MSc Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 2009. / INTRODUCTION
Rugby is a high impact sport with many injuries reported in the literature. A high rate
of ankle injury is reported with resultant recurrence of these injuries. There is
however only scarce epidemiological data with minimal detail to highlight clinical
findings and prevalence of ankle injuries especially in the club rugby fraternity.
AIMS
This study investigated the prevalence of clinical signs of ankle injuries in rugby
players at club rugby level in the South Gauteng region. The data collected was used
to identify the clinical signs related to ankle instability for perceived, mechanical and
functional parameters and was applied to determine the difference between players
with and those without previous injury. METHODOLOGY
The researcher obtained ethical clearance to do the study from the Human Research
Ethics Committee of the University of the Witwatersrand. Permission was obtained
from the Golden Lions Gauteng Rugby Union to use players in the South Gauteng
region. One hundred and eighty players from nine clubs in the region participated in
the study. Informed consent was obtained from all parties concerned and players were
asked to complete a battery of tests.
To determine the prevalence of clinical signs of perceived instability each player was
asked to complete a data questionnaire and the Olerud and Molander questionnaire.
The data questionnaire also included questions pertaining to the exclusion criteria.
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Objective testing was done to determine the clinical signs of mechanical instability of
both ankles of each player through mechanical tests; the talar tilt and anterior drawer
tests.
Balance and proprioception were assessed through the Star Excursion Balance Test
(SEBT) and Balance Error Scoring System (BESS) which is used to indicate clinical
signs of functional instability and these tests were used to determine the prevalence of
clinical signs of functional instability and to relate the clinical signs of functional
instability to the other clinical findings.
RESULTS
The prevalence of ankle injuries at club rugby level is discussed for the different
parameters of instability. The prevalence of clinical signs of perceived instability
based on the Olerud and Molander questionnaire is 47%, as reported by the player and
is further described in a sub-analysis of perceived problems. The prevalence of
clinical signs of mechanical ankle instability, when laterality is ignored is 38.7%. The
prevalence of clinical signs of functional ankle instability depends on the surface and
the visual input and is greater as the challenge or protuberance increases in difficulty.
The clinical signs of perceived, mechanical and functional ankle instability are further
described and related to other clinical findings for two groups, namely those with and
those without previous injury to the ankle and as expected clinically significant
differences were noted with the players with previous injury recording a higher
prevalence for perceived and mechanical parameters. The odds ratios for the presence
of certain clinical signs revealed significant p-values for the presence of pain, stiffness
and swelling and the need for supports e.g. bracing or taping and the affect on
activities of daily living.
DISCUSSION
In this study there is a high prevalence of clinical signs of ankle instability in club
rugby players for perceived, mechanical and functional parameters, compared to the
prevalence reported in the literature. From the study the clinical findings associated with the presentation of ankle injuries in club rugby players have been established and
related to the perceived, mechanical and functional signs of instability. Differentiation
between players with reported ankle injury and those without were also done and
significant differences were noted between the two groups for perceived and
mechanical parameters but where the functional assessment was done it supported the
fact that balance and proprioception tests included the whole kinetic chain and does
not view the ankle in isolation. It was evident that previously injured players were
more likely to sustain future injury to the ankle and odds-ratios to support this showed
an increased risk of the presence of swelling, stiffness and pain for players with
previous injury and the greater need for the use of supports and influence on activities
of daily life.
The information gathered can be used in the future to set up a management plan for
pre-season screening, assessing and addressing individual predisposing biomechanical
factors, managing acute injuries successfully and rehabilitation in the post-season
phase.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/8232 |
| Date | 28 June 2010 |
| Creators | Mellet, Eloize |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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