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- Volume 20, Issue 4, 2008
South African Journal of Sports Medicine - Volume 20, Issue 4, 2008
Volumes & issues
Volume 20, Issue 4, 2008
Author Mike LambertSource: South African Journal of Sports Medicine 20 (2008)More Less
Despite the proliferation of new specialist journals it is becoming increasingly difficult to get research work published. There are a number of reasons for this - perhaps the most obvious is that there are more institutions which specialise in sports medicine and exercise science now than there were 10 years ago. Therefore the volume of research has increased precipitously. This means the standard of the journals can be kept at a reasonably high level because there is always a surplus of papers which are submitted for consideration.
Source: South African Journal of Sports Medicine 20, pp 95 –101 (2008)More Less
Background. The low back is an integral part of the entire movement chain as it functions as part of a complex network of the skeletal, muscular and nervous system. Eighty to 90% of acute low back pain episodes dissipate within 8 - 12 weeks regardless of any intervention, but 5 - 10% regress into chronic low back pain. As a result of its undistinguished aetiology, the treatment for low back pain remains controversial. Treatment options for low back pain include the following: analgesics, muscle relaxants, antidepressants, nonsteroidal anti-inflammatory drugs, epidural steroid injections, manipulation, back schools, electromyographic biofeedback, traction, orthoses, behaviour therapy, transcutaneous electrical nerve stimulation, acupuncture, and exercise therapy.
Results. Therapeutic exercises for low back pain have been shown in 6 different randomised controlled trials to be beneficial in reducing pain by up to 60% and improving functional ability by up to 47%. Furthermore, a Cochrane review on low back pain found strong evidence that exercise therapy is an effective intervention in the treatment of low back pain. When prescribing exercises for an individual with low back pain the following goals need to be considered: (i) improve performance in endurance activities; (ii) improve muscular strength around the spine; (iii) eliminate any impairments in spinal flexibility; (iv) reduce the intensity of the pain being experienced by the individual; and (v) reduce back pain-related disability. A rugby player will have increased core stability / strength and a reduced risk of injury if the internal support mechanisms of the spine have been conditioned to resist distortion or injury from external forces. Not only will improved core stability benefit players on the field during matches or practices, it will also assist in preventing unnecessary injuries during weight training and pre-season conditioning.
Conclusion. Exercise programmes which combine core stability with general strength training should be prescribed for rugby players to prepare them for the level of impact involved in the game, as well as for sport-related weight training and non-sport-related daily activities.
Source: South African Journal of Sports Medicine 20, pp 102 –108 (2008)More Less
Motivation. There is growing interest in the use of cardiovascular variability indicators as measures of autonomic activity, even though reported results are not always comparable or as expected. This review aims to determine the consistency of results reported on the autonomic response to physical exercise as measured by heart rate variability, blood pressure variability and baroreceptor sensitivity.
Method. An Ovid MEDLINE Database search for the period 1950 - March 2008 produced 46 articles for review. The published articles that evaluate the effect of exercise on the autonomic nervous system (ANS) are summarised in three categories: the response of the ANS during a bout of exercise, directly after exercise (recovery measurements), and after a long-term exercise programme.
Results. Articles on the effect of training on the ANS as measured by cardiovascular variability indicators show increased variability, decreased variability, and no change in variability.
Conclusion. Findings in this review emphasise that standardisation and refinement of these measuring tools are essential to produce results that can be repeated and used as reference. Standardisation is essential as these measurements are increasingly employed in studies regarding investigations of central autonomic regulation, those exploring the link between psychological processes and physiological functioning, and those indicating ANS activity in response to exercise, training and overtraining. This review shows that important aspects are inter-individual differences, duration and intensity of the exercise programme, and choice and specific implementation of variability analysis techniques.
Accelerated hydrotherapy and land-based rehabilitation in soccer players after anterior cruciate ligament reconstruction : a series of three single subject case studies : original research articleSource: South African Journal of Sports Medicine 20, pp 109 –114 (2008)More Less
Objective. To investigate the effectiveness of accelerated rehabilitation and accelerated hydrotherapy after anterior cruciate ligament (ACL) reconstruction in male athletes participating in soccer.
Design. A non-concurrent single subject, multiple baseline design (ABA design) was conducted over 10 weeks. A series of three N=1 studies was conducted to assess the effect of an accelerated hydrotherapy programme on pain, function, and range of motion.
Setting. The study was conducted at a private physiotherapy practice in Port Elizabeth, South Africa.
Interventions. The land rehabilitation programme was a home-based programme supervised every week by the physiotherapist. The accelerated hydrotherapy consisted of a 6-week programme, and participants attended two treatment sessions of accelerated hydrotherapy per week each of 30 minutes' duration.
Main outcome measures. The knee injury and osteoarthritis outcome scale (KOOS) as a subjective measure of pain, function and quality of life; the goniometer to measure active knee ROM and the 6-minute walking test (6MWT) as an objective measure of function.
Results. All three patients demonstrated good improvement during the treatment phase for the KOOS scale and progressed well in terms of their walking ability during the study. Significant improvement was gained during the baseline phase for all three participants with high initial levels of knee flexion while active knee extension improved gradually in all three participants.
Conclusion. The study findings indicate that an accelerated land-based and hydrotherapy programme may be useful in improving patient outcomes and that there are no risks for harm.
Clinical relevance. The study findings indicate that accelerated hydrotherapy may be a useful and safe adjunct to an accelerated land-based programme after ACL reconstruction.
Cricket : nature and incidence of fast-bowling injuries at an elite, junior level and associated risk factors : original research articleSource: South African Journal of Sports Medicine 20, pp 115 –118 (2008)More Less
Objective. To compile an injury profile of 46 fast bowlers aged 11 - 18 years, and to identify the associated risk factors for injury during one academy cricket season.
Methods. The fast bowlers selected were tested and observed for one academy cricket season (March - November). Subjects were grouped into injury classifications (uninjured=S1; injured but able to play=S2; injured and unable to play=S3). Anthropometrical and postural data for the subjects were collected preseason (T1). Physical fitness screenings were conducted and the relationship between fitness and occurrence of injuries was assessed. Additional factors such as bowling techniques and bowling workload were assessed. A regression analysis was conducted to analyse the relationship between bowling workload and weeks incapacitated.
Results. Fifteen per cent of the subjects remained injury free for the duration of the season. The incidence of serious injury (S3) showed a statistical and moderate, practical significant increase (V=0.23, df≥2) throughout the data collection period (4% at T1 - 30% at T3 (post-season)). The most common injuries were to the knee (41%) and lower back (37%), occurring from mid-season (T2) to T3. The nature of the injuries was predominantly strains (39%) and 'other' (39%), with the highest reported incidence during the period T1 - T3. Sprains followed, with an overall incidence of 14%. Subjects were incapacitated approximately 1 out of every 7 weeks of play. The S1 and S2 bowlers performed consistently better than the S3 bowlers in all the fitness variables tested. Bowling workload presented a statistically significant (p<0.0005) increased risk of injury. A strong, significant positive relationship (R²=0.62, <0.0005) was found between the number of weeks incapacitated and bowling workload.
Conclusion. The results indicated that inadequate fitness, high bowling workload and bowling technique all have a multifactorial role in predisposing a bowler to increased risk of injury. These variables did not act alone, but have all contributed to recurring injuries.
Source: South African Journal of Sports Medicine 20, pp 119 –120 (2008)More Less
Elbow injury in sports is dependent on the nature of the game. Well-defined injury patterns like the valgus hyperextension syndrome have been reported in throwers, in racquet sports and in baseball. The demands of throwing in cricket theoretically do not involve significant stress on the elbow. We report for the first time a typical case of valgus hyperextension syndrome in an international cricket fast bowler. The mechanism of trauma seems to involve a terminal thrust at the elbow with stress concentration on the posterior and lateral sides and with some degree of distraction on the medial side.