Development and validation of the School Clinical Rugby Measure (SCRuM) test battery: understanding the qualities or skills defining good male adolescent rugby union players

Background: Globally, the number of schoolboy adolescents playing highly competitive rugby is increasing even in countries such as Zimbabwe hardly known for dominating international rugby events. Given the increased participation rates, burgeoning talent identification and recruitment programs and the reportedly high injury risk associated with competitive youth rugby in Zimbabwe and globally, the minimal qualities or skills defining good male adolescent rugby players need further clarification. This study assembled a testing battery and compared the anthropometric variables, physiological characteristics and rugby-specific game skills of Zimbabwean schoolboys to identify qualities and/or skills discriminating elite from sub-elite male adolescent rugby players and non-rugby players within and between Under 16 (U16) and U19 age categories. Methods: This study was structured in three phases. Phase I developed the School Clinical Rugby Measure (SCRuM) test battery based on amalgamated information derived from narrative literature review, qualitative study and two systematic reviews. Using mixed methods sequential explanatory study designs, Phase II refined the test battery through the evaluation of face and logical validity using key informants (n=5) and rugby experts (n=20), respectively. Subsequently, rugby coaches (n=30) assessed the practical feasibility of implementing each SCRuM test item in the local context considering test equipment, procedural and acceptability issues. Phase III evaluated the test-retest reliability of each SCRuM test item among a sample of elite U16s (n=41) and U19s (n=41). The final study in Phase III compared cross-sectional test performances of 208 athletes from different playing standards and age category to identify SCRuM test items discriminating (i) older (U19) players from younger (U16) players regardless of playing standards, and (ii) elite from both sub-elite and nonrugby players regardless of age. Results: Phase I produced the first version of the SCRuM test battery with 23 variables. Phase II reduced the constituent components to 15 variables. The test-retest reliability study showed high intraclass correlation coefficient (ICC>0.70) for all SCRuM test items except for the 5-m, 10-m speed tests and passing-for-accuracy test. Age category had a significant main effect on all SCRuM test items except for sum of seven skinfolds (p=0.45, η2 p=0.003). Playing standard had a significant main effect ii on all variables except for height (p=0.40, η2 p=0.01) and sum of seven skinfolds (p=0.11, η2 p =0.02). Upper-and-lower body muscular strength and power, prolonged high-intensity intermittent running ability, repeated high-intensity exercise performance ability, tackling, passing and catching significantly improved with increasing playing standards. However, the Yo-Yo intermittent recovery level 1 test, vertical jump test, tackling proficiency test and running-and-catching ability skills test demonstrated greater discriminative ability across playing standards among U16s. The 40-m speed test, 2-kg medicine ball chest throw test, repeated high-intensity exercise test, one-repetition maximum bench press and back squat tests, and passing ability skills test showed better discriminative validity for differentiating U19s by playing standards. Conclusion: Irrespective of playing standard and consistent with previous studies, all SCRuM test items significantly increased with age except for skinfolds measures. These results highlight the sensitivity of component SCRuM test items in discriminating younger (U16s) from older (U19s) athletes. U16 coaches should consider these differences when designing training interventions to assist with the development of prospective U19 players. However, prolonged high-intensity intermittent running ability, lower-body muscular power, tackling proficiency and running-andcatching ability demonstrated greater discriminative ability among U16s only, indicating a possible link to higher playing standards for that age category. Upper-body muscular power, upper-and-lowerbody muscular strength, 40-m sprinting ability, repeated high-intensity exercise performance ability, and passing ability significantly improved with playing standards among U19s, highlighting the physiological characteristics and game skills capable of differentiating elite male adolescent rugby players from both sub-elite or non-rugby players at that age category. Collectively, these findings provide insight to the high school rugby coaches into the qualities and skills contextually relevant for training for the attainment of higher playing standards in schoolboy rugby at distinct age categories

Differences in personal and lifestyle characteristics among Zimbabwean high school adolescents with and without recurrent non-specific low back pain: a two part cross-sectional study

Background: Recurrent non-specific low back pain (NSLBP) is increasingly becoming common among adolescents worldwide. A recent study in Zimbabwe showed a relatively high prevalence (28.8 %) among high school students. Influential associated factors, however, remain unclear. This is a significant shortcoming. The aim was to determine personal or lifestyle-related factors associated with recurrent NSLBP among high school adolescents in Harare, Zimbabwe. Methods: This study was part of a large epidemiological study conducted in two continuous parts. Part one sought to determine self-reported associated factors among 532 participants (mean age =16 ± 1.72 years) drawn randomly from selected government schools using a reliable and content-validated questionnaire (Kappa coefficient, k = 0.32–1). Part two purposively identified adolescents (N = 64, median age =17 years, interquartile range, IQR = 15–18 years) with a history of ‘severe’ recurrent NSLBP from part one based on a specific eligibility criteria and compared body mass index, relative school bag weight and hamstring flexibility with matched adolescents without NSLBP. Data was analysed using Statistica version 11. Independent t-tests or χ 2 tests of association were used for continuous and categorical data, respectively. The statistical significance was set at p < .05. Results: Recurrent NSLBP was associated with self-reported factors such as perceptions of a heavy school bag [χ 2 (1) = 85.9, p < 0.001]. A significant proportion of adolescents with recurrent NSLBP spent over 30 min carrying the school bag to and from school [χ 2 (1) =32.2, p < 0.001]. It was also associated with prolonged sitting (p < 0.001), not playing sports [χ 2 (1) =5.85, p = 0.02] and tight hamstrings [χ 2 (1) =7.6, p = 0.006]. Conclusions: Although conclusions from this study are hesitant because of the cross-sectional nature of the study and the relatively small sample size in follow-up study, recurrent NSLBP is associated with perceptions of a heavy school bag, duration of school bag carriage, no sports participation, prolonged sitting on entertainment activities, and tight hamstrings. These findings add to the importance of promoting physical activity at school or home especially aimed at improving muscle flexibility

Anthropometric, physiological characteristics and rugby-specific game skills of schoolboy players of different age categories and playing standards

Abstract Background Rugby is increasingly gaining popularity among school-aged male junior players in countries hardly known for dominating international rugby, such as Zimbabwe. Given rugby combativeness, participating adolescents should possess qualities or skills commensurate with the physical demands of the sport for effective participation. This study investigated the independent and interactive effects of age category and playing standard on anthropometric, physiological characteristics and rugby-specific game skills among Zimbabwean athletes. Methods Two hundred and eight elite, sub-elite and non-rugby players competing at Under 16 and Under 19 age categories were assessed using the School Clinical Rugby Measure (SCRuM) test battery. Participants underwent height, sitting height, mass, skinfolds, speed, agility, upper-and-lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching assessments in a cross-sectional experimental design. Results Age categories had significant main effect on all SCRuM test items except sum of seven skinfolds (p = 0.45, η2p = 0.003). Playing standard had significant main effects for all variables except height (p = 0.40, η2p = 0.01) and sum of seven skinfolds (p = 0.11, η2p = 0.02). Specifically, upper-and-lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching improved with increasing playing standards. However, two-way analysis of variance only demonstrated significant interactions between the effects of age category and playing standards for vertical jump height (VJ) test, 2-kg medicine ball chest throw (2-kg MBCT) test, Yo-Yo intermittent recovery test level 1 (Yo-Yo IRT L1), and tackling and catching tests. Yo-Yo IRT L1, VJ, tackling and catching tests demonstrated greater discriminative ability among Under 16 s, whereas the 2-kg MBCT test showed better ability in Under 19 s. Conclusion All SCRuM variables except skinfolds improved with age, highlighting relative sensitivity in differentiating older from younger athletes. However, the discriminative ability by playing standards for VJ, 2-kg MBCT, Yo-Yo IRT L1, tackling and catching ability tests was age-dependent. These findings informs on general attribute development in junior rugby players with age and on specific players attributes in need of monitoring for attainment of elite status at U16 or U19 level

Does an educational workshop have an impact on caregivers’ levels of knowledge about cerebral palsy? A comparative, descriptive cross-sectional survey of Zimbabwean caregivers

BackgroundThe diagnosis of a child with a life-long disability, such as cerebral palsy (CP), can be catastrophic to parents. It is often accompanied by feelings of despair, anxiety, hopelessness, and the fear of the unknown. Knowledge about CP is thus essential for caregiver adjustment and preparation for the caregiving role. However, there is a paucity of empirical evidence regarding the best method for educating caregivers. The aim of this study was therefore to evaluate the impact of an educational intervention on caregivers’ knowledge about cerebral palsy.MethodsThis cross-sectional survey included 49 caregivers of children with cerebral palsy. Convenience sampling was used to select participants from two central hospitals in Harare, Zimbabwe. The caregivers were divided into two groups based on whether or not they had attended an educational workshop. The knowledge of cerebral palsy questionnaire (KCPQ) was administered once to assess the caregivers’ CP knowledge.ResultsThe caregivers were comparable in terms of sociodemographic characteristics. The mean KCPQ scores for caregivers who attended workshops was 17.4 (SD 1.5), versus 13.8 (SD 2.5) for those without exposure to workshops. The differences between the two groups was statistically significant (U =77.0, Z = -4.45, and P &lt; 0.001).ConclusionsOur findings suggest that educational workshops may lead to improved CP  knowledge among caregivers. This may better equip parents and guardians to meet the extra caregiving demands associated with CP, leading to improved health  outcomes for children with CP and their caregivers

Psychometric evaluation of the Shona version of the Multidimensional Scale of Perceived Social Support Scale (MSPSS–Shona) in adult informal caregivers of patients with cancer in Harare, Zimbabwe

Background: Providing care for a patient with cancer can negatively affect the health and psychosocial well-being of informal caregivers. However, social support has been enlisted as an essential buffer to stressful life events. There is now a greater call to routinely measure and provide support for caregivers and this is only feasible through use of validated outcome measures. The multidimensional scale of perceived social support (MSPSS) is one of the most commonly used social support outcome measure. Consequently, the MSPSS has been translated into several languages and validated across several populations. The aim of the present study was to translate the MPSS to Shona (Zimbabwean native language) and validate it in caregivers of patients with cancer.Methods: The MSPSS was translated to Shona using a backward-forward translation method, pretested on a group of caregivers (n = 10) before being administered to large sample (N = 126) at Parirenyatwa Group of Hospitals. Both exploratory and confirmatory factor analysis were performed to assess the structural validity of the MSPSS-Shona version. Reliability was assessed using the Cronbach’s alpha.Results: Data for 120 caregivers were analysed. Most were females (69.2%), had attained at least secondary education (81.7%) and married (75%). There was moderate evidence for structural validity for the 2-factor model and excellent evidence for internal consistency as the scale yielded α = 0.905.Conclusions: Despite moderate evidence for structural validity, the translation of MSPSS into native languages (e.g. MSPSS-Shona) in low resource settings can be deemed as “steps in the right direction” for evidence based practise in management of cancer. There is also need for further psychometric evaluation of the MSPSS-Shona

Play profiles of children with HIV/Aids: A comparative study

Introduction: Despite play being widely used in occupational therapy practice as a means and ends in intervention, no research has explored how the play of children with HIV/AIDS is affected. Therefore, the specific processes through which play can be used in therapy with children with HIV/AIDS remains underexplored, especially in low resourced settings. This study aims to compare the level of playfulness of children with HIV/AIDS to that of age and gender matched typically developing children living in the same low resourced community. Methods: The Test of Playfulness (ToP) was used to examine the differences and similarities of play between children aged 4–7 years who are typically developing children (n = 52) and children with HIV/AIDS who receive antiretroviral treatment (n = 44). Each child was video recorded playing with a familiar playmate both indoors and outdoors. The videos were scored by two independent raters who were blinded to all aspects of the study. Scores were subjected to Rasch analysis to calculate interval level measure scores. Independent t-tests were used to compare differences between the means of the groups. Results: Typically developing children scored significantly higher when playing outdoors, as compared to children with HIV [t (94) = 3.57, p =.001]. There was no significant difference between mean measure scores for indoor play when comparing typically developing children and children with HIV. Children who are HIV positive scored significantly lower than typically developing children on items related to the ability to suspend reality and framing in both indoor and outdoor environments. Conclusions: Children with HIV/AIDS exhibited lower levels of playfulness when compared to typically developing children. This study provides insight on the play profiles of children with HIV/AIDS, highlighting play deficits and differences between indoor and outdoor play. Occupational therapy can play a significant role in promoting playfulness in children with HIV/AIDS

Absolute and relative reliability of SCRuM test battery components assembled for schoolboy rugby players playing competitive rugby in low-resource settings: A pragmatic in-season test-retest approach

Background: Schoolboy rugby is a popular sport which forms the bedrock of rugby development in many African countries, including Zimbabwe. With burgeoning talent identification programmes, the development of multi-dimensional, logically- validated, and reliable test batteries is essential to inform the objective selection of potentially talented young rugby athletes. Objectives: This study sought evidence on the absolute and relative test-retest reliability of the component test items in the newly-assembled SCRuM test battery. Methods: Utilising a pragmatic test-retest experimental design, a sample of 41 Under-19 schoolboy players playing competitive rugby in the elite Super Eight Schools Rugby League in Harare, Zimbabwe, participated in the study. Results: Physiological and game-specific skills tests which showed good to excellent relative reliability and acceptable absolute reliability, included: 20 m and 40 m speed, L-run, Vertical Jump (VJ), 60 s Push-Up, 2 kg Medicine Ball Chest Throw test (2 kg MBCT), Wall Sit Leg Strength test (WSLS), Repeated High Intensity Exercise test (RHIE), One Repetition Maximum Back Squat (1-RM BS) and Bench Press tests (1-RM BP), Yo-Yo Intermittent Recovery Level 1 test (Yo-Yo IRT L1), Tackling Proficiency test, Passing Ability Skill test and Running and Catching Ability skill test. Conclusion: All these tests are reliable and warrant inclusion in the SCRuM test battery for possible profiling of U19 schoolboy rugby players during the ‘in-season’ phase provided there is adequate participant familiarisation and test standardisation. The test-retest ICCs and measurement errors are generalisable to other young athletes in this population, making the tests useful for the evaluation of training and developmental effects of the measured constructs

The impact of social support on the health-related quality of life of adult patients with tuberculosis in Harare, Zimbabwe: a cross-sectional survey

Objective Tuberculosis (TB) is the second prime cause of mortality in Sub-Saharan Africa and remains a major worldwide public health problem. Unfortunately, patients with TB are at risk of poor mental health. However, patients who receive an adequate amount of social support are likely to have improved health outcomes. The study was done to establish how social support influences the health-related quality of life (HRQoL) of patients with TB in Harare, Zimbabwe. Data were collected from 332 TB patients and were analysed through structural equation modelling. Results The mean age of the participants was 40.1 (SD 12.5) years and most were; males (53%), married (57.8%), educated (97.3%), unemployed (40.7%), stayed with family (74.4%), and reported of less than average levels of income (51.5%). Patients received the most significant amount of social support from the family. Patients also presented with lower HRQoL as they considerably reported of pain, anxiety and depression. The final model accounted for 68.8% of the variance. Despite methodological limitations, the study findings suggest that social support optimises patients’ HRQoL. Based on the patients’ responses, it was noted that patients presented with lower mental health, therefore, there is a need to develop and implement patient wellness interventions