RESUMO
BACKGROUND: A limited number of studies on the epidemiology of injuries and fitness profiles of netball players in South Africa have been conducted, but no research on the potential morphological and skill-related fitness predictors of injuries could be located. OBJECTIVES: We investigated whether morphological or skill-related factors measured in the pre-season could predict injuries sustained in-season. METHOD: In our cohort study, 77 under-18 (U18), U19, U21 and senior elite netball players underwent pre-season testing including anthropometry, balance, flexibility, explosive power, upper and lower body strength, core strength, speed and agility testing. A questionnaire was used to collect demographic data, elite-level experience and injury history. Injuries in pre-season, training and matches were recorded during the subsequent 2017-2018 season using an injury profile sheet. RESULTS: Amongst the 77 players who underwent pre-season fitness tests, 33 players (42.9%) had at least one injury. Regarding player morphology, a significant association of body mass and body fat percentage with injury risk was found in a simple logistic regression. In a multiple logistic regression analysis, only fat percentage (p = 0.0508) remained a significant predictor of injury at the 10% significance level, with higher fat percentage being associated with lower injury risk. CONCLUSION: Heavier players and players with a higher fat percentage had a decreased injury risk. CLINICAL IMPLICATIONS: As a result of the apparent protective effect of heavier weight of players, referees should more strictly enforce the no-contact rule in netball. Further research on functional movement screening as a tool for potential prediction of injury in netball is recommended.
RESUMO
BACKGROUND: Field hockey, a team sport played by both men and women at both recreational and professional levels, requires maintaining a forward flexed posture putting stress on the lumbar spine. Hence, it is necessary to assess the muscles supporting the lumbar spine, especially those surrounding the hip, to inform strengthening exercises for this population. OBJECTIVES: To establish the best body weight rehabilitation exercises shown to produce high muscle activation (≥ 61%MVIC - maximal voluntary isometric contraction) for both the gluteus maximus (Gmax) and medius (Gmed) muscles. Four exercises fell into this category. METHOD: Surface electromyography (sEMG) was used to record the muscle activation of Gmax and Gmed of four body weight rehabilitation exercises in 26 high-performance female field hockey players. The %MVIC activation data of both Gmax and Gmed were analysed using a three-way ANOVA. RESULTS: The single-leg squat generated the highest %MVIC activation of both Gmax (125.65%MVIC) and Gmed (126.30%MVIC). The only statistically significant difference for Gmax was between the single-leg squat and plank with hip extension (p = 0.0487). No statistically significant difference was observed for Gmed between the four body weight rehabilitation exercises (p = 0.6285). CONCLUSION: The four exercises generated similar %MVIC activation levels. The single-leg squat produced the highest observed %MVIC of Gmax and Gmed in high-performance female field hockey players and is, therefore, recommended. CLINICAL IMPLICATIONS: Implementation of the findings could result in benefits during prehabilitation, injury prevention programmes and the later stages of rehabilitation for high-performance female field hockey players.
RESUMO
BACKGROUND: Patellar tendinopathy (PT) is an overuse injury of the knee. The mechanism of injury is associated with repetitive stress on the patellar tendon of the knee as a result of explosive movement. Patellar tendinopathy is prevalent in all populations and is associated with intrinsic and extrinsic risk factors. OBJECTIVES: Primarily, the objective was to report on the intrinsic and extrinsic risk factors for PT, entailing a systematic review of the literature; the secondary objective was to use these risk factors to compile a proposed PT screening tool from the review and standard outcome measures. METHOD: A systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Elimination criteria of the articles included duplicates, titles, abstracts and methodological quality. The evidence was collected, characterised with regard to the intrinsic and extrinsic risk factors and summarised descriptively. RESULTS: The search yielded 157 feasible articles prior to commencement of article elimination. Six articles were included with a mean methodological quality score of 69%. Eight intrinsic and five extrinsic risk factors were identified. These identified risk factors are all relevant to the pathology and formed the basis for a proposed PT screening tool. The Victorian Institute of Sports Assessment for Patellar Tendinopathy Questionnaire, Visual Analog Scale and the Pain Provocation Test are also included in the proposed test. CONCLUSION: Intrinsic and extrinsic risk factors for PT were identified, and consequently, the proposed PT screening tool was formulated for possible future testing in appropriate studies. CLINICAL IMPLICATIONS: Prevention of PT through intrinsic and extrinsic risk factor identification, and implementation in the clinical setup as a possible outcome measurement tool with which to verify functional improvement in PT rehabilitation.
RESUMO
BACKGROUND: Patellar tendinopathy (PT) is a common chronic pathology of the knee, with a high prevalence in athletes and the general population. OBJECTIVES: The objectives of this article were to systematically investigate all the evidence applicable to the intrinsic and extrinsic causative factors and rehabilitation of PT, and then integrate and link rehabilitation with the main causative factors identified. METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Various tools were used to evaluate the methodological quality of the eligible articles. Data were interpreted descriptively, and the causative factors and rehabilitation of PT were analysed. RESULTS: Twenty studies were included in the review. The distinctive factor responsible for PT is the mechanical theory. Seven intrinsic and four extrinsic risk factors were identified, with the main intrinsic risk factors being muscle flexibility and strength, and extrinsic risk factors being acquisition and level of skills. PT can be treated with numerous different therapeutic modalities, although eccentric muscle training showed exceptional results. The intrinsic and extrinsic risk factors can only be transformed and reduced by rehabilitation, which is inevitable to improve PT pain and function. CONCLUSION: The essence of an integrated management protocol for PT is to identify the dominant contributing factors, whether intrinsic or extrinsic, and to reduce the load on the patellar tendon by modifying these factors by either rehabilitation intervention or direct modification of the equipment or environment to obtain a positive outcome towards pain management and function.