A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / To compare the relative activation and endurance of core stability muscles in 2 different populations i.e. elite athletes and non-athletes, and establish whether these findings correspond to episodes of mechanical lower back pain. / M

The purpose of this study was to examine the influence of self-motivation and several non-psychological variables on injured athletes' adherence to rehabilitation. Twenty-five (17 male, 8 female) injured intercollegiate athletes from several sports (football, gymnastics, diving, swimming, volleyball, cross country/track, baseball, and tennis) participated. After injured athletes reported to the training room for treatment, they were informed of the study by the head athletic trainers. Athletes agreeing to participate were required to complete an injury information form and the Self-Motivation Inventory. The head athletic trainers recorded injury information, attendance to rehabilitation, and made judgments regarding each athletes' adherence to rehabilitation.Adherence was measured four different ways (i.e., attendance rates, trainer judgments, trainer rankings, and a combination of the previous three to create an overall adherence measure). The results of this study are inconclusive, due to the fact that the different adherence measures did not agree for each independent measure. The results, however, suggest that self-motivation and certain non-psychological variables (i.e., academic class, scholarship status, and injury severity) may serve as predictors of injured athletes' adherence to rehabilitation. / Department of Counseling Psychology and Guidance Services

The purpose of this study was to assess the level of perceived social support reported among student-athletes from their strength coach (SC) during the later reconditioning stage of rehabilitation. Data from (n = 82) participants were utilized in this study from 6 Division I Universities in the Midwest region of the United States. Each participant reported being injured for a minimum of 5 consecutive days or more. Participants were administered a survey packet consisting of; 1 demographic form, 2 consent forms, and 3 social support survey forms consisting of 6 types of social support measured on a 5 point Likert scale. The 6 types of social support assessed included; listening support, task appreciation, task challenge, emotional support, emotional challenge, and reality confirmation.AChi-Square Test was employed to assess the injured student-athlete's level of perceived social support received from their SC's during the later reconditioning stage of rehabilitation. Results showed that SC's have a significant psychosocial impact on a student-athletes overall psychological well-being during reconditioning. In conjunctionwith similar research, listening support, task appreciation, task challenge, and reality confirmation showed to be reported most frequent among student-athletes as needed or expected and most salient for their overall mental well-being during reconditioning.Among genders both male and female participants reported expecting and/or needing task challenge and reality confirmation from their SC's in addition, both male and female participants also reported task challenge and reality confirmation as the types of social support received from their SC's that was most important for their overall psychological well-being during the later reconditioning stage of rehabilitation. Furthermore, emotional challenge was reported the least overall among participants and among genders.This study provided sufficient evidence of the important psychosocial role that SC's can play during the later reconditioning stage of rehabilitation to injured student-athletes. Furthermore, the results of this study support other similar studies which also assessed the psychological impact of social support provided by the athletic trainer (AT) which was reported among student-athletes during rehabilitation. / School of Physical Education, Sport, and Exercise Science

Thesis(M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005 xi, 62 leaves / To compare the relative activation and endurance of core stability muscles in 2 different populations i.e. elite athletes and non-athletes, and establish whether these findings correspond to episodes of mechanical lower back pain.

Dissertation (PhD)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: The present study was undertaken with the aim of developing and implementing a model for the rehabilitation of sports injuries. Injury is, without a doubt, one of the most significant obstacles to athletic performance. Very few, if any, athletes escape injury and it seems that regardless of experience and ability, all physically active individuals are prone to injury at some stage of their careers. The ability to resist injury and to rehabilitate well when injury does occur is fundamental to longevity in sport. Previous injury rehabilitation interventions commonly addressed only the physiological dimensions of injury, excluding the psychological dimensions. Only very recently has there been a shift in focus to include psychological principles in the treatment procedures, with Heil (1993) and Pargman (1993a) some of the first authors to publish works on the subject. A comprehensive literature review was done. In the first chapter attention was paid to the role of personality in injury occurrence and rehabilitation outcome, with special emphasis on the model of stress and athletic injury of Andersen and Williams (1993). An extension to this model, taking into account the role of personality, coping resources, cognitions, interventions and other injury and treatment related factors in the rehabilitation process was added by Grove (1993). The next chapter was devoted to the causes and stresses of sports injuries. Topics that were covered include the over-training syndrome, understanding injuries from the athlete's, physician's and psychologist's points of view and a study of what exactly the stresses involved in athletic injury are. Special attention was paid to the concept of pain and all its dimensions, the social well-being of the injured athlete and the impact of injury on the athlete's self-concept and identity. In the following chapter psychological adjustment to athletic injury was discussed. The concepts of loss and grief and applicability of grief response models in particular were discussed. In response to grief response models, cognitive appraisal models (Brewer, 1994) and an integrated model by Wiese-Bjomstal et al. (1998) were also discussed. Attention was given to the factors associated with rehabilitation adherence with particular remarks on malingering athletes. Peer modelling as a coping strategy in injury rehabilitation also came under scrutiny, as did the role and effect of social support. The next chapter focused on the development of the service-provider model for sports injury rehabilitation. From the initial literature review it was clear that of all the treatment providers involved with injured athletes, physiotherapists and biokineticians (athletic trainers) are probably those who spend the most time with them. In the development of the model for injury rehabilitation, special emphasis was therefore placed on the role of the physiotherapist and biokineticians. As a basis for developing the model, the traditional medical model was used, but it was adapted to incorporate psychological principles. A computer program was written to assist physiotherapists and biokineticians in treating injured athletes through the use of psychological principles. This program was constructed using psychological instruments that already exist, but they were adapted to be used as non-pen and paper tests. The tests used were the Emotional Responses of Athletes to Injury Questionnaire (ERAIQ), the Incredibly Short POMS (ISP), a Pain Drawing Instrument, a Visual Analogue Scale and the Affective subscale of the McGill Pain Questionnaire. Provision was made for handouts to be included in the program which can then be given to patients after each therapy session. To be able to determine whether the program was successful in assisting physiotherapists and biokineticians in their treatment of injured athletes, the program was evaluated in the next chapter. Feedback from both patients, physiotherapists and biokineticians using the program were received. Two short questionnaires were used for this purpose. Finally, conclusions were drawn from the information received from the program and recommendations based on these conclusions were made. Key words: Sports injuries, injury rehabilitation. / AFRIKAANSE OPSOMMING: Die doel van die huidige studie was die ontwikkeling en implementering van 'n model vir die rehabilitasie van sportbeserings. Beserings is, sonder twyfel, van die belangrikste struikelblokke in die weg van sportprestasie. Baie min, indien enige, atlete spring beserings vry. Dit wil ook voorkom of alle fisiek aktiewe individue, ongeag hulle ondervinding en vermoë, op een of ander stadium van hulle loopbane 'n besering opdoen. Fundamenteel aan volgehoue deelname aan sport, is die vermoë om beserings te vermy en om atlete suksesvol te rehabiliteer indien 'n besering welopgedoen word. In die verlede het rehabilitasie-intervensies hoofsaaklik die fisieke dimensies van beserings aangespreek sonder inagname van die sielkundige dimensies. Slegs on1angs het daar 'n klemverskuiwing begin plaasvind deurdat daar begin is om sielkundige beginsels in te sluit in behandelingsprosedures. Heil (1993) en Pargman (1993a) was van die eerste skrywers wat werke oor hierdie onderwerp gepubliseer het. 'n Uitgebreide literatuuroorsig is onderneem. In die eerste hoofstuk was aandag geskenk aan die rol wat persoon1ikheid speel in die voorkoms van beserings en die suksesvolle rehabilitasie daarvan, met spesiale klem op Andersen en Williams (1993) se model van stres en sportbeserings. Hierdie model is deur Grove (1993) uitgebrei deur inagname van die rol van persoon1ikheid, hanteringsvaardighede, kognisies, intervensies en ander beserings- en behandeling-verwante faktore in die rehabilitasieproses. Die volgende hoofstuk was gewy aan die oorsake van, en die stres verbonde aan, beserings. Onderwerpe wat aangespreek is, het ingesluit die ooroefeningsindroom, begrip van beserings soos gesien vanuit die atleet, medikus en sielkundige se oogpunte, asook presies watter faktore stres tydens beserings veroorsaak. Spesiale aandag is aan die konsep van pyn en al sy dimensies, die sosiale welstand van die beseerde atleet en die impak van beserings op die selfkonsep en identiteit van die atleet geskenk. In die volgende hoofstuk is die sielkundige aanpassing by beserings bespreek. Die konsepte van "verlies" en ''rou'' en die toepaslikheid van rouresponsmodelle in besonder, is bespreek. In antwoord op rou responsmodelle is kognitiewe waarderingsmodelle (Brewer, 1994) en die geïntegreerde model van Wiese-Bjornstal et al. (1998) bespreek. Aandag is ook geskenk aan faktore wat 'n rol in volgehoue deelname aan rehabilitasieprosedures speel, met klem op atlete met skynsiektes. Navolging van voorbeelde deur eweknieë as 'n hanteringsvaardigheid is ondersoek, asook die rol en effek van sosiale ondersteuning. Die volgende hoofstuk het gefokus op die ontwikkeling van die diensleweraar-model vir sportbeseringrehabilitasie. Vanuit die aanvanklike literatuuroorsig het dit geblyk dat van al die persone betrokke by die behandeling van beseerde atlete, dit waarskynlik fisioterapeute en biokinetici is wat die langste by hulle betrokke is. Tydens die ontwikkeling van die model vir rehabilitasie van beserings, is as basis die tradisionele mediese model gebruik, maar met sekere aanpassings om sielkundige beginsels in te sluit. 'n Rekenaarprogram is geskryf om fisioterapeute en biokinetici te ondersteun in die behandeling van beseerde atlete. Die program het gebruik gemaak van bestaande psigometriese toetse, maar dit was aangepas om as nie-potlood-en-papiertoetse gebruik te kan word. Die toetse wat gebruik is, is die Emotional Responses of Athletes to Injury Questionnaire (ERAIQ), die Incredibly Short POMS (ISP), 'n pyntekeninginstrument, 'n visueelanaloogskaal en die affektiewe subskaal van die McGill Pain Questionnaire. Voorsiening is gemaak na afloop van elke behandelingsessie om uitdeelstukke aan pasiënte beskikbaar te stel. Om te bepaal of die program suksesvol was om fisioterapeute en biokinetici tydens behandeling van beseerde atlete te ondersteun, is die program in die volgende hoofstuk kortliks geëvalueer. Terugvoer vanaf beide die pasiënte, fisioterapeute en biokinetici wat die program gebruik het, is verkry. Twee kort vraelyste is vir dié doel gebruik. Laastens is gevolgtrekkings op grond van die terugvoer gemaak en aanbevelings vir aanpassings is gedoen. Sleutelwoorde: Sportbeserings, rehabilitasie

Recent research suggests that psychological techniques may facilitate injured athletes' rehabilitation, yet little is known about the psychological techniques trainers currently employ and how they view these interventions. In this study, 206 athletic trainers assigned Likert scale ratings to 11 psychological techniques indicating how much they valued a specific technique, how skillfully they employed it, and how often they utilized it. Trainers also responded to an open ended question asking how they would deal with the psychological aspects of an injury described in a short scenario. Results revealed a tentative model for the way trainers view psychological techniques. Categories of techniques included techniques involving the modification of physical and psychological states (goal setting, pain management, relaxation, imagery, and breathing techniques), techniques involving verbal cognitive techniques (communicating openly, changing negative self talk, emotional counseling, and crisis counseling), and non-recommended techniques (encouraging heroism and screening negative information). The study explored trainers' perceptions of each of the 11 psychological techniques in depth and discussed these findings. The study found that although trainers highly value psychological interventions in their work with injured athletes, they assigned low ratings to the techniques they knew little about. However, as exposure to sport psychology information increased, ratings assigned to the techniques that modify physical and psychological states also increased. Similarly, the longer trainers had worked in their field, the more highly they valued the verbal cognitive interventions. In contrast, neither exposure to sport psychology information or athletic training experience proved predictive of ratings assigned to the non-recommended psychological techniques. These findings suggest the importance of introducing skills training for psychological techniques early in the athletic trainers' educational curriculum so that trainers can gain awareness of the efficacy of certain psychological techniques and skill at using these techniques. Moreover, trainers could benefit from course work explaining potential negative consequences of employing harmful or ineffectual psychological interventions.

M.Tech. / OBJECTIVE: To determine the most effective treatment protocol in the treatment of Lower-Crossed Syndrome by comparing objective results gained from a Rehabilitation program (group one), Spinal Manipulative Therapy (group two) and a combination of these therapies (group three) directed at the sacroiliac joints and lumbar spine. DESIGN: The study was a clinical trial in which three experimental groups of sixteen participants each were compared to each other. These participants were recruited from the local general population and were selected on the basis of inclusion and exclusion criteria, presenting with Lower-Crossed Syndrome and demonstrating unremarkable clinical and radiological findings. INTERVENTION AND DURATION: After randomisation, group one received a Rehabilitation program which consisted of a stretching and strengthening program only, group two received Spinal Manipulative Therapy only whereas group three received a combination of Spinal Manipulative Therapy and a Rehabilitation program. The frequency of the follow up consultations for this study was two consultations over the first two weeks of the trial and once a week for the following four weeks of the trial. MEASUREMENTS: Objective measurements included lumbar spine flexion and extension ranges of motion, hip flexor flexibility (hip extension), active and passive hamstring flexibility, gluteus maximus and abdominal strength tests and Sorenson’s Test (static back extensor strength test). Subjective measurements were the Oswestry Low Back Pain and Disability Index and McGill’s Questionnaire. Measurements were taken before (pre-) and after (post-) the first (initial), third, fifth and eighth (last) consultations. CONCLUSIONS: The aim of the study was to determine the most effective treatment protocol in the management of Lower Back Pain in athletes presenting with Lower-Crossed Syndrome. Although the combined group (group three) showed the greatest improvement these findings were statistically no greater than the statistical findings in group one and group two. All groups showed a statistically significant improvement over the trial period. This illustrates that both Spinal Manipulative Therapy and a Rehabilitation program (including stretching and strengthening) was effective in the management of Lower-Crossed Syndrome. From this study it can therefore be concluded that one treatment protocol did not prove to be more effective than that of the others.