Soccer injury surveillance and implementation of an injury prevention programme in Rwanda

Background: There is growing participation in soccer at all levels of sport. Soccer increases the physical and psychological demands on players, which subsequently increase the risk of injuries. There are limited prospective epidemiological studies in Africa, and studies that have been conducted to date often fail to incorporate standardised injury definitions or reporting methods. Therefore, there is an urgent need to conduct epidemiological studies within the context of low to middle-income countries, where resources may be limited, and taking into consideration exposure times to design appropriate preventive measures. Aim: The purpose of the study was to explore the nature and incidence of soccer-related injuries in first division players in Rwanda, and to establish intrinsic risk factors for injuries. Methods: A prospective cohort study was conducted for two seasons. Eleven teams (326 players) and 13 teams (391 players) were followed for the seasons 2014-2015 and 2015-2016. Anthropometric and musculoskeletal screening composed of flexibility tests, strength and endurance, balance and proprioception tests, and lower limb function tests were conducted as well as training and match exposure were recorded. Team medical personnel recorded the location, type, duration and mechanism of time-loss injuries following the suggestion of the International Federation of Football Associations (FIFA). The primary outcome was the incidence of overall, training and match injury as well as body part, type, patterns and severity of injuries. Multivariate model using the Chi-squared Automatic Interaction Detection (CHAID) was used to assess intrinsic predictors of injury. Significance was accepted as p<0.05. Results: There were 455 injuries and approximately 46% of the players were injured in each of the two seasons. The team weighted mean incidence of match injuries was significantly lower during season one (14.2 injuries/ 1000 hours) compared to season two (21.9 injuries/ 1000 hours) (t(22)= -2.092, p=0.048). No difference was observed in the team-weighted incidence for overall and training injuries between the two seasons. There was increased injury incidence with increased acute: chronic training and match workload ratios. Lower extremities were the most frequently affected over the two seasons (80% of all injuries), with the knee joint most commonly injured (28% off all injuries) followed by the ankle joint (25% of all injuries). Ligament strains were the most common form of injury followed by muscle strains and contusions. The most common mechanisms of injury were collisions between players and receiving a tackle. About three quarters of the reported injuries were mild or moderate in severity and injuries to the Achilles tendon lead to the longest median lay-off time. The greatest incidence of injuries was sustained between the 46thand 60thminute of match play. A score of 11cm or less on the Sit and Reach test, more than one year in the current club and a timed hop of more than 2.5 seconds were all associated with injury. Conclusions: The rate of injuries found in this study is lower compared to the studies that reported injuries in adult male at either professional or amateur level. The patterns of training and match injuries, location, type and severity of injuries are similar to previous studies. Flexibility and balance, and coordination emerged as being significant predictors of increased risk of injury. More studies with emphasis on intrinsic and extrinsic factors are needed to attain wider knowledge concerning injuries among soccer players in Africa. Prevention intervention is necessary to minimise the of lower limb injuries

Factors influencing implementation of soccer injury prevention strategies in Rwanda

Magister Scientiae - MScBackground: Three epidemiological studies conducted in Rwanda have highlighted that many people at different levels in the community of soccer do not implement accepted control measures for reducing the risk of injuries. However, little is known about what soccer community members themselves know about injury prevention. Purpose: The aim of this study was to identify perceptions of factors influencing the implementation of soccer injury prevention strategies in Rwanda.South Afric

A systematic review on the effect of stretching in sports injury prevention

INTRODUCTION: Although stretching increases soft tissue flexibility and joint range of motion, numerous studies demonstrated contradictory findings as to its effect in injury prevention. AIM: The purpose of this systematic review is to assess the effectiveness of stretching on the prevention of injuries. METHODOLOGY: An electronic search using MEDLINE, SCIENCE DIRECT, COCHRANE, EBSCOHOST, SPORTDiscus and CINAHL databases, checking the references. Randomised control trials (RCTs) and cohort studies investigating stretching as an injury prevention measure published in the last decade were selected rn this review. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Results: Two RCTs and two prospective cohort studies all of high quality were included in this analysis. One cohort study found that stretching reduced the incidence of exercise related injuries. Two RCTs and one cohort study found that stretching did not produce practical reduction on the occurrence of injuries. CONCLUSION: Stretching exercises does not give a practical useful reduction in the risk of injuries. Not enough recent research has been done to draw definitive conclusion on the effect of stretching in injury prevention. Well designed studies are needed to shed light as to the effect of stretching in exercise-related injury risk reduction

Impact of Maternal Periodontitis on Preterm Birth and Low Birth Weight in Babies: Results of a Scoping Review

Background Periodontitis has been documented as public health concern but its association with preterm and low birth weight remains uncertain, thus the objective of this scoping review is to summarize the most recent published evidence related to the impact of periodontitis on preterm birth and low birth weight in order to improve public awareness and to inform policies for oral health during pregnancy. Methods Hinari, PubMed, and Google Scholar were searched to acquire the published literature. The retrieved studies included cross-sectional, case control studies and randomized controlled trials with available full text published in English from 2008 to 2019. Results After combining the key words, 333 articles were identified with only 133 eligible articles published from 2008 to 2019. After reviewing the available 50 full text articles, duplicates were removed and 15 studies fully met the inclusion criteria. There were 13 articles that supported the association between maternal periodontitis and preterm low birth weight while 2 found no evidence to support the association. Conclusion The results of this scoping review contribute to an increasing body of evidence to support the hypothesis that maternal periodontal disease may be a risk factor for preterm delivery and low birth weight. Rwanda J Med Health Sci 2020;3(3):372-38

Profile of injuries among sitting volleyball players with disabilities in Rwanda

Background: Sports injuries are some of the risk of paralympics sport. Injuries are somewhat high compared with injury rates in able-bodied athletes. Injuries might have an impact on the participation and future health. It is paramount to investigate sports specific injuries to eliminate associated risks.Aim: To identify patterns of injuries among sitting volleyball players in Rwanda.Methods: A prospective quantitative study was conducted among 158 sitting volleyball players competing in the 2013-2014 season. The research team composed by physiotherapists used the data collection process following the consensus on injury definitions and data collection procedures. The ethical clearance and permission were obtained from relevant bodies. ANOVA or the Mann–Whitney U-test were used for continuous variables while Chi-square or Fisher’s exact tests were used for categorical variables.Results: All the 158 players aged 25±6 years participated in the study; with male predominance (66.5%). Fifty-eight players (37%) sustained at least one injury. Nearly half of injuries (n=43) were mild, consistent for both male and female. There was no statistical difference in the patterns of injuries comparing male and female participants.Conclusion: Sitting volleyball players with disability in Rwanda sustained a high prevalence of injuries. The fingers, hands and wrists were the most injured body parts. However, the health and integrative advantages should outweigh the risk of adverse effects associated with participation in sports such as injuries.Keywords: Sitting volleyball, People with disabilities (PWDs), Injur

A systematic review on the effect of stretching in sports injury prevention

Introduction Although stretching increases soft tissue flexibility and joint range of motion, numerous studies demonstrated contradictory findings as to its effect in injury prevention. Aim The purpose of this systematic review is to assess the effectiveness of stretching on the prevention of injuries. Methods An electronic search using MEDLINE, SCIENCE DIRECT, COCHRANE, EBSCOHOST, SPORTDiscus and CINAHL databases, checking the references. Randomised control trials (RCTs) and cohort studies investigating stretching as an injury prevention measure published in the last decade were selected in this review. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Results Two RCTs and two prospective cohort studies all of high quality were included in this analysis. One cohort study found that stretching reduced the incidence of exercise related injuries. Two RCTs and one cohort study found that stretching did not produce practical reduction on the occurrence of injuries. Conclusion Stretching exercises does not give a practical useful reduction in the risk of injuries. Not enough recent research has been done to draw definitive conclusion on the effect of stretching in injury prevention. Well designed studies are needed to shed light as to the effect of stretching in exercise-related injury risk reduction

Effect of the FIFA 11+ soccer specific warm up programme on the incidence of injuries: A cluster-randomised controlled trial.

BackgroundSoccer players incur injuries that typically affect their performance. Injuries are caused by intrinsic and extrinsic factors that call for multifactorial preventive interventions. The study examines the impact of the FIFA 11+ warm up programme on the incidence and severity of injuries in second division soccer players in Rwanda.MethodsTwelve teams (309 players) were randomised in the intervention group and 12 teams (317 players) in the control group using a cluster randomized controlled trial with teams as the unit of randomization. Intervention group teams implemented the FIFA 11+ soccer specific warm-up programme during training and matches at least three times a week over seven months of the Rwandan soccer season. Control group teams continued with usual warm up exercises. The primary outcome of this study was the overall incidence of training and match injuries. Injuries, training and match exposure as well as severity categories were recorded per the F-MARC guidelines.ResultsA lower proportion of players sustained injuries in the intervention group (52%) compared to the control group (63%) (Odd ratio: 0.7; 95%CI: 0.5-0.9). A significantly lower rate ratio was observed in the intervention group for overall (RR = 0.6; 95%CI: 0.5-0.8) and match (RR = 0.6; 95%CI: 0.5-0.8) injuries. Compliance to the injury prevention programme was 77%. In the intervention group, the incidence of injury was similar across all teams and across the medium and highly compliant teams. There was a statistically significant 55% and 71% reduction of the rate of moderate and severe injuries in the intervention group respectively.ConclusionThe 11+ warm up injury prevention programme resulted in a significant reduction in the odds of sustaining injuries. In addition, injuries sustained were less severe. The programme should be rolled out to all teams in Rwanda and may well result in a decrease in the incidence and severity of injury in similar contexts.Trial registrationPan African Clinical Trial Registry (PACTR201505001045388)

Leadership Development of Rehabilitation Professionals in a Low-Resource Country: A Transformational Leadership, Project-Based Model

Background and rationale: This paper presents an overview of the activities and outcomes of the Leadership Institute (LI), a short-term leadership development professional development course offered to physiotherapists in a low-resource country. Previous studies have provided examples of the benefits of such programs in medicine and nursing, but this has yet to be documented in the rehabilitation literature. The prototype of leadership development presented may provide guidance for similar trainings in other low-resource countries and offer the rehabilitation community an opportunity to build on the model to construct a research agenda around rehabilitation leadership development. Pedagogy: The course used a constructivist approach to integrate participants’ experiences, background, beliefs, and prior knowledge into the content. Transformational leadership development theory was emphasized with the generation of active learning projects, a key component of the training. Outcomes: Positive changes after the course included an increase in the number of community outreach activities completed by participants and increased involvement with their professional organization. Thirteen leadership projects were proposed and presented. Discussion: The LI provided present and future leaders throughout Rwanda with exposure to transformative leadership concepts and offered them the opportunity to work together on projects that enhanced their profession and met the needs of underserved communities. Constraints and challenges: Challenges included limited funding for physiotherapy positions allocated to hospitals in Rwanda, particularly in the rural areas. Participants experienced difficulties in carrying out leadership projects without additional funding to support them. Lessons learned: While the emphasis on group projects to foster local advocacy and community education is highly recommended, the projects would benefit from a strong long-term mentorship program and further budgeting considerations. Conclusion: The LI can serve as a model to develop leadership skills and spur professional growth in low-resource settings. Leadership development is necessary to address worldwide inequities in health care. The LI model presents a method to cultivate transformational leadership and work toward improvements in health care and delivery of service