associated with ergonomic changes experienced with remote working during the COVID-19 pandemic. It is hoped that the results of this study will inform interventions to redress such effects in remote working climates.
An injury profile of musculoskeletal injuries in mountain bikers in the eThekwini Municipality
(2022-09-29) Van Eck, Rochelle; Varatharajullu, Desiree
Background: Mountain biking is a sport that appeals to men and women who enjoy an adrenalin rush. It is practised on any terrain classified as ‘off-road’ such as gravel roads, sugar cane fields, farmland, mountainous areas, and forests. It involves riding over rough and tricky terrain with a mountain bike and has become a global phenomenon among many athletes of all fitness levels. The popularity of this sport has grown as it is well known for its health benefits, family participation, recreational enjoyment, its ability to enhance overall fitness, and the fact that it offers those who are driven opportunities to be highly competitive. However, as is the case with any competitive and recreational sport, mountain bikers are prone to suffering a unique set of injuries. Mountain bikers want to recover and get back on their bikes as soon as possible, but there is a paucity of literature on the injury profile of mountain bikers in South Africa, hence recovery strategies may not always have the desired results. Aim: The aim of this study was to establish the injury profile of the musculoskeletal injuries that mountain bikers sustain, with special focus on those enthusiasts in the eThekwini municipality of KwaZulu-Natal, while the risk factors associated with this sport were also explored. Methodology: Participants were recruited at cycling clubs, after training sessions when they gathered in coffee shops, and individually at mountain bike parks. Before completing the questionnaire, each participant was required to read a letter of information and sign an informed consent form. Informed consent and post-pilot study questionnaires were completed, gathered, and deposited into separate sealed boxes. Each questionnaire was given a code for statistical analysis before data were captured on a spreadsheet. Results: A total of 175 questionnaires were received and the data were statistically analysed. The results revealed that not applying any preventative measures when training for this sport was the main causative factor of injuries among mountain bikers in the eThekwini Municipality. The majority of the injuries occurred in white males between the ages of 45 to 50 years and in participants who practised this sport for more than 12 hours a week. The most common areas of the body that sustained injuries were shoulders, legs, knees, and wrists, while the most common types of injuries were bruises, cuts, and sprains. The predominant mechanisms that caused these injuries were falls and contact with stationary objects. Conclusion: The findings that emerged from the data were consistent with the literature on mountain biking, but it must be mentioned that the injuries that were described related to earlier studies that had been conducted among either international mountain bikers or road cyclists. The current study’s findings are distinctive of the eThekwini Municipal area in KwaZulu-Natal, South Africa. Additional studies need to be conducted in other provinces of South Africa in order to create a more accurate injury profile associated with the mountain biking sport in this country.
Upper extremity work-related musculoskeletal injuries among chiropractic students at the Durban University of Technology
(2021-05-27) Singh, Kyle Andrew; Padayachy, Keseri
Background: Chiropractic students the world over undergo rigorous training in manual therapy, specifically musculoskeletal manipulation and adjustment. These therapeutic modalities involve the use of the upper extremity to deliver its effects, usually with high velocity and force. This leaves the upper extremity vulnerable to injury, as a result of the repetitive and forceful nature of these manual techniques. Despite this risk, the research available on work-related musculoskeletal injuries of chiropractic students in South Africa is limited. This study aims to determine the prevalence of upper extremity work-related musculoskeletal injuries among chiropractic students at the Durban University of Technology, and selected risk factors associated with work-related musculoskeletal injuries. Method: The study design was a quantitative, descriptive, self-administered questionnaire study that used the total available population. The questionnaire was adapted from a similar study and included the use of a pilot study. The questionnaire had three sections: the first for demographic data, the second was applicable for any new injury to the upper extremity from work-related tasks, and the third was applicable for any old injuries to the upper extremity that were aggravated by work-related tasks. Prevalence was estimated using 95% confidence intervals. Factors associated with injury were assessed at univariate level, using Pearson’s chi-square tests and t-tests, and factors associated at the <0.1 level were selected as independent variables in a multiple logistic regression model to predict risk of injury. The odds ratios and 95% confidence intervals were reported. A stepwise backward selection method, based on likelihood ratios, was used to arrive at a final model consisting only of statistically significant risk factors (p<0.05). Chi-square testing and cross-tabulations were performed on the use of dominant hand and injury. Results: Eighty-six chiropractic students (n=86) were eligible for the study, seventy-seven elected to participate in the study, giving a response rate of 93.9%. The period prevalence of upper extremity work-related musculoskeletal injuries was 59.7% (95% CI 47.93 to 70.57%). The most commonly injured areas were the wrist (60%), shoulder (20%) and hand (17%), with majority of the injuries involving the soft tissue structures: muscle/ tendon strain (42%), ligament sprain (17%) and tendinitis (17%). Most injuries occurred during adjustive procedures (74%) and ischemic compression (19%). None of the demographic variables showed a significant association with prevalence of injury, apart from a moderately non-significant association with year of study (p=0.080). The frequent use of electro-modalities (p=0.073) and temperature therapy (p=0.077) were suggestive of possible associations, however, were not statistically significant. The results showed no significant differences between frequency of adjustments and injury. Despite an absence of statistical significance, a trend was noted showing an increased likelihood of injury when adjusting with the dominant hand. Conclusion: The study findings are consistent with those of similar international and local studies on the chiropractic profession (both academic training and professional), determining a high prevalence of work-related musculoskeletal injuries. The wrist was most commonly injured when performing adjustive procedures with the dominant hand. This study is in response to a call for further investigation and will help in future efforts to develop an injury preventative strategy for chiropractic training institutions.
The prevalence of musculoskeletal dysfunction in the upper quadrant and its relationship with mobile phone usage in a student population at a University of Technology
(2020-06-10) Durell, Jacques; Varatharajullu, Desiree
The aim of this study was to investigate mobile phone factors relating to demographics, anthropometry, usage and technique associated with those who were or were not experiencing upper quadrant musculoskeletal pain and dysfunction in a student populace. Subjects: A total of 384 participants selected from 21 909 registered students at the DUT spread over the six faculties, in order to reflect the accuracy of the total population and give a statistically significant result. The faculties included Accounting and Informatics, Applied Sciences, Arts and Design, Engineering and the Built Environment, Health Sciences and Management Sciences. This 378 was calculated by a biostatistician using a 95% confidence interval and 5% margin of error, from the total DUT population of 21 909 (Matthews 2017) (Appendix C). The total response rate was 384 which was six more than what was required as more questionnaires were distributed in order to account for short fall. All questionnaires were completed and analysed giving a response rate of 100%. Methodology: The measurement tool was a three-tiered questionnaire. The first section was demographics and anthropometric related questions, the second section was related to pain and dysfunction and the third section around the parameters of mobile phone usage and technique. After full approval and permission was granted by the Institutional Research Ethics Committee and the Durban University of Technology research office, students were either approached directly by the researcher or during a selected lecture period. Lecturers were contacted by the researcher directly to obtain permission. In requesting permission, it was pre-arranged that the first or last twenty minutes would be available on a certain lecture date, so as not to disrupt academic time if the lecturer concerned was agreeable to this. Two separate ballot boxes would be used to collect the informed consent forms and the questionnaires respectively in order to maintain confidentiality and anonymity. The participant’s name was not used on the data sheets. A code was allocated to each questionnaire. Results: In total, 384 questionnaires were completed and analysed. Participants who were experiencing current pain or discomfort totalled 37.2% (n=143) and those participants experiencing pain in more than one region was 23.2% (n=89). The most common prevalence of pain was lower thoracic pain and/or discomfort affecting 6.3% (n=24) of participants and a combination of regions was reported by 20.3% (n=78) of participants. The more specific locations of pain and/or discomfort were lower thoracic pain/discomfort reported in 16% (n=62), posterior neck pain in 12% (n=46), posterior left shoulder pain in 8.9% (n=34), posterior right shoulder pain in 7.6% (n=29) and the occipital region pain in 7.6% (n=29). The reason for location of lower thoracic pain/discomfort being higher than that of lower thoracic pain, was due to a combination factor of regional pain being reported by 20.3% (n=78) of participants, when reporting on the prevalence of pain. Participants experiencing no associated symptoms was 0.5% (n=2). Types of pain experienced that was reported in this study consisted of dull achy pain found in 2.6% (n=10) and sharp shooting pain consisted of 2.6% (n=10) of participants. Dysfunction reported was headaches in 4.4% (n=17) and stiffness in 2.9% (n=11) of participants. Pain intensity versus typing technique revealed a statistical significance between pain intensity and preferred typing technique (p=0.001). Conscious aggravation of pain and use vs demographics showed three statistically significant results occurring between years enrolled (p=0.014), hand dominance (p=0.039) and occupation (p=0.010) with respect to current aggravation by a mobile phone. Conscious aggravation of pain and use vs technique showed a statistical significance with respect to phone orientation (p=0.044). Conclusion: This studies prevalence may have decreased, but the incidence of pain and/or discomfort is consistent with the knowledge of previous studies conducted on the prevalence of musculoskeletal pain associated with mobile device usage. Though due to the uniqueness in design, one can now associate estimated factors and see that focus needs to be placed on an ergonomic approach (Hooper 2014) consisting of a holistic perspective with both phone user and work space environment factors. Dahl (2000) breaks down the biopsychosocial approach into factors of importance such as physical, cognitive, cultural, perceptual and sensing systems, biorhythms and disabilities, work experience, communication and vocational training, as well as health history and occupational stress. It would be best applied in conjunction with the use of chiropractic spinal manipulation, as well as manual therapeutic therapies and other modalities used by chiropractors that have been shown to be effective in the conservative treatment of conditions such as myofascial pain syndromes caused by myofascial trigger points, tendinopathies and chronic neck pain and especially in conjunction with exercise therapy (Pfefer 2001; Vernon and Schneider 2009)
A clinical profile of geriatric patients at a chiropractic teaching clinic in KwaZulu-Natal
(2019) Schirmer, Carissa Anja; Varatharajullu, Desiree
Aim: The aim of this study was to determine the clinical characteristics of geriatric patients that presented to the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) between the clinic operational dates from the 18th of January 2010 to the 4th of December 2015. Methods: A clinical profile of the clinical records pertaining to individuals who were 65 years of age and older, that frequented the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) between the 18th of January 2010 and the 4th of December 2015. Data recorded included patient demographics, lifestyle habits and blood pressure, presenting complaint and the nature thereof, medication use, presenting co-morbidities, further tests and patient management. Results: Data from 397 clinical records was utilized. The majority of the patients were aged between 65 to 69 years with a mean age of 71.31 years (±5.43). More females (56.9%) presented to the DUT CDC in the sampling years, marriage (49.9%) was the most common form of union, and over two thirds of the patients stated that they were retired (63.0%). No history of smoking (73.8%) was the most reported smoking habit, and no history of alcohol consumption (64.5%). In terms of exercise habits, 38.8% did not participate in any form of exercise, over half of the patients reported normal sleeping patterns (56.6%), just over a quarter of the patients were reported as overweight (27.5%), and pre-hypertension (34.0%) was the most commonly documented blood pressure reading. The most common area of complaint reported was the low back (36.5%), with the majority stating that they were suffering with pain only, with an initial onset of pain over one year ago and having previously had x-ray examinations done. Patients consumed on average 3.35 medications, with most taking between three to five medications (43.1%). Anti-hypertensive, non-steroidal anti-inflammatories and cholesterol lowering drugs were the most commonly consumed. The mean co-morbidities presented were hypertension, diabetes and headaches. Generally, the patients had three treatments (mean = 2.94). Soft tissue therapy, electro-modalities and mobilisation were the preferred treatment methods. X-rays were the preferred form of referral and stretching was the most prescribed continuation of care at home. Conclusion: This is a clinical profile of the patients which presented at a chiropractic teaching clinic in KwaZulu-Natal, South Africa. Similarities to other local and international studies were noted, namely: females were the most documented gender, the most commonly presented areas of complaint were the low back and the cervical spine, the patients generally suffered with chronic pain and multiple co-morbidities and consumed on average of three to five medications. To validate the findings of this study, follow-up studies should be conducted every five years.
An epidemiological study of musculoskeletal injuries in league squash players in the eThekwini Municipality
(2019) Hawkesworth, Stephen; Haswell, Garrick David
Background: Internationally squash is a very popular sport with over 15 million players worldwide from 135 nations. With the rapid growth of squash comes a rise in the number of injuries occurring during play. Despite squash being such a popular sport, several reports have stated that there is a paucity of literature and limited research that has been conducted on the injuries occurring from playing the sport. A study of this nature would create an awareness and understanding of the prevalence of injuries in squash which will allow for event organisers, medical personnel, managers and coaches to adapt training approaches that will minimise the development of injuries. Objectives: This study aimed to investigate the prevalence of musculoskeletal injuries in squash players within the eThekwini Municipality, and to identify selected factors associated with an increased risk of injury in order to improve the management of squash players. Methods: A quantitative, descriptive questionnaire-based survey was conducted on 126 league squash players in the eThekwini Municipality. Statistical analysis was performed on the results obtained from the questionnaire using IBM SPSS version 24. A p value < 0.05 was used to indicate statistical significance. Associations between demographic variables and the prevalence of injury were first tested using chi-square tests in the case of categorical variables, and t-tests in the case of continuous variables. The variables that were associated at the p = < 0.01 level of significance were entered into a binary logistical regression to analyse the risk factors of injury. A backward selection method was used, using likelihood ratios. Odds ratios and 95% confidence intervals of the variables remaining in the model at the end were reported. Graphical representation of scores by groups was done using graphs and tables. Results: One hundred and twenty-nine squash players responded giving a response rate of 69%. The period prevalence and point prevalence of squash related musculoskeletal injury was 62% and 25.6% respectively. A predominance of injuries to the lower limb were recorded (67.65%) compared to the upper limb (21.4%) and the back and trunk (11.3%). The foot and ankle were the most common anatomical site of injury (22.5%) followed by the knee (15%), the thigh (13.8%) and the elbow (13.8%). Alcohol consumption was considered to be a risk factor for injury (p = 0.03); for every increase in five units of alcohol consumption the odds of incurring an injury increased by 29%. The likelihood of injury decreased in those that did weight training; the odds of an injury for a player not doing weight training was 3.3 (1/0.305) times more compared to a player who did weight training. Thus, it was more likely for a player not doing weight training to sustain an injury. Conclusion: The lack of evidence that players train off the court, and the large amount of alcohol consumed on a weekly basis shows that for the majority of players in the eThekwini Municipality squash is more a recreational activity than a professional activity. Despite the study sample being ranked in the top three divisions, this study found that within the eThekwini Municipality squash has not developed on a professional level. Results found that players were more likely to get injured if they did not do weight training and/or consumed alcohol. The population seems to be living a sedentary lifestyle in which squash is their only weight training activity, and after their squash session they consumed alcohol. This lack of training and alcohol consumption predisposes them to lower limb injuries, especially the ankle. Given these results coaches, team captains and medical practitioners should put together cross training programs, which would be a helpful injury prevention. Future studies could look at the effect that cross training programs have on lowering injury prevalence.
The epidemiology of musculoskeletal injuries in trail runners in the eThekwini Municipality of KwaZulu-Natal
(2019) Millar, Maxine-Lee; Varatharajullu, Desiree; Abdul-Rasheed, Ashura
AIM: The aim of this study was to determine the point and period prevalence of musculoskeletal injuries, the injury profile, associated risk factors and the impact of musculoskeletal injuries on trail runners who participated in selected trail races in the eThekwini municipality of KwaZulu-Natal. SUBJECTS: Participants from various trail running races volunteered to participate in the study after the completion of a trail race. METHODOLOGY: Participants were approached individually following the completion of a minimum of a 10 kilometre trail race. Each participant read a letter of information and signed an informed consent form before completing the questionnaire. A total of 197 completed informed consent and post-pilot questionnaires were collected and placed in separate sealed ballot boxes. A code was allocated to each questionnaire before data was captured on a spreadsheet for statistical analysis. RESULTS: In total, 145 questionnaires were statistically analysed. The results revealed that only ethnicity and how often the participant's trail ran per month were significant predictors of developing an injury. White participants were five times more likely to be injured compared to African participants and those who ran more than 10 times a month were 4.65 times more likely to be injured than those who ran less than five times a month. The most common past injuries sustained by trail runners was shown to be predominantly due to trauma, and were located in the knee, ankles and ITB regions. Current injuries were shown to be equally due to trauma and overuse, with predominant location being in the same anatomical regions as past injuries. CONCLUSION: The majority of the data collected was in line with the literature on running; however, most of those studies were done on road runners. The findings of this study were unique to trail runners in KwaZulu-Natal. Further studies are required on trail runners in other regions of South Africa to determine a clearer injury profile.

Theses and dissertations (Health Sciences)

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