The vulnerability of adolescents participating in rugby and football in Dubai, UAE, to exertional heat illness

Heynes, Andre (2018-03)

Thesis (MScPhysio)--Stellenbosch University, 2018.

Thesis

ENGLISH SUMMARY : Background: Regular appropriate physical activity for children and adolescents are needed to improve and maintain health. There are several risk factors for developing exertional heat illness (EHI), which negatively affect the thermoregulatory ability of the body, resulting in increased core body temperature. Exercising in high environmental temperatures and humidity increase the risk for EHI. Dubai, UAE, experience these environmental conditions. EHI presents as symptoms ranging from exercise associated muscle cramps, heat syncope and exercise related collapse, heat exhaustion, and exertional heat stroke. In the USA, exertional heat stroke is the leading cause of death in young athletes. Objective: To determine the vulnerability of adolescent union rugby and football participants in terms of risk factors present for EHI, self-reported EHI symptoms and the hydration practices of the participants for the duration of the study. Methods: A cross-sectional, descriptive design was used to address the research questions. The study was conducted at clubs offering union rugby or football in the Middle Eastern city of Dubai, UAE. Population sampling was applied, which included adolescents, aged between 10 -19 years old. The study occurred during a single training session at the start of the 2015/2016 season, during the month of October 2015. A questionnaire was used to elicit responses from the participants to measure self-reported risk factors, symptoms of EHI and hydration practices. Results: A response rate of 22.4% (n= 111) was obtained, 49 union rugby and 62 football participants were recruited from a total of 500 players that initially attended the information session. The main findings of the study include: 19 % (n=21) of participants self-reported EHI risk factors; 14.4% (n= 16) of participants’ self-reported exercises-associated muscles cramps, which was the only EHI symptom category, and 10.8% (n= 12) of participants did not report any EHI symptom. Fluid was consumed by 94.5% (n= 105) before training, 100% (n= 111) during training, and 100% after training. Water was the most abundant fluid consumed before (86%, n= 91), during (94.5%, n=105) or after (55%, n= 61) training. Many participants (77.5%, n= 86) indicated that they are knowledgeable if they consumed too much fluid. Beside fluid provided by the two football clubs, no other side-line support measures were noted. Poorer general physical fitness was associated with more EHI symptoms (rho = -0.211, p = .026). An additional significant association was found between the number of EHI risk factors and the fluid intake volume after practice, with higher intake being associated with more symptoms (rho = 0.197, p = .043). In those participants who reported generally better physical fitness (rho = -0.206, p = .030), significantly fewer EHI symptoms were noted. For those participants who reported consuming more fluids before practice (rho = 0.313, p = .001), and consuming fluids a longer time prior to practice (rho = 0.253, p = .009), the number of EHI symptoms were significantly greater. There were no significant associations between self-reported EHI risk factors (any vs. none) with self-reported EHI symptoms (any vs. none). Conclusion: The findings imply that slightly less than one in five participants were vulnerable to develop EHI in this sample of adolescents in the UAE. No significant association was demonstrated between self-reported EHI risk factors and self-reported EHI symptoms. This correlates to current disagreement on ability to identify those at risk for development of EHI. Amateur clubs lack adequate preparation to prevent, recognise and treat severe EHI episodes, which was demonstrated through the lack of any available emergency action plans. The self-reported hydration practices suggested that the participants did consume sufficient fluids.

AFRIKAANSE OPSOMMING : Inleiding: Daar is verskeie risiko faktore vir die ontwikkeling van oefenings-geassosieerde hittesiekte (OGH), wat 'n negatiewe invloed op die temperatuur regulasie vermoë van die liggaam het, en wat dan lei tot verhoogde kern liggaam’s temperatuur. OGH vertoon simptome wat wissel van oefeninge-verwante spierkrampe, hittesinkopee en oefening-verwante ineenstorting, hitte-uitputting, en oefening-geassosieerde hitte ontsteek. Oogmerk: Die studie is uitgevoer om die kwesbaarheid van adolessente, unie rugby en sokker, spelers te bepaal in terme van self-gerapporteerde risiko faktore, OGH-simptome teenwoordig en die hidrasie praktyke, te bepaal. Metodologie: Die studie is uitgevoer by verskeie klubs wat unie rugby of sokker aanbied in Dubai, VAE. Die studie het plaasgevind tydens 'n enkele oefensessie aan die begin van die 2015/2016 seisoen, gedurende Oktober 2015. 'n Deursnee-, beskrywende metode was gebruik om die navorsingsvrae te beantwoord. Bevolking-steekproefneming was toegepas, adolessente tussen 10 -19 jaar oud is ingesluit. 'n Vraelys is gebruik om antwoorde van die deelnemers te kry sodat self-gerapporteerde risikofaktore, simptome van OGH en hidrasie praktyke bepaal kon word. Resultate: Die belangrikste bevindinge van die studie is die volgende: 19% (n= 21) van die deelnemers het self-gerapporteerde OGH risiko faktore; 14.4% (n= 16) van die deelnemers het self-gerapporteerde oefeningsverwante spierkrampe, wat die enigste OGH simptoomkategorie wat getoon was, en 10.8% (n= 12) van die deelnemers het geen OGH simptoome gerapporteer nie. Vloeistof was deur 94.5% (n = 105) deelnemers voor oefeninge, 100% (n = 111) tydens oefeninge, en 100% na oefeninge ingeneem. Water was die vloeistof wat die meeste voor (86%, n = 91), tydens (94.4%, n = 105) of ná (55%, n = 61) eofeninge gebruik is. Baie deelnemers (77,5%, n = 86) het aangedui dat hulle kundig is indien hulle te veel vloeistof gebruik. Geen ander kantlyn ondersteunings materiaal, behalwe vloeistof wat deur beide sokkerklubs voorsien was, is opgemerk nie. Die swakste algemene fisiese fiksheid is geassosieer met meer OGH-simptome (rho = -0,211, p = 0,026). ’n Bykomende beduidende assosiasie is gevind tussen die aantal OGH risikofaktore en die volume van vloeistof in geneem na die oefen sessie, met ’n hoër inname wat verband hou met meer simptome (rho = 0,197, p = 0,043). By daardie deelnemers wat oor die algemeen beter fisiese fiksheid angedui het (rho = -0,206, p = 0,030), is aansienlik minder OGH simptome opgemerk. Vir diegene wat gerapporteer het dat hulle meer vloeistof voor oefeningsessie (rho = 0,313, p = 0,001), en vir ’n langer tydsduur voor ’n oefen sessie (rho = 0,253, p = 0,009), die aantal OGH simptome aansienlik meer. Gevolgtrekking: Die bevindinge impliseer dat effens minder as een uit elke vyf deelnemers vatbaar om OGH te ontwikkel uit hierdie bevolking van adolessente in VAE. Amateur klubs is nie voldoende voorbereid om ernstige OGH-episodes te verhoed, te identifiseer en te behandel nie, soos gedemonstreer deur die gebrek aan enige nood aksie planne. Die self-gerapporteerde hidrasie praktyke het daarop gedui dat die deelnemers voldoende vloeistowwe gedrink het , maar nie altyd volgens aanbevole riglyne nie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/103415
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