24 hour movement behaviours and the health and development of pre-school children from Zimbabwean settings: the SUNRISE pilot study.

Background: In 2019, the World Health Organization (WHO) released global guidelines for physical activity, sedentary behaviour and sleep for the early years. The International Study of Movement Behaviours in the Early Years, SUNRISE, aimed to assess the extent to which children aged three and four years meet the WHO global guidelines and its association with health and development. Objectives: To assess movement behaviours in pre-school children from low-income settings in Zimbabwe and to establish associations between these movement behaviours and adiposity, motor skills and executive function. Methods: Pre-school children/caregivers were recruited from two urban and two rural public schools respectively in Zimbabwe. The caregivers answered questions on the children's physical activity, screen time, sedentary behaviour and sleep patterns. Children's movement behaviours were objectively measured using accelerometers. Gross and fine motor skills and executive function were assessed using the Ages and Stages Questionnaire-3 and Early Years Toolbox, respectively. Focus group discussions were carried out with caregivers and teachers on the acceptability and feasibility of the study. Results: Eighty-one children participated in the study. The proportions of children meeting the guidelines were physical activity 92%, sedentary behaviour 70%, and sleep 86%, and all guidelines combined 24%. Boys and girls were similar (p>0.05 for all variables) for all executive function variables, but rural children had significantly lower inhibition scores (p=0.026) than urban children. Conclusion: The study adds to the growing literature on movement behaviours and associated risk factors in low-resourced settings. Further investigations of movement behaviours in this age group in Zimbabwe are recommended.

Absolute and relative reliability of SCRuM test battery components assembled for schoolboy rugby players playing competitive rugby in low-resource settings: A pragmatic in-season test-retest approach.

Background: Schoolboy rugby is a popular sport which forms the bedrock of rugby development in many African countries, including Zimbabwe. With burgeoning talent identification programmes, the development of multi-dimensional, logically-validated, and reliable test batteries is essential to inform the objective selection of potentially talented young rugby athletes. Objectives: This study sought evidence on the absolute and relative test-retest reliability of the component test items in the newly-assembled SCRuM test battery. Methods: Utilising a pragmatic test-retest experimental design, a sample of 41 Under-19 schoolboy players playing competitive rugby in the elite Super Eight Schools Rugby League in Harare, Zimbabwe, participated in the study. Results: Physiological and game-specific skills tests which showed good to excellent relative reliability and acceptable absolute reliability, included: 20 m and 40 m speed, L-run, Vertical Jump (VJ), 60 s Push-Up, 2 kg Medicine Ball Chest Throw test (2 kg MBCT), Wall Sit Leg Strength test (WSLS), Repeated High Intensity Exercise test (RHIE), One Repetition Maximum Back Squat (1-RM BS) and Bench Press tests (1-RM BP), Yo-Yo Intermittent Recovery Level 1 test (Yo-Yo IRT L1), Tackling Proficiency test, Passing Ability Skill test and Running and Catching Ability skill test. Conclusion: All these tests are reliable and warrant inclusion in the SCRuM test battery for possible profiling of U19 schoolboy rugby players during the 'in-season' phase provided there is adequate participant familiarisation and test standardisation. The test-retest ICCs and measurement errors are generalisable to other young athletes in this population, making the tests useful for the evaluation of training and developmental effects of the measured constructs.

Qualities or skills discriminating under 19 rugby players by playing standards: a comparative analysis of elite, sub-elite and non-rugby players using the SCRuM test battery.

OBJECTIVE: Although schoolboy rugby is growing in popularity and played at different competitive levels in Zimbabwe, the influence of playing standard on qualities or skills of older male adolescent rugby players is unknown. Utilising a cross-sectional design, this study determined anthropometric, physiological characteristics and rugby-specific game skills defining elite under 19 (U19) schoolboy rugby players. Following development and subsequent assessment of test-retest reliability of School Clinical Rugby Measure (SCRuM) test battery, this study compared performance outcomes of elite rugby players (n = 41), sub-elite rugby players (n = 46) and non-rugby athletes (n = 26) to identify qualities or skills discriminating (i) elite from sub-elite and non-rugby players, and concomitantly (ii) sub-elite from non-rugby players. RESULTS: 40 m speed test (p < 0.001, ES = 1.78) and 2 kg Medicine Ball Chest Throw test (p < 0.001, ES = 1.69) significantly discriminated elite U19 from sub-elite and non-rugby players. These tests further differentiated sub-elite from non-rugby athletes. Additionally, 1RM back squat (p = 0.009, ES = 0.57), 1RM bench press (p = 0.005, ES = 0.61), repeated high-intensity exercise test (p < 0.001, ES = 0.88) and passing ability test (p < 0.001, ES = 0.99) discriminated elite from sub-elite counterparts. These findings highlight important attributes linked to elite U19 schoolboy rugby in Zimbabwe. However, no significant differences were observed for sum of seven skinfold (p = 0.28), tackling (p = 0.08) and catching ability (p = 0.05).

Coaches' perceptions on qualities defining good adolescent rugby players and are important for player recruitment in talent identification programs: the SCRuM project.

OBJECTIVE: Competitive rugby is increasingly becoming popular among adolescent players even in countries hardly known for rugby such as Zimbabwe. Given the increased participation rates, burgeoning talent identification (TID) programs and the reportedly high injury-risk associated with competitive youth rugby, the minimal qualities or skills needed for effective performance by all young players need further clarification. Therefore, this qualitative study was conducted to explore the perceptions of high-school based rugby coaches on the key qualities or skills defining good adolescent rugby players and should be considered for player recruitment in TID programs. Currently, there is no consensus in literature from the coaches' perspective on these qualities. RESULTS: The final sample had 22 coaches (median age = 45.5 years) with years of coaching high-school rugby ranging from 6 to 17 years. Using the conventional approach to inductive content analysis four broad themes emerged suggesting the multifaceted nature of the requirements imperative for effective and optimal rugby performance among adolescent rugby players as perceived by the coaches. Themes identified included: physiological characteristics, anthropometric attributes, psychological qualities and game-specific skills. Possibly, training approaches or design of rugby-specific test-batteries should consider all these important qualities and be multi-dimensional in composition.

High-school adolescents' motivation to rugby participation and selection criteria for inclusion in school rugby teams: coaches' perspective (the SCRuM project).

OBJECTIVE: Despite increasing rugby popularity among schoolboys' worldwide, specific factors influencing their motivation to participate in rugby remain unclear. Therefore, this study was conducted in two parts with a dual purpose of exploring perceptions of rugby coaches on (i) factors motivating schoolboys to engage in competitive rugby, and (ii) criteria for selecting schoolboy rugby players for possible inclusion in school rugby teams. RESULTS: A qualitative study targeting Zimbabwean high school-based rugby coaches purposively-recruited during the 2017 Dairiboard Zimbabwe Rugby School Festival was conducted. Using the conventional approach to content analysis, the 22 recruited male coaches (median age = 45.5 years) felt that playing rugby is a choice largely influenced by either intrinsic or extrinsic motives for schoolboys. Additionally, coaches considered players' characteristics (performance during training, attitude, physical qualities and skills) and match-related factors when selecting schoolboys for possible inclusion in school rugby teams. To effectively promote competitive rugby participation among schoolboys and promote sustainable and effective talent identification programmes in Zimbabwe, more recognition should be paid to factors motivating schoolboys to participate in rugby and also on the factors coaches consider when assembling school rugby teams which indirectly informs on what coaches think should be trained among schoolboy rugby players.

The burden of low back pain among undergraduate physiotherapy students at the University of Zimbabwe: a cross-sectional study.

OBJECTIVE: Globally, non-specific low back pain (NSLBP) is a common cause of morbidity in all people including physiotherapy students. However, no study has investigated the problem among undergraduate physiotherapy students in Zimbabwe. This study was conducted, therefore, to provide evidence of the prevalence, clinical characteristics and consequences of recurrent NSLBP among undergraduate physiotherapy students at the University of Zimbabwe. RESULTS: The final sample had 90 participants, giving a study response rate of 97.8%. The median age of the participants was 22 years. The lifetime prevalence of NSLBP was 56.7% (n = 51) and the mean age of onset for NSLBP was 19.7 years (SD = 1.64 years). The 12-month prevalence of recurrent NSLBP was 38.9% (n = 35). Of the 35, 20 (57.1%) experienced at least three episodes in the last 12 months. Each episode lasted for 1-7 days in most participants (n = 31, 88.6%). The mean intensity of recurrent episodes was 3.37 (SD = 1.43) measured on Visual Analogue Scale. Only 7 (20%) experienced at least one functional limitation due to recurrent NSLBP. Additionally, only 2 (5.7%) sought medical treatment for the pain. However, 6 (17.1%) had to be absent from the university secondary to recurrent NSLBP.

Human immunodeficiency virus associated pulmonary conditions leading to hospital admission and the pulmonary rehabilitation services received by patients at two central hospitals in Harare.

OBJECTIVE: Use of highly active antiretroviral therapy has led to marked reductions in the incidence of HIV-associated opportunistic infections but has had comparatively less impact on the incidence of some pulmonary diseases. This study was done to determine the pulmonary conditions leading to hospital admissions in people living with HIV/AIDS at two central hospitals in Zimbabwe and the pulmonary rehabilitation intervention received. RESULTS: A total of 92 participants were recruited of which 60 (65.2%) were females. The mean age of the participants was 41.3 years (SD = 9.1). The most common pulmonary condition leading to hospital admission was tuberculosis in 53 (57.6%). About 52 (56.6%) of the participants suffered from pulmonary complications in the last 6 months, 48 (92.3%) were admitted and 26 (50.0%) of the participants received physiotherapy treatment during their admission. None of the participants indicated that they once attended an outpatient pulmonary rehabilitation clinic. Respiratory complication is one of the leading causes of morbidity associated with HIV but no pulmonary rehabilitation services are being offered to these patients. There is need for introduction of pulmonary rehabilitation programs for people living with HIV/AIDS in the current setting.

Work-related musculoskeletal disorders among registered general nurses: a case of a large central hospital in Harare, Zimbabwe.

OBJECTIVE: Worldwide, work-related musculoskeletal disorders (WMSDs) are a common cause of morbidity affecting occupational individuals such as health-care professionals. However, nothing is known about WMSDs in hospital nurses in Zimbabwe. This study was conducted to provide cross-sectional evidence of the 12-month prevalence, consequences and factors associated with WMSDs among 208 nurses at Parirenyatwa Group of Hospitals (PGH). RESULTS: The response rate for the study was 55.7%. The median age for the participants was 32.0 years (interquartile range = 29-36 years). The lifetime prevalence of WMSDs in nurses was 95.7% (n = 112). The first episodes were experienced in the first 5 years of working (n = 59, 52.7%). However, 82.1% (n = 96) nurses experienced WMSDs in the last 12 months. Low back pain was the most common WMSDs reported (n = 55, 67.9%). WMSDs were significantly associated with qualification attained, postgraduate ergonomic training and working experience. Overall, 87.5% (n = 84) nurses experienced at least one of the consequences of WMSDs. Cognisant of the limitations of the study, the present study found that WMSDs are a common occurrence among nurses at PGH. This creates a need for prompt hospital education programs aimed at raising awareness among nurses on the existence of WMSDs and the consequences at PGH.

A cross-sectional study investigating impressions and opinions of medical rehabilitation professionals on the effectiveness of the Ponseti method for treatment of clubfoot in Harare, Zimbabwe.

BACKGROUND: The Ponseti method of managing clubfoot was introduced in Zimbabwe in 2011. This followed massive training of health workers such as medical rehabilitation practitioners through a programme called the Zimbabwe Sustainable Clubfoot Programme. Today, the Ponseti method is the technique of choice for managing clubfoot in hospitals. However, since then, there is no published evidence documenting the efficacy and the relevance of the technique especially comparing to previously used methods. This is a significant shortcoming if sustainability issues are to be considered. Therefore, this study was designed to investigate the impressions and opinions of medical rehabilitation practitioners on the method in terms of its effectiveness, perceived challenges and possible recommendations for improvement of the technique application in their setting. METHODS: A descriptive cross-sectional study was conducted targeting medical rehabilitation practitioners previously trained on the method and working in public or private clinics that offer clubfoot management in Harare. A questionnaire was self-administered to 41 participants who volunteered to participate in the study. Data from open-ended questions was analysed thematically. Statistica version 12 was used for analysis for quantitative data. RESULTS: The Ponseti method was perceived as an effective method in the treatment of children with clubfoot by all the participants. All the participants 41 (100 %) felt that the method was relevant because of better clinical outcomes. Amongst challenges faced when using Ponseti method, 25 (61 %) participants agreed that caregivers to the children with clubfoot were not compliant to treatment. A total of 22 (54 %) participants felt that lack of adequate insight by the caregivers of this new method was a challenge which hinder progress in treating clubfoot. CONCLUSIONS: The medical rehabilitation professionals in Harare, Zimbabwe trained to use the Ponseti technique for the management of clubfoot, perceived the method as an effective method resulting in better clinical outcome than previous methods. This probably highlights the need to continue training medical rehabilitation professionals so that there is widespread use of the technique in the country. However, there is need to increase awareness of the method among caregivers to improve compliance, which is key to successful rehabilitation of the clubfoot.