Frederik F. Coetzee

Causative factors and rehabilitation of patellar tendinopathy : a systematic review

Background Patellar tendinopathy (PT) is a common chronic pathology of the knee, with a high prevalence in athletes and the general population. Objectives The objectives of this article were to systematically investigate all the evidence applicable to the intrinsic and extrinsic causative factors and rehabilitation of PT, and then integrate and link rehabilitation with the main causative factors identified. Method The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Various tools were used to evaluate the methodological quality of the eligible articles. Data were interpreted descriptively, and the causative factors and rehabilitation of PT were analysed. Results Twenty studies were included in the review. The distinctive factor responsible for PT is the mechanical theory. Seven intrinsic and four extrinsic risk factors were identified, with the main intrinsic risk factors being muscle flexibility and strength, and extrinsic risk factors being acquisition and level of skills. PT can be treated with numerous different therapeutic modalities, although eccentric muscle training showed exceptional results. The intrinsic and extrinsic risk factors can only be transformed and reduced by rehabilitation, which is inevitable to improve PT pain and function. Conclusion The essence of an integrated management protocol for PT is to identify the dominant contributing factors, whether intrinsic or extrinsic, and to reduce the load on the patellar tendon by modifying these factors by either rehabilitation intervention or direct modification of the equipment or environment to obtain a positive outcome towards pain management and function.

Analysis of the general match profile of international rugby union between 2007 and 2013

Abstract Law amendments are fundamental to the development of rugby and are introduced for a variety of reasons. The aim of this study was to investigate and compare the general match profile of international rugby between 2007 and 2013 in order to determine the effect of law changes. The researchers made use of mixed method methodology approach for this study. For the quantitative approach, a total of 248 matches were recorded and analyzed using the Fairplay video analysis software package. For the qualitative approach, the researchers conducted semi-structured interviews with expert coaches, specialist coaches, players and referees and referee coaches. The results revealed a practical significant decrease in the number of scrums (d = 1.03) line-outs (d = .86), rucks (d = .86), mauls (d = .62) and kicks (d = .46). An increase in the number of passes (d = .43), ball carries (d = 1.22) tackles attempted (d = .65) and penalty kicks (d = .98) between 2007 and 2013 was observed. The interviews revealed that under the current laws, there is an imbalance between attack and defence. The general match profile of international rugby has moved to a game with a decrease in the number of set pieces and kicks to an increase in the number of ball carries and tackles.

Scoring and general match profile of Super Rugby between 2008 and 2013

Rugby research has focused on a range of performance indicators related to game structures and tactical aspects. The purpose of this study was to investigate and compare the effect of law changes on the match profile of Super Rugby between the 2008 and 2013 seasons. For the purpose of this study the researchers made use of mixed-method methodology. A total of 646 Super Rugby matches were recorded and analyzed by means of the Fairplay video analysis software package. Further semi-structured interviews were conducted with expert coaches, specialist coaches, players and referees and referee coaches. Results revealed a significant increase in the number of points scored (p<0.01) and a decrease in the number of tries scored (p<0.01). Results of the study show that the profile of Super Rugby has changed to a more continuous game dynamic with the increase in the number of ball carries (d=1.34), passes (d=0.43), tackle breaks (d=1.59) and line breaks (d=2.40), and has led to an increase in the number of tackles (d=0.63). A decrease in the number of rucks (d=1.73), mauls (d=0.63), scrums (d=0.27) and scrum resets (d=1.36) was found. An increase in penalty kicks (d=2.04) and a decrease in free kicks (d=0.4.53) between 2008 and 2013 were observed. The general match profile of Super Rugby has moved to a game with fewer scrums and kicks and more ball carries and tackles. According to the interviewed experts, good playing surfaces in the Southern Hemisphere allow for an open-game approach by the teams.

Proposing a Patellar Tendinopathy Screening tool following a systematic review

Background Patellar tendinopathy (PT) is an overuse injury of the knee. The mechanism of injury is associated with repetitive stress on the patellar tendon of the knee as a result of explosive movement. Patellar tendinopathy is prevalent in all populations and is associated with intrinsic and extrinsic risk factors. Objectives Primarily, the objective was to report on the intrinsic and extrinsic risk factors for PT, entailing a systematic review of the literature; the secondary objective was to use these risk factors to compile a proposed PT screening tool from the review and standard outcome measures. Method A systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Elimination criteria of the articles included duplicates, titles, abstracts and methodological quality. The evidence was collected, characterised with regard to the intrinsic and extrinsic risk factors and summarised descriptively. Results The search yielded 157 feasible articles prior to commencement of article elimination. Six articles were included with a mean methodological quality score of 69%. Eight intrinsic and five extrinsic risk factors were identified. These identified risk factors are all relevant to the pathology and formed the basis for a proposed PT screening tool. The Victorian Institute of Sports Assessment for Patellar Tendinopathy Questionnaire, Visual Analog Scale and the Pain Provocation Test are also included in the proposed test. Conclusion Intrinsic and extrinsic risk factors for PT were identified, and consequently, the proposed PT screening tool was formulated for possible future testing in appropriate studies. Clinical implications Prevention of PT through intrinsic and extrinsic risk factor identification, and implementation in the clinical setup as a possible outcome measurement tool with which to verify functional improvement in PT rehabilitation.