Theses and dissertations (Health Sciences)
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Item The prevalence, knowledge, attitude and practice regarding self-administered over-the-counter analgesic use among patients with chronic musculoskeletal pain attending the Durban University of Technology Chiropractic Day Clinic(2023) Engelbrecht, Donna; Thandar, YasmeenChronic pain is a major concern globally, with the greatest contributor being chronic musculoskeletal pain (CMSP). CMSP decreases quality of life, affects activities of daily living, increases work absenteeism and health care expenses. Recommendations for the management of CMSP include exercise and the use of analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), or more potent analgesics, including opioids. Amongst those suffering from CMSP, it is common to self medicate with analgesics. Over-the-counter (OTC) analgesics, in particular, help patients manage their own CMSP symptoms. However, OTC medicine use can be a problem when misused. The common reasons why patients self-medicate with OTC analgesics is the easy access to these medications; previous experience with treating their condition; and financial and economic difficulties, which prevent visiting a primary physician (for more potent analgesics), especially in developing countries. There are many studies that have examined the prevalence of self-medication of OTC analgesics using population-based studies and some among health science students at universities but these do not focus on the prevalence of self-medication among those with CMSP. There appears to be limited research conducted in South Africa with regards to the prevalence of self-administered OTC analgesic use among patients with CMSP, especially within a chiropractic clinic setting, where the treatment of CMSP consumes a large portion of primary care. It has also been noted in the literature that information and research needed to quantify the scale of misuse is currently lacking. Primary care physicians, including chiropractors, who more frequently treat chronic pain, are thus best suited to ascertain this by assessing the attitudes, knowledge and practices regarding self-administered OTC analgesic use amongst patients suffering from CMSP. Method This study is a quantitative, descriptive cross-sectional study, whereby a survey was conducted (using questionnaires) to collect data and make statistical inferences about the Chronic pain is a major concern globally, with the greatest contributor being chronic musculoskeletal pain (CMSP). CMSP decreases quality of life, affects activities of daily living, increases work absenteeism and health care expenses. Recommendations for the management of CMSP include exercise and the use of analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), or more potent analgesics, including opioids. Amongst those suffering from CMSP, it is common to self medicate with analgesics. Over-the-counter (OTC) analgesics, in particular, help patients manage their own CMSP symptoms. However, OTC medicine use can be a problem when misused. The common reasons why patients self-medicate with OTC analgesics is the easy access to these medications; previous experience with treating their condition; and financial and economic difficulties, which prevent visiting a primary physician (for more potent analgesics), especially in developing countries. There are many studies that have examined the prevalence of self-medication of OTC analgesics using population-based studies and some among health science students at universities but these do not focus on the prevalence of self-medication among those with CMSP. There appears to be limited research conducted in South Africa with regards to the prevalence of self-administered OTC analgesic use among patients with CMSP, especially within a chiropractic clinic setting, where the treatment of CMSP consumes a large portion of primary care. It has also been noted in the literature that information and research needed to quantify the scale of misuse is currently lacking. Primary care physicians, including chiropractors, who more frequently treat chronic pain, are thus best suited to ascertain this by assessing the attitudes, knowledge and practices regarding self-administered OTC analgesic use amongst patients suffering from CMSP. Method This study is a quantitative, descriptive cross-sectional study, whereby a survey was conducted (using questionnaires) to collect data and make statistical inferences about the indicated that they use their own experience of what helps relieve their pain; a further number (39.3%) indicated that they read the information insert inside the medication box. The percentages do not add up to 100% because the participants had chosen more than one option in the question. Regarding the number of participants who responded to the use of different analgesics, most participants (70.3%) were using NSAIDs; followed by paracetamol only (57.7%); combination analgesics not easily obtainable without a prescription (54.1%); combination analgesics that can be obtained without prescription (41.1%); aspirin (15.3%) and other (0.9%). It was determined that more participants (66.7%) indicated that they did not experience any side effects from the analgesics that they were consuming (p<.001). Gender has shown to have an influence on self-administered analgesic use. It was found that there was a significantly larger number of females (86.2%) who used self-administered analgesics compared to males (69.1%) (p=.001). The age group 35–44 was found to be statistically more likely to use self-administered painkillers (88.9%), followed by those aged 65+ (88%) (p=0.48). A significant number of Black participants (p=0.43) indicated that they did not use self administered OTC analgesics (29.1%) and a significant number of participants who indicated “Other” also did not use self-administered OTC analgesics (44.4%) (p=0.43). Conclusion The findings from this study reinforce that primary care physicians, including chiropractors, need to take better initiatives in educating, providing better guidelines and promoting safe and effective OTC analgesic use to their CMSP patients. Considering that this study demonstrated a high prevalence of CMSP, and a high prevalence of OTC analgesic use, it is important that chiropractors understand patients with chronic pain and why they may make certain decisions. Seeking additional pain relief options like chiropractic treatment for CMSP earlier may help reduce reliance on OTC analgesic medication.Item The injury profile of musculoskeletal injuries, and the impact thereof, in amateur pole sports athletes in eThekwini municipality(2024) Worth, Kim; Pillay, Julian DavidBackground: 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.Item Prevalence and associated risk factors of musculoskeletal disorders among undergraduate radiography students during work integrated learning at the university of technology, in Kwazulu-Natal(2023-05-31) Siphesihle, Masondo Siyanda; Khoza, Thandokuhle EmmanuelBackground The term musculoskeletal disorders (MSDs) refer to injuries or disorders of the nerves, ligaments, muscles, joints, tendons and supporting structures of the upper and lower limbs, neck and spine which are caused by sudden or accumulative exposures to physical exertion. Musculoskeletal disorders (MSDs) are common among healthcare students including radiography students. Undergraduate radiography students during their study program are being placed in different hospitals for Work-integrated learning (WIL). During this period, they are prone to several risk factors that can trigger the occurrence of MSDs. There is a scarcity in the literature on the prevalence of MSDs in undergraduate radiography students attending WIL in the public and private sectors of South Africa. To date, no study has been performed which determines the risk factors for developing MSDs among Undergraduate radiography students within the eThekwini Municipality. Aim The aim of the study is to determine the prevalence of MSDs and to identify the risk factors associated with MSDs among undergraduate radiography students attending WIL within hospitals in the eThekwini Municipality. Research Methodology The research conducted was a quantitative study with a descriptive design that targeted undergraduate radiography students attending WIL within the hospital of the eThekwini Municipality, KwaZulu Natal. The research questionnaires were administered to undergraduate radiography students at the Durban University of Technology in order to determine the prevalence of MSDs and its associated risk factors. The questionnaire included demographic information, work routine during WIL, symptoms and impacts of MSDs on participants. Data was captured by the researcher and sent to a statistician for statistical analysis. Results In total, 144 questionnaires were utilised for statistical analysis, giving a response rate of 84.2%. The results showed a significantly high prevalence of the musculoskeletal disorder among the students (92.4%). The most common areas of pain reported by the participants were the lower back (79.7%), neck (72.2%) and upper back (54.1%). The statistically significant risk factors for musculoskeletal disorder among radiography students were bending, stress and depression. The Chi-square test showed that participants who are more often involved in bending experience significantly higher lower back pain. Multiple regression analysis shown found depression and stress during work-integrated learning (WIL) as independent risks factor for musculoskeletal disorders among radiography students Conclusion and Recommendations The study showed that the prevalence of musculoskeletal disorder is high (92.4%) among undergraduate radiography students during WIL. Further research is needed in this population and South Africa in order to address the high incidence of MSDs and their impacts on healthcare students. In addition, to prevent the recurrence of MSDs among students, it is recommended that the faculty of health sciences and the radiography department design and implement suitable interventions, such as an education program/training on ergonomics practice. Also, it would be beneficial for the students to become more aware of MSDs and take corrective measures to better equip themselves to mitigate MSDs and seek treatment when necessary.Item Prevalence and risk factors of occupational injuries among emergency care providers(2020-11-30) Chule, Ntuthuko Gift; Govender, Kevin; Sobuwa, SimpiweIntroduction: Occupational injuries and diseases affect approximately 260 million people worldwide and kill nearly 2.3 million people per year. While paramedics and other healthcare workers (HCWs) are responsible for ensuring the health of others, their working environment is also considered to be one of the most hazardous environments. Purpose: To describe the prevalence and risk factors associated with occupational injuries, as well as perceptions of both the mitigation and prevention of occupational injuries among paramedics working for KwaZulu-Natal (KZN) Emergency Medical Rescue Services (EMRS). Methodology: The study adopted a quantitative, descriptive, cross-sectional approach. The study population comprised operational paramedics working for the KZN EMRS with a sample of 334 paramedics being drawn from a total of 2378 KZN EMRS paramedics. The study was conducted in five of the eleven districts in KZN. The data collection methods used included a closed ended questionnaire and a document review. The data which had been collected was analysed using Stata version 15. The Pearson chi-squared test was used to test for associations between any two categorical variables and, in instances, where Pearson chi-squared test was invalid Fisher’s exact test was used. A p-value of less than 0.05 was considered to be statistically significant. Results: Two of the five districts provided the required information for reviewing the records. A total of 36 injuries were reported in the two districts between 2011 and 2018. The reported injuries included injuries from motor vehicle accidents (61%), musculoskeletal injuries (16.7%), needle-stick injuries (13.9%), accidental surgical blade cuts (5.6%) and assault injuries (2.8%). A total of 152 survey questionnaires were completed and returned – a 45% response rate. The findings from the selfadministered questionnaire revealed 25 (16.5%) unreported injuries which included musculoskeletal injuries (48%, n = 12), needle-stick injuries (48%, n = 12), and one (1) (4%) assault-related injuries. A further 49 (32.2%) injuries which had resulted in medical attention being sought included musculoskeletal injuries (55.1%, n = 27), injuries due to motor vehicle accidents (44.9%, n = 22), needle-stick injuries (26.5%, n = 13) and assault-related injuries (8.2%, n = 4). Overall, 59 (38.8%) paramedics had experienced occupational injuries (both reported and unreported). The paramedics’ perceived risk factors for occupational injuries included high speed driving (87.5%, n = 133), violent members of society (87.5%, n = 133), heavy objects and patient lifting (86.2%, n = 131), physical exhaustion (78.3%, n = 119), hazardous material (77%, n = 117), and temperature extremes (73%, n = 111). In addition, the paramedics’ perceptions regarding occupational injury prevention revealed the following precautions, namely, avoiding high speed driving (79.6%, n = 121), specific positioning during equipment and patient lifting (63.8%, n = 97), avoiding chaotic scenes (61.8%, n = 94) and avoiding working longer hours (49.3%, n = 75). Conclusion: While it may be anticipated that information regarding occupational injuries suffered by paramedics would not be public knowledge, access to this information for purposes of research that aim to establish mitigation and prevention strategies, should be subjected to fewer challenges. From the data that was available, paramedics from KZN EMRS experienced multiple types of occupational injuries from a variety of injury sources. These injuries could be a result of both, the nature of the work and environment in which paramedics operate. However, further research is necessary to identify and validate these findings, as well as presented strategies required to minimise the rates of occupational injury among paramedics working for KZN EMRS.Item Risks, prevalence and management of carpal tunnel syndrome amidst Somatologists within the Western Cape(2020-11-30) Kistoor, Charne; Brooks, N.; Rammanhor, K.Carpal Tunnel Syndrome (CTS) has been recognised for many decades across various industries and researched extensively in these domains. The practice of Somatology has greatly evolved from the beauty therapy industry of past years that simply focussed on aesthetic techniques of beautifying clients. The new techniques and general physical demands of the somatologist profession, however, raise concerns for the health and wellness of the somatologist. This research was motivated by the lack of data available on musculoskeletal disorders generally, and specifically, the prevalence among somatologists in the Western Cape of carpal tunnel syndrome. The study objectives were to determine the general prevalence of CTS among qualified somatologists in the Western Cape, to identify risk factors that contribute to the development of CTS in somatologists, and to determine current preventative measures and management of CTS among somatologists. A quantitative research approach was used to evaluate the objectives by collecting the data, using a questionnaire as the research tool. Various beauty schools and businesses within the field were contacted to determine the prevalence rate of qualified somatologists being diagnosed with CTS. A sample group of somatologists who had worked or were working in the Western Cape was recruited to the study and the questionnaire included openended questions to elicit more detailed responses beyond the statistical data. The results of the study indicated CTS is generally prevalent in the beauty therapy industry and has debilitating long-term consequences for the health and career longevity of somatologists, many of whom have to prematurely leave their chosen career paths due to their development of CTS, or to divert income to treatment costs in an industry where earnings are typically low. The study highlighted several issues that require further and wider study, such as compensation for injury, access to medical aid or employer subsidies, inherent health risks in the nature of some treatments and the need for more education and possible adjustments to training to prevent or alleviate the onset of CTS. Such future studies should provide insight for companies within the industry to aid their revision of policies and procedures to better facilitate and support somatologists suffering from CTS.Item The epidemiology of musculoskeletal injuries in competitive lifesavers in KwaZulu-Natal(2020-11-30) Billson, Carmel Beth; O'Connor, Laura; Clifton, Stuart RonaldLifesaving is a multidimensional sport which can lead to injury and a high likelihood of overuse-related injuries. The environment within which lifesaving occurs is unique, with the soft beach sand and unpredictable nature of the ocean. It is difficult to assess the effects that injuries may have on the training and competitive performance of lifesavers as the incidence and severity of these injuries have not previously been studied in South Africa. Thus, this study investigated the epidemiology of lifesaving induced musculoskeletal (MSK) injuries in competitive lifesavers in KwaZulu-Natal. Lifesavers are under-investigated, yet the growth and development of the sport requires that athletes are assessed for injury. This study could aid in educating federations, coaches and athletes regarding MSK injuries sustained by lifesavers, thereby assisting athletes to be more competitive at national and international competition levels. Method: A quantitative, descriptive, cross-sectional epidemiological survey was used to collect data from 100 competitive lifesavers in KwaZulu-Natal. The questionnaire was pre-validated and hand delivered to the lifesaving clubs that agreed to participate, where the lifesavers selfselected to participate. Informed consent was obtained. The survey contained questions related to demographics, activity participation, psychosocial factors and the occurrence of lifesaving related musculoskeletal pain. Results: The respondents were male (65%, n=65) and had a mean age of 28.6 years (±SD 14, range 16-73). The lifetime prevalence of MSK injury from lifesaving was 72% (n=72), with a total of 177 injuries being reported with shoulder pain being the most prevalent (38%). The 12- month prevalence showed 133 injuries were sustained whereas for current prevalence there were 86 injuries. Lower back pain was most frequently reported over these periods (26% and 22% respectively). The board race was the most popular event participated in at 76% (n=76), followed by surf ski 69% (n=69) and thirdly surf swim 67% (n=67). Seventy-four percent (74%) of board paddlers, 68% of surf ski paddlers and 67% of beach sprint and flags participants had experienced MSK pain related to lifesaving. Of the 72 competitors that experienced lifesaving MSK injuries more than half reported that it negatively affected them psychologically either in training, competition or overall. Injuries cause athletes to miss training sessions, which result in loss of fitness and falling behind the other athletes, this could cause a lack of confidence, lack of self-belief and lack of motivation to continue training and competing. The worst injury that the respondents had sustained occur mostly due to running (44%), was overuse related (43%), occurring in season (70%) and was described as a sharp, shooting severe pain with a constant and recurrent nature. It affected the athlete’s participation in the sport (75%) and required them to seek medical attention (89%). The only factor found to be related to MSK injuries was the number of rest days, which was significantly lower in those who suffered injuries (p=0.04). All other demographic, health, lifestyle and lifesaving activity participation factors were not associated with MSK lifesaving injuries (p < 0.05). Conclusion: This is the first study to document MSK injuries in lifesaving athletes in South Africa. The high prevalence of injuries necessitates that mechanisms are put in place to prevent injury. In addition, the mechanics of running on sand requires further investigation to understand its impact on injuryItem The epidemiology of low back pain in male adolescent field hockey players in the eThekwini municipality(2019-09-05) De Wit, Dale Cameron; Pillay, Julian David; Ducray, Jennifer FrancesBackground: Field hockey is a popular international sport which is played in 132 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk for pain and injury to the lumbar spine. Due to the popularity of the sport of field hockey more empirical randomised controlled studies and/or observational studies need to be conducted to determine the pathomechanics of the nature of lower back pain and injury among players. Objectives: The objectives of this study were to determine the prevalence and incidence of low back pain in male adolescent field hockey players; to determine the characteristics of the low back pain in terms of location, chronicity, disability and treatment sought; and to determine the selected risk factors (demographics, equipment, health and lifestyle) of low back pain in male adolescent field hockey players. Method: A descriptive study of cross-sectional design, using a survey data collection tool was used on 112 male adolescent field hockey players in the eThekwini Municipality. The questionnaire data were then statistically analysed using IBM SPSS version 25 with statistical significance set at p value <0.05. Descriptive statistics such as mean and standard deviation, or median and inter-quartile range were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi square test and t-tests as appropriate. Results: A total of 68 participants completed and returned their questionnaires yielding a participation rate of 60.7%. The period prevalence of low back pain was 63.2% and the incidence was 38.2%. Point prevalence at the beginning of the season, mid-season, and end of season was 25%, 32.4% and 22.1% respectively. The most common location for low back pain was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their low back pain. The results were found to be statistically significant between hydration and low back pain (p = 0.050) i.e. those individuals who did not hydrate frequently during matches and training were significantly more likely to experience low back pain. Conclusion: Low back pain in male adolescent field hockey players is a common phenomenon. The results of this study, although limited to a select group of adolescents, showed a slightly higher prevalence of LBP to that of previous studies. More importantly, even though most participants did not experience low back pain classified as a disability, low back pain still had a large impact on participants, as nearly half of participants consulted with a medical professional for treatment. The study further indicates the need for frequent hydration during matches and training as inadequate hydration was found to be significantly related to low back pain. We highlight this as a novel finding and recommend special consideration to this by athletes and coaches. Moreover, the need for the development of strategies in the prevention and management of low back pain in field hockey is further recommended.Item Back pain and its relationship to socio-demographic and psycho-social factors in a cohort of pregnant women attending a primary health care clinic in the eThekwini municipality(2019) Hawker, Carmen; O'Connor, LauraBackground: The prevalence of back pain and general discomfort is not uncommon in pregnant women, often being under-reported until it affects their daily routine. South Africa, a third world developing country has unique risk factors and demographic profile. Although many studies have previously studied the various factors relating to back pain in pregnancy, this topic is far from being exhausted as a research area. Specifically, new studies should be conducted on the prevalence of back pain in pregnancy to analyse the impact it has on women worldwide. Little research has been conducted on rural communities in Africa especially in South Africa, to assess the risk of pregnancy-related back pain. Therefore, the information obtained from this study will provide a better understanding of the demographics, physical demands and psycho-social stresses experienced by pregnant women in this understudied population. Back pain and general discomfort is not uncommon in pregnant women, but it is often under- reported and can be disabling. International studies report a high prevalence especially in the last trimester. Little is known about the prevalence of and risk factors for back pain in South African pregnant women. Thus, this study aimed to determine the relationship between socio-demographic and psychosocial factors in a cohort of pregnant women attending a primary health care clinic in the eThekwini municipality of the province of KwaZulu-Natal, South Africa. Method: A retrospective descriptive cohort design was utilized whereby 382 participants’ files were assessed for eligibility. The files consisted of a socio-demographic questionnaire, a chart review and two epidemiological questionnaires that were administered to the participants during the first and third trimester. Permission to access these files was obtained from the principle investigator of the MRC/DUT project. All participants signed consent forms for research purposes. The data relevant to this study was extracted and analysed using Statistical Package for the Social Science version 24.0 (IMB Analytics). Descriptive statistics were used to describe the data in terms of means and standard deviations or frequencies and count where appropriate. Inferential statistics allowed for relationships between the variables to be assessed. A p - value of less than 0.05 was used to indicate statistical significance. Results: The total of 303 files were included. Participants were Black Africans, mostly single (81.2%, n=229) with a mean age of 25.84 (±SD 6.04). There was a high unemployment rate (70.8%, n=199), with most having obtained a secondary education (77.1%, n=213), and 44.1% (n=122) residing in squatter camps. There was a high human immunodeficiency infection rate (40.5%, n=94). Of the 303 participant files eligible for the study only 46 returned for the third trimester follow up. The prevalence of BP in the first trimester was 12.4% (n=35) and 10.9% (n=5) in the third trimester. LBP was the most (8.5%, n=24) in the first and 10.9% (n=5) in the third trimester, followed by UBP and NP. The incidence of back pain over the duration of pregnancy was zero. Being single (p = 0.03), reporting no stress (p = 0.04), not using pain killers (p = 0.01), and no alcohol consumption in the current pregnancy (p = 0.03) were associated with a decreased risk of back pain. There were no relationships found between the variables and back pain prevalence in the third trimester. Conclusion: The women attending this primary health care clinic are relatively young, come from a low socio-economic area with low reported levels of stress and substance abuse. They reported low levels of back pain. The follow up rate at the third trimester was low and this may skew the results of this study. Further research is needed in this community and South Africa to appreciate the prevalence and impact of back pain in pregnancy.Item A retrospective profile of musculoskeletal injuries of ultra-endurance triathletes in South Africa(2019) Momberg, Courtney Dean; Matkovich, GrantAim The aim of this study was to determine the injury profile of ultra-endurance triathletes in South Africa. Background An ultra-endurance triathlon comprises a combination of swimming, cycling and running; the distances covered are a 3.8km swim, 180km cycle and a 42.2km run all in succession. Ultra-endurance triathlon has grown in popularity since its inception in the 1970s. However, there is insufficient data relating to injuries in the South African context especially related to age and gender. Methods This Institutional Research Ethics Committee of the Durban University of Technology approved study included 100 active members of My Training Day and ultra-endurance triathletes associated with My Training Day that were training and taking part in the 2017 South African ultra-endurance triathlon (2017 South African Ironman Race). After signing the informed consent form and letter of information, participants completed an online questionnaire on training and injury profiles. All data captured was anonymous and confidential. Data was described using frequency tables for categorical data and summary statistics for continuous data. Odds ratios were reported and a p value < 0.05 was considered statistically significant. For triathletes reporting injuries, linear regression was used for factors associated with injury severity. Results Questionnaires were returned by 86 ultra-endurance triathletes, of which 71 were deemed viable giving a response rate of 71%. The past and periodic (day of the race) prevalence of ultra-endurance triathlon-related musculoskeletal injury was 46.5% and 9.85% respectively. The most common site of injury in the year leading up to the 2017 ultra-endurance race was the posterior compartment of the lower limb, being the hamstring / calf (36.4%), while there was an equal split of injuries on race day with the shoulder, hamstring / calf, knee / quadriceps region all having the same percentage (28.6%). Of the 71 participants 66.2% were male and 33.8% were female. The most common age group was 30 to 34 years (25.7%). The majority of the participants started participating in ultra-endurance triathlons between 24 and 29 years of age (32.4%). There was no significant difference in age between those who had injuries prior to the event and those who did not (p = 0.079). There was no statistically significant difference in prior injury prevalence between males and females (p = 0.395). There was a borderline non-significant difference indicating younger athletes were at higher risk for injury on race day (p = 0.069). Females had a higher risk of injury on race day (p = 0.039). Conclusions and recommendations The results concur with previous research and add further insight into factors predisposing triathletes to injury. The most common injuries require investigation to develop preventative interventions to reduce injuries in triathletes. Further research into age and gender interactions as risk factors for injury is needed in South Africa. Health professionals require education about ultra-endurance triathlon-related injuries to improve preventative and curative interventions.Item An epidemiological study of musculoskeletal injuries in league squash players in the eThekwini Municipality(2019) Hawkesworth, Stephen; Haswell, Garrick DavidBackground: 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.