South African Journal of Sports Medicine - latest Issue
Volumes & issues
Volume 28, Issue 1, 2016
Author Mike LambertSource: South African Journal of Sports Medicine 28 (2016)More Less
The South African Journal of Sports Medicine is entering a new phase in its development. The journal started in 1982 and was published in-house. These early editions of the journal are in the archives (http://journals.assaf.org.za/index.php/sajsm/index). It is worth reading papers published in this era to see how far some of the topics on sports medicine have progressed, and how other areas have remained rather static. Reading these papers also gives a glimpse into the development of the South African Sports Medicine Association (SASMA) and how it has evolved from being a discipline representing mostly orthopaedic surgeons to a multidisciplinary organisation representing a range of health professionals.
Changes in markers of fatigue following a competitive match in elite academy rugby union players : original researchSource: South African Journal of Sports Medicine 28, pp 2 –5 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a418More Less
Background: Post-match fatigue has yet to be investigated in academy rugby union players.
Objectives: To determine the magnitude of change in upper- (plyometric push-up (PP) flight-time) and lower-body (countermovement jump (CMJ) mean power) neuromuscular function (NMF), whole blood creatine kinase (CK) and perception of well-being following a competitive match in academy rugby union players.
Methods: Fourteen academy rugby union players participated in the study. Measures were taken 2 h pre-match (baseline) and immediately post-match. Further testing was also undertaken at 24-, 48- and 72 h respectively post-match. Changes in measures from baseline were determined using magnitude-based inferences.
Results: Decreases in CMJ mean power were likely substantial immediately (-5.5±3.3%) post-match, very likely at 24 h (-7±3.9), likely at 48 h (-5.8±5.4), while likely trivial at 72 h (-0.8±3.8) post-match. PP flight-time was very likely reduced immediately (-15.3±7.3%) and 24 h (-11.5±5.7%) post-match, while possibly increased at 48 h (3.5±6.0%) and likely trivial at 72 h (-0.9±5.4%) post-match. Decreases in perception of well-being were almost certainly substantial at 24 h (-24.0±4.3%), very likely at 48 h (-8.3±5.9%), and likely substantial at 72 h (-3.6±3.7%) post-match.Increases in CK were almost certainly substantial immediately (138.5±33%), 24 h (326±78%) and 48 h (176±62%) post-match, while very likely substantial at 72 h (57±35%) post-match.
Conclusion: These findings demonstrate the transient and multidimensional nature of post-match fatigue in academy rugby union players. Furthermore, the results demonstrate the individual nature of recovery, with many players demonstrating different recovery profiles from the group average.
Source: South African Journal of Sports Medicine 28, pp 6 –10 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a1206More Less
Background: Rugby is a popular team sport and due to its contact nature carries a relatively high potential for injury, including concussion. Moreover, it is estimated that as much as 50% of concussions are not reported due to a variety of reasons, including not considering the injury to be sufficiently serious or not wanting to miss game time.
Objectives: The aim of this brief review was to investigate and summarise current best practice for on-field identification and on-field management of concussion in amateur rugby.
Methods: PubMed and ClinicalKey were searched between September and December 2014 for articles in the five years preceding the search dates. The latest versions of the Consensus Statement for Concussion in Sports and World Rugby's concussion guidelines were also consulted.
Results: Based on this search strategy, eight systematic reviews, one physician information article and four patient guidelines were investigated. Four reviews specifically described an "action plan" for on-field evaluation and management. Education of key stakeholders could reduce the number of unreported concussions. Once identified or suspected, concussions should be managed according to best practice procedures, which include removing the player from play immediately and consulting a medical doctor. If a medical doctor is not immediately available on the field tools such as the BokSmart on-field pocket "Concussion Guide", and World Rugby's "Pocket Concussion Recognition Tool", are freely available online.
Conclusion: Stakeholder education (including players, parents, teachers, coaches, referees, spouses) on both the on-field identification and management of concussions could reduce under-reporting and improve the overall management of concussed rugby players.
The medial tibial stress syndrome score : item generation for a new patient reported outcome measure : original researchSource: South African Journal of Sports Medicine 28, pp 11 –16 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a426More Less
Background: There is no valid and reliable instrument that evaluates injury severity and treatment effects for medial tibial stress syndrome (MTSS) patients.
Objective: The aim was to generate items for the MTSS score, a new patient-reported outcome measure for patients with MTSS.
Methods: The authors consulted experts in the field of MTSS to generate items that measure the severity of MTSS and to reach consensus on the relevance of items for the MTSS score. This research consisted of a pilot study and two Delphi rounds. The Delphi approach entails the consultation of experts about a topic for which no evidence is available during which consensus is sought on this topic. Additionally, 20 MTSS patients appraised the MTSS score on readability and comprehension.
Results: Nineteen experts consented to participate, 13 of whom reached consensus. Generated items address the following domains: 'limitation in sporting activities', 'pain while performing sporting activities', 'pain while performing activities of daily living' and 'pain at rest'. Patients with MTSS confirmed the good readability and comprehension of the items.
Conclusion: This study supports the importance of items in the aforementioned domains while evaluating treatment effects in patients with MTSS.
Source: South African Journal of Sports Medicine 28, pp 17 –22 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a479More Less
Background: The small number of black African (BA) cricket players progressing through the talent development pathways to the elite level has been a constant concern for Cricket South Africa (CSA). Previous attempts to accelerate the development of BA players have not produced the desired results. A description of the barriers to development is imperative for appropriate interventions.
Objectives: To understand the career progression of BA cricketers in South Africa by investigating their and other key informants' perceptions, and identifying factors that may influence progress to the elite level.
Methods: A qualitative study consisting of 23 semi-structured interviews with BA players who had succeeded at the senior level (n = 11), and key informants (n = 12), was conducted. Content analysis of the data identified 92 themes, which were then aggregated into 12 categories.
Results: Five enablers (exposure to the game, education, facilities and equipment, coaching and support networks), and five barriers (team environment, quality opportunities to compete, socio-economic factors, cricket player development pathways and leadership) were identified. Two further factors (intrapersonal attributes and targets) were identified, but the differing opinions of the interviewees on the influence of these variables made it difficult to classify them. Whilst all categories were perceived to contribute in the progress of BA players to the elite level, education, support networks, quality opportunities to compete, team environment and socio-economic factors were believed to be the most important.
Conclusion: The sustainable transformation of South African cricket appears to be not only about ensuring demographically representative teams, but also about addressing barriers affecting progress that may be experienced by all players. This study highlighted the key factors that are perceived to be specific to BA cricketers.
Reliability and concurrent validity of an alternative method of lateral lumbar range of motion in athletes : original researchSource: South African Journal of Sports Medicine 28, pp 23 –26 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a745More Less
Background: Cricket bowling involves combined spinal movements of side bending and rotation and, consequently, injury to the low back is a common problem. Therefore the assessment of lumbar spine kinematics has become a routine component in preseason screening. This includes static measurement of lateral spinal flexion as asymmetrical range of motion may predispose an athlete to low back injury.
Objectives: This study examined intra-rater reliability and concurrent validity of the fingertip-to-floor distance test (FFD) when compared to a criterion range of motion measure.
Methods: Thirty-four junior-level cricket players aged 13-16 years were recruited. Lumbar spine lateral flexion was measured simultaneously with the fingertip-to-floor distance test and digital inclinometry methods. Relative and absolute intra-rater reliability were investigated with intraclass correlation coefficients (ICC3,1) of agreement, standard error of measurement (SEM) estimates, Bland and Altman bias estimates and 95% limits of agreement, respectively. The concurrent validity of the fingertip-to-floor distance test, compared to digital inclinometry measures, was examined with Pearson correlation coefficients.
Results: Intra-rater reliability demonstrated substantial agreement for both measures (ICC3,1 > 0.84). The fingertip-to-floor distance test SEM values ranged from 1.71-2.01 cm with an estimated minimum detectable change (MDC) threshold of 4.73-5.55 cm. The inclinometry SEM values ranged from 1.00-1.09° with minimal detectable change estimates of 2.77-3.01°. There were strong correlations between the index test and criterion measure outcomes (r > 0.84, p > 0.001).
Conclusions: This study's results support the intra-rater reliability and concurrent validity of the finger-to-floor distance test, suggesting it to be a suitable surrogate measure for lumbar lateral flexion testing.
An elite runner with cerebral palsy : cost of running determines athletic performance : original research - case studySource: South African Journal of Sports Medicine 28, pp 27 –29 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a424More Less
Background: Running performance is widely understood in terms of the Joyner model (VO2max, %VO2max at ventilator threshold (VT), running economy (often measured as cost of running (CR) as VO2 in ml.kg-1.km-1).
Objective: To test the Joyner model by evaluating a runner in whom one element of the Joyner model is systematically abnormal.
Methods: The case of a two-time Paralympian with cerebral palsy (CP), 2nd place in the Sydney 2000 Paralympic 1500 m (T37) is reported. Incremental and steady state treadmill runs as well as simulated competitions were completed. Incremental and steady state (50% PPO) cycling with two legs (2L), the non-affected leg (NL), and the affected leg (AL) were also completed.
Results: His silver medal (2000 Sydney OG) performance for 1500 m was 269 s (4:29) (77.2% of velocity in contemporary able-bodied world record (WR). At the time of study, his VO2max was 64.2 ml.min-1.kg-1. His cost of running (CR) (1% grade) was higher, at 257 vs 228, 211 and 188 ml.kg-1.km-1 (for ACSM norms, elite Europeans, elite East Africans). During cycling, his VO2max with 2L, NL and AL was 3.74, 3.78 and 3.71 l.min-1, and his gross efficiency (GE) was 18.4, 12.2 and 9.3%, respectively.
Conclusions: In a former elite runner with CP, there is little evidence of a central oxygen transport limitation. The higher CR (plausibly reflected by the reduced GE of his AL) appears to account for much of the difference in performance compared to able-bodied runners. The results provide both insight into the physiological limitations of runners with CP and support for the Joyner model of competitive running performance.
Incidental intima-media wall changes in the lower-limb arteries : a case series in habitual distance runners : original research - short reportSource: South African Journal of Sports Medicine 28, pp 30 –32 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a689More Less
This case series describes the observed presence of echogenic circular "beads" identified by high-resolution ultrasound imaging in the peripheral arterial walls of the lower limbs of three vascularly asymptomatic runners. The aetiology, mechanisms and clinical implications of these observations remain uncertain.
Source: South African Journal of Sports Medicine 28, pp 33 –34 (2016) http://dx.doi.org/http://dx.doi.org/10.17159/2078-516X/2016/v28i1a465More Less
In the following case study an atypical presentation of myositis ossificans (MO) in the superior anterolateral thigh of a young soccer player is discussed. This case demonstrates that MO can present without obvious history of trauma, which makes the diagnosis of this condition more challenging. The most important differential diagnosis is malignant osteosarcoma or soft-tissue sarcoma, which usually presents without trauma. Additionally both pathologies typically occur in the same population.