Assessing calf exercise fidelity among people with Achilles tendinopathy using videos recorded via Zoom®: an observational study.

PURPOSE: Exercise fidelity is a fundamental aspect of exercise prescription by physiotherapists. Assessing exercise fidelity via telehealth (videoconference) is potentially useful but its reproducibility has not been assessed. The objective was to evaluate agreement (reproducibility) of video rating of calf exercise fidelity within (over four weeks) and between telehealth raters and compared with live rating. METHODS: Nineteen videos of participants with AT undertaking calf exercises were rated by physiotherapists in person (live) and by watching pre-recorded videos (replicating telehealth). Three forms of agreement were assessed: (i) between live assessment and recorded video (telehealth) assessment; (ii) between telehealth raters (inter-rater); (iii) agreement within telehealth raters over four weeks (intra-rater). RESULTS: There was weak to almost perfect agreement (Kappa = 0.65 to 1.00, rater 1, Kappa = 0.57 to 1.00, rater 2) between the telehealth and live raters. There was moderate to almost perfect agreement (Kappa = 0.65 to 1.00) when assessing intra-rater reliability, aside from one of the six criteria (quality of movement). CONCLUSION: Assessing calf exercise fidelity via videos recorded on Zoom® appears to demonstrate weak or greater agreement versus live rating and over time. Inter-rater agreement was lower, suggesting that the criteria developed may be better suited to use by individual raters over time.Implications for rehabilitationTelehealth assessment (when compared with live, in person assessment) shows a moderate or greater agreement for the majority of assessment criteria when assessing calf exercise fidelity.The calf exercise fidelity criteria developed can be used as an adjunct to assessment and management of people with Achilles Tendinopathy.Intra-rater assessment was shown to be moderately or more consistent over a four-week period when assessing calf exercise fidelity.

Injury and Illness Incidence in 2017 Super Rugby Tournament: A Surveillance Study on a Single South African Team.

Background: Professional rugby presents significant injury and illness risks to players, which need to be regularly assessed to monitor the effects of interventions and competition rules changes. Hypothesis/Purpose: The purpose of this study was to determine the incidence and nature of time-loss injuries and illness during the pre-season and competition period of the 2017 Super Rugby tournament in a single South African team. Study Design: Descriptive Epidemiology Study. Methods: Forty-five adult players were recruited from one 2017 Super Rugby South African team, with 39 included in the final data set. Daily injury and illness data were routinely collected during the season by support staff over a 28-week period (January to July 2017), based on standardized injury and illness definitions. Retrospective analyses of the data were performed. Results: The incidence of match injuries (241.0 per 1000 player hours) was significantly higher than training injuries (3.3 per 1000 player hours). Twenty one percent of all injuries occurred during the tackle; 37.5% of all injuries were of a "moderate" severity. The proportion of players who sustained a time-loss injury was 76.9% (n=30). The overall incidence of illness was 1.8 per 1000 player days. Acute respiratory tract infection (28.6%) was the most common diagnosis, and the majority of illnesses (64.3%) did not result in time-loss. Conclusion: This study presented a longer study period than previous research by including the pre-season training, but represented only one single team. The incidence of match injuries was significantly higher than previously reported in Super Rugby tournaments, whereas illness rates were significantly lower. Support staff in professional rugby need to be trained on the standardized Orchard System of Classifications to ensure good quality data that can be compared to other teams within the same or other sporting codes. Level of evidence: Level 3.

A Masterclass on developing clinical tools in sport and exercise medicine using principles of clinimetrics.

Musculoskeletal assessment and skill screening tests are regularly used in sports and exercise science to determine performance levels or injury risk in athletes. Many of these tests are used without having undergone clinimetric evaluation. The steps to develop these screening tests and assessment tools should include a structured process according to the clinimetric principles (conceptual and measurement model, reliability, validity, responsiveness, interpretability, burden, alternative forms, and cultural and language adaptation). This systematic process ensures the test measures what it intends to measure and also quantifies the error around the measurement. In this Masterclass we discuss the systematic development and clinimetric evaluation of clinical and performance tests used in sports and exercise science. We use the sport of mountain biking to provide a contextual example of how these principles may be practically applied.

Incidence of Injuries, Illness and Related Risk Factors in Cross-Country Marathon Mountain Biking Events: A Systematic Search and Review.

BACKGROUND: Cycling is a popular global sport and method of transportation and a significant contributor to admissions to hospital emergency units following an injury. Mountain biking events present additional challenges with remote venues and isolated courses, for which on-site medical care is often provided, for both injury and illness occurring during races. National health data may not represent these unique events, and specific data on incidence of injury and illness in mountain biking events are essential. Therefore, the aim of this study was to review the available injury and illness literature, reporting methods and risk factors in cross-country mountain biking. METHODS: Search engines PubMed, Scopus, CINAHL (EBSCOhost), Scopus, PEDro and the Cochrane Library were systematically searched, and a grey literature search was performed. Narrative analyses of the types, severity and area of injuries and illness type and severity were performed as pooling of data was impossible due to insufficient high-quality studies with the same injury and illness definitions. RESULTS: Seven studies comprising 28,021 participants were included for analysis. Four to 71% of participants sustained an injury in a cross-country mountain bike event. Injuries to the skin were the most common, followed by bony injuries and concussion. Five to 47% of cyclists reported the onset of gastrointestinal symptoms post-event. The prevalence of illness during events ranged from 0.5 to 23.0%. CONCLUSION: The injury and illness definitions were varied and prevented clear comparisons between studies. Injury and illness present a concern in cross-country marathon mountain biking and should be investigated further to provide the true burden of these during race events. Registration: This protocol has been registered with PROSPERO International prospective register of systematic reviews (No: CRD42019134586).

Motivation and Behaviour Change in Parkrun Participants in the Western Cape Province, South Africa.

Mass participation events are promoted in South Africa as a positive public health initiative. Parkrun has grown to be one of the most popular. The present study identifies the motives of residents in the Western Cape Province to join parkrun and how their involvement influences future physical activity levels. Participants (N = 1787) completed a survey consisting of demographic history, parkrun participation history, motivations for participation, and physical activity-related behaviour changes associated with parkrun participation. The majority of participants were female (n = 952) and over 50 years of age (median = 50; IQR = 38-59). Along with health-related benefits, the provision of a safe and organised event was reported as a key motive to participate. The social connectedness developed by parkrun encouraged continued participation and promoted uptake of more physical activity. Close to half the participants reported increases in physical activity levels after joining parkrun, which demonstrates the benefit obtained from participation in structured mass participation events. With the large diversity in socioeconomic status in South Africa related to physical activity levels, parkrun provides a protected and engaging environment that provides opportunity for increased physical activity and potentially reducing the burden on the healthcare system.