3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item The test-retest reliability of the lower extremity functional scale in HIV-related distal sensory peripheral neuropathy(2018) Munemo, Abraham CyrilBackground: The Human Immunodeficiency Virus (HIV) and the Acquired Immune Deficiency Syndrome (AIDS) have posed a serious disease burden on society. The side effects issuing from the anti`-retroviral drugs (ARVs) include Distal Sensory Peripheral Neuropathy (DSPN), a common neurological complication. The Lower Extremity Functional Scale (LLFS) is a reliable and valid tool that has been used for measuring the lower limb functional capacity of patients presenting with DSPN in countries other than Botswana. As such, it is necessary to test its test-retest reliability in Botswana. Aim: The aim of this study was to determine the test-retest reliability of the Lower Extremity Functional Scale (LEFS) among HIV-related DSPN patients in Botswana. Methodology: This study involved a test-retest reliability study based on a time interval of seven to 10 days. A total of 320 HIV patients from six hospitals in Gaborone, Botswana, were screened for DSPN according to the relevant inclusion and exclusion criteria .The percentage of the total patients who were diagnosed with DSPN was 26.3% (84). The lower extremity functional scale LEFS questionnaire was administered twice with a seven to 10-day period interval and the results of the assessment were recorded and analysed. Measurements of central tendencies were used to summarize the demographic data and the clinical information for the lower extremity functional scale information obtained. Because the data sets were categorical, Spearman’s correlation analysis was conducted to determine the efficacy of the test-retest reliability. Furthermore, the Intraclass correlation (ICC) was used for measuring the internal consistency of the LEFS questionnaire. Demographic data such as age, gender, education and marital status, and clinical information pertaining to the participants were used to describe them. Results: A total of 84 HIV patients from six hospitals who were on anti-retroviral therapy (ART) and presenting with DSPN participated in the study. The test-retest reliability was found to range from rs=0.74-0.99, ICC = 0.96. SEM=4.88 Conclusion: The study results showed strong test-retest reliability and good internal consistency. Hence, the LEFS questionnaire can be considered reliable as a standard from which to monitor lower limb functionality in HIV-related Distal Sensory Peripheral Neuropathy among patients in Botswana.Item A Kinematic Analysis of the star excursion balance test and its ability to predict Injury(2018) Hoosen, TaskeenBackground Recent studies have shown an increase in incidence and prevalence of injury in cricket. Successful injury prevention requires ongoing injury surveillance and injury screening for early intervention of at risk players. Objective The aims of this study are to determine if the Star Excursion Balance Test (SEBT) and 3D kinematics of the lower limb are predictive of lower limb injury in cricket and to determine the lower limb kinematics during the SEBT. Method This is an observational, longitudinal cohort study. Twenty-four provincial level adult male cricket players participated in this study. Pre-season questionnaires were completed for baseline information and to determine eligibility. Participants performed the SEBT while being analysed by Optitrack 3D kinematics cameras and software. Injury surveillance took place during the 2015/2016 cricket season with injury monitoring questionnaires. Statistical test including correlations, tests for significance, a receiver operating curve and regression analyses were all performed, in order to establish if there is a relationship between the SEBT, 3D kinematics and injury prediction. Results Twenty-two participants with a mean age of 20.2 (SD= 3.8) completed the study. 50% sustained injuries; 59% of which were in the lower limb. Lumbar injuries were the most prevalent. There were no statistically significant results between the injured and non-injured groups during the SEBT. Regression analysis revealed decreased hip flexion angles of the stance leg in the anterior direction accurately predict 76% likelihood of injury. The ankle abduction angle was statistically significant when comparing injured and non-injured participants in the anterior direction of both limbs (Dominant p= 0.035; Non-Dominant p= 0.022) and in the postero-lateral direction of the dominant limb (p= 0.035). Knee abduction angles were statistically significant when comparing injured and non-injured participants in the postero-medial direction in the non-dominant limb (p= 0.008). Conclusion The SEBT in its simplest form did not predict an increased risk of injury. Supplemented with the hip, knee and ankle angular kinematics, the findings of the SEBT were able to predict injury.Item The lower limb muscle activity and lumbo-pelvic movement control in soccer players: a matched case control study(2017) Roos, RialiBackground Soccer is a sport that is gaining in popularity in the elite and non-elite populations worldwide. As a result, the number of injuries in soccer is increasing. Hamstring injuries in particular, with a reported incidence rate as high as 63%, are of significant concern. Most hamstring injuries tend to occur during the swing phase of sprinting when hamstring activity is at its highest. As the speed of sprinting increases, greater mobility in the lumbo-pelvic area is required to maximise sprinting efficiency. Any abnormal or dysfunctional lumbo-pelvic movement during this phase could induce pain and hamstring injury. Lumbo-pelvic movement control dysfunction may therefore indirectly link abnormal lumbar spine movement to lumbo-pelvic pain and hamstring injury. The first aim of this study was to compare the performance of the erector spinae, gluteus maximus, hamstrings (biceps femoris) and quadriceps (rectus femoris) muscles in soccer players, with and without recent hamstring injuries, while performing isometric contractions, a functional squat and sprinting. The study’s second aim was to compare lumbo-pelvic movement control in soccer players with and without recent hamstring injuries. Method Thirty soccer players were selected to participate in this study. Fifteen were assigned to the injured group and 15 to an uninjured group. The injured group comprised players who had sustained a hamstring injury six months prior to the research and who had partially returned to training, and the uninjured group comprised players with no recent hamstring injuries and who were actively involved in full training. Players were matched in respect of age, height, weight and playing position. All players gave informed written consent, completed the physical activity, training and injury questionnaire, and the Oslo hamstring injury questionnaire. Physical tests, which included isometric contraction of the erector spinae, gluteus maximus, hamstrings (biceps femoris) and quadriceps (rectus femoris) muscles, a functional squat and a thirty-metre sprint were done. Muscle activity during these tests was recorded via electromyography (EMG). To determine the lumbo-pelvic movement control of the players, the dorsal pelvic tilt, waiter’s bow, one leg stand and prone knee bend tests were used. Cohen's d (parametric) and Spearman’s correlation coefficient (nonparametric) were used to calculate the effect size, and the Chi-square test and Fisher’s exact to analyse the lumbopelvic movement control data. To establish a statistical significance, the p-value of the study was set at p<0.05. Results EMG muscle activity during isometric contractions was lower in the erector spinae muscles (p=0.04) and biceps femoris muscle (p=0.02) of the injured group. Both these findings were statistically significant. There was no statistically significant difference in muscle activity during the functional squat between the study and uninjured groups. The results of the EMG activity in the thirty-metre sprint were determined to be significant as they demonstrated that the hamstring muscle (p=0.01) activation in the injured group was decreased in comparison with the uninjured group. During the performance of the lumbo-pelvic test, no association was found between the two groups in the dorsal pelvic tilt and one leg stand. The performance of the waiter’s bow (p=0.01) and prone knee bend (p=0.004) revealed statistically significant differences between the study and uninjured groups. The majority of the players in the injured group performed both of these functional tests incorrectly (WB n=10; PKB n=14). Conclusion The study found that the hamstring muscle is at great risk of injury during eccentric contraction of the hamstring muscles. This can be associated with poor lumbo-pelvic movement control, as the load on the hamstring muscle is increased to provide intersegmental stability around the neutral zone, the area of high spinal flexibility.