Masters of Science / BACKGROUND: Hamstring injuries remain a growing concern within a large variety of sports from the elite athlete to the weekend warrior. A copious amount of research has been performed in an attempt to reduce these injuries. The aim of this study was to understand the changes in lengthened state eccentric strength of the hamstrings following four separate protocols. METHODS: A quantitative research approach, using a true experimental design, was adopted for this study. A convenience sample of non-sedentary, 35 male participants, between the ages of 18 and 35 within the City of Cape Town was used. Participants were randomly allocated to one of four groups namely; Control group (C), resistance training alone (RT), neuromuscular electrical stimulation alone (NMES), or NMES superimposed with RT (NMES&RT). Participant’s eccentric hamstring strength was tested in a lengthened state, on the Biodex system 4 Pro™ for the pre- and post-test. The intervention spanned over four weeks. SPSS version 25 was used for data analysis. RESULTS: All groups demonstrated a mean increase in relative peak torque. However, a repeated-measures analysis of variance (ANOVA) showed no interaction effect (p = 0.411) between the four groups. Further analysis using Magnitude-based inferences (MBI), to identify the magnitude of changes, showed a small positive effect for both the NMES and NMES&RT group when compared to the C and RT groups. CONCLUSION: Although there are no statistically significant differences between the four groups employed in this study (C, RT, NMES, NMES&RT), NMES and NMES&RT did show small positive effects compared to C and RT with a very low likelihood of negative effects. Thus, using NMES either alone or superimposed with resistance training will be beneficial for trained athletes but it is not a necessity and the use of specific resistance training may be just as effective. / 2019-04-30

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Professional rugby union has grown to become the third most popular team contact sport in the world. The physical nature of the game results in a high prevalence of injuries on all levels of play. Injury prevalence as high as 83.9 injuries per 1000 playing hours has been reported for the 2007 Rugby World Cup in France. Although research indicates schoolboy rugby union to be safer than professional rugby, injury rates as high as 65.8 injuries per 1000 playing hours have been reported. These injuries are mostly caused by the tackle situation, with the knee– and shoulder–joints being the most injured site. The risk of injuries in rugby union is heightened by professionalism, previous injuries, higher training demands, intrinsic factors and psychological issues. Due to the professional nature the game has taken on, the management of rugby union injuries has become increasingly more important. This should include prehabilitation or injury prevention programs, rehabilitation up until the final, sport specific phase as well as structured return to play testing. Another important aspect of injury management is the education of coaches, players and other persons involved in the sport. Objectives The first objective of the study was to observe the prevalence and nature of injuries in South African schoolboy rugby union players. Secondly, the treatment of these injuries was observed as well as the return to play criteria used to determine readiness to return to play after injury. The association between the treatment of injuries and the severity of injuries was then obtained. Lastly re–injury prevalence was compared to treatment received and return to play criteria used to determine readiness. Methods Ten schools from across South Africa partook in the study. The schools were all identified by the NWU–PUK as elite schools due to performances in the previous year (2008). Only the first team squad of each school was participated, amounting to a total number of 194 boys answering questionnaires conducted by the researcher for each of their injuries. The questionnaires included injury severity and site, recurrence of injury, cause of injury, treatment procedures and criteria used for return to play. Severity was defined in terms of game and training days missed due to injury and are describe as slight (0 – 1 day), minimal (2 - 3 days), mild (4 - 7 days), moderate (8 - 28 days) or severe (>28 days). The results were then analyzed and presented through descriptive statistics. Statistical significance was indicated by p <= 0.05. Practical significance was described by the Phi–coefficient. The practical significance indicated by phi, was indicated as large if phi >= 0.5. Results A total number of 118 injuries were reported amounting to 78.51 injuries per 1000 playing hours. New injuries accounted for 68.64% (n=81) while recurrent injuries was reported to be 31.36% (n=37). The most frequent site of injury was the knee (n=26), followed by the shoulder (n=21). The event leading to injury that was most frequently reported, was the tackle (including making the tackle and being tackled) (n=49). Most injuries were slight (48%) but a high rate of moderate and severe injuries (39%) were reported. These moderate to severe injuries resulted in a minimum total of 360 days missed. Severe injuries were more likely to be treated by a doctor. Treatment by a doctor for severe injuries indicated the only significance in the study (p = 0.7). No fixed return to play protocol was in place for deciding if a player should be allowed to return to play. Thirteen of the injuries were however investigated through further testing (either through isokinetic or on–field testing). Conclusion Injury prevalence amongst top teams in South African schoolboy rugby union is very high. Rehabilitation does not follow a structured program or guidelines and there is no definite return to play protocols available. Re–injury rates are high, possibly due to the lack of structured rehabilitation and return to play protocols. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2011.

Professional rugby union has grown to become the third most popular team contact sport in the world. The physical nature of the game results in a high prevalence of injuries on all levels of play. Injury prevalence as high as 83.9 injuries per 1000 playing hours has been reported for the 2007 Rugby World Cup in France. Although research indicates schoolboy rugby union to be safer than professional rugby, injury rates as high as 65.8 injuries per 1000 playing hours have been reported. These injuries are mostly caused by the tackle situation, with the knee– and shoulder–joints being the most injured site. The risk of injuries in rugby union is heightened by professionalism, previous injuries, higher training demands, intrinsic factors and psychological issues. Due to the professional nature the game has taken on, the management of rugby union injuries has become increasingly more important. This should include prehabilitation or injury prevention programs, rehabilitation up until the final, sport specific phase as well as structured return to play testing. Another important aspect of injury management is the education of coaches, players and other persons involved in the sport. Objectives The first objective of the study was to observe the prevalence and nature of injuries in South African schoolboy rugby union players. Secondly, the treatment of these injuries was observed as well as the return to play criteria used to determine readiness to return to play after injury. The association between the treatment of injuries and the severity of injuries was then obtained. Lastly re–injury prevalence was compared to treatment received and return to play criteria used to determine readiness. Methods Ten schools from across South Africa partook in the study. The schools were all identified by the NWU–PUK as elite schools due to performances in the previous year (2008). Only the first team squad of each school was participated, amounting to a total number of 194 boys answering questionnaires conducted by the researcher for each of their injuries. The questionnaires included injury severity and site, recurrence of injury, cause of injury, treatment procedures and criteria used for return to play. Severity was defined in terms of game and training days missed due to injury and are describe as slight (0 – 1 day), minimal (2 - 3 days), mild (4 - 7 days), moderate (8 - 28 days) or severe (>28 days). The results were then analyzed and presented through descriptive statistics. Statistical significance was indicated by p <= 0.05. Practical significance was described by the Phi–coefficient. The practical significance indicated by phi, was indicated as large if phi >= 0.5. Results A total number of 118 injuries were reported amounting to 78.51 injuries per 1000 playing hours. New injuries accounted for 68.64% (n=81) while recurrent injuries was reported to be 31.36% (n=37). The most frequent site of injury was the knee (n=26), followed by the shoulder (n=21). The event leading to injury that was most frequently reported, was the tackle (including making the tackle and being tackled) (n=49). Most injuries were slight (48%) but a high rate of moderate and severe injuries (39%) were reported. These moderate to severe injuries resulted in a minimum total of 360 days missed. Severe injuries were more likely to be treated by a doctor. Treatment by a doctor for severe injuries indicated the only significance in the study (p = 0.7). No fixed return to play protocol was in place for deciding if a player should be allowed to return to play. Thirteen of the injuries were however investigated through further testing (either through isokinetic or on–field testing). Conclusion Injury prevalence amongst top teams in South African schoolboy rugby union is very high. Rehabilitation does not follow a structured program or guidelines and there is no definite return to play protocols available. Re–injury rates are high, possibly due to the lack of structured rehabilitation and return to play protocols. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2011.

ABSTRACTPreoperative Activity Level and Outcomes in Older ¨Adult Cardiac Surgery Patients: A Pilot StudyDon Howard Sorensen Jr.College of Nursing, BYUMaster of SciencePurpose: To assess the relationship between preoperative physical activity levels and health related quality of life on intra- and post-hospital outcomes following scheduled cardiothoracic surgery in older adults.Rationale/Background: Adults age 50 and older tend to accumulate more sedentary time and are less physically active. Sedentary behavior is linked with early morbidity and death and may predispose patients to postoperative complications. Preoperative activity levels and its relationship to surgical outcomes is an underexplored area. Insight on this topic could influence how to optimize interventions prior to surgery to improve outcomes. Methods: Seven participants were fitted with an ActiGraph GT3X+ accelerometer to measure preoperative activity levels for 1 week and complete the RAND Short Form-36 health-related quality of life tool. This process was then supposed to be repeated during the first and last weeks of cardiac rehabilitation (rehab). This information, along with demographics, was then correlated with information pulled from the Society of Thoracic Surgeons database on post-surgical outcomes and the 6-minute walk tests (6MWT) done during rehab. Results: The only statistically significant result was participants who experienced some type of intra-hospital complication also scored low in emotional wellbeing (r = -0.928, p = 0.003) as reflected in the quality of life score. Other findings with p values > 0.05 but <<> 0.1 were noted as œareas needing further exploration. Such areas for further exploration included: participants who spent more time in light physical activity reported less role limitations due to physical health (r = 0.864, p = 0.059), higher preoperative activity levels related to higher postoperative 6MWT (r = 0.830, p = 0.082), increased body mass index related to a decrease in postoperatively 6MWT (r = -0.869, p = 0.056). Implications: Exploring the relationship between preoperative activity levels and post-surgical outcomes could provide insight optimizing interventions before surgery to improve surgical success and rehab outcomes.

The thesis deals with the issue of vestibular compensation in patiens after vestibular schwannoma surgery. The aim of this thesis was to objectively evaluate the dynamics of vestibular compensation in the early postoperative period and to determine whether the application of gentamicin impacts the dynamics of equilibrium functions. 32 patients participated in the study (20 women and 12 men) ranging from 28 to 73 years of age. Patients underwent a rehabilitation program with visual feedback using the interactive rehabilitation system, Homebalance. This rehabilitation program was carried out daily from the 5th postoperative day until hospital discharge. Patients were examined preoperatively, postoperatively and after rehabilitation. To assess the vestibular compensation, static posturography, the Synapsys Posturography System, and the Activities-Specific Balance Confidence Scale were used. The statistical analysis showed a significant increase in mean values of measured COP parameters (the length of the COP trajectory and COP confidence elipse area) postoperatively. After completing the rehabilitation program no significant reduction of measured COP parameters was found. The total score from the Activities- Specific Balance Confidence Scale showed a statistically significant decrease in postoperative...

Bakgrund   Fysisk aktivitet innebär all form av kroppslig rörelse som möjliggörs av skelettmuskulaturens arbete. Med träning avses fysisk aktivitet som har ett specifikt mål. Patienter som ägnar mer tid åt sin hälsa genom att motionera upplever ett bättre fysiskt såväl som psykiskt välmående. Det har visats att patienter som upplever en känsla av kontroll över sitt välmående, tack vare den fysiska aktiviteten, även ser sjukvårdsinsatser som mer effektiva. Fysisk aktivitet, om den så bara är kortvarig, inför en operation har visats minska patienternas postoperativa komplikationer och därmed förkortat deras vårdtid. Genom att studera vad som motiverar, eller hindrar, patienterna till att utföra fysisk aktivitet kan vårdpersonal utveckla sitt preoperativa omvårdnadsarbete och således minska patienters lidande samt bidra till en snabbare återhämtning. Syfte Var att beskriva patientens erfarenhet av ordinerad fysisk aktivitet inför planerad kirurgi. Metod Studien är en icke-systematisk litteraturöversikt som har inkluderat 15 vetenskapliga originalartiklar med både kvalitativ och kvantitativ metodansats. CINAHL och PubMed var de databaser som användes för att hitta de inkluderade artiklarna. Sophiahemmets Högskolas bedömningsunderlag användes för att granska artiklarnas kvalitet. Resultatet analyserades genom en integrerad dataanalys. Resultat I litteraturöversiktens resultat identifierades två huvudkategorier; Aspekter som påverkar genomförandet av fysisk aktivitet samt Motivatorer till följsamhet av fysisk aktivitet följt av åtta underkategorier. Resultatet visade betydelsen av personcentrerad vård där man ser till hela människan när fysisk aktivitet ordineras. En kontinuerlig kontakt med hälso- och sjukvårdspersonal, stöd från omgivningen och uppsättning av realistiska mål var betydande motivatorer.     Slutsats Patienternas erfarenheter av ordinerad fysisk aktivitet inför planerad kirurgi kan, från denna icke-systematiska litteraturöversikts resultat, ses som övervägande positiva. Subjektiva fysiska såväl som psykiska hälsomarkörer förbättrades samtidigt som känslan av kontroll över deras egen situation, och behandling, förstärktes. Den goda kontakten som uppstod, patient och vårdgivare emellan, visade sig utgöra en betydande faktor för följsamheten till den fysiska aktiviteten. Upplevda negativa erfarenheter av prehabiliteringen kunde härledas till bristande information och bristande rådgivning och uppföljning från hälso- och sjukvården. / Background Physical activity means any form of bodily movement that is made possible by the work of the skeletal muscles. Exercise refers to physical activity that has a specific goal. Patients who devote more time to their health by exercising experience better physical as well as psychological well-being. It has been shown that patients who experience a sense of control over their well-being, thanks to the physical activity, also see healthcare interventions as more effective. Physical activity, if only for a short period, before an operation has been shown to reduce patients' postoperative complications and thereby shorten their length of stay. By studying what motivates, or prevents, patients from performing physical activity, healthcare professionals can develop their preoperative nursing work and thus reduce patients' suffering and contribute to a faster recovery. Aim The aim of this study was to describe the patients experiences of prescribed physical activity prior to elective surgery.   Method The study is a non-systematic literature review that has included 15 original scientific articles with both a qualitative and quantitative methodological approach. CINAHL and PubMed were the databases used to find the included articles. Sophiahemmet University assessment basis document was used to review the quality of the articles. The result was analyzed through an integrated data analysis.  Results In the results of the literature review, two main categories were identified; Aspects that influence the implementation of physical activity as well as Motivators for adherence to physical activity followed by eight subcategories. The results showed the importance of person-centered care where the whole person is considered when physical activity is prescribed. Continuous contact with healthcare professionals, support from the environment and setting realistic goals were significant motivators. Conclusions The patients' experiences of prescribed physical activity before planned surgery can, from the results of this non-systematic literature review, be seen as predominantly positive. Subjective physical as well as mental health markers improved while the sense of control over their own situation, and treatment, was enhanced. The good contact that arose between patient and caregiver proved to be a significant factor for compliance with the physical activity. Perceived negative experiences of the prehabilitation could be derived from a lack of information and a lack of advice and follow-up from the healthcare.

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The thesis summarizes available information about the possibilities of rehabilitation in patients with abdominal hernia. The theoretical part presents current approach to prehabilitation and postoperative rehabilitation in patients with abdominal hernia. In the theoretical part of the thesis is brief list of risk factors which increase probability of occurrence of the postoperative complications. The possibilities of modification of these risk factors by prehabilitation are presented. The approaches supporting as well as questioning prescription of prehabilitation are discussed. The thesis also contains the guidelines for early postoperative period and guidelines for long-term postoperative programs. These guidelines are proceeded from foreign literature. Long-term training programs intensity is based on the preoperative examination results. Determining preoperative performance reduces the risk of overloading the patient and maximizes the benefits which the physical activity has to offer. In the experimental part of the thesis are presented data obtained from group of patients who underwent the Preoperative program for patients with hernia on the Clinic of Rehabilitation and Sport Medicine the Motol University Hospital. The comparison of data before and after therapy is concluded. Another...

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