Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background There has been a remarkable increase in the participation of sport for athletes with disabilities. Consequently, there have been many international studies on injuries in athletes which have shown a high prevalence in wheelchair basketball, largely attributed to the fast-paced, high intensity nature of the sport. This sport has grown worldwide including South Africa, however, very little research has been published on South African wheelchair basketball players and more research is, therefore, needed. Aim To determine the prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa. Hypothesis 1: Upper extremity (including neck and back) pain is experienced more commonly in lower point classified wheelchair basketball players than in higher point classified players. Hypothesis 2: Lower extremity pain is experienced more commonly in higher point classified players than in lower point classified players Method This study was a quantitative, cross-sectional, questionnaire-based study. The questionnaire comprised of sub-sections on demographics and disability characteristics; activity levels pertaining to wheelchair basketball and other sport/physical activity; the prevalence of pain and the impact thereof on wheelchair basketball and/or activities of daily living. This questionnaire was administered to 48 wheelchair basketball players who were competing in the 2015 Supersport League. A response rate of 70% was decided as the lower limit cut-off for statistical power. Results Fourty-three participants responded yielding an 89.58% response rate. The mean age of participants was 33.3 (SD:9.5) years and the majority of participants (n=35) were male and African (n=29). Out of the 43 participants, 79.1% (n=34) used mobility devices, the majority (n=20) used wheelchairs. Most of the participants (n=41) played wheelchair basketball for more than five years and 32 participants did not participate in other sport. Almost half of the participants (n=25) experienced musculoskeletal pain in the last twelve months or at present, 75% of whom (n=12) visited a Physiotherapist for the pain. More than half of these participants (n=15; 60%) reported that the pain negatively affected their basketball performance. It was established that arm pain occurred frequently in lower point classified players (1.0-2.5 point players) and that hand and wrist pain was also more prevalent in lower point players than in higher point players. The prevalence of lower extremity pain was low and there was no statistically significant difference between higher and lower point classified players. Conclusions and Recommendations The finding that upper extremity pain occurred more frequently in lower point classified players was in keeping with the first hypothesis (the null hypothesis was, therefore, rejected). The second hypothesis was, however, rejected (and the null hypothesis was, therefore, accepted) as lower extremity pain did not occur more frequently in higher point classified players than in lower point classified players. The Eta scores may have been higher and may have shown a much larger than typical relationship between point classification and the prevalence of musculoskeletal pain had there been a larger sample size. Notwithstanding this limitation, it is a challenge to obtain a significantly larger sample size due to the nature and limited number of participants in this sport. More studies are warranted on this group of individuals, as a large number experienced pain which affected more than half of the participants’ performance in wheelchair basketball. These studies are important for the future success of the South African players and the sport in South Africa. / M

Submitted in fulfillment of the requirements for Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, 2017. / Background: Ice hockey is a fast paced team sport, played on an ice surface in an enclosed arena. As a result of the high contact, aggressive nature of the sport, players are susceptible to injury. Ice hockey is not a popular sport in South Africa and the environment is unique in comparison to international ice hockey countries. The playing surfaces and ice rink arenas differ across South Africa, which may affect the risk of injury in this population. Protective equipment is not easily accessible to ice hockey players in South Africa and therefore they may be at a higher risk of injury. Participation in ice hockey is developing in South Africa; however there is a paucity in the literature relating to injuries in the South African context. This study aimed to determine a profile of ice hockey injuries in South African players. Methodology: This study was a quantitative, descriptive study that used a self-administered questionnaire. The questionnaire was administered to 187 ice hockey players (141 male and 46 female) who were registered with the South African Ice Hockey Association. Players were required to sign the letter of information and informed consent form, following which, questionnaires were distributed to the participants who met the study criteria. The researcher was present to supervise and collect all forms and completed questionnaires directly after completion. The questionnaire contained sections on demographics, injuries sustained over the previous season as well as the use of protective equipment. The results were analysed using SPSS version 24 and a p value of < 0.05 was considered statistically significant. Results: The response rate met the minimum requirement of 138 males and 45 females. Of the 187 participants, 110 (58.8%) of the participants sustained at least one injury due to ice hockey. Age was considered to be a risk factor in this study as those participants in the youngest age group of 18-27 were at a higher risk of all injuries (χ2 p-value < 0.0001). Although gender was not a risk factor for the total number of injuries, female players in this study were at a greater risk of head and knee injuries (χ2 p-value = 0.0196 and χ2 p-value = 0.0046 respectively). The most severe injury affected the head (10.2%, n = 19) and overall the knee was the most commonly affected area of injury (n = 30). The majority of the injuries were sustained during a game and resulted from contact with another player. The results of this study showed that the use of protective equipment does not prevent all injuries in ice hockey. The type of facial protection worn was a risk factor for facial injuries and the lack of a mouthguard was a risk factor for head injuries. Conclusion: The aim of this study was to determine a profile of ice hockey injuries in South African players. The South African demographic profile of ice hockey players showed similarities to international profiles with respect to age, gender, BMI and player position. The profile of injuries in this study was similar to international injury profiles in terms of site, type, severity, onset and mechanism of injury and regarding the majority of injuries being sustained during a game. Ice hockey players in the younger age groups were at a higher risk of injury both in South Africa and internationally. Females were at a higher risk of head injuries in comparison to males which is congruent with international literature. In South Africa, and internationally, the use of full facial protection and a mouthguard was shown to decrease the risk of facial and head injuries respectively. The South African demographic profile differed from international findings in terms of experience level, total hours of training per week and number of games played in a season. The injury profile of South African ice hockey players showed that this population is at a higher risk of muscular injuries than international players. Larger ice surfaces and flexible boards and glass did not reduce the risk of injury in South African ice hockey players in the same way as it has internationally. / M

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.