Doctoral Degrees (Physiotherapy)

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Browsing Doctoral Degrees (Physiotherapy) by Author "Robyn, Aneurin Dean"

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    Return to play in elite rugby players after severe knee injuries : addressing the knowledge gaps
    (Stellenbosch : Stellenbosch University, 2022-04) Robyn, Aneurin Dean; Louw, Quinette; Baumeister, Jochen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Introduction: Rugby union has been a professional sport for many years. Along with the growing professionalism of the sport, there has been increasing scientific interest in the physical profiles of rugby players as such profiling may inform player selection, conditioning, monitoring, and injury prevention strategies. Medical professionals working in an elite sports environment have the challenging task of determining if an athlete is ready to return to the playing field after severe injury. Merely passing a battery of physical tests is arguably insufficient for an injured athlete to successfully recover to preinjury status. Aim: This dissertation aims to describe elite rugby union players' physical and psychological profiles at the return to play after sustaining severe knee injuries compared to their preinjury level. This dissertation contributes new knowledge and adds practical pieces to the growing return to play puzzle. Research setting: This study was performed in Cape Town, South Africa, with the identified participants of five elite rugby teams based in the Cape Winelands and Metropole areas. Testing was conducted in an indoor biomechanical laboratory and an indoor sports facility with an artificial grass surface. This kept the testing environment consistent by eliminating any weather condition interference. Methodology: Study 1: This descriptive cross-sectional study aimed to compare the anthropometry and physical profiles of elite junior rugby union players according to specific playing positions. Study 2: A prospective cohort study was performed to compare the injured participants' physical testing at return to play with baseline after sustaining a severe knee injury. Study 3: A prospective cohort study was done with injured participants completing two psychological questionnaires to assess their psychological readiness at return to play and evaluate if there was any improvement between return to training and return to play. Study 4: A prospective cohort study with a new analytical method of statistical parametric mapping analysis to assess the countermovement jump curve. Results: Study 1: This study provides up-to-date confirmation of the variation in specific playing position profiles and skills according to specific game demands at the junior elite level. Players’ profiles are matched to the specific demands of the game. Study 2: This study highlights that injured players’ running speed and decision-making time are slower after injury. The uninjured players' exposure to training and match stimulus improved their running speed and lower body explosive power during the season. Study 3: This study reported good psychological readiness and successful recovery to the preinjury status of elite rugby players after a severe knee injury. The improved scores from return to training to return to play give insight to treating professionals that athletes need longer recovery time as training exposure will decrease fear of reinjury and increase confidence in their knee function before returning to the competitive playing field. Study 4: This study's two key findings are that there was (i) no asymmetry detected and (ii) the improved peak force of affected limb at return to play after a severe knee injury which is contrary to current evidence. Conclusion: An athlete who returns to play is a complex problem and needs a complex solution. My dissertation has contributed to the elite sports population by providing return to play details on elite rugby union players’ physical and psychological profiles after a severe knee injury. This new information will give treating professionals the necessary insight and additional pieces to this complex return to play puzzle. Recommendation: An interdisciplinary approach with specific needs by developing a more holistic return to play recipe for better return to play decisions and lower reinjury rates. We monitor elite athletes for a more extended period (at least six months) after a successful return to the playing field; provide the sports medicine community information on any reinjuries, other musculoskeletal injuries, and return to (match) performance parameters. Artificial intelligence is one promising approach to inform decision-making processes by adding various player data in an algorithm to provide a return to play recommendation.