A) The short term outcome of extracorporeal shockwave therapy for the treatment of various soft tissue injuries seen in private practice: a descriptive study.

Introduction

  • The purpose of this piece is to evaluate the effect of the PowerShocker LGT -2500A Extracorporeal Shock Wave Therapy (ECSWT) on various soft tissue injuries. The use of ECSWT is becoming widely used within the sporting community and more so in the Physiotherapy Community.

Shockwaves are defined as “acoustic waves with high energy, high amplitude wave and non-periodicity.” They are similar to the type of wave left after a sonic boom or lightning strike left in the atmosphere. There use has been documented since the early 1980s where ECSWT was used to treat Kidney Stones 1. Currently, it is used private practice to treat various soft tissue injuries.

Some of the medical effects of ECSWT are Neovascularization of Damaged tissue, causing micro-rupturing of Capillaries which stimulates growth indicators. This leads to the formation of new blood vessels 2. The physiological effects of ECSWT are well known.

Aim

  • The aim of the 3 month trial was to determine the short-term effect of ECSWT on pain perception using the visual analogue scale (VAS) and function in patients who presented with soft tissue injuries to the Sports Science Physiotherapy Centre.

Objectives

  1. To determine the short-term effect of ECSWT on Pain perception of patients who presented with various injuries at the Sports Science Physiotherapy Centre over a period of 3 months, utilising the Visual Analogue Scale
  2. To determine the short-term effect of ECSWT on function in patients who presented with various injuries at the Sports Science Physiotherapy Centre over a period of 3 months, utilising various private practice Functional Outcomes measures.

Methods

21 Patients gave their consent to use their information in the 3 month trial period. A Visual Analogue Score (VAS) was used to determine the effect of ECSWT on pain perception. Various functional outcome measures were used to measure functinality. These tests included : Knee-to-wall, Single-leg calf raise, Thomas test, Running distance and shoulder external rotation strength which are used in private practice. All tests were graded 1-4. Injuries of participants ranged from: Achilles tendinopathy, Plantar Fasciitis, Tibialis Posterior Tendinopathy, ITB Syndrome, Patellar Tendinopathy, Hamstring Tendinosis, Biceps Tendinopathy, Medial Tibial Stress Syndrome, Adductor Tendinopathy, Calcific Tendinitis of the Rotator Cuff tendon, Lateral Epicondylitis and Chronic Anterior Knee pain.

Methodology

Patients presented to the Sports Science Physiotherapy Centre (SSPC) with various injuries. They were assessed by a physiotherapist and diagnosed with an injury, after which they were treated and then referred for ECSWT. Only one Physiotherapist administered the ECSWT to the 21 participants. Patients had the procedure explained to them and had an opportunity to ask questions and enquire about more information prior to treatment. Immediately post-treatment, Functional testing was done. Pain perception was done at the commencement of ECSWT (first session) and then at 2 week intervals. Patients were treated according to standard ECSWT protocol for individual injuries devised at SSPC. Treatment prescriptions were indicated for 2,3 weeks or 5 weeks.

Results

At initial treatment, average pain perception was 5,3/10. Pain perception at week 3 averaged 3/10 and at week 5, average was 2/10. Functional scores, according to grading, at initial treatment was 2.3 out of a possible 4 grades. At week 3, functional scores averaged 3.1 out of 4 possible grades. At week 5, functional scores averaged 4 out of a possible 4 grades. Two subjects dropped out of the trial. 21 participants began ECSWT and 19 completed the trial, average treatment time was 3.4 weeks, with the shortest treatment time of 2 weeks and longest being 6 weeks.

Summary

In summary, Participants improved on average 1 point per week on the Visual Analogue Scale for pain perception. The funtionality improved by 1 grade every 2 weeks as measured by  the various functional tests. From the above information. From the trial, ECSWT can be seen to have a reduced the VAS scores and increased the Functional Test Grades.

References

  • 1. Eisenberger F, Fuchs G, Miller K, Bub P, Rassweiler J.Extracorporeal shock wave lithotripsy (ESWL) and endourology: an ideal combination for the treatment of kidney stones. World Journal of Urology,1985;3(1);41-47.
  • 2. van Leeuwen MT, Zwerver J, van der Akker-Scheek I. Extracorporeal shock wave therapy for patellar tendinopathy: a review of the literature. Br J of Sports Med, 2009; 43:163-168.

B) The effect of BioScar Serum on the appearance of acute and sub-acute scars – a Pilot Study.

Theodore Calligeris 1  (BSc (Physiotherapy)(Hons) M.Phil (Sports Physiotherapy)

Sports Science Physiotherapy Centre, Sports Science Institute of South Africa, Newlands, Cape Town, South Africa

Address for correspondence:

Theo Calligeris,

Sports Science Physiotherapy Centre, Sports Science Institute of South Africa, Newlands, Cape Town, South Africa

Email: theo@sspc.co.za

Phone: +27 21 6595684

Abstract

Background:

This trial was undertaken to assess the affect of the BioScar serum on the appearance and function in postoperative scar formation.

Objective:To determine the appearance of the scar formation at month 1, 2 and 3 with the application of the BioScar Care Program.

Methods:

Patient and observer data of the subjects in the study (n = 13) were recorded on a monthly basis according to the methods acceptable in scar research. The range of motion of the body part was documented

Results:

Thirteen subjects were recorded in the study. The affected body parts were the hips, knees, wrists, lumbar area, ankles and feet. The range of motion of the body part was restored to functional and acceptable ranges of motion. The overall improvement in the subjective and objective assessments was 51,2% and 50% respectively. The average time between assessments was one month with the better results at month 3.

Conclusion:

The scar assessment scales used in this study have been successfully used in other scar studies and have shown to be reliable. The early application of the BioScar serum has shown to improve the appearance and outcome of the scars in this study. It is suggested that further studies be done to explain the detailed physiological effect of the serum on wound healing and scar appearance.

C) The incidence of injuries and exposure time of professional football club players in the Premier Soccer League during football season

T Calligeris,1,3 BSc (Hons) (Physio), MPhil (Sports Physio); T Burgess,2,3 BSc (Physio), PhD; M Lambert,2 PhD

Sports Science Physiotherapy Centre, Sports Science Institute of South Africa, Cape Town, South Africa

Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa

Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa.

Corresponding author:T Calligeris (theo@sspc.co.za)

Background.

Data on the incidence of football injuries and exposure time of players during matches and training in the South African (SA) Premier Soccer League (PSL) are lacking.

Objective.

To calculate the incidence of injuries and the exposure time (practice and match) of the players of a PSL team over a full season.

Methods.

Injury and training data of the players in the squad (N=32) were recorded on a daily basis by the medical support staff, according to the methods of the F-MARC protocol.

Results.

One hundred and thirty injuries were recorded in the season. The most affected body parts were the thigh (n=27, 21%) and ankle (n=27, 21%). The overall incidence was 13.4 injuries per 1 000 player-hours. The incidence during training was 6.6 injuries/1 000 player-hours and during matches 88.9 injuries/1 000 player-hours. The most frequent injury was haematoma/contusion/bruising (n=43, 33%). Of the total injuries, 12% were recurrent. Injury through contact with another player was high (62%). Seventy-six percent of the injuries were not associated with any violation of the laws of the game. The average time off due to injury was 8 days. The total exposure time over the full season resulted in a combined average of 18 162 minutes (~303 hours).

Conclusion:

These data differ from the data in European studies. Injury and exposure data measured throughout the season have the potential to identify risks and mechanisms of injuries. This study highlights the necessity for all clubs in the PSL to adopt a standardised injury monitoring programme, using standardised methodology, so that the management of professional players in SA may be improved.

Implications:

The implications of such a study is ground breaking in the field of Football Medicine in South Africa and Africa. It has a far reaching effect in describing the football population and identifying what variables need intervention for change to occur progressing the level and standards in African Football.

Keywords: incidence of football injuries; exposure time; epidemiology; monitoring program; Professional Soccer League

Funding Acknowledgements:This work was self funded by Theo Calligeris as a student and supported by UCT and AJAX CT FC.

S Afr J Sports Med 2015;27(1):16-19. DOI:10.7196/SAJSM.610