Masters Degrees (Sports and Exercise Medicine)
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Browsing Masters Degrees (Sports and Exercise Medicine) by Author "Holtzhausen, L. J."
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Item Open Access Dehydration in u/19 rubgy players in the hot conditions of the Karoo(University of the Free State, 2013-01) Vermeulen, Petrus Van der Walt; Holtzhausen, L. J.; Coetzee, F. F.English: Objectives: The aim of this study was to determine the dehydration status of u/19 School rugby players during a game of rugby in the Hopetown district in high temperatures. Methods: This study was a cohort-analytical study on certain variables associated with hydration levels of u/19 rugby players from Hopetown High School during two matches in 2007 and two matches in 2009. The group of rugby players was subjected to a pre- evaluation (15min before the game) followed by a re-evaluation performed 10min after the game. In this way the dehydration status of the players could be determined. Thirty-one rugby players participated. Readings were taken of Urine-Specific Gravity (SG), blood haematocrit, and body mass of every rugby player before and after every rugby match. The student t-test was used to test for significant differences within the group. A significance level of 0.05 was used throughout the study. Results: The anthropometric characteristics in our study for 2007 and 2009 are very similar as expected, and showed a mean length of 177 ± 7-8 cm, ranging from 165 to 190 cm, a mean body mass of 71.5 ± 13.7kg and a mean body mass index (BMI) of 22.88 ± 3.98kg/m2. Between 3 (17%) and 10 (67%) of the players were dehydrated post-match according to the decrease in body mass. The pre-exercise urine specific gravity measures were significantly lower (p < 0.05) before all 4 matches than after the matches as expected, and most of the players could have been better hydrated at the beginning of the match. 20% - 94% of the players were dehydrated pre-match and almost all the players (93% and 100%) were dehydrated after the match. The pre-match mean haematocrit (HCT) and the post-match mean HCT was in the range of 0.46 - 0.47. However, in two of the matches significant differences (p < 0.05) in HCT were recorded. Conclusions: It was alarming to find that a large number of the players were dehydrated before the match, but more important, almost all of them after the match. Recommendations for fluid and electrolyte replacement must be carefully considered and monitored in rugby players to promote safe hydration and avoid hyponatremia.Item Open Access Die epidemiologie van beserings by Suid-Afrikaanse netbalspelers(University of the Free State, 2010-09) Langeveld, Emile; Coetzee, F. F.; Holtzhausen, L. J.English: Netball is a sport that places high physical demands on players. Quick acceleration, changing of direction, high jumps to receive a ball or to intercept an opponent’s pass is some of the tasks that players are required to perform. These requirements leave the players vulnerable to injury. From international studies it is clear that netball players have an increased risk to sustain injuries to the lower limbs. The ankle is the joint most likely to be effected. Injuries to the ankle can account for more than 80% of all netball injuries. The ligaments are the most commonly injured structures. Due to a lack of literature on injuries in South-African netball players, injury patterns in South-Africa cannot be compared to international trends. Epidemiological studies provide the proof on which risks for specific sporting codes are assessed as well as the success of therapeutic intervention programs. The aim of the study was therefore to assess the incidence and severity of injuries in a cohort of elite South-African netball players. The subjects were all the players (n = 1280) that participated in three elite netball tournaments during the 2009 season. The medical staff of each team completed a questionnaire for each player that sustained an injury during the three tournaments. The completed questionnaires were collected at the adjournment of each days play. For those players whose teams did not have their own medical officer, completed questionnaires were collected from the First Aid station where the players received medical attention. Most injuries occurred to the ankle joint (36%) followed by the knee (18%) and injuries to the fingers, hand and wrist (15%). There was a high total injury rate of 500.7 injuries per 1000 playing hours, but the severity of injuries were low, with the majority of the participants being able to continue play or being available for the next match. In order to reduce the amount of injuries to the lower extremities it is recommended that netball players follow a structured program aimed to enhance proprioception and optimize biomechanical execution of functional movement patterns. These exercises should not only be done as part of the pre-season program but continued throughout the remainder of the season.Item Open Access Epidemiology of tackle injuries in professional rugby(University of the Free State, 2013-01) Strauss, Georg Linde; Holtzhausen, L. J.Objectives: Rugby union is a contact sport with a high injury rate. The tackle situation in rugby union is the cause of most injuries. The aim of this study was to investigate biomechanical aspects of the tackle in professional rugby to identify possible mechanisms of injury in the tackle. From this recommendations can be made to make the tackle safer. Methods: Video material from six Super 14 rugby matches involving the Cheetahs was analysed. The number of tackles (20) resulting in injury to a player was reported and nine further associated factors explored by determining differences using 95% confidence intervals. Significance was set at p = 0.05 and calculated from the proportional number of injuries from each category relative to the total number of tackles made. An odds ratio was calculated to determine practical significance where clinical significance could not be found. A total number of 744 tackles were analysed which occurred during 480 minutes of rugby accounting for 7200 player minutes. Results: From the 744 tackles that were made or received, 20 (2.7%) tackles resulted in injury, accounting to 167 tackle injuries per 1000 player match hours. The study found that significantly more injuries (p = 0.048) were sustained by tacklers performing a tackle in the attacking 22m compared to the other field positions. Most of the tackles occurred in Channel 2+ (n = 622, 83.6%) which resulted to the vast majority of tackles occurring in this game situation. Seventeen (85.0%) of the 20 injuries were sustained during Channel 2+ play, of which 13 (65.0%) ball carriers and 4 (20.0%) tacklers were injured. This had an odds ratio with practical significance. The body part hit in the tackle was often not the body part injured. Muscle contusions were the most common type of injury. Conclusions: A high incidence of tackle injuries was recorded. The tackle remains the most dangerous phase of play in rugby union. Different biomechanical aspects occur in the tackle that contribute to injury. The field position where a tackle takes place was found to be an important risk factor in the cause of injury. Front-on tackles and high impact vectors are associated with increased injury rates. The channel of play was also an important area where ball carriers sustained injuries. Factors influencing the tackle situation in certain areas of the field and certain channels of play can be made safer by placing emphasis on mental coaching, composure in pressure situations and maintaining the correct playing and tackle techniques to prevent tackle injuries in these areas and channels of play. Further research on these aspects is recommended.Item Open Access Exercise prescription: knowledge, practice and attitude among South African doctor(University of the Free State, 2014) Roos, Gerhard Marius; Schoeman, M.; Holtzhausen, L. J.Background: Physical inactivity is fourth on this list of leading causes of deaths worldwide. South Africans are reported to have low physical activity (PA) levels. Increased levels of PA and aerobic fitness will have a positive influence on morbidity and mortality since sedentary lifestyles are responsible for many of the chronic diseases we face today. Prescriptions from General Practitioners (GPs) represent a well-understood interaction between patient and doctor. An exercise prescription from a GP will remind the patient that PA is part of their treatment plan and should be adhered to with the same diligence with which their mediation is taken. GPs have access to a large proportion of the sedentary population and can play a key role in motivating people to become physically more active. However, very little is known about the exercise prescription practices, knowledge and attitudes towards exercise prescription of South African GPs. Aims: This study sought firstly to determine the practices, attitudes toward and knowledge on exercise prescription among General Practitioners in South Africa (SA) and secondly to identify possible barriers why South African GPs do not prescribe exercise. Methods: A self-administered, anonymous electronic questionnaire was developed according to guidelines from literature to assess the practices, attitudes toward and knowledge on exercise prescription among GPs in South Africa. The questionnaire was circulated to a database of GPs via email on three separate occasions, two weeks apart and was completed by a total of 349 GPs. The outcomes measures consisted of the demographic information, training histories, practices of general practitioners regarding exercise prescription, attitudes of doctors towards exercise prescription as well as their attitudes toward the importance of exercise as preventative modality for chronic diseases. Knowledge on benefits, risk factors and contraindications regarding exercise prescription, as well as knowledge of doctors regarding recommendation and formulation of exercise prescriptions were also assessed. Results: The response rate from this study was considerably lower compared to the average response rate reported for online questionnaires. Despite the fact that a purposeful attempt was made to draw the participants’ attention to the fact that exercise prescription does not involve casual advice such as “you should stop smoking and exercise more”, substantially higher prescription rates (90.9%) were reported by the participants from this study compared to those from international literature. Possible reasons for these disparities between local and international findings may not only lie in possible self-report bias, but also in the different barriers to exercise prescription reported by the South African doctors compared to the international literature. A minority (18.0%) of the participants felt that exercise prescription will be too time consuming, while almost half (46.0%) of the non-prescribing doctors from this study reported a lack of confidence in their knowledge to be able to prescribe exercise. Approximately 98% of the GPs believed that it should be part of their practice to prescribe exercise to their patients, despite the fact that very few were familiar with the knowledge and safety principles inherent to a safe and effective exercise prescription. The knowledge of the GPs in this study regarding recommendations for physical activity and the formulation of an exercise prescription was poor. Conclusion: Although general practitioners reported a fairly high incidence of exercise prescription, insufficient knowledge about not only exercise prescription, but also lifestyle modifications were noticed. Barriers to exercise prescription different from international literature and should be investigated further. A lack in confidence and knowledge to enable safe and effective exercise prescription highlights a need to rethink the undergraduate medical curricula. The good news resulting from this study is the positive attitude from the medical practitioners and their acknowledgement of the ability of physical activity, in the form of exercise training, to prevent the burden of non-communicable diseases.Item Open Access Injury and illness profiles during the 2014 South African ironman ultra-distance triathlon(University of the Free State, 2015-06) Smit, Charles Reinecke; Holtzhausen, L. J.; Von Hagen, K.Background: The Ironman South Africa (IMSA) is one of 28 Ironman races worldwide and is one of the most prominent events on the South African sports calendar. The 2014 event was held on the 6th of April in the city of Port Elizabeth in Nelson Mandela Bay. Even though Ironman events are among the most popular long distance triathlons worldwide, there is a need for ongoing data gathering regarding the injuries and illness profiles of athletes during events. The importance of ongoing research is highlighted by the fact that these ultra-distance athletes are exposed to environmental conditions and physiological demands in excess of those that athletes participating in individual sporting events of similar duration experience. Consequently such an event requires a wellorganised medical and emergency system. Aim:The aim of this study was to analyse the medical information of athletes that received medical attention at the 2014 Ironman South Africa (IMSA) event (N=179). Demographic information and medical histories of the athletes that participated in the event were also collected. A detailed report of the weather conditions on race day was included as additional information in this study. The IMSA medical plan was also reviewed to analyse the treatment plans, medical resources and medical personnel that provided care at the event. Method: The study was a retrospective, cross-sectional study. Athletes that presented for medical attention and their related medical notes recorded as standard procedure during the 2014 IMSA event were included in this study. This study undertook to use the information by transferring the data recorded in the medical notes to a data collection form developed for this study. The captured data was then coded and analysed. Descriptive statistics for the measures of central tendency presenting frequency, percentages, means and averages were calculated. Results and Recommendations: Of the 2331 athletes who started the race8% required medical attention. This number is slightly lower than data documented for recent previous IMSA events. At the 2014 event weather conditions were mild and likely played a role in a somewhat lower incidence of injury and illness among the participants. However, the incidence is comparative with international data documented for international Ironman and other triathlon events. IMSA has seen a significant increase in participants and a 1% increase in female participation. Although analysis of the data did not find a statistically significant difference for gender between the group of athletes that did not require any medical attention on race day and the group of athletes that did require medical attention, the trend of an increasing number of female participants needs to be considered in future planning. A statistically significant difference was found for age between the group of athletes requiring medical attention and those athletes that did not. Younger athletes between the ages of 18 and24 years had the largest number of injuries (15%), followed by athletes in the 25-29 year age group (13%). IMSA also recorded an increase in novice participation in 2014 of almost 12% from the previous year. This information, together with the incidence of injury among younger athletes found in this study also deserves further consideration. Race participants, especially novice athletes, should be clearly advised on conditions that may exacerbate heat illnesses such as obesity, lower levels of fitness, dehydration, lack of acclimatisation, a previous history of heat stroke, sleep deprivation, certain medications including diuretics and antidepressants, and sweat gland dysfunction or sunburn. Exercise/exertion related diagnoses were made in 64% of these athletes, with 72 cases of Exercise Associated Collapse (EAC)/hypotension being diagnosed. This finding is supported by literature in which EAC is consistently listed as one of the most commonly encountered medical problems during Ironman and other endurance events. A significant finding of this study also supports existing literature highlighting pre-existing injuries and medical disorders as important factors in identifying the at-risk athlete with 19% of those athletes that received medical attention during the race were on chronic medication. The prevalent use of NSAIDs both before and during the event is another significant finding of this study. This finding may highlight an important need for more comprehensive preparticipation screening and continuous medical education among athletes. Specifically pre-participation screening, the viability of pre-race seminars, and comprehensive medical education by way of more effective and detailed communication with both medical personnel and race entrants needs to be investigated.Item Open Access The use of traditional medicines and rituals in professional soccer in South Africa(University of the Free State, 2015-06) Mulungwa, L. C.; Holtzhausen, L. J.Objectives: Anecdotally and from observation there is wide spread use of traditional medicine (TM) and traditional rituals (TR) in sport in South Africa. It is predominantly practiced by ethnic black athletes, and is an apparent common occurrence in professional soccer. No scientific literature could be found on TM and TR in sport in South Africa. In order to advise athletes on the use of TM and TR, scientific evidence is required on the prevalence of TM and TR use, the types and substances used, efficacy, adverse effects, and possible content of banned substances. The aim of the study was therefore to gather baseline data on the use of TM and TR, to assess the prevalence and the role thereof in sport, and to identify substances and rituals in order to guide future research on this very relevant topic. Methods: Semi-structured interviews were conducted on former South African professional soccer players. The interview guide was constructed by identification of key questions to elucidate the prevalence and importance of TM and TR use in South Africa, to identify specific medicines and rituals, the perceived effectiveness thereof, and to understand the role and importance of secrecy that apparently surrounds TM and TR practices. Data was analysed by transcription and classification of the interviews, to produce predominantly qualitative data. Results: It was confirmed that TM and TR use is common practice in South African professional soccer. TM is used for minor ailments, stamina, injury healing, protection, improved performance, and as part of team rituals. A list of commonly used TMs has been identified and presented. Even though TM and TR are commonly used and regarded as important, the majority of participants preferred to use western medicine before they resort to TM. A list of TR has been identified and presented. The majority of participants (80%) did not believe that TR improves sport performance. Secrecy about the use of TM and TR is an important component of the traditional culture, which complicates research on this topic.