Injury profiles in sub-elite Women's Cricket: Exploring incidence, prevalence, nature, onset and body region.

INTRODUCTION: The rise in participation in sports, like women's cricket, is linked with increased injury risk. Providing high-level longitudinal data is the first step in implementing evidence-based injury prevention strategies. DESIGN: Prospective cohort study. OBJECTIVE: This cohort study aims to describe the injury profiles in sub-elite women's cricket in South Africa during the 2022/23 season. METHODS: Injuries were prospectively recorded using injury surveillance questionnaires, injury surveillance database, and logbooks completed by each team's medical staff. Injury rates were investigated for match and training days, body region, player role, nature, and activity at the time of injury. RESULTS: Three teams with a total of 44 players (20.86 ± 1.6 years) were included in the study. Injury incidence was 85.23 per 1000 player match days, 15.91 for match time-loss and 69.32 for non-time-loss, with 2.95% of players unavailable for match selection on any day. Fast bowlers had the highest injury incidence. Fielding caused 46.67% of all injuries. Injury incidence was higher in training than in matches. The wrist/hand had the highest injury incidence and caused the most match time-loss. CONCLUSION: This study provides valuable insights regarding the current injury rates in sub-elite female cricket players.

Anthropometric and biomechanical factors in elite male and female fast bowlers.

Researchers have extensively studied the biomechanics and anthropometrics of fast bowling in men's cricket, but there is still limited research in women's cricket. This study describes and compares the anthropometric qualities and bowling biomechanics between elite male and female fast bowlers. An inertial measurement system was used to collect three-dimensional biomechanical data for 20 elite fast bowlers (13 males and seven females). Kinematic data was captured at one step before back foot contact, back foot contact, front foot contact, ball release to one step after ball release. Anthropometric measurements included body segment lengths, mass, body fat (BF%) and muscle mass (MM%). The student t-test and Mann-Whitney U test were used for analyses. Hotelling's T2 statistic was calculated to control Type I error during multiple comparisons (p = 0.045). Males and females differed in overall height, limb length, BF% and MM%. Females presented with slower ball release speeds (p = 0.001). Biomechanically, the females were more front-on when approaching the delivery stride and then initiated pelvis and trunk rotation during the delivery stride, not seen in the males. Females and males have a similar magnitude of trunk side-flexion, but females present with a different strategy than males (p = 0.038). Females presented with increased front knee extension at ball release (p = 0.05). The findings from this study emphasise the differences between male and female fast bowlers and suggest that the coaching principles used in male fast bowling may not be relevant to female fast bowlers.

Physical Profiles of All-Rounders, Batters, and Bowlers in Sub-Elite Women's Cricket.

ABSTRACT: Jacobs, J, Olivier, B, Brandt, C, and Jafta, G. Physical profiles of all-rounders, batters, and bowlers in sub-elite women's cricket. J Strength Cond Res 38(6): 1095-1102, 2024-The unique physical profile of each player's role in sub-elite women's cricket is vital for optimizing performance as these players progress to the elite levels. This quantitative, cross-sectional study investigates the physical profiles of sub-elite women's cricket players as a group and compares these profiles across different player roles. Sub-elite female cricket players in the South African domestic women's cricket league were included in this study. A battery of physical assessments were conducted at the start of the 2022/23 season. The physical assessments included body composition, individual muscle strength testing using dynamometry, 2-km time trial (TT), countermovement jump (CMJ), single-leg jump (SLJ), isometric mid-thigh pull, push-up, and hop test on force plates. A total of 44 female players (20.86 ± 1.6 years) were included in the study. Differences were found in muscle mass (p = 0.004) and peak power (p = 0.040) for all-rounders and bowlers. Player roles presented with different dominant (p = 0.006) and non-dominant (p = 0.066) knee flexion strength. The bowlers' body composition and physical strength profile are compromised compared with batters and all-rounders. There were several physical strength and power differences between pace and spin bowlers in CMJ and SLJ tests for jump height (p = 0.009) and peak power (p = 0.006). Batters performed the best in the 2-km TT. Body composition and musculoskeletal profiles for each player role can be baseline markers in sub-elite women's cricket. Stakeholders can use this information to guide physical preparation for players advancing to elite levels.

Physical activity, lifestyle, sociocultural factors and prevalence of excess weight gain among postmenopausal women: A cross-sectional study.

BACKGROUND: Most women experienced postmenopausal symptoms during the menopause transition, and they are a common reason for seeking medical attention and lifestyle modification during this phase of life. OBJECTIVE: This study assessed the physical activity, lifestyle, and sociocultural levels-associated prevalence of excess weight (overweight and obesity) among postmenopausal women (PW) in Bono-East (Techiman) region, Ghana. DESIGN: This is cross-sectional study. METHOD: This was a cross-sectional study conducted at Bono-East regional capital, Techiman in Ghana over 5 months. Self-administered questionnaires were used to obtain sociodemographic data, physical activity, lifestyle, and sociocultural associated prevalence of excess weight. Anthropometric indices including ((body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR)) were assessed. RESULTS: A total of 393 postmenopausal women with a mean age of 60.09 ± 6.24 years participated in the study. When reporting prevalence, obesity, and overweight were distinguished. Using the anthropometric parameters (BMI, WHtR, and WHR) as measured for being overweight, the prevalent rates were 35.7%, 21.7%, and 9.0% respectively. Also, when using obesity, the prevalent rate was 37.8%, 70.1%, and 82.0% using BMI, WHtR, and WHR, respectively. Over 55 (55.2%) of the study participants engaged in moderate physical activities, 23.1% were low and 21.7% with high physical activities. Housewives and unemployed participants are shown to have a higher risk of gaining weight (obese) especially when assessed with WHR and WHtR. Most participants responded that cultural beliefs prevent them from losing weight. Most participants had a poor attitude toward their eating habits. CONCLUSION: According to the findings, postmenopausal Ghanaian women showed a high level of obesity and a moderate level of being overweight. The cultural perception of beauty influences Ghanaian postmenopausal women's physical activity level and dietary habits.

Physiotherapy practice in lymphoedema in South Africa: A survey.

Background: Lymphoedema is a chronic condition that is increasing in prevalence and requires specialised management to avoid possible life-threatening complications. Objectives: To describe the perceived knowledge of physiotherapists about lymphoedema and its management, the lymphoedema patient load seen by physiotherapists, and the current treatment approaches of physiotherapists in South Africa when managing lymphoedema. Method: A quantitative study using self-administered, online questionnaires were distributed among physiotherapists. Results: Knowledge of lymphoedema management is perceived to be lacking among physiotherapists. Physiotherapists are getting limited referrals and spending little time managing patients with lymphoedema. Only a few physiotherapists have post-graduate education in lymphoedema management, thus international treatment standards still need to be met. Conclusion: In order to meet international standards and patient needs, future research investigating the physiotherapy perspective is needed in lymphoedema management. Clinical implications: Educational bodies and policymakers may use this data to facilitate improvement in physiotherapy management of the condition and provision of care.

Prevalence of excess weight and associated socio-demographic factors among postmenopausal women: A population-based study in Ghana.

BACKGROUND: Excess weight (obesity and overweight) is a pervasive condition that is considered a global epidemic and a threat to public health. Furthermore, numerous changes in fat deposits occur with the advent of menopause, leading to a change in the distribution of body fat. Knowledge of sociodemographic factors and prevalence can inform the effective management of these women. AIM: This study aimed to investigate the prevalence of excess weight among postmenopausal women in Ghana's Bono East (Techiman) region. SETTING: This study was conducted in Bono East regional capital, Techiman, Ghana. METHODS: This is a cross-sectional study conducted over 5 months at Bono East regional capital, Techiman in Ghana. Anthropometric parameters such as body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were obtained using physical measurements while socio-demographic data were gathered using questionnaires. Data analysis was performed using IBM SPSS 25. RESULTS: The mean age of the 378 women who participated in the study was 60.09 ± 6.24 years. Body mass index, WHtR and WHR indicated excess weight of 73.2%, 91.8% and 91.0%, respectively. Education and ethnicity were predictors of excess weight (WHR). Women of the Ga tribe with high school education have 4.7- and 8.6-times increased odds of having excess weight. CONCLUSIONS: There are higher prevalence rates of excess weight (obesity and overweight) among postmenopausal women using BMI, WHtR and WHR. Education and ethnicity are predictors of excess weight.Contribution: The study's findings can be used to develop interventions that focus on addressing excess weight in postmenopausal women within the Ghanaian context.

An exploratory study on excess weight gain: Experiences of Postmenopausal Women in Ghana.

INTRODUCTION: Excess weight gain is a problem with a significant impact on health and quality of life as well as the consequent economic burden on human populations. While society advocates preference for excess weight gain, limited evidence exists concerning postmenopausal women's experiences in Ghana. AIM: The current study explored the experiences regarding excess weight (overweight and obesity) gain among Ghanaian postmenopausal women in Bono East (Techiman) region. METHODS: This is a qualitative exploratory descriptive study where anthropometric measurements [body mass index (BMI), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR)] were determined and participants who were identified with excess weight (obesity and overweight) were recruited to participate in a focus group discussion (FGD). Four focus group discussions were held and 24 postmenopausal women (>45 years) in Techiman took part. Discussions were audio-recorded and transcribed for thematic analysis. RESULTS: From the qualitative analysis of the FGD, three major themes emerged from the study namely, (i) perception of body weight, (ii) measures to reduce body weight, and (iii) support to adhere to the weight management program. Sub-themes revealed that weight gained was viewed as the presence of diseases and admired by society as a culturally accepted body image. Diet-related changes, a combination of diet modification and physical activity, and weight management supplements emerged as measures to reduce excess weight. Support to adhere to the weight program included health education, access, affordable exercise facilities, and social support. CONCLUSIONS: Sociocultural norms influence the image perception and acceptance of weight gain among postmenopausal women in Ghana, but there is an acknowledgment of the perceived negative health implications of such excess weight. Measures for weight reduction and support to adhere to the weight reduction programme require attention in Ghana.

Neck Pain and Disability: Are They Related to Dysfunctional Breathing and Stress?

Purpose: People with neck pain are likely to have negative respiratory findings. The purpose of this study was to investigate the relationship between neck  pain and dysfunctional breathing and to examine their relationship to stress. Method: This cross-sectional study included 49 participants with neck pain and 49 age- and sex-matched controls. We measured neck pain using the numeric rating scale (NRS); neck disability using the Neck Disability Index (NDI); dysfunctional breathing using the Nijmegen Questionnaire (NQ), Self-Evaluation of Breathing Questionnaire (SEBQ), breath hold time, and respiratory rate (RR); and stress using the Perceived Stress Scale (PSS). Results: Participants with neck pain scored higher on the NQ (p < 0.01) and the SEBQ (p < 0.01) than controls. NQ and SEBQ scores correlated moderately with NDI scores (r > 0.50; 95% CI: 0.25, 0.68 and 0.33, 0.73, respectively) and PSS scores (r > 0.50; 95% CI: 0.29, 0.78 and 0.31, 0.73, respectively). SEBQ scores showed a fair correlation with NRS scores and RR a fair correlation with NDI scores. Conclusions: Participants with neck pain had more dysfunctional breathing symptoms than participants without neck pain, and dysfunctional breathing was correlated with increased neck disability and increased stress. The NQ and SEBQ can be useful in assessing dysfunctional breathing in patients with neck pain.

Objectif : les personnes qui éprouvent des douleurs cervicales sont susceptibles d'avoir des problèmes respiratoires. La présente étude visait à examiner le lien entre les douleurs cervicales et une respiration dysfonctionnelle, de même que leur lien avec le stress. Méthodologie : la présente étude transversale incluait 49 participants ayant des douleurs cervicales et 49 sujets témoins appariés. Les chercheurs ont mesuré la douleur cervicale au moyen de l'échelle d'évaluation numérique (ÉÉN); les incapacités cervicales au moyen de l'indice d'incapacité cervicale (IIC); la respiration dysfonctionnelle au moyen du questionnaire de Nijmegen (QN), du questionnaire d'autoévaluation de la respiration (QAÉR), de la durée de retenue de la respiration et de la fréquence respiratoire (FR); et le stress au moyen de l'échelle de perception du stress (ÉPS). Résultats : les participants qui éprouvaient des douleurs cervicales obtenaient des résultats plus élevés que les sujets témoins au QN (p < 0,01) et au QAÉR (p < 0,01). Les scores du QN et du QAÉR avaient une corrélation modérée avec les scores de l'IIC (r > 0,50; IC à 95 %, 0,25, 0,68 et 0,33, 0,73, respectivement) et les scores de l'ÉPS (r > 0,50; IC à 95 %, 0,29, 0,78 et 0,31, 0,73, respectivement). Les scores du QAÉR ont révélé une corrélation claire avec les scores de l'ÉÉN et la FR, ainsi qu'avec les scores de l'IIC. Conclusions : les participants qui éprouvaient des douleurs cervicales avaient plus de symptômes de respiration dysfonctionnelle que les participants sans douleur cervicale, et la respiration dysfonctionnelle était corrélée avec une incapacité cervicale et un stress accrus. Le QN et le QAÉR peuvent être utiles pour évaluer la respiration dysfonctionnelle chez les patients éprouvant des douleurs cervicales.

Postoperative Physiotherapy in Women Undergoing Pelvic Floor Reconstructive Surgery: A Randomized Controlled Clinical Trial.

Purpose: Postoperative physiotherapy in conjunction with pelvic organ prolapse (POP) surgery is still under-investigated and controversial. In this randomized controlled trial, pelvic floor muscle training (PFMT) and abdominal training were compared with a control condition (standard in-hospital treatment). Method: Eighty-one women were randomized to one of three groups. The Prolapse Quality of Life questionnaire, two-dimensional ultrasound, Pelvic Organ Prolapse Quantification System scale, the PERFECT (power, endurance, repetitions, fast contractions, every contraction timed) scheme, electromyography, Sahrmann scale, and pressure biofeedback unit (PBU) were used to measure quality of life (QOL), POP, and pelvic floor and abdominal muscle function. A mixed-model analysis of variance and the Kruskal-Wallis test was used for analysis. Results: Beneficial effects (p < 0.05) were found for the PFMT group - increased power, number of fast contractions, amount of movement, endurance, and Sahrmann and PBU measures - compared with the control group. Abdominal training led to a significant (p < 0.05) increase in bulging and discomfort, number of pelvic floor muscle contractions, and Sahrmann and PBU measures compared with the control condition; both groups showed significantly increased urinary frequency (p < 0.05). Conclusions: Postoperative physiotherapy did not have a beneficial effect on QOL or POP symptoms. PFMT and abdominal training had beneficial effects on pelvic floor muscle function and abdominal muscle measures. Additional abdominal training led to increased symptoms.

Objectif : la physiothérapie postopératoire, conjuguée à une chirurgie du prolapsus (CP), est encore sous-évaluée et controversée. Le présent essai aléatoire et contrôlé compare la rééducation périnéale et pelvienne (RPP) à l'entraînement abdominal auprès d'un groupe témoin. Méthodologie : les chercheurs ont réparti 81 femmes en trois groupes. Ils ont utilisé le questionnaire sur la qualité de vie liée au prolapsus, l'échographie bidimensionnelle, le système de classification pour quantifier le prolapsus, l'échelle PERFECT (puissance, endurance, répétitions, rapidité des contractions, durée de chaque contraction), l'électromyographie, l'échelle de Sahrmann et l'unité de rétroaction par pression (URP) pour mesurer la qualité de vie (QdV), la CP et la fonction du plancher pelvien et des muscles abdominaux. Ils ont utilisé un modèle mixte d'analyse de variance et le test de Kruskal-Wallis pour procéder à l'analyse. Résultats : les chercheurs ont constaté des effets bénéfiques (p < 0,05) dans le groupe RPP (puissance, nombre de contractions rapides, quantité de mouvements, endurance et mesures de Sahrmann et d'URP) par rapport au groupe témoin. L'entraînement abdominal a suscité une augmentation significative (p < 0,05) du gonflement et de l'inconfort, du nombre de contractions en RPP et des mesures de Sahrmann et d'URP par rapport au groupe témoin. Les deux groupes ont accru la fréquence de leurs mictions de manière significative (p < 0,05). Conclusion : la physiothérapie postopératoire n'avait pas d'effet bénéfique sur la QdV ou les symptômes de la CP. L'entraînement abdominal et la RPP avaient des effets bénéfiques sur la fonction des muscles pelviens et les mesures des muscles abdominaux. Un entraînement abdominal supplémentaire provoquait une augmentation des symptômes.

Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review.

BACKGROUND: Metacarpal fractures, one of the most prevalent upper limb fractures, account for 10% of all bony injuries. OBJECTIVE: Our systematic review aimed to review, appraise and collate available evidence on hand rehabilitation programmes for the management of second to fifth metacarpal fractures in an adult human population after conservative and surgical management. Since 2008, no review on a similar topic has been performed, thus informing clinical practice for physiotherapists and occupational therapists. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) principles guided the reporting. Experimental, quasi-experimental, cohort and case-control studies between January 2008 and September 2018 were included. Searches were conducted on Medline, Academic Search Ultimate, CINAHL, CAB Abstracts, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information and MasterFILE Premier, Web-of-Science and Scopus. Screening, selection, appraisal and data extraction were independently performed by two reviewers. No meta-analysis was performed. RESULTS: A total of 1015 sources were identified, 525 duplicates removed and 514 excluded. Three articles were included in the final data extraction: one randomised controlled trial (RCT) and two observational studies. CONCLUSION: Limited evidence is available that a well-designed, well-implemented home-based exercise programme results in statistically significant improved hand function (p ˂ 0.0001) and digital total active motion (TAM) (p = 0.013) compared with traditional physiotherapy (PT) post-surgically. CLINICAL IMPLICATIONS: Our study contributes to the knowledge base of hand rehabilitation after an individual sustained a second to fifth metacarpal fracture. The authors identified a gap where future studies should further investigate the effect of hand rehabilitation after conservative and surgical management.

Physiotherapy and pelvic floor health within a contemporary biopsychosocial model of care: From research to education and clinical practice.

BACKGROUND: Pelvic floor dysfunction (PFD) is a common problem in both men and women. Despite the high prevalence and negative effects on quality of life, there is still a lack of research in this area which translates into clinical practice and education. OBJECTIVES: My study discusses how gaps and controversies in current research and evidence on PFD might be addressed by positioning PFD within a contemporary biopsychosocial model of care (BPSM). METHOD: Various databases were searched for relevant studies published between 2010 and 2020 to support hypotheses and statements. RESULTS: My study focuses on the available evidence of PFD in both men and women as related to the themes and sub-themes of the BPSM, and how this available evidence might translate into education and clinical practice. It highlights areas of research, education and clinical practice that need to be explored and how the different components of healthcare may influence one another. CONCLUSION: Biomedical aspects regarding pelvic health are mostly investigated and taught, whilst psychological, cognitive, behavioural, social and occupational factors, individualised care, communication and therapeutic alliances are still under-investigated and not integrated or translated at a sufficient level into research, education and clinical practice. CLINICAL IMPLICATIONS: Incorporating the integration of all factors of the BPSM into research is important for effective knowledge translation and enhancement of a de-compartmentalised approach to management. The interaction between the different components of the BPSM should be investigated especially in a South African population.

Systematic review of screening tools for common soccer injuries and their risk factors.

BACKGROUND: Several screening tools are available for use in a clinical setting to predict injury. However, there is a lack of evidence regarding the accuracy of these tools to predict soccer-specific injuries. OBJECTIVES: The purpose of this systematic literature review was to determine the psychometric properties or accuracy of screening tools for common soccer injuries. METHODS: A systematic review of diagnostic test accuracy was undertaken based on the Joanna Briggs Institute (JBI) procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed and grey literature were searched in order to access suitable studies. RESULTS: A total of 10 studies were included for the analysis - three were analysed quantitatively whilst the remaining seven were analysed qualitatively. The screening tools were of high reliability, sensitivity and specificity (calculated as intraclass correlation coefficient [ICC] (0.68 95% confidence interval [CI]: 0.52-0.84 and 0.64 95% CI: 0.61-0.66, respectively). CONCLUSION: The screening tools assessed for the prediction of common soccer injuries that emerged from this systematic review include the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS) and the conventional hamstrings to quadriceps ratio; all with good evidence of predicting common soccer injuries. These tools were of high sensitivity and specificity thus reliable for soccer screening. CLINICAL IMPLICATIONS: The validity of these tools is acceptable and therefore the authors recommend that these tools be included in an injury prevention programme for soccer players.

An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse.

BACKGROUND: There is little evidence on movement impairment of the abdominal and pelvic floor muscles (PFM) in women with pelvic organ prolapse (POP). OBJECTIVES: The aim of this study was to determine the movement impairments and interactions between the PFM and abdominal muscles in POP. METHOD: The PFM and abdominal muscles of 100 conveniently sampled South African women with POP were assessed by ultrasonography, electromyography (EMG), the PERFECT scale, Sahrmann scale and a Pressure Biofeedback Unit (PBU). A demographic questionnaire determined contextual factors (exercise and medical history) and Visual Faces Scale pain intensities. Data were analysed descriptively and with Spearman and Pearson correlation coefficients. RESULTS: Participants (59 ± 9.31 years) were mostly unemployed (80%), physically inactive (85%), with comorbidities, heart or vascular disease, hypothyroidism and depression. The mean levator hiatus at rest (56.38 mm, standard deviation [SD] 9.95), thickness (5.1 mm, SD 1.41), amount of movement (4.28 mm, SD 6.84), strength (level 1.89, SD 1.13) and endurance (4.04 s, SD 3.32) of the PFM indicated dysfunction. Median values of zero were found for the Sahrmann scale (interquartile [IQ] range [0-1]) and PBU (IQ range [0-2]) and 10.95 µV for abdominal EMG (IQ range [7.9-17.8]). Pelvic floor muscle strength, endurance, movement and EMG activity correlation was fair (r > 0.4, p < 0.001), as was PFM strength, endurance and abdominal muscle function (r > 0.4, p < 0.05). CONCLUSION: Movement impairment of local and global stability and mobility functions of PFM and abdominal muscles was present, as well as correlations between these functions. Addressing these impairments may affect the identified contextual factors (socio-economic, psychological and lifestyle factors) and the possible activity limitations and participation restrictions in patients with POP. Further research is needed to investigate these interactions. CLINICAL IMPLICATIONS: The findings suggest that assessment and management of patients with POP might need to be based on a comprehensive neuro-musculoskeletal assessment and a holistic approach. Standardised protocols for patients with pelvic floor dysfunction (PFD) should therefore be used with caution. Randomised controlled trials should investigate patient-specific and holistic intervention approaches.

Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse.

BACKGROUND: Pelvic organ prolapse (POP) is a multifactorial, poorly understood condition impacting quality of life (QOL). The pathology and aetiology might imply population-specific differences in domains of the International Classification of Function, Disability and Health (ICF). There is, however, a lack of research in this regard in South Africa. OBJECTIVES: To describe the dysfunction, activity limitations, participation restrictions and contextual factors in South African women with POP. METHOD: One hundred women were conveniently sampled in a primary health care setting. They completed a self-compiled medical and exercise history questionnaire, the standardised Prolapse-Quality of Life (P-QOL) questionnaire and the Visual Faces Scale. The stage of prolapse was determined by the Pelvic Organ Prolapse Quantification (POP-Q) Scale. Means, medians, standard deviations, percentages and frequencies were calculated. RESULTS: Eighty-six per cent had a stage III POP, 57% had overactive bladder, 50% had constipation, 37% had stress urinary incontinence, 31% had urge urinary incontinence, 32% had incomplete emptying and 30% had anal incontinence. Comorbidities included cardiovascular disease (65%), depressive symptoms (12%) and hypothyroidism (18%). Other contextual factors included limited physical activity (80%), an increased body mass index (29 kg/m2), older age (59 years) and unemployment (80%). Quality of life was affected in the severity, social, emotional and sleep/energy domains (median scores were 66.7% - 33.3%). CONCLUSION: The dysfunction domain of the ICF was similar to other populations with POP. Activity and participation restrictions included social, emotional and sleep/energy aspects. Contextual factors seem to be population-specific, possibly leading to differences comparing QOL amongst different populations. CLINICAL IMPLICATIONS: Activity and participation restrictions, as well as contextual factors, may differ in different populations with POP. Interactions between contextual factors and movement impairment should be considered during management and be further investigated.

An evidence-based review on the validity of the Kaltenborn rule as applied to the glenohumeral joint.

Kaltenborn's convex-concave rule is a familiar concept in joint treatment techniques and arthrokinematics. Recent investigations on the glenohumeral joint appear to question this rule and thus accepted practice guidelines. An evidence-based systematic review was conducted to summarize and interpret the evidence on the direction of the accessory gliding movement of the head of the humerus (HOH) on the glenoid during physiological shoulder movement. Five hundred and eighty-one citations were screened. Data from 30 studies were summarized in five evidence tables with good inter-extracter agreement. The quality of the clinical trials rated a mean score of 51.27% according to the Physiotherapy Evidence Database scale (inter-rater agreement: kappa=-0.6111). Heterogeneity among studies precluded a quantitative meta-analysis. Weighting of the evidence according to Elwood;s classification and the Agency for Health Care Policy and Research classification guidelines indicated that evidence was weak and limited. Poor methodological quality, weak evidence, heterogeneity and inconsistent findings among the reviewed studies regarding the direction of translation of the HOH on the glenoid, precluded the drawing of any firm conclusions from this review. Evidence, however, indicated that not only the passive, but also the active and control subsystems of the shoulder may need to be considered when determining the direction of the translational gliding of the HOH. The indirect method, using Kaltenborn's convex-concave rule as applied to the glenohumeral joint, may therefore need to be reconsidered.