published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Orthopaedic Surgery / Master / Master of Philosophy

The purpose of this study is to investigate the relationship between oral contraceptive use and the musculo-tendinous stiffness of the knee flexors. Twenty-three female participants and ten male participants (control group) ranging in age from 20 - 30 years. A uniaxial accelerometer was used to assess stiffness based on the exponential decay of the damped oscillation. Female groups had estradiol and 17 a-OH progesterone levels tested. At 30% of MVC, the Ortho-Tri Cyclen group, the Other OC group and women not using OC's had a mean stiffness of 249.3+94.5, 274.1+79.1 and 216.0+43.3 Nm/rad respectively and at 50% of MVC values of 290.2+70.7, 326.7+78.9 and 267.9+52.6 Nm/rad respectively. No significant difference in stiffness was found. Also no correlation was found between estradiol and stiffness. These results indicate that there was no significance between knee stiffness and oral contraceptives within the female groups. / School of Physical Education, Sport, and Exercise Science

The purpose of this study was to determine the jump landing impact absorption kinematic and kinetic characteristics of the four subject groups: a) male high school athletes, b) female high school seasonal athletes, c) female high school year-round athletes, and d) female college athletes who train year-round. Subjects dropped onto a force platform from a height of 40 centimeters. Variables analyzed were flexibility, strength, Fz, Fy, and Fx force, free moment, range of motion, contact and maximum angles, time to maximum angle, contact and maximum angular velocities, and time to maximum angular velocity. Significant differences among subject groups were determined through use of a factorial analysis of variance and Scheffe' post hoc test.A difference was noted in the landing patterns of males and females. Male subjects exhibited a significantly longer time to first vertical peak force. This longer time may allow for greater initial force attenuation; however, the male athletes had a significantfy greater second peak force. Males also differed significantly from females in anteroposterior and mediolateral force.The differences in method of force attenuation may be due to significantly greater ankle eversion shown by the males and greater knee flexion used by the females. Additionally, the males had significantly greater leg strength, which may have allowed them to increase the time to first peak.The year round female high school athletes were found to use the best biomechanical landing method. They had a greater range of motion in the knee and ankle, and subsequently produced the lowest amount of vertical and anterio-posterior force. / School of Physical Education

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: Groin injuries are among the top six injuries in contact sports and may lead to career ending chronic pain. Research on the role of knee kinematics in developing chronic groin pain in sport is scarce. Objective: The purpose of this study was to determine if there are differences in knee kinematics during a single-leg drop-landing in sports participants with chronic groin pain compared to asymptomatic controls. Methodology: A descriptive study was conducted. Twenty active sports’ participants were recruited from soccer and rugby clubs situated around the Cape Peninsula area, Western Cape, South Africa. The three-dimensional (3D) knee kinematics of ten cases with chronic groin pain and ten asymptomatic controls was analysed. Knee kinematics was analysed in the FNB-3D Vicon Laboratory at Stellenbosch University, using an eight camera Vicon system. A positive adductor squeeze test was used as a diagnostic test to include cases with chronic groin pain. Each participant performed six single-leg drop landings. The main outcome measure was 3D knee kinematics at initial foot contact and at the lowest vertical position of the drop landing. The following sub-groups were analysed: seven unilateral groin pain cases compared to their seven matched controls; three bilateral groin pain cases where their most painful leg and least painful leg were compared to their matched controls, respectively. Descriptive statistical techniques were used for all outcome measures; means and standard deviations (SD) were calculated, followed by a Student’s t-test to determine significant differences between the cases and controls. For all outcomes with p-values equal to or below 0.05, the effect size was calculated using the Cohen’s D. Results: The findings of this study indicated a significant difference (p=0.0001) between cases with unilateral groin pain having less knee internal rotation compared to the controls at the lowest vertical position of the drop landing in the transverse plane. Significantly less internal rotation (p<0.0001), was also noted in the cases with bilateral groin pain (in the most painful leg and the less painful leg), although this was noted at foot contact. Cases with bilateral groin pain also had significantly (p<0.001) more knee varus (adduction) during the landing phase. Conclusion: Differences in knee kinematics between sports participants with chronic groin pain and asymptomatic controls were found. These findings imply that the knee joint should be included during assessment and rehabilitation of individuals suffering with chronic groin pain. Due to the cross-sectional study design of the current study, it cannot be stated for certain whether the knee kinematics noted in the groin pain group are causative or as a result of groin pain. Future prospective studies are thus recommended; these studies should focus on the effect of contralateral knee kinematics on the hip adductors and may include exploration of the muscular components during a single-leg drop landing. / AFRIKAANSE OPSOMMING: Inleiding: Lies beserings is een van die top ses beserings in kontak sport en kan lei tot chroniese lies pyn en selfs die be-eindigging van ‘n sportloopbaan. Navorsing oor die rol van knie kinematika in die ontwikkeling van chroniese liesbeserings in sport is skaars. Doelwit: Die doel van hierdie studie was om te bepaal of daar verskille in die knie kinematika is tydens 'n enkel been val landing in sport deelnemers met chroniese lies pyn in vergelyking met gesonde kontroles. Metode: 'n Beskrywende studie was uitgevoer. Twintig aktiewe sport deelnemers is gewerf van rugby en sokker sportklubs geleë rondom die Kaapse Skiereiland, Wes-Kaap, Suid-Afrika. Die 3D knie kinematika van tien gevalle met chroniese lies pyn en tien asimptomatiese bypassende kontroles is ontleed. Knie kinematika was ontleed in die FNB-3D Vicon Laboratorium by die Universiteit van Stellenbosch, met behulp van 'n agt-kamera Vicon stelsel. 'n Positiewe Adduktor druk toets was gebruik as 'n diagnostiese toets om gevalle met chroniese lies pyn in te sluit. Om die knie kinematika te analiseer, het elke deelnemer ses enkel been val landings uitgevoer . Die belangrikste uitkomsmeting was 3D knie kinematika by die aanvanklike voet kontak en by die laagste vertikale posisie van die enkel-been val landing. Die volgende sub-groepe was ontleed: sewe unilaterale lies pyn gevalle in vergelyking met hul sewe bypassende kontroles; drie bilaterale lies pyn gevalle waar hul mees pynlike been, sowel as minder pynlike been onderskeidelik vergelyk was met hul bypassende kontroles. Beskrywende statistiese tegnieke was gebruik vir alle uitkoms maatreëls; gemiddeldes en standaardafwykings (SA) was bereken, gevolg deur 'n Studente’s t-toets om beduidende verskille tussen die gevalle en kontroles te bepaal. Vir al die uitkomste met p-waardes gelyk of onder 0.05, is die effekgrootte bereken deur die Cohen’s D. Resultate: Die bevindings van hierdie studie dui op 'n beduidende verskil (p=0,0001) tussen gevalle met unilaterale lies pyn met minder interne knie rotasie in vergelyking met die kontroles by die laagste vertikale posisie van die val landing in die dwars vlak. Aansienlik minder interne rotasie (p<0,0001), is ook opgemerk in gevalle met bilaterale lies pyn (in die mees pynlike been en die minder pynlik been), alhoewel tydens voet kontak. Gevalle met bilaterale lies pyn het ook betekenisvol (p <0.001) meer knie varus (adduksie) tydens die landingsfase gehad. Gevolgtrekking: Verskille bestaan in die knie kinematika tussen sport deelnemers met chroniese liesbesering pyn en gesonde kontroles. Hierdie bevindinge impliseer dat die knie behoort ingesluit te word tydens die assessering en rehabilitasie van individue met chroniese lies pyn. As gevolg van die deursnee-studie ontwerp van hierdie studie, kan dit nie bevestig word of die knie kinematika die oorsaak van die chroniese pyn is nie. Toekomstige voornemende studies word dus aanbeveel, hierdie studies moet fokus op die effek van die kinematika van die kontralaterale knie op die heup adduktore en kan moontlik die ondersoek van die spier kinetika tydens hierdie aktiwiteit insluit.

Despite years of research, females continue to have a higher incidence of non-contact ACL injuries. One of the major findings of this research is that males and females perform certain tasks, such as, cutting, landing, and single-leg squatting, differently. In particular, females tend to move the knee into a more valgus position; a motion putting the ACL at risk for injury. Yet the underlying spinal control mechanisms modulating this motion are unknown. Additionally, the mechanisms regulating the ability to rapidly initiate and produce maximal torque are also unknown. Therefore, the purpose was to: 1) determine if the sexes modulate spinal control differently, 2) examine the contributions of spinal control mechanisms to valgus knee motion, and 3) identify contributions of spinal control to the ability to rapidly produce force. The spinal control variables were the first derivative of the Hoffmann (H)-reflex, the first derivative of extrinsic pre-synaptic inhibition (EPI), the first derivative of intrinsic pre-synaptic inhibition (IPI), recurrent inhibition (RI), and V-waves. To assess the neuromuscular system’s ability to rapidly activate, rate of torque development (RTD) and electromechanical delay (EMD) were measured. Lastly, valgus motion was determined by the frontal plane projection angle (FPPA). The results reveal males and females do modulate spinal control differently; specifically males had an increased RTD, which is the slope of the torque-time curve, and increased RI, which is a post-synaptic regulator of torque output. However, the spinal control mechanisms did not significantly contribute to FPPA at the knee. EMD which is the time lag from muscle activity to torque production was significantly predicted by the spinal control mechanisms. Specifically, EPI, a modulator of afferent inflow from peripheral and descending sources, IPI, a regulator of Ia afferent inflow, and sex significantly contributed to EMD. Lastly, the spinal control mechanisms significantly contributed to RTD. Specifically, IPI, sex, and V-waves, a measure of supraspinal drive, all significantly contributed to RTD. / Graduation date: 2009