Thesis (M.App.Sc. in Physiotherapy)--University of South Australia, 1994.

Thesis (M.App.Sc. in Physiotherapy)--University of South Australia, 1994.

Athletic pelvic/groin injuries can be difficult to define, diagnose and therefore manage. These injuries are often the result of multifactorial dysfunction, making them susceptible to becoming chronic. Transverse pelvic belts have shown effectiveness in reducing pain and improving function in athletes with pelvic/groin pain, but there may be better alternatives. Exploring different pelvic belt configurations with athletes with pelvic/groin pain confirmed the role of a transverse belt but also found that diagonal belts produced significantly (< 0.05) greater effects upon clinical measures of pain and function. Dynamic elastomeric fabric orthoses (DEFOs) are Lycra®-based orthoses theorised as providing stability and enhancing proprioception. A DEFO was designed to apply diagonal force to the pelvic girdle and mimic transverse belt application. In a series of single case studies the DEFO was found to have beneficial effects upon pain and/or function in selected athletes with pelvic/groin pain. Athletes’ subjective reports suggested that balance and power may have also been positively influenced. Further work exploring appropriate measures of athletic balance led to the investigation of the intra-rater reliability of a functional measure; the multiple single-leg hop-stabilisation test. Good to excellent reliability (ICC = 0.85; CI 0.61-0.90) confirmed this measure as being reliable for use in a future study, and highlighted relationships with other factors such as age and training status. The findings of a pilot RCT indicated that with minor revisions this protocol could be effectively implemented in informing a future RCT. Findings also indicated that the DEFO led to moderate to large effect sizes on clinical measures (d = 0.6-1.1) of active straight leg raise and squeeze test force, and negligible to small effects on measures of power and functional balance (d = 0.1-0.3). This thesis therefore outlines the development and initial evaluation of a novel DEFO for supporting the management of athletic pelvic/groin injury. Further work is required to undertake a fully powered RCT, and to explore the mechanistic action of this DEFO.

Bakgrund: Ljumskskador, ljumsk- och höftsmärta hos fotbollsspelare har oftast samband med minskat rörelseomfång i höfter, svaghet i bål och höftmuskulatur. Risk för ljumsksmärta ökar hos idrottare som inte tränar skadepreventivt. Syfte: Att undersöka om ett preventionsprogram med sex övningar för styrka och rörlighet kan minska förekomsten av ljumsksmärta hos herrfotbollsspelare. Material och metod: En kvantitativ experimentell fallstudie med kontrollgrupp, som utfördes med 14 herrfotbollslag (7 lag interventionsgrupp, 7 lag kontrollgrupp). I studien deltog 514 manliga fotbollspelare i åldern mellan 15-47 år. Resultat: I interventionsgruppen som genomförde ett preventionsprogram var antalet spelare med ljumsksmärta oförändrat, medan antalet deltagare med ljumsksmärta i kontrollgruppen ökade. Konklusion: Ett preventionsprogram med övningar för styrka och rörlighet kan förebygga förekomst av ljumsksmärta hos herrfotbollsspelare. Nyckelord: Fotboll, prevention, ljumskskada, ljumsksmärta, höftsmärta / Background:Groin injuries, groin pain and hip pain for soccer players are often associated with decreased range of motion (ROM) in the hip, weakness in abdominal muscles and poor hip muscles. The risk of groinpain increases for athletes who do not practice any preventing exercises. Objective:To research if an injury prevention program with six exercises for strength and mobility has any effect on groin pain and hip pain for male soccer players. Measures and Methods: Quantitative experimental study with control group. 14 male soccer teams participated (7 teams in intervention group, 7 teams in control group). In the study 514 male soccer players participated, in the age of 15-47 years. Result: In the intervention group who practiced the prevention program did not the number of players with groinpain increased, compared with the control group where the numbers of players with grioinpain increased. Conclusion: An injury prevention program for male soccer players with exercises for strength and mobility could prevent increase of groinpain among male soccer players. Keywords: Soccer, prevention, groin injury, groin pain, hip pain

Background Surgery has traditionally been considered more expensive than many other health care interventions and with little impact on the burden of disease in a global perspective. One of the reasons behind this misconception is that the effects of surgical conditions and their treatment have not been factored into the equation. Cost-effectiveness analyses of surgical interventions have largely been missing. An estimated 20 million herniorrhaphies are carried out annually but over 200 million people suffer from groin hernias. Herniorrhaphy is one of the most commonly performed surgical procedures also in Low and Middle Income Countries (LMIC). However, the surgical repair method is not the same due to financial constraints. In high income countries a synthetic mesh is used and has reduced the risk of recurrence. This 125 USD mesh is too costly for the majority in LMIC. Mosquito mesh, which is cheaper but very similar to commercial meshes, is used in several settings but outcomes need to be investigated more extensively before this practice can be recommended in routine surgical service. The Aims of this thesis were to define the prevalence of groin hernia, to relate it to the surgical capacity, outcomes and costs of surgery in eastern Uganda and to investigate the feasibility and difference in cost and cost-effectiveness of replacing a commercial mesh with a mosquito mesh in groin hernia surgery. Methods Three studies (1-3) were carried out in eastern Uganda. 1: A cross sectional study investigating the prevalence of groin hernia in adult males in the Health and Demographic Surveillance Site (HDSS) in Iganga and Mayuge districts. 2: A facility based study with prospective data collection of all surgeries undertaken in the two hospitals providing surgery for the HDSS population. 3: A double blinded, randomised controlled trial comparing the outcomes of using a mosquito mesh relative using a commercial mesh in groin hernia surgery. Results 1: the prevalence of untreated groin hernia among the study participants was 6.6%. 2: the rate of groin hernia surgery was 17 per 100 000 population. Thus, less than 1% of the estimated number of cases of groin hernia in the catchment area of the two hospitals are operated per year. A herniorrhaphy costs around 60 USD to perform. This corresponds to a third of the cost of TB treatment and a 15th of the cost of HIV/AIDS treatment per year in Uganda. 3: No significant differences in terms of recurrence rates, post operative and chronic complications and patient satisfaction were demonstrated between the patients operated using the mosquito mesh and the commercial mesh. Cost-effectiveness was very high for both materials but total cost in the mosquito mesh group was 124 USD lower per surgery than in the commercial mesh group. Conclusion There is a vast unmet need for groin hernia surgery. Cost of surgery compares favourably with other health care interventions prioritised by the international organisations and funders. A superior technique can be used in groin hernia surgery at low cost, with high cost-effectiveness in a Low Income Country.

Thesis (Ph. D.)--University of Missouri--Columbia, 1998. / Typescript. Vita. Includes bibliographical references (leaves: 104-107). Also available on the Internet.

Title The issue of groin injuries and risk factors affecting this type of injuries among football players. Objectives The main objective of this thesis is to summarize theoretical findings regarding the groin injuries among soccer players and to prove efficiency of preventive training program aimed at reduction of groin injuries incidence in soccer players. Methods The theoretical part deals with the given issue as a research and theoretical overview of the current findings, based on Czech and especially foreign literature. Findings of theoretical part were obtained by foreign periodicals, monographies and electronic database, mostly PubMed and PEDro. In the second part of thesis a preventive training program was applied at a specific group of soccer players (n=42) in age U16 (n=20) and U17 (n=22). Selected group of probands performed preventive intervention training once a week for 6 months. After that results were compared with the same time of season in the previous year, when no preventive measures had been taken. Information about previous injury has been obtained by non-standardized questionnaire. Results Based on the literature review previous injury is considered to be the most significant risk factor for new injury in groin. Other significant risk factors include untimely return to...

Title The issue of groin injuries and risk factors affecting this type of injuries among football players. Objectives The main objective of this thesis is to summarize theoretical findings regarding the groin injuries among soccer players and to prove efficiency of preventive training program aimed at reduction of groin injuries incidence in soccer players. Methods The theoretical part deals with the given issue as a research and theoretical overview of the current findings, based on Czech and especially foreign literature. Findings of theoretical part were obtained by foreign periodicals, monographies and electronic database, mostly PubMed and PEDro. In the second part of thesis a preventive training program was applied at a specific group of soccer players (n=42) in age U16 (n=20) and U17 (n=22). Selected group of probands performed preventive intervention training once a week for 6 months. After that results were compared with the same time of season in the previous year, when no preventive measures had been taken. Information about previous injury has been obtained by non-standardized questionnaire. Results Based on the theoretical overview previous injury is considered to be the most significant risk factor for new injury in groin. Other significant risk factors include untimely return to...

Coastal erosion is, more than ever, a global problem. By adopting a high-efficient, cost effective and reliable numerical model, it would help predict and manage erosion, as well as alleviate many coastal problems. This thesis reports the results of a though out investigation on the popular one dimension long-term shoreline change model--- GENESIS, analyze its suitability, sensitivity and technical difficulties likely to encounter while using the model, with the aim to predict the effect of coastal structure on shoreline changes. Prior to perform a modeling task, this report provides constructive recommendation on the setting of the length of shoreline to be covered in the modeling, boundary conditions, grid space, transport parameters K1 and K2 and revision of wave angle, followed by verification using results of several physical scale models, in order to enhance the reliability of the modeling and the parameters employed. Finally, reasonable ranges of K values are proposed. For modeling shoreline changes induced by a detached breakwater with normal incident waves, an empirical equation is proposed to determine the K ratio(K2/K1), which offer a useful guide in achieving the results with in a tolerance limits of 12%~-7%. When consider oblique wave incident to single detached breakwater, K1=0.6 is used and the ratio of K2/K1 ≈ 0.25~0.5. For modeling the effect of a single groin, the present study suggests K1=0.6 and K2/K1 ≈ 1~2. On the basis of these principles for setting the K values, the results are then applied to model the shoreline changes due to the installation of detached breakwater and groin. From the results of this study, for normal wave incident to single detached breakwater, it shows that for a small ratio of the offshore distance to the length of the breakwater S/B or a larger wave height, the salient dimension will increase and wave period has almost no effect on the results produced; for small S/B ratio, the maximum downcoast retreat increase, and its quantity is almost not affected by the wave conditions imposed. For oblique wave incident to single detached breakwater, it shows that for a larger wave angle, a small S/B or a larger wave height, the salient dimension will increase and wave period has almost no effect on the results produced; for larger wave angle or small S/B ratio, the maximum downcoast retreat increase, and its quantity is almost not affected by the wave height and wave period. For modeling the effect of a single groin, it shows that for larger wave angle or length of groin, the maximum downcoast retreat increase, and its quantity is almost not affected by the wave height and wave period.

Thesis (Ph. D.)--University of Missouri--Columbia, 1998. / "May 1998." Typescript. Vita. Includes bibliographical references (leaves 104-107). Also available on the Internet.