Masters Degrees (Exercise, Sport and Lifestyle Medicine)

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Browsing Masters Degrees (Exercise, Sport and Lifestyle Medicine) by browse.metadata.advisor "Derman, Wayne"

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    Anterior cruciate ligament rupture, reconstruction, rehabilitation and recovery: The personal experiences of competitive athletes.
    (Stellenbosch : Stellenbosch University, 2018-03) Borman, Anel; Grobbelaar, Heinrich; Derman, Wayne; Stellenbosch University. Faculty of Education. Dept. of Sport Science.
    ENGLISH ABSTRACT: Injury is an unavoidable part of sport with inevitable physical as well as psychological consequences. Anterior Cruciate Ligament (ACL) injuries is one of the most prevalent injuries in sport and although considerable research has focussed on the physical recovery, the psychological effects have been neglected. Identifying the thoughts, feelings and behaviours associated with the ACL rupture, reconstruction, rehabilitation and return-to-sport could enhance our understanding of the psychological impact of the ACL recovery process. The aims of the study were to explore and analyse the personal experiences of athletes who sustained a unilateral ACL rupture and underwent ACL reconstruction (ACLR) surgery at six time intervals during the post-injury recovery period up to and including return-to-sport. Seven competitive male athletes took part in the study. Semi-structured interviews were conducted immediately post-injury, preoperative, postoperative (phases 1, 2 & 3), as well as upon return-to-sport. The interviews elicited information about the personal and situational factors that influenced each athlete’s response to an ACL injury and undergoing ACLR surgery; their cognitive appraisal of the injury and recovery process; their emotional response to the injury and recovery process, as well as their behavioural response to the injury and recovery process. A total of 42 interviews were transcribed and analysed through the use of thematic analysis (TA). Six superordinate themes emerged; 1) establishing identity (athletic and personal), 2) cognitive appraisal, 3) responses (emotional and behavioural), 4) coping strategies (approach- and avoidance orientated), 5) types of social support (emotional, informational and tangible) and 6) advice/recommendations from injured research participants. The latter was specific to the return-to-sport phase. Each superordinate theme emerged as a result of a range of themes, sub-themes and categories of codes captured immediately post-injury, preoperatively, postoperatively (phases 1, 2 and 3) and upon return-to-sport. Direct quotes from participant transcripts were included to give meaning to each superordinate theme. All participants recovered physically from their injury and returned to sport within 12 months post-injury. This study reported thoughts, feelings and behaviours associated with athletes’ experiences of the rupture, ACLR surgery, rehabilitation and recovery process, as well as prior to and following return-to-sport. To the best of my knowledge, this is the first study of its kind conducted within a South African context and one of only a few studies to note the role of a biokineticist as a source of social support. This study provides guidelines and recommendations for medical professionals involved in the ACL rehabilitation process. Those involved in the rehabilitation process should be aware of the cognitions, emotions and behaviours associated with the rupture, reconstruction, rehabilitation and return-to-sport on the timeline to recovery. Focusing on athletes’ experiences of the five R’s associated with the ACL injury recovery process (i.e., Rupture, Reconstruction, Rehabilitation, Return-to-sport and Recovery) might help medical professionals, coaches, teammates, friends and family to have a better understanding of the injured athletes’ needs. Future research should aim to follow participants for up to two years post-surgery as it could take much longer for athletes to recover psychologically.
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    Muscle activation patterns during functional movements in transtibial amputees
    (Stellenbosch : Stellenbosch University, 2018-11) Arnold, Sarah; Ferreira, Suzanne; Derman, Wayne; Runciman, Phoebe; Stellenbosch University. Faculty of Education. Dept. of Sport Science.
    ENGLISH ABSTRACT: Functional movement capabilities of individuals with unilateral transtibial amputations are altered due to muscle loss and prosthesis limitations compared to healthy, typical individuals. The extent of the adaptions made during functional activities is however, unknown. The purpose of the study was to gain a better understanding of unilateral transtibial amputees (UTTA) muscle activation levels during functional activities. A systematic review (article one) relating to the gait and balance of UTTA was completed. It revealed the need for research relating to muscle activation and movement strategies during functional activities. Stage two of the Van Mechelen model was addressed through biomechanical analysis during single leg balance (SLB) and sit-to-stand-to-sit (SiStSi) tasks through muscle activation and biomechanical analysis. The study included 12 UTTA (34±10 years) and 13 able-bodied controls (CON) (34±11 years). The average time since amputation was 10±7 years. Each UTTA made use of their personal prosthesis for the observational testing. The participants were required to perform a unilateral SLB task followed by 10 continuous SiStSi movements. Muscle activation was measured for seven muscle groups using surface electromyography (EMG) together with a three dimensional biomechanical analysis. The results of article two relates to the single leg balance activity. Significantly greater muscle activation levels were found for the lumbar erector spinae (LES), gluteus medius (Gmed), gluteus maximus (Gmax), biceps femoris (BF) and vastus lateralis (VL) (p<0.05) for the affected side (AF) in comparison with the unaffected side (UN) and CON. Greater hip flexion moment and concentric hip power were observed for AF (p<0.05) while hip and knee flexion was greater than UN and CON (p<0.05). No significant differences were found for the knee and ankle joint moments during SLB (p>0.05). The SiStSi results are discussed in article three. Lower muscle activation levels were found for VL of AF compared to UN and CON, with greater activation levels of the tibialis anterior (TA) for UN than CON (p<0.05). The peak hip moment for AF during the SiSt was greater than UN and CON (p<0.05). Significantly greater hip power and hip flexion were identified for UTTA compared to CON (p<0.05), while the knee and ankle joint moments and powers were greater for UN than AF and CON (p<0.05). Lastly, vertical ground reaction force (vGRF) was significantly higher for UN than AF (p<0.05) The main findings included greater muscle activation of the muscles surrounding the hip joint of UTTA during the SLB and the SiStSi activities. Joint overloading was noted for the UN knee as well as overcompensation by the UN ankle during the SiStSi. Lastly, asymmetry was observed in the vGRF between the AF and UN sides during the SiStSi.
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    Risk factors associated with sport-related injuries in para athletes: an analysis of the 2012 and 2016 Summer Paralympic Games
    (Stellenbosch : Stellenbosch University, 2025-01-01) Adam, Faatima; Runciman, Phoebe; Derman, Wayne; Schwellnus, Martin; Stellenbosch University. Faculty of Medical and Health Sciences. Dept. of Exercise, Sport and Lifestyle Medication.
    ENGLISH ABSTRACT: A Para athlete enters into competition with a pre-existing medical impairment, and perhaps an inherent risk for injury compared to able-bodied counterparts. For Para athletes, the risk and type of injury is dependent on the physiological or biomechanical dysfunction associated with their impairment. The relationship between an athletes’ medical impairment and sport-related injuries has not yet been comprehensively studied. In the first study, a narrative review of the literature was conducted summarising information regarding injury profiles associated with an athletes’ impairment type. Databases were searched for articles until June 2021. Impairment categories searched included: (1) Musculoskeletal (impaired passive range of movement (IPROM), limb deficiency (LD), leg length difference (LLD), short stature (SS)), (2) Neurological (brain disorders (BD), neuromuscular disorders (NMD), spinal cord injuries (SCI)), (3) Visual (VI), and (4) Intellectual (II) impairments. Twenty-one studies were identified that reported on injuries by impairment type. Most reviewed studies had variations in methodologies, limiting comparisons between studies. Impairment-specific studies showed differences in injury chronicity and anatomical area based on ambulatory status or impairment type. Studies with athletes who were ambulant reported higher numbers of lower limb injuries while shoulder injuries were only common amongst studies that investigated injuries during wheelchair sports yet were not reported by specific impairment type. The review showed that there is a substantial gap of impairment-related injury epidemiological literature in Para sport and a need for future studies to report on injuries by impairment type. In the second study, an epidemiological analysis of impairment-related injuries was conducted using the Paralympic Injury and Illness Surveillance Studies (PIISS) of the London 2012 and Rio 2016 Summer Paralympic Games (S-PGs). Combined analyses of injuries sustained were conducted for a total of 7222 athletes for 101 108 athlete-days. Injury incidence rates (IRs) and proportions were reported by impairment and age, sex, sport, period, chronicity, and anatomical area for athletes with BD, LD, NMD, SCI, VI and ‘all others’ (OTH: IMPROM, II, LLD, SS). The impairment group with the highest IR/1000 athlete-days was VI (13.6 (95% CI 11.9-15.7)), followed by NMD (13.3 (95%CI 10.9-16.1)), and SCI (11.1 (95% CI 9.7-12.8)). The precompetition period had an overall higher IR (13.8) for all impairment groups. Acute sudden-onset injuries (IR 5.8) were higher than gradual-onset injuries (IR 3.7), except for athletes with NMD (IR 5.8). Regression analysis showed that sport is a significant risk factor for injuries sustained by athletes with VI (p<0.0001). Sports with high IRs were football-5-a-side (25.9), athletics (16.9) and Judo (15.3). This study was the first study to report on impairment-specific injury risk factors from a combined analysis of two S-PGs. The findings from this thesis contribute towards advancing the understanding of impairment-related factors associated with injuries in athletes during a S-PGs. Clinicians working with Para athletes can gain impairment-specific information for training and injury prevention. Clinicians should work around; (1) decreasing precompetition injuries in athletes with musculoskeletal impairments, (2) prioritise postural control and balance in athletes with VI and (3) consider biomechanical compensations and assistive device usage as cause for injury in athletes with NMD.