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Theses and dissertations (Health Sciences)

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    An injury profile of high school soccer players on a synthetic surface at a private school in the eThekwini municipality
    (2024) Timul, Asthiq; Ally, Fazila
    Background In South Africa, sport is a compulsory activity in the majority of schools and most of the population that play soccer at schools are amateur players. Many schools in Durban have astroturf courts on which the scholars play soccer. Astroturf is a synthetic surface that has gained much popularity due to it being cost effective and easy to maintain. Despite the benefits associated with playing on astroturf, one of the concerns is increased risk if injury to the players. Over the last decade, soccer injuries have become commonplace amongst scholars, with the most affected age group being between 13–15 years of age. The aim of this study is to determine the injury profile of amateur scholar soccer players playing on a synthetic surface at a private school in the eThekwini municipality. Methodology The research study is a quantitative study with a descriptive design. An organised, quantitative questionnaire was handed out to 108 registered learners at Al-Falaah College. The responses of the questionnaire were used to establish the demographic and injury profile of the soccer players in this study. Results A 100% response rate was recorded. The majority (n=24; 22.2%) of the learners were in the 14 year age group of Indian (n=98; 90.7%) ethnicity. The most common site of injury was recorded as the knee joint (n=54; 50%), followed by the ankle joint (n=36; 33.3%), wrist (n=29; 26.9%) and foot (n=28; 25.9%). The most common mechanism of injury reportedly occurred during tackling (n=61; 56.5%) and the least number of injuries were reported as occurring during heading (n=4; 3.7%). Most of the participants were found to be using incorrect footwear when playing on a synthetic surface, such as, studded boots (n=63; 58.3%) and sneakers (n=39; 36.1%). Conclusion The majority (79.6%) of the injuries reported were characterised as mild to moderate. The lower extremity was the most frequently injured, specifically the knee and ankle joint. Ligament and muscular injuries were the most common injury affecting the lower extremity. Younger individuals are more likely to face injury when playing soccer on a synthetic surface.
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    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.
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    The prevalence, risk factors and management of musculoskeletal injuries in male amateur indoor soccer players in the eThekwini Municipality
    (2022-05-13) Nair, Caleb; Abdul-Rasheed, Ashura; Prince, Cleo Kirsty
    Background: Soccer is a popular sport played and viewed globally. Furthermore, indoor soccer has been gaining popularity, especially in South Africa. Investigating the prevalence and risk factors of musculoskeletal injuries associated with indoor soccer, creates an awareness among health practitioners and players, especially when there is limited literature on this sport. Aim: The aim of this study was to determine the prevalence of musculoskeletal injuries, the associated risk factors and effective management of musculoskeletal injuries in amateur male indoor soccer players in the eThekwini Municipality, Durban, South Africa. Methodology: The study utilized a quantitative paradigm and a cross-sectional survey design. A total of 166 male participants, between the ages of 18 and 40 years, were recruited for this study. The sample population included amateur indoor soccer players from the eThekwini Municipality. The survey was distributed via links in which participants completed the survey. Data were analyzed using SPSS version 26 and exported into Microsoft Excel. Results: A total of 89 participants sustained musculoskeletal injuries due to indoor soccer. This resulted in a prevalence rate of 74.2% which indicates more than half of indoor soccer players sustain musculoskeletal injury. Muscle strains are seen as the most common injuries by accounting for 32.6% of the total injuries. The study further revealed that players are more likely to sustain an injury through twisting and turning playing mechanisms as 20.2% of injuries were sustained due to this mechanism of play. Playing with a chronic condition was regarded as a significant risk factor for musculoskeletal injuries. While 58.4% of injured participants implemented a management protocol, 38.5% utilized a home remedy as their management protocol. Conclusion: This study revealed that high musculoskeletal injury prevalence rate exists among amateur indoor soccer players, in the eThekwini Municipality. Male indoor soccer players are commonly prone to muscle strains and sprains with the knee being the most common site of injury. The twisting and turning playing mechanism utilized in indoor soccer appears to be a common mechanism that predisposes players to musculoskeletal injury. Players with chronic conditions should play with caution as chronic conditions may predispose players to injuries and exacerbate health conditions. Urgent measures are required to educate indoor soccer players on injuries and effective management as the results demonstrated high rates of injury and poor management protocols.
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    A retrospective profile of musculoskeletal injuries of ultra-endurance triathletes in South Africa
    (2019) Momberg, Courtney Dean; Matkovich, Grant
    Aim 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.
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    A profile of musculoskeletal injuries in competitive swimmers in the greater Durban area
    (2008) Sutherland, Kelly Michelle; Korporaal, Charmaine Maria
    lntroduction: Swimming is one of the most popular participation sports 1 as people are drawn to swimming for leisure, cardiovascular workouts, or competition 2 . As a result, the sport of swirnrninq has improved 9reatly over the past 20 years 3 . Olbjectoves: The aim of this study was to determine a profile of musculoskeletal injuries in competitive swimmers in the greater Durban area of KwaZulu-Natal, South Africa; as well as to determine whether any relationships exist between swimming injuries sustained in this study and the risk factors identified in other studies, and to compare the results with international data. Therefore; for the purpose of this study, the following information was gathered in order to build up an injury profile: o Demographics of competitive swimmers in South Africa, o The participants swimming history, o The presence of any past or current injuries and o Factors associated with current and previous injuries were also investigated. This study was a prospective, cross-sectional, questionnaire based study, investigating the profile of musculoskeletal injuries in 101 competitive swimmers in the greater Durban area. The data was collected by means of a self-administrated questionnaire, which was completed by the participants, under the supervision of the researcher, parents or coach.
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    The effect of four different manipulative techniques on Iliotibial Band Friction Syndrome (ITBFS) in terms of primary and secondary outcome measures
    (2016) Botes, Jacques Andre; Gomes, Adrian Neil; Korporaal, Charmaine Maria
    Background: Iliotibial band friction syndrome is a common dysfunction seen in athletes. Athletes develop biomechanical changes yet still continue with their sport. However, this syndrome limits their ability to participate at peak performance. This study determined which participants benefitted in terms of biomechanical and clinical outcomes in one of four groups: ankle joint, superior tibio-fibular joint, sacroiliac joint or a combination manipulation group (which contained any two of the three joint restrictions). Methods: This Durban University of Technology Institutional Research and Ethics Committee approved prospective clinical trial, utilised stratified sampling, with 48 participants across four groups: ankle (14); superior tibio-fibular (11), sacroiliac (12) and combination (11). The participants underwent six treatments in three weeks. Data collection occurred before consultations one, three, five and seven. The data included primary measures of the knee score questionnaire (KSQ), the algometer, the visual analogue scale (VAS) and the secondary measures of the Feiss line, the heel leg alignment, bilateral leg length, Q angle and tibio-femoral angle. All data was computed utilising the ANOVA testing, with a p-value <0.05 being significant and a 95% confidence interval. Pearson’s correlations were completed for intragroup associations between primary and secondary outcome measures. Results: The intragroup analysis revealed that all groups had significant changes in the KSQ and VAS, with the exception of the sacroiliac joint manipulation group (KSQ outcome not significant). Intergroup analysis revealed no differences between the groups with the exception of the combination group, which showed a significant increase in the tibio-femoral angle. Most commonly, the Pearson’s correlation revealed that changes in leg length were related to differences in primary outcome measures, irrespective of the group being tested. Conclusion: The outcomes of this study indicated that manipulation of the distal kinematic chain improved alignment and clinical outcomes to a greater degree than manipulating proximal restrictions. It is suggested with caution (due to limited sample size) that patients should first have their distal kinematic chain manipulated before more proximal joints are manipulated to achieve better outcomes.
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    The epidemiology of injuries of female high school soccer players in the eThekwini district
    (2015) Sentsomedi, Keamogetse Refilwe; Puckree, Threethambal; Kell, Colette
    Introduction: Participation of young females in soccer has started to increase in the past few years. Females participating in soccer are more vulnerable to injuries than males due to the nature of the sport especially because the sport is characterised as a vigorous, high intensity, intermittent ball and contact activity. Objective: This study sought to determine the epidemiology of injuries in high school female soccer players in the eThekwini district. Method: A quantitative approach using a cross sectional survey was used to determine the epidemiology of injuries in female high school soccer players in the eThekwini district. One-hundred-and-ninety-seven female high school soccer players, between the ages of 14 to 19 years who have played soccer for at least one season, from 27 female high schools in the eThekwini district were invited to participate. A self-administered questionnaire was used to determine the demographic profile of the players and the reported prevalence of injuries in the soccer players. The study also determined the profile of soccer related injuries, management of injuries, identified risk factors for injury, and compared injuries occurring during training and during matches. Results: Out of a total of 85 respondents only 31 sustained injuries. The injury prevalence for the season was 36.5%. Only 61 injuries (71.8%) were reported by the injured players. The rate of injury was 90 per 1000 athlete exposure hours during the season. Only two female players reported the five injuries while all 29 female players sustained at least one injury. The defenders (31.7%) and midfielders (28.6%) sustained the most injuries. Most injuries reported were contact in nature (12.9%). More injuries occurred during training (12.9%) rather than during matches (8.2%). The lower extremity (77.8%) was injured more than the upper extremity (22.2%). The knee (22.2%) and ankle (15.9%) were the most frequently injured body parts. Muscle injury (23.5%) was the most commonly reported followed by bruising (10.6%). Conclusion: Prevalence of injuries was high in the cohort studied. The lower limb, specifically the knee and ankle were most commonly injured. Muscle injury and bruising were the most common injury affecting the lower extremity. It is recommended that the study be extended to a larger cohort of school children.
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    An investigation into the effectiveness of two different taping techniques in the treatment of plantar fasciitis
    (2015) Petzer, Justin L.; Matkovich, Grant
    Background: Plantar fasciitis (PF) is inflammation of the plantar surface of the foot, usually at the calcaneal attachment and is most commonly due to overuse. It is the most common foot condition treated by healthcare providers. Conservative treatment using taping is one of the first lines of treatment for PF. Low-Dye taping and Kinesio taping are two types of taping techniques commonly used to treat PF. Low-Dye taping and Kinesio taping have different intrinsic tape properties as well as different mechanisms of action in the treatment of PF. Low-Dye taping involves the use of a non-stretch, rigid tape. Rigid tape is commonly used by therapists primarily for the mechanical properties the tape provides to support the injured structure as well as to protect against re-injury. Low-Dye taping shortens the distance between origin and insertion of the plantar musculature and fascia, decreasing stress and tensile forces along the plantar plate to protect the plantar fascia and allow healing to occur. Kinesio tape is an elastic tape that allows a one-way longitudinal stretch; it is applied in a specific manner to achieve its therapeutic effects and forms convolutions on the skin. The proposed mechanism of action of Kinesio tape involves improving circulation of blood and lymphatics to resolve oedema caused by the inflammatory component of PF; suppressing pain, and; relieving muscle tension to return fascia and muscle functioning to normal. Both forms of tape have shown effectiveness in the treatment of PF; however the effectiveness of one taping technique versus the other has not yet been explored. Objectives: The purpose of this study was to determine the effectiveness of Kinesio tape alone versus Low-Dye tape alone in the treatment of PF in terms of both objective and subjective measures. Methods: Thirty participants with a diagnosis of PF, between the ages of 20 and 45, were randomly allocated into two treatment groups. Both groups received treatment in the form of a taping technique, either Kinesio tape or Low-Dye tape. Assessments were made pre-treatment at each visit and at a follow up visit, with seven visits in total. Assessments included objective data measures (ultrasonography, algometer readings, weight-bearing ankle dorsiflexion measurements) and subjective measures (the visual analogue scale and the foot function index questionnaire). Data was recorded in a data collection sheet and Statistical Package for the Social Sciences version 21 was used to analyze the data with a p value of < 0.05 considered as being statistically significant. Results: Most outcomes showed a significant improvement over time regardless of which form of treatment they received. For the VAS and pain walking outside, in the disability section of the FFI, there was statistical evidence of the Kinesio tape group improving more than the Low-Dye tape group. For morning pain, in the pain section of the FFI, and pain climbing curbs, in the disability section of the FFI, there was statistical evidence of the Low-Dye tape group improving more than the Kinesio tape group. For all the other outcomes there was a non-significant trend towards the Low-Dye tape group showing a greater improvement than the Kinesio tape group. Conclusion: Kinesio taping and Low-Dye taping were both found to be effective in the treatment of PF with neither form of tape showing superiority to the other in the treatment of PF.
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    An injury profile of amateur and semi-professional KwaZulu-Natal triathletes
    (2014-05-20) Coetzee, Cuan Wayne; Korporaal, Charmaine Maria
    Background: A triathlon comprises of a combination of swimming, cycling and running. Triathlons are usually classified as sprint distance, Olympic distance, and Ironman or ultra-distance. Triathlon was popularized in the 2000 Summer Olympic Games and, despite this, there is insufficient data relating to injuries in the South African context. This study aimed to determine the injury profile of amateur and semi-professional Kwa-Zulu Natal triathletes. Methods: This Institutional Research Board approved, cross sectional study, included 80 active members of the Kwa-Zulu Natal Triathlon Association. All triathletes completed a questionnaire on training and injury profiles; with only those having had a musculoskeletal complaint additionally completing a clinical consultation. In order to assess associations between presence of injury and explanatory variables, binary logistic regression using backward selection based on likelihood ratios was used. Data was described using frequency tables for categorical data and summary statistics for continuous data. Odds ratios was 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: Fifty seven triathletes responded giving a response rate of 71% (68% male, 32% female). The point and period (year) prevalence of triathlon-related musculoskeletal pain was 17.5% and 68.4% respectively. The ranking of the most common site of injury in the last 12 months included the knee (64%), low back (21%) and thigh (18%); with females having had a significantly higher risk of injury than males (p=.019). Additionally, injury risk also increased with weight (p=.055), number of triathlons undertaken in the previous year (p=.031), number of triathlons in the last 4 months (p=.009) and running distance during competition times (p=.011). Injury risk decreased with increasing distance of cycling (p=.061) and swimming (p=.030) in a competition, and length of training in- and off-season (p=.105 and p=.043 respectively). Strong trends were demonstrated between injury severity and long-slow training distance (p=.006) and weight (p=.006). By contrast to risk of injury, injury severity was negatively associated with weight, while a long-slow distance was positively associated with the severity of the injury. Of all the health professions, chiropractic was the most utilized health profession. Conclusion and recommendations: The results concur with previous research, but add insights into factors predisposing triathletes to injury. The most common injuries require investigation to develop preventative interventions to reduce injuries in triathletes. Health professionals require education about triathlon-related injuries to improve preventative and curative interventions.
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    The effectiveness of three treatment protocols in the treatment of iliotibial band friction syndrome
    (2010) Turnbull, Grant S. D.; Kruger, Brian D.
    Iliotibial Band Friction Syndrome (ITBFS) is an overuse injury induced by friction of the iliotibial band (ITB) over the lateral epicondyle of the femur (LFE) with secondary inflammation. ITBFS is a prevalent condition and is the most common cause of lateral knee pain in long distance runners and cyclists. There are a significant number of aetiological factors related to ITBFS. As a result of this the general chiropractic approach to the treatment of ITBFS is multimodal and include interventions such as joint manipulation, cryotherapy, orthotics, massage, electrical stimulation, acupuncture type procedures and therapeutic exercise. Dry-needling is an effective therapy in the treatment of active Myofascial Trigger Points (MFTP’s) that are associated with ITBFS. However, the available literature suggests that to determine its efficacy, it should be performed in isolation. The association of sacroiliac joint dysfunction in ITBFS has also been addressed and are thought to co-exist and perpetuate one another. It is recommended that chiropractors include pelvic manipulation in their treatment protocol for ITBFS however there is a paucity of literature showing its effectiveness in the treatment of this condition. There appears to be a need for further research in the form of randomized controlled clinical trials with regard to chiropractic specific procedures, performed in isolation, in the treatment of ITBFS. Therefore this study aimed to add to the literature by assessing the effect of the sacroiliac joint manipulation and dry needling in the treatment of ITBFS. Objectives The study aimed to determine the comparative effectiveness of dry needling alone versus manipulation alone, as well as a combination of the two interventions in the treatment of ITBFS. Methods This study was a randomised, open label trial. 47 participants with ITBFS were divided into three groups, each group receiving a different intervention i.e.: group one received dry needling of the active MFTP’s in the Tensor Fascia Lata (TFL) and ITB, group two received sacroiliac joint manipulation, group three received a combination of the two interventions. Subjective measurements, in the form of the Numerical Pain Rating Scale-101 (NRS-101), and objective measurements, in the form of algometer readings in the TFL, ITB and Nobles Compression test as well as digital inclinometer readings of Modified Obers test, were utilised to determine the effects of the respective interventions. These measurements were recorded twice, once prior to commencing the treatment programme. These values were then evaluated to compare the efficacy of the different treatment interventions. Each participant received four treatments over a two week period. Results There were no statistically significant differences between the three treatment groups as they all seemed to parallel one another with regards to overall improvement in subjective and objective measurements (P<0.5). However on closer examination subtle differences between the groups were noted. An interesting endpoint is that the combination group did not fair the best throughout the study, which was contrary to the original hypothesis. The groups receiving only the single intervention appeared to fair marginally better over the combination group. A secondary endpoint that became evident during the study and on analysis of the data, was that hip joint instability must also be considered when treating ITBFS when there is concomitant sacroiliac joint dysfunction. Conclusion A decision needs to be made with regard to which intervention best suits the individual at the time. A combination therapy, which originally was thought to be the best treatment option, should possibly be reconsidered. Perhaps a single intervention of manipulation or dry needling should be decided upon. In totality, all intervention proved to be effective in the treatment of ITBFS.