bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of extreme fatigue in underperforming athletes - a synthesis of recent hypotheses and reviews
Authors: Robson-Ansley PJ , Lakier Smith L
Published: January 2017

The underperformance syndrome (UPS), previously known as the overtraining syndrome (OTS), has been defined as a persistent decrement in athletic performance capacity despite 2 weeks of relative rest. Clinical research has suggested that cytokines play a key role in fatigue in disease and chronic fatigue syndrome. Furthermore, it has recently been demonstrated that exogenous administration of interleukin-6 (IL-6) increases the sensation of fatigue during exercise. In light of current cytokine and chronic fatigue
syndrome research, this article reviews and updates the cytokine theories that attempt to explain the aetiology of the debilitating fatigue experienced in OTS/UPS. Initially,
it was proposed that UPS may be caused by excessive cytokine release during and following exercise, causing a chronic inflammatory state and ‘cytokine sickness'. More recently, the hypothesis was extended and it was proposed that time-dependent sensitisation could provide a model through which the aetiology of UPS may be explained.
According to this model, the principal abnormal factor in UPS is an intolerance/heightened sensitivity to IL-6 during exercise. South African Journal of Sports Medicine Vol. 18 (4) 2006: pp. 108-114
The quadriceps angle and the incidence of knee injury in Indian long-distance runners
Authors: Puckree T , Govender A , Govender K , Naidoo P
Published: January 2017

Objective. To investigate the incidence of knee injuries in runners and to determine the proportion of injuries involving abnormal quadriceps (Q)-angles.
Design. One hundred male Indian runners between the ages of 25 and 65 years from 5 athletic clubs in Durban volunteered to participate in the study. The Q-angle was
measured using a goniometer. Other relevant information was obtained using a validated questionnaire. The data were analysed by comparing measured Q-angles with
‘normal' values of Q-angles obtained from the literature. A paired t-test at a probability of 0.05 was used.
Setting. Data were collected at club meetings. Main outcome measure. The primary outcome of the study was to determine the proportion of runners with abnormal Q-angles. Thereafter the rate of knee injuries in runners with abnormal Q-angles was determined.
Results. Data from 88 runners were usable. Fifty-one per cent of the runners sustained knee injuries. Fifty-eight per cent of the sample had abnormal Q-angles. Sixty-seven
per cent of the runners with abnormal Q-angles sustained knee injuries.
Conclusion. More runners with abnormal Q-angles sustained knee injuries. There is a need to determine reference values for Q-angles for the South African population,
the proportion of the population that present with abnormal Q-angles, and the reasons for this. South African Journal of Sports Medicine Vol. 19 (1) 2007: pp. 9-11
Travel fatigue and home ground advantage in South African Super 12 rugby teams
Authors: Du Preez M , Lambert MI
Published: January 2017

Objectives. Studies have shown the existence of a significant home ground advantage in a range of sports. The aim of this study was to determine whether home performances of the South African teams during the 1996 - 2005 seasons were different before touring to Australia and New Zealand, compared with the home matches played after the 4 - 5-week tour. The question was relevant because this competition places unusual demands on the players. For example, the duration of the tournament is 12 weeks, during which time the South African teams travel across 37.3 ± 2.5 time zones as they play 11 matches. Therefore, any home ground advantage may be negated by travel fatigue. Outcome measures. The mean points difference was calculated for home fixtures for four South African teams both prior to and following touring during the competitions from 1996 to 2005. Play‑off matches were excluded from analysis. Performance was defined as a positive points difference (points difference = points ‘for' minus points ‘against').
Results. The first finding of the study was that a home ground advantage did indeed exist for all the teams during the tournament (points difference of 6.6 ± 17.4 (N =
664 matches) home vs. -6.8 ± 17.3 points away (N = 656 matches) (p < 0.05). There was no difference between the mean ‘home' points difference for all the South African rugby teams either before (1.9 points, N = 96 matches) or after (2.3 points, N = 107 matches) touring overseas in the Super 12 competition. South African Journal of Sports Medicine Vol. 19 (1) 2007: pp. 20-22
Sports medicine – still evolving?
Authors: Lambert M
Published: January 2017

Sports medicine – still evolving?
Ethically we can no longer sit on the fence?
Authors: Patricios J
Published: January 2017

To the Editor: We would like to comment on the review article by Shuttleworth-Edwards et al. 'Ethically we can no longer sit on the fence – a neuropsychological perspective on the cerebrally hazardous contact sports', published in the July edition of your Journal.
Rugby setting the pace
Authors: Lambert M
Published: January 2017

Rugby setting the pace
A censervative programme for treatment of anterior knee pain in adolescents
Authors: Phillips J , Coetsee MF
Published: January 2017

Objective. The purpose of this study was to determine the effectiveness of a 2½-week conservative rehabilitation programme in addressing anterior knee pain in adolescents.
Design. Subjects were randomly allocated to a control group (N=12) and an experimental group (N=18). The experimental group was subjected to a 2½-week strength, flexibility and
neuromuscular rehabilitation programme. Both groups were tested before and after the 2½ weeks and the experimental group also 1 month after the post-test.
Results. The experimental group reported significant (p
Effect of music on submaximal cycling
Authors: Schie NA , Stewart A , Becker P , Rogers GG
Published: January 2017

Objective. Athletes frequently report training to music, yet there have been relatively few studies that have addressed the benefit of exercising with music.
Design. Volunteer men and women (N=30), aged between 18 and 40 years, performed an initial familiarisation session. Part of this session involved the measurement of maximal oxygen consumption. With at least a 48-hour intervening period, this was then followed by a first 20-minute submaximal cycling session, at 80% of maximal oxygen consumption. At least 48 hours later a second submaximal cycling session was performed. Subjects were randomly divided into two groups. Group A cycled without music and group B cycled with music for the first submaximal cycling session. Subjects underwent the same testing procedure for the second submaximal cycling session, but this time group A cycled to music and group B cycled without music. Subjects served as their own controls.
Setting. The study was performed in the physiology exercise laboratory, at the University of the Witwatersrand.
Main outcome measures. During the submaximal sessions heart rate, perceived exertion (Borg scale) and plasma lactate concentration were assessed. Subjects completed a post-test questionnaire once both submaximal cycling sessions were completed.
Results. There were no significant differences in physiological variables (change in plasma lactate and heart rate), nor were there any significant differences in Borg scale ratings when the subjects cycled with and without music. However, according to the post-test questionnaire 67% of subjects identified the cycling session with music to be easier
than the session without music.
Conclusion. Listening to music while performing submaximal cycling resulted in no physiological benefit. Yet, the cycling session done in conjunction with music was deemed, by the majority of the subjects, to be easier than the cycling session without music. South African Journal of Sports Medicine Vol. 20 (1) 2008: pp. 28-31
Efficacy of a modified tapering protocol on swimming performance
Authors: Bosch AN , Medonca M
Published: January 2017

Objective. The aim of this study was to determine any difference in performance following two different tapering protocols after a period of heavy training.
Design. Twelve swimmers who regularly trained at a high volume and intensity were recruited and trained together for 3 weeks. They were then randomly split into two groups (N=6 per group). One group underwent a standard taper protocol, while the second followed a modified taper in which training load was gradually resumed for 1 week following a standard taper. Performance assessment following tapering consisted of 2 swims over a distance of 200 m, with a recovery period of 5 hours between swims. After resuming normal training, subjects tapered a second time, each group following the alternate protocol.
Outcome measures. Total time and split times for each length, stroke rate, distance per stroke, and stroke index in a performance swim were determined as well as
heart rate (HR), profile of mood state (POMS), rating of perceived exertion (RPE) and muscle pain during each taper.
Results. Mean swim times for the modified and conventional tapers were 134.7±9.1 and 134.7±9.3 seconds, respectively (mean ±SD). There was also no difference in the split times between groups, although both became slower in the final three laps. Stroke rate, distance per stroke, and stroke index were also not different between protocols. There were no differences between protocols in HR, RPE or rating of muscle pain over the duration of
the tapering period. However, there was a significant reduction in HR on day 5 of both tapers and a lower POMS on days 3, 4 and 5 on the standard taper protocol. At the time of the performance swim, however, there was no difference in POMS.
Conclusion. There were no performance or physiological advantages from the modified tapering protocol. South African Journal of Sports Medicine Vol. 20 (2) 2008: pp. 49-54
Incremental exercise test performance with and without a respiratory gas collection system
Authors: Clark J
Published: January 2017

Objective. Despite their widespread use in exercise testing, few data are available on the effect of wearing respiratory gas collection (RGC) systems on exercise test performance. Industrial-type mask wear is thought to impair exercise performance through increased respiratory dead space, flow resistance and/or discomfort when compared with RGC facemasks, but whether performance decrements exist for RGC facemask wear versus non-wear is unclear. The objective of this study was to evaluate the difference in incremental exercise test performance with and without a RGC system. Incremental exercise test performance with and without a respiratory gas collection system  Design. Twenty moderately active males (age 21.0 ± 1.9 years; VO2peak 55.9 ± 3.0 ml∙kg-1∙min-1) performed two progressive treadmill tests to volitional exhaustion. In random order subjects ran with (MASK) or without (NO-MASK) a RGC facemask and flow sensor connected to a gas analyzer. Descriptive data (mean ± SD) were determined for all parameters. The Wilcoxon signed rank test for paired differences was used to assess mean differences between MASK and NO-MASK conditions. Results. Exercise time to exhaustion, peak treadmill speed, peak blood lactate concentration, peak heart rate and rating of perceived exertion (RPE) were not different (p>0.05) between MASK and NO-MASK conditions. Conclusions. Incremental exercise test performance is not adversely affected by RGC and analysis equipment, at least in short duration progressive treadmill exercise. Respiratory gas analysis during exercise testing for diagnostic, performance assessment or training prescription purposes would appear to be unaffected by RGC systems.
Effects of timing of pre-exercise nutrient intake on glucose responses and intermittent cycling performance
Authors: Pritchett K , Bishop P , Pritchett R , Kovacs M , Davis JK , Casaru C , Green M
Published: January 2017

Objective. To evaluate the effects of two different pre-exercise feeding schedules (15 minutes and 60 minutes prior to exercise) of a mixed-nutrient nutritional bar on blood glucose levels and subsequent intermittent, high-intensity cycling performance.
Methods. Ten moderately trained athletes participated in this counterbalanced, crossover, repeated measures study. Participants completed a 50-minute counterbalanced treatment intermittent exercise protocol. During one trial, participants consumed 400 ml water and a nutritional bar 15 minutes before the exercise session (15MPE). During another trial, participants consumed 400 ml water and a nutritional bar 60 minutes before the exercise
session (60MPE). During a control trial (CON) participants consumed 400 ml water.
Results. There were no significant differences in plasma glucose response at rest or during exercise among the three treatments (CON, 15MPE and 60MPE). There were no significant differences in mean power (MP) between the three trials.
Conclusions. Pre-exercise nutrient feedings at 15 minutes or 60 minutes before exercise did not affect intermittent cycling performance or blood glucose concentration. These results suggest that the time of ingestion, within 1 hour prior to exercise, of a complex carbohydrate similar in composition and volume used in this study does not impact on performance. South African Journal of Sports Medicine Vol. 20 (3) 2008: pp. 86-90
Accelerated hydrotherapy and land-based rehabilitation in soccer players after anterior cruciate ligament reconstruction: a series of three single subject case studies
Authors: Momberg B-L , Louw C , Crous L
Published: January 2017

Objective. To investigate the effectiveness of accelerated rehabilitation and accelerated hydrotherapy after anterior cruciate ligament (ACL) reconstruction in male athletes participating in soccer.
Design. A non-concurrent single subject, multiple baseline design (ABA design) was conducted over 10 weeks. A series of three N=1 studies was conducted to assess the effect of an accelerated hydrotherapy programme on pain, function, and range of motion.
Setting. The study was conducted at a private physiotherapy practice in Port Elizabeth, South Africa.
Interventions. The land rehabilitation programme was a homebased programme supervised every week by the physiotherapist. The accelerated hydrotherapy consisted of a 6-week programme, and participants attended two treatment sessions of accelerated
hydrotherapy per week each of 30 minutes\' duration. Main outcome measures. The knee injury and osteoarthritis outcome scale (KOOS) as a subjective measure of pain, function
and quality of life; the goniometer to measure active knee ROM and the 6-minute walking test (6MWT) as an objective measure of function.
Results. All three patients demonstrated good improvement during the treatment phase for the KOOS scale and progressed well in terms of their walking ability during the study. Significant improvement was gained during the baseline phase for all three participants
with high initial levels of knee flexion while active knee extension improved gradually in all three participants. Conclusion. The study findings indicate that an accelerated landbased
and hydrotherapy programme may be useful in improving patient outcomes and that there are no risks for harm. Clinical relevance. The study findings indicate that accelerated
hydrotherapy may be a useful and safe adjunct to an accelerated land-based programme after ACL reconstruction South African Journal of Sports Medicine Vol. 20 (4) 2008: pp. 109-114
BokSmart: Preventive rehabilitation for rugby injuries to the lower back and core
Authors: Hopkins N
Published: January 2017

Background. The low back is an integral part of the entire movement chain as it functions as part of a complex network of the skeletal, muscular and nervous system. Eighty to 90% of acute low back pain episodes dissipate within 8 - 12 weeks regardless of any intervention, but 5 - 10% regress into chronic low back pain. As a result of its undistinguished aetiology, the treatment for low back pain remains controversial. Treatment options for low back pain include the following: analgesics, muscle relaxants, antidepressants, nonsteroidal anti-inflammatory drugs, epidural steroid injections, manipulation, back schools, electromyographic biofeedback, traction, orthoses, behaviour therapy, transcutaneous electrical nerve stimulation, acupuncture, and exercise therapy. Results. Therapeutic exercises for low back pain have been shown in 6 different randomised controlled trials to be beneficial in reducing pain by up to 60% and improving functional ability by up to 47%. Furthermore, a Cochrane review on low back pain found strong evidence that exercise therapy is an effective intervention in the treatment of low back pain. When prescribing exercises for an individual with low back pain the following goals need to be considered: (i) improve performance in endurance activities; (ii) improve muscular strength around the spine; (iii) eliminate any impairments in spinal flexibility; (iv) reduce the intensity of the pain being experienced by the individual; and (v) reduce back pain-related disability. A rugby player will have increased core stability/strength and a reduced risk of injury if the internal support mechanisms of the spine have been conditioned to resist distortion or injury from external forces. Not only will improved core  stability benefit players on the field during matches or practices, it will also assist in preventing unnecessary injuries during weight training and pre-season conditioning. Conclusion. Exercise programmes which combine core stability with general strength training should be prescribed for rugby players to prepare them for the level of impact involved in the game, as well as for sport-related weight training and non-sport-related daily activities.
Impact of a primary school-based nutrition and physical activity intervention on learners in KwaZulu-Natal, South Africa: A pilot study
Authors: Naidoo R , Coopoo Y , Lambert EV , Draper C
Published: January 2017

No Abstract.
Impact of training status on maximal oxygen uptake criteria attainment during running
Authors: Christie CJ , Lock BI
Published: January 2017

Objectives. The aims of this study were to assess whether training status influenced maximal physiological and perceptual responses and whether certain maximal criteria were more sensitive for individuals with different levels of training. Methods. Males who were either trained (N=8) or untrained (N=9) underwent a maximal treadmill test to assess whether thecriteria to indicate VO2 max were training-specific.Results. VO2 max was significantly higher in the trained (70.0mlO2.kg-1.min-1) compared with the untrained group (54.5 mlO2.kg-1.min-1). Only 11% of the trained and 56% of the untrained individuals achieved a plateau in the oxygen uptake curve. Peak treadmill running speed was significantly faster and total test time significantly longer in the trained group. In contrast, peak lactate, although maximal for both groups, was significantly higher in the untrained group (13.5 mmol.l-1 compared with 10.3 mmol.l-1). The other responses were not different between the groups. Noteworthy is that none of the subjects achieved all of the criteria indicating a maximal effort. The criteria most achieved in both sampleswere HRmax, RPEmax and Lamax with the latter being the mostattained in the untrained group and RPEmax being mostly attainedby the trained group.Conclusions. The criteria used to indicate attainment of VO2 max may be limited and may differ when comparing a heterogeneous training sample. Although VO2 max was significantly higher in the trained group, responses were different for O2 plateau attainment and Lamax but similar for the other British Association of Sports Sciences criteria. It may be concluded that the physiological variables coinciding with maximal effort may differ in individuals with different levels of training.
Training volume and injury incidence in a professional rugby union team
Authors: Viljoen W , Saunders CJ , Hechter GD , Aginsky KD , Millson HB
Published: January 2017

Objective. To describe the incidence of injuries in a professional rugby team, and to identify any associations between injury rates and training volume.Methods. This retrospective, descriptive study included all injuries diagnosed as grade 1 and above in a South African Super 12 rugby team. Injury incidence and injury rates were calculated and compared with training volume and hours of match play.Results. Thirty-eight male rugby players were injured during the study period. The total number of annual injuries decreased from 50 (2002) to 38 (2004) (χ2=0.84, p=0.36). The number of new injuries showed a similar trend (χ2=2.81, p=0.09), while the number of recurring injuries increased over the 3-year period. There was a tendency for total in-season injury rates to decrease over the 3 years (χ2=2.89, p=0.09). The pre-season injury rate increased significantly over the 3 years (χ2=12.7, pConclusions. One has to be cognisant of the balance between performance improvement and injury risk when designing training programmes for elite rugby players. Although the reduction in training volume was associated with a slight reduction in the number of acute injuries and in-season injury rates over the three seasons, the performance of the team changed from 3rd to 7th (2002 and 2004, respectively). Further studies are required to determine the optimal training necessary to improve rugby performancewhile reducing injury rates.
A silver lining …
Authors: Lambert M
Published: January 2017

A silver lining …
Effect of body mass and physical activity volume and intensity on pedometry-measured activity energy expenditure in rural black South Africans in the Limpopo Province
Authors: Cook I , Alberts M , Lambert EV
Published: January 2017

Objectives. We developed a novel approach to investigate patterns of pedometry-measured total weekly activity energy expenditure (EEAct) in rural black South Africans in the Limpopo Province. Design. We analysed 7-day pedometry data in 775 subjects (female: N=508; male: N=267). Variance components models for EEAct were used to estimate the variance explained by body mass (BM), total weekly steps (volume) and estimated intensity (kcal. kg-1.step-1). Univariate General Linear Models, adjusting for age, BM and physical activity (PA) volume, were used to determine if EEAct was primarily affected by volume or intensity. Results. BM (13.1%), PA intensity (24.4%) and PA volume (56.9%) explained 94.4% of the variance in EEAct. Adjusted EEAct did not differ between sexes (78 kcal.week-1, p =0.2552). There were no significant differences across activity categories (sedentary to very active) for adjusted EEAct (62 - 287 kcal.week-1, p>0.1). Adjusted EEAct for 6 - 7 days of compliance (≥10 000 steps.day-1) differed significantly from 1 - 2 days of compliance (266 - 419 kcal.week-1, p<0.04). Obese (body mass index ≥30 kg.m-2) and normal weight (body mass index 18.5 - 24.9 kg.m-2) women did not differ significantly across activity categories for EEAct (200 - 592 kcal.week-1, p>0.30). Conclusions. We have highlighted an intensity effect for days of compliance and at very active ambulatory levels (≥12 500 steps. day-1). A volume effect appeared to dominate between sexes, across activity categories and weight-by-activity categories. It is important that post hoc statistical adjustments be made for body mass and PA volume when comparing EEAct across groups.
Evaluation of a school-based physical activity intervention in Alexandra Township
Authors: Draper CE , De Kock L , Grimsrud AT , Rudolph M , Nemutandani S , Kolbe-Alexander T , Lambert EV
Published: January 2017

Objectives. Non-communicable diseases and limited participation in school physical education have become increasing concerns in South Africa. In response to these concerns, a schoolbased physical activity intervention, Healthnutz, was implemented in three primary schools in Alexandra Township, Johannesburg. Evaluation of Healthnutz included assessing its feasibility and acceptability, and short-term changes in learners’ physical fitness, knowledge and attitudes. Methods. To assess feasibility and acceptability, a situational analysis and focus groups with teachers and programme monitors were conducted. Pre-post fitness testing (3-month interval) was conducted with learners, and a questionnaire assessed changes in learners’ knowledge, attitudes, self-efficacy, and perceived barriers to physical activity, in control and intervention schools. Results. At implementation, teachers identified the need for more physical activity in the school environment and were positive about Healthnutz. Follow-up focus group discussions suggested that it was positively impacting teachers, learners and the school in general. Scores for sit and reach (p<0.001), sit ups (p<0.02) and shuttle run (p<0.0001) improved significantly in intervention but not control schools. A significant decrease was observed in learners’ perceived external barriers to physical activity (p<0.0001) along with a positive change in learners’ self-efficacy for physical activity (p<0.05). Conclusions. Healthnutz raised awareness of the importance of physical activity in intervention schools. Findings indicate that even limited exposure to a physical activity intervention can lead to a significant improvement in aspects of learners’ fitness, knowledge, attitudes and perceptions regarding physical activity. Furthermore, training and support of teachers needs to be nonjudgemental and empowering.
The COL5A1 gene and musculoskeletal soft-tissue injuries
Authors: Posthumus M , September AV , Schwellnus MP , Collins M
Published: January 2017

Background. It has been shown that there is an association between various genetic variants and Achilles tendon injuries as well as anterior cruciate ligament (ACL) ruptures. Among other variants the BstUI restriction fragment length polymorphism (RFLP) within the COL5A1 gene has been shown to be over-represented in asymptomatic participants when compared with those with chronic Achilles tendinopathy, and in asymptomatic female participants when compared with those with ACL ruptures. The male asymptomatic control participants in the ACL study, which were 10 years younger than previously investigated cohorts, had a distinctly different genotype frequency. Aim. The aim of this study was therefore to determine whether the distribution of the COL5A1 BstUI RFLP in the combined asymptomatic participants without any known history of tendon injuries is age dependent, particularly among males. Results. When the 265 male asymptomatic participants from all studies were pooled and divided into age-group tertiles, there was a significant linear increase in the CC genotype frequency (p=0.032) among the male age groups, with the youngest group having the lowest frequency (CC genotype frequency, 13%) and the oldest group having the highest (CC genotype frequency, 27%) frequency. There was however a similar CC genotype content in all three female (N=231) age groups (CC genotype frequency, 24 - 27%; p=0.795). Conclusion. The practical implication is that the selection of asymptomatic groups is of critical importance when future studies of this nature are designed. Future research investigating this genetic variant as a risk factor for soft-tissue injuries should consider these findings when selecting asymptomatic participants.
Analysing recurrent events in exercise science and sports medicine
Authors: Cook I
Published: January 2017

Episodic or recurrent events are a class of data that is frequently reported in health sciences research. The purpose of this paper is to highlight the prevalence of published reports, especially within the South African context, that have used inappropriate statistical techniques when dealing with episodic events and to urge the use of appropriate univariate and multivariate techniques.
Beneficial effects of exercise: shifting the focus from body weight to other markers of health*
Authors: King N
Published: January 2017

Background: Exercise is widely promoted as a method of weight management, while the other health benefits are often ignored. The purpose of this study was to examine whether exercise-induced improvements in health are influenced by changes in body weight. Methods:  Fifty-eight sedentary overweight/obese men and women (BMI 31.8 (SD 4.5) kg/m2 ) participated in a 12-week supervised aerobic exercise intervention (70% heart rate max, five times a week, 500 kcal per session). Body composition, anthropometric parameters, aerobic capacity, blood pressure and acute psychological response to exercise were measured at weeks 0 and 12. Results: The mean reduction in body weight was -3.3 (3.63) kg (p<0.01). However, 26 of the 58 participants failed to attain the predicted weight loss estimated from individuals’ exercise-induced energy expenditure. Their mean weight loss was only -0.9 (1.8) kg (p<0.01). Despite attaining a lower-than-predicted weight reduction, these individuals experienced significant increases in aerobic capacity (6.3 (6.0) ml/kg/min; p<0.01), and a decreased systolic (-6.00 (11.5) mmHg; p<0.05) and diastolic blood pressure (-3.9 (5.8) mmHg; p<0.01), waist circumference (-3.7 (2.7) cm; p<0.01) and resting heart rate (-4.8 (8.9) bpm, p<0.001). In addition, these individuals experienced an acute exercise-induced increase in positive mood. Conclusions:  These data demonstrate that significant and meaningful health benefits can be achieved even in the presence
Drinking during marathon running in extreme heat: a video analysis study of the top finishers in the 2004 Athens Olympic marathons
Authors: Van Rooyen M , Hew-Butler T , Noakes TD
Published: January 2017

Objective. To assess the drinking behaviours of top competitors during an Olympic marathon. Methods. Retrospective video analysis of the top four finishers in both the male and female 2004 Athens Olympic marathons plus the pre-race favourite in the female race in order to assess total time spent drinking. One male and female runner involved in a laboratory drinking simulation trial. Results. For the five female athletes, 37 of a possible 73 drinking episodes were captured. The female race winner was filmed at 11 of 15 drinking stations. Her total drinking time was 23.6 seconds; extrapolated over 15 seconds this would have increased to 32.2 seconds for a total of 27 sips of fluid during the race. Eighteen of a possible 60 drinking episodes for the top four male marathon finishers were filmed. The total drinking time for those 18 episodes was 11.4 seconds. A laboratory simulation found that a female athlete of approximately the same weight as the female Olympic winner might have been able to ingest a maximum of 810 ml (350 ml.h-1) from 27 sips whilst running at her best marathon pace whereas a male might have drunk a maximum of 720 ml (330 ml.h-1) from 9 sips under the same conditions. Conclusions. These data suggest that both the female and male 2004 Olympic Marathon winners drank minimal total amounts of fluid (<1 litre) in hot (>30ºC) temperatures while completing the marathon with race times within 2.5% of the Olympic record.
BokSmart: Pre-participation screening of rugby players by coaches based on internationally accepted medical standards
Authors: Patricios JS , Collins RM
Published: January 2017

A comprehensive medical history forms a significant part of any medical assessment or screening. In the athlete, pre-participation screening is aimed at determining those aspects of personal and family history that place the participant at greater risk of sudden death, serious illness or musculoskeletal injury. In rugby union, where the incidence of head and neck injuries is higher than in other sports, emphasis needs to be placed on screening for potential risk factors for neurological injury. In a South African rugby environment, pre-season medical screening is not standard and indeed rarely practised. In most club and school settings, the rugby coach may well be the person most in contact with players and therefore in the best position to conduct an initial screening. This article reviews the relevant literature pertinent to such a guideline.
Lack of transformation in sport and the long-term athlete development programme
Authors: Lambert M
Published: January 2017

Lack of transformation in sport and the long-term athlete development programme
South African Sports Medicine Association (SASMA) consensus statement on policy for managing athletes with disorders of sexual development (DSD)
Authors: . .
Published: January 2017

SASMA views disorders of sexual development (DSD) as a medical condition that has profound physical and psychological effects on not only the individuals affected, but also their families. Like any other disorder, this condition has to be managed with a view to offer the best outcomes for affected individuals. When the attending physician identifies stigmata suggesting DSD in a newborn there should be proper consultation and education of parents.
Popular physical therapy modalities in the management of whiplash-associated disorders
Authors: Watson ED , Coopoo Y
Published: January 2017

Objectives. The aim of this study was to determine current physiotherapy practice in private clinics across the UK in the management of whiplash-associated disorder (WAD) injuries. Design. All treatment reports provided to a private health care company between January 2008 and July 2010 (N=365) were included and analysed to determine the following: the treatments favoured in the management of whiplash; the number of sessions used on average; and the main reasons for discharge. Results. Joint mobilisations, stretches and mobility exercises were favoured in the management of acute whiplash treatment and were used in 74%, 68% and 61% of cases, respectively. The most popular treatments in chronic whiplash, in order of preference, were: stretches (73%), joint mobilisations (69%) and soft-tissue massage (63%). On average, physiotherapists used 4.46 sessions and 7.21 modalities per patient. Although the outcome measures were limited to reason for discharge, the majority of patients were discharged because of ‘treatment complete/self management sufficient’, which may be assumed to be a favourable recovery for 79% of patients. Conclusion. This study found that physical therapists across the UK generally use evidence-based modalities in the treatment of whiplash. However, there remains a need to emphasise and embrace a more educational and active approach to the management of these injuries. The study recommends a protocol for treating WAD that includes supplementing therapeutic modalities with an exercise component, and routinely providing information and advice to ‘act as usual’.
The effects of three days of sub-maximal-intensity mountain biking on sleep
Authors: Murphy SP , Fuller A , Bentley AJ , Avidon I
Published: January 2017

Objectives. We determined the effect of three consecutive days of sub-maximal-intensity mountain biking (4.5 hours per day, ~64 km per day), on the sleep of ten healthy, trained male and female mountain bikers. Methods. The sleep of the mountain bikers was assessed both subjectively (visual analogue scales and sleep questionnaires) and objectively (activity data logger) on each night of mountain biking and for seven nights when they were not cycling (pre-exercise, mean of seven nights). The cyclists’ mood and muscular pain were assessed each night using visual analogue scales. The cyclists slept at home in their normal environment. Results. There was no significant difference between the mountain bikers’ muscular pain and mood (calm/anxious visual analogue scale) measured during the pre-exercise stage and their pain and mood measured on each of the mountain biking nights (p>0.05). However, compared with the pre-exercise stage, the mountain bikers reported that they were significantly more tired (tired/energetic visual analogue scale) on each night of cycling (p<0.01). The sleep of the mountain bikers was disrupted on the night of the third day of mountain biking only. On this night, compared with the pre-exercise stage, the mountain bikers reported that they woke up more during the night (double the number of times) (p<0.001), and an activity data logger recorded that they were awake for about half an hour longer during the night (p<0.05). Conclusion. We have shown that three days of repeated, endurance sub-maximal mountain biking disrupted the sleep of the mountain bikers on the third night of cycling.
‘Mean response’ disregards the importance of individual variation
Authors: Mann T
Published: January 2017

The conventional approach in the field of exercise science is to report the response to interventions as the mean (average) of the intervention group. While the mean may be a convenient measure, it fails to consider the significant individual variation present in all aspects of human biology, resulting in findings that are at best simplistic and, at worst, misleading.
CPD Questionnaire
Authors: . .
Published: January 2017

CPD questionnaire
CPD Questionnaire
Authors: . ,
Published: January 2017

CPD Questionnaire
The influence of a moderate aerobics programme on the body self-image of women in middle adulthood
Authors: Daniels Andrea K , Van Niekerk Rudolph L
Published: January 2017

Objectives. This empirical study investigated the effect of a moderate aerobic exercise programme on the body self-image of a sample of women (n=49) in middle adulthood with a mean age of 54.2 years. Methods. The participants were randomly assigned to an experimental group (n=24) and a control group (n=25). The experimental group participated in a (guided) moderate aerobics programme over six weeks, while the control group participated in a sedentary (guided) meditation programme. The participants in both groups were assessed for body self-image using the nine factors defined in the Body Self-Image Questionnaire (BSIQ) of Rowe (2000). The BSIQ comprises both perceptual-cognitive and affective-attitudinal factors. Results. The results indicated that there was an overall positive shift in the perceptual-cognitive factors of the body self-image in the exercise group, namely for overall appearance evaluation, health fitness evaluation and fatness evaluation. Although no significant shifts were found in all the affective-attitudinal factors of the participants, there was a significant change in the negative affect of the participants. Conclusion. The results suggest that such a programme has a positive influence on the way these women think and feel about their bodies. No significant changes were found in the body selfimage of the control group. These findings suggest the positive effect of a (guided) aerobic exercise programme in improving the body self-image of women in middle adulthood.SAJSM, vol 23 No. 4 2011
Debating the utility of computerised neurocognitive testing in the sports concussion arena
Authors: Shuttleworth-Edwards Ann B
Published: January 2017

The purpose of this article was to contribute to an argument regarding the utility of computerised baseline and follow-up neurocognitive testing within the sports concussion arena. Heated debate around this issue via a number of contributions has appeared recently in the journal Current Sports Medicine Reports, with its use being roundly condemned by one party as ‘scientifically unfounded’ and therefore ‘financially irresponsible’. It is proposed that this vehemently negative viewpoint is located in a ‘smoke and mirrors’ portrayal of the validity of such neurocognitive screening, being substantiated on questionable extrapolations from laboratory-type group research to the clinical situation. The stance runs counter to the tenets of modern clinical neuropsychology, and is incompatible with more rigorous scientific pointers from current research. Abreast of the latest concussion in sport consensus recommendations, it is concluded that there is compelling support for the burgeoning use of computerised neurocognitive evaluation in the sports concussion arena as the optimal and most responsible healthcare currently available in this arena.SAJSM, vol 23 No. 4 2011
The limits to exercise performance and the future of fatigue research
Authors: Marino FE , Gard M , Drinkwater EJ
Published: January 2017

The study of human fatigue stretches back centuries and remains a significant part of medical and social discourse. In the exercise sciences fatigue is routinely related to the ability to produce muscle force or to the recovery from force decrements. However, the study of fatigue has by virtue of the experimental paradigm excluded the subjective sense a person attributes to an event or experience, thus reducing our overall understanding of the fatigue process. Modern studies report the causes of fatigue as either central or peripheral in origin. Although useful, this dichotomy can also exclude the individual subjective assessment. Furthermore, adhering dogmatically to set parameters is likely limiting the advancement of our understanding. A more realistic paradigm would permit the individual to use the sensory cues to adjust the effort alongwith the fatigue process rather than rely purely on feedback mechanisms. Therefore, bringing feedforward mechanisms of the brain into fatigue research perhaps represents the next phase in the unravelling of the fatigue process.
Italian weather scientists and sports scientists - is there a link?
Authors: Lambert M
Published: January 2017

Italian weather scientists and sports scientists - is there a link?
The relationship between anxiety and shoulder injuries among South African university and club rugby players
Authors: Van Niekerk R L
Published: January 2017

Objectives. This correlational study investigated the relationship between competitive anxiety and shoulder injuries in a sample of club rugby players (N=112) from two universities and three suburban clubs. Methods. The participants were asked to complete a biographical questionnaire and the Sport Competition Anxiety Test,1 while the injury history of the players for the 2012 season was obtained from the responsible health professions after consent was given. Group differences and a direct logistical regression were calculated to determine the relationship between injury and anxiety. Results. The results indicated that rugby players who contracted a shoulder injury in a 1-year season have significantly higher levels of anxiety than those players who did not. However, the effect size of the difference seems to be small. The anxiety levels of players with shoulder injuries were regarded as too high when competing. A logistical regression, including various factors, was able to predict injury fairly well, but anxiety seems to be the only variable that contributed significantly to the model. Conclusion. The results suggest that the contribution of anxiety to the occurrence of shoulder injuries in club and university rugby cannot be ignored. The high level of anxiety associated with players who suffered shoulder injuries has to be targeted with anxiety management skills as part of a player development and injury management programme.
Endurance Training - Science and Practice
Authors: Capostagno B
Published: January 2017

Endurance Training - Science and Practice
CPD Questionnaire
Authors: . .
Published: January 2017

CPD Questionnaire
Thoracic posture, shoulder muscle activation patterns and isokinetic strength of semi-professional rugby union players
Authors: Bolton G , Moss SJ , Sparks M , Venter PC
Published: January 2017

Background. Shoulder injuries are the most severe injuries in rugby union players, accounting for almost 20% of injuries related to the sport and resulting in lost playing hours.Objective. To profile the thoracic posture, scapular muscle activation patterns and rotator cuff muscle isokinetic strength of semi-professionalrugby union players.Methods. Using the hand-behind-the-neck and -back methods, we manually tested the range of motion (ROM) of the shoulder joints of 91 uninjured semi-professional rugby union players who consented to participate in the study. Profiling and classification of thoracic posture was performed according to the New York Posture Test. Activation patterns of the upper and lower trapezius, serratus anterior and infraspinatus scapular muscles were determined by electromyography. The isokinetic muscle strength of the rotator cuff muscles was determined at 60°/sec by measuring the concentric and eccentric forces during internal rotation (IR) and external rotation (ER).Results. Participants presented with non-ideal or unsatisfactory internal (59%) and external (85%) rotators of the shoulder. A slightly abnormal or abnormal forward head posture was observed in 55% of participants, while 68% had an abnormal shoulder position in the lateral view. The muscle activation sequence of the rotator cuff muscles was: (i) serratus anterior, (ii) lower trapezius, (iii) infraspinatus, and (iv) upper trapezius. The isokinetic ER/IR muscle-strength ratio during concentric muscle contraction was 64% (standard deviation (SD) ±14) for the left shoulder and 54% (SD ±10) for the right shoulder. The ER/IR ratio for eccentric muscle contraction was 67% (SD ±12) and 61% (SD ±9) for the left and right shoulders, respectively.Conclusions. Non-ideal or unsatisfactory flexibility of the external rotators of the shoulder, a forward shoulder posture in the lateral view, and weakness of the external rotators did not result in an abnormal rotator cuff muscle activation pattern in this study. Postural deviations may, however, increase the risk of shoulder injury in rugby union players in the long term, and should be corrected.
Exercise effects on mood in breast cancer patients
Authors: Van Oers HM
Published: January 2017

Breast cancer is one of the most common cancers worldwide, and statistics reveal that the number of women diagnosed with breast cancer in South Africa is increasing. As such, medical practitioners will treat an increasing number of breast cancer patients. Although increasingly effective treatments improve patient survival intervals, a significant number of patients experience psychological distress, at the time of diagnosis and sometimes well beyond the start of treatment. This can be attributed to the disease itself and to treatment side-effects. Historically, patients experiencing such distress have been treated with pharmacotherapy or have been referred for psychotherapeutic intervention. Although it is well known that physical exercise is beneficial to physical health, only recently, and comparatively, has the effect of exercise been recognised as beneficial to psychological well-being. Cancer patients are often advised to reduce physical activity to avoid cancer-related fatigue. Paradoxically, recent research shows that physical exercise, of the type and intensity appropriate for the ability of each patient, can in fact play a significant role in improving mood and aiding physical recovery. This opens up a valuable additional resource to augment patients’ quality of life, both physically and psychologically. One precaution stands vitally important, however: the prescribed exercise regimen must be tailored to the physical capabilities of the patient.