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The effect of graded exercise on motor performance tasks used in the neurological assessment of sports related concussion
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Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
WORKSHOP 86 Dealing with different cultures S. Hanrahan The University of Queensland Whether we are doctors, physios, nutritionists, psychologists, podiatrists, exercise scientists, or health promoters, we are or will be working with people from a variety of cultural backgrounds. Interventions can be less than optimal and research can be culturally insensitive if we are colour or culture blind and assume that all people are alike regardless of colour or culture. Being a culturally sensitive practitioner or researcher means being aware of the culture(s) of your clients or participants as well as your own cultural values, stereotypes, and biases. In Australia many members of the dominant culture are accustomed to thinking as people in an individualistic culture and may struggle when working with people from collectivist cultures. Norms, values, beliefs, and behaviours are all heavily influenced by culture. We have all been enculturated (i.e., have gone through the process of learning to live within a particular culture). Some of us have also engaged in the process of acculturation, adopting the culture of another group to varying degrees. Because of the variance in the adoption of culture, we cannot generalize or group people by culture. Nevertheless, awareness of cultural differences in interpersonal space, time, eye contact, communication, and sense of self can enhance our interactions with individuals in our multicultural society. Examples of culturally specific considerations as they relate to sport will be discussed, and attendees will be challenged to consider how culture might affect their interactions with clients or participants. Cultural (in)sensitivity can influence clarification of presenting issues/complaints and client/patient compliance. doi:10.1016/j.jsams.2009.10.087
annual update for their daily work and is designed to fulfil the requirements for their professional education. So it will be a multidisciplinary team workshop. In March 2006, the Australian Resuscitation Council released their updated guidelines for Basic and Advanced Life Support for Adults, Children and Neonates.Key principles of the new Australian guidelines are: • • • • • •
Any resuscitation attempt is better than none. You should minimise any interruptions to compressions. Compressions should be delivered harder and faster. Avoid over ventilation. Rescuers should compress the centre of the chest. 30:2 ratio (30 compressions to 2 ventilations) for infants, children and adults. • Emphasis on early defibrillation. doi:10.1016/j.jsams.2009.10.088 WORKSHOP 88 The appropriate use of analgesia—guidelines for clinicians S. Brun 1,2 1 Musculoskeletal
& Sports Medicine, School of Medicine & Dentistry, James Cook University, Queensland 2 Vice President, Sports Doctors Australia The aim of this workshop is to outline the recommended evidence based management approaches for both acute and chronic musculoskeletal conditions. The workshop will involve guides and recommendations for management which may be implemented by both medically and non medically trained health professionals in their daily practice. doi:10.1016/j.jsams.2009.10.089
WORKSHOP
89
87
The effect of graded exercise on motor performance tasks used in the neurological assessment of sports related concussion
CPR accreditation A. Green 1 , M. Brown 2,∗ , Sports Doctors Australia 3,∗ 1 The
A. Schneiders 1,∗ , S.J. Sullivan 1 , P. Handcock 1 , A. Gray 1 , P. McCrory 2
University of Queensland QLD 3 Sports Doctors Australia
2 University
This Workshop is designed to provide a CPR update with a Sports Medicine flavour. It provides an ideal opportunity for Sports Medicine Clinicians to up skill in a credentialed emergency resuscitation hands on session. It is primarily provided for Doctors, Physiotherapists and Podiatrists who require an
Introduction: Motor performance tasks are used to clinically assess sports-related concussion (SRC), however, there is limited understanding of how exercise/exertion affects these measures. The purpose of this study was to investigate the effect of graded exercise on three selected measures of motor performance used in the assessment of SRC.
2 SMA
1 University
of Otago of Melbourne
Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
Methodology: The study employed a balanced three group cross-over randomised experimental design. Three levels of exercise intervention were employed; No Exercise/Rest (NE), Moderate Intensity Exercise (ME) and, High Intensity Exercise (HE). Blood lactates, heart-rate and “perceived-exertion” (Borg Scale) were recorded to verify the level of exercise intensity. Ninety asymptomatic participants (45♂:45♀) performed timed motor performance tasks; Finger-to-Nose (FTN), Tandem Gait (TG) and Single Leg Stance (SLS). The tasks were administered pre- and postexercise and 15-min after exercise (recovery). Linear mixed models with adjusted means and contrasts were used to compare exercise effects. Data were log-transformed with the analyses accounting for clustering. Results: When task change-scores were contrasted to NE; HE caused a significant decrease in SLS (p < 0.05) andTG (p < 0.05) performance but facilitated FTN (p < 0.05). Fifteen-minutes of recovery improved TG (p = 0.01) and SLS (p < 0.05) but decreased performance of FTN (p < 0.05). Fifteen-minutes of ME caused a significant decrease in performance in SLS (p = 0.03) but not in the other tasks. No significant change occurred in any tasks after 15-min recovery following ME. Conclusions: Changes in the performance of motor tasks after exercise has implications for the immediate assessment of SRC, given that measures of motor performance are commonly utilised in concussion assessment instruments. doi:10.1016/j.jsams.2009.10.090 90
e43
to evaluate the relationships between morphology, physical capacity, skill and overall football performance. Results: Most tests of physical capacity were positively correlated, as were many tests of football skill. There was minimal correlation between physical capacity and skill; however, balance was positively correlated to overall football performance and many skill and physical capacity measures. Conclusions: Football-specific skills are a stronger predictor of football performance than general measures of athletic ability. This highlights the need for exercise programs for the training and rehabilitation football players to be designed to improve football-specific skills in order to optimally impact on football performance and facilitate return to sport. Balance exercises are also important to include in this population. Balance has been shown to be affected following injury and it has been suggested that decreased balance increases risk of injury. Therefore, it is necessary to address deficits in balance in order to decrease risk of future injures and avoid negatively impacting on football performance. doi:10.1016/j.jsams.2009.10.091 91 Links between musculoskeletal screening and lower back/lower limb injury in Australian first class cricketers: A 3 year prospective study K. Sims 1,∗ , M. Portus 1 , M. Pfitzner 2 , P. Farhart 1,2,3 , J. Orchard 3 1 Cricket
Australia practitioner, Adelaide 3 Cricket New South Wales 2 Private
What is the relationship between physical capacity, skill and performance among football players? M. Smith 1,∗ , R. Wilson 2 , T. Russell 1 1 The
University of Queensland, School of Health and Rehabilitation Sciences 2 The University of Queensland, School of Integrative Biology Introduction: Training to improve sporting performance typically involves prescription of exercises to challenge and progress physical capacity and skill. However, when an individual is recovering from an injury, it is common for more emphasis to be placed on improving physical capacity than sport-specific skill, and the relationship between physical capacity and skill is not always clear. The primary aim of this study was to investigate the relationship between physical capacity, skill and performance measures in football players. Methodology: Thirty male football players aged 17–31 years participated in 16 different physical capacity and skill tasks which included tests of power, endurance, balance, flexibility, agility, ball control and accuracy. Morphology measurements were also taken and players participated in one-on-one football games which were used as a measure of overall football performance. Statistical models were used
Introduction: The aim of this research was to investigate whether a battery of musculoskeletal tests could be used to prospectively identify injuries in Australian first class cricketers. Methodology: Musculoskeletal physiotherapy screening procedures consisting primarily of measures of joint range of motion were standardized across 6 states. These were then performed pre-season over 3 consecutive seasons from 2006–2008 giving 121,102 and 123 screens respectively. This information was then collated with injury surveillance data over the course of the three seasons and univariate (one way ANOVA) and multivariate (discriminant analysis) statistics were performed to determine whether it was possible to predict lower back/lower limb injury based on the screening results. Results/Conclusions: Players who suffered from lower back or lower limb injury were found to have significantly reduced left hip external rotation (p = 0.002) and left ankle dorsiflexion (p = 0.005) compared to the non injured group. They also exhibited significantly increased right 1st metatarsophalangeal extension (p = 0.01) and shoulder/thoracic extension in prone (p = 0.002). Using these
Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
WORKSHOP 86 Dealing with different cultures S. Hanrahan The University of Queensland Whether we are doctors, physios, nutritionists, psychologists, podiatrists, exercise scientists, or health promoters, we are or will be working with people from a variety of cultural backgrounds. Interventions can be less than optimal and research can be culturally insensitive if we are colour or culture blind and assume that all people are alike regardless of colour or culture. Being a culturally sensitive practitioner or researcher means being aware of the culture(s) of your clients or participants as well as your own cultural values, stereotypes, and biases. In Australia many members of the dominant culture are accustomed to thinking as people in an individualistic culture and may struggle when working with people from collectivist cultures. Norms, values, beliefs, and behaviours are all heavily influenced by culture. We have all been enculturated (i.e., have gone through the process of learning to live within a particular culture). Some of us have also engaged in the process of acculturation, adopting the culture of another group to varying degrees. Because of the variance in the adoption of culture, we cannot generalize or group people by culture. Nevertheless, awareness of cultural differences in interpersonal space, time, eye contact, communication, and sense of self can enhance our interactions with individuals in our multicultural society. Examples of culturally specific considerations as they relate to sport will be discussed, and attendees will be challenged to consider how culture might affect their interactions with clients or participants. Cultural (in)sensitivity can influence clarification of presenting issues/complaints and client/patient compliance. doi:10.1016/j.jsams.2009.10.087
annual update for their daily work and is designed to fulfil the requirements for their professional education. So it will be a multidisciplinary team workshop. In March 2006, the Australian Resuscitation Council released their updated guidelines for Basic and Advanced Life Support for Adults, Children and Neonates.Key principles of the new Australian guidelines are: • • • • • •
Any resuscitation attempt is better than none. You should minimise any interruptions to compressions. Compressions should be delivered harder and faster. Avoid over ventilation. Rescuers should compress the centre of the chest. 30:2 ratio (30 compressions to 2 ventilations) for infants, children and adults. • Emphasis on early defibrillation. doi:10.1016/j.jsams.2009.10.088 WORKSHOP 88 The appropriate use of analgesia—guidelines for clinicians S. Brun 1,2 1 Musculoskeletal
& Sports Medicine, School of Medicine & Dentistry, James Cook University, Queensland 2 Vice President, Sports Doctors Australia The aim of this workshop is to outline the recommended evidence based management approaches for both acute and chronic musculoskeletal conditions. The workshop will involve guides and recommendations for management which may be implemented by both medically and non medically trained health professionals in their daily practice. doi:10.1016/j.jsams.2009.10.089
WORKSHOP
89
87
The effect of graded exercise on motor performance tasks used in the neurological assessment of sports related concussion
CPR accreditation A. Green 1 , M. Brown 2,∗ , Sports Doctors Australia 3,∗ 1 The
A. Schneiders 1,∗ , S.J. Sullivan 1 , P. Handcock 1 , A. Gray 1 , P. McCrory 2
University of Queensland QLD 3 Sports Doctors Australia
2 University
This Workshop is designed to provide a CPR update with a Sports Medicine flavour. It provides an ideal opportunity for Sports Medicine Clinicians to up skill in a credentialed emergency resuscitation hands on session. It is primarily provided for Doctors, Physiotherapists and Podiatrists who require an
Introduction: Motor performance tasks are used to clinically assess sports-related concussion (SRC), however, there is limited understanding of how exercise/exertion affects these measures. The purpose of this study was to investigate the effect of graded exercise on three selected measures of motor performance used in the assessment of SRC.
2 SMA
1 University
of Otago of Melbourne
Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
Methodology: The study employed a balanced three group cross-over randomised experimental design. Three levels of exercise intervention were employed; No Exercise/Rest (NE), Moderate Intensity Exercise (ME) and, High Intensity Exercise (HE). Blood lactates, heart-rate and “perceived-exertion” (Borg Scale) were recorded to verify the level of exercise intensity. Ninety asymptomatic participants (45♂:45♀) performed timed motor performance tasks; Finger-to-Nose (FTN), Tandem Gait (TG) and Single Leg Stance (SLS). The tasks were administered pre- and postexercise and 15-min after exercise (recovery). Linear mixed models with adjusted means and contrasts were used to compare exercise effects. Data were log-transformed with the analyses accounting for clustering. Results: When task change-scores were contrasted to NE; HE caused a significant decrease in SLS (p < 0.05) andTG (p < 0.05) performance but facilitated FTN (p < 0.05). Fifteen-minutes of recovery improved TG (p = 0.01) and SLS (p < 0.05) but decreased performance of FTN (p < 0.05). Fifteen-minutes of ME caused a significant decrease in performance in SLS (p = 0.03) but not in the other tasks. No significant change occurred in any tasks after 15-min recovery following ME. Conclusions: Changes in the performance of motor tasks after exercise has implications for the immediate assessment of SRC, given that measures of motor performance are commonly utilised in concussion assessment instruments. doi:10.1016/j.jsams.2009.10.090 90
e43
to evaluate the relationships between morphology, physical capacity, skill and overall football performance. Results: Most tests of physical capacity were positively correlated, as were many tests of football skill. There was minimal correlation between physical capacity and skill; however, balance was positively correlated to overall football performance and many skill and physical capacity measures. Conclusions: Football-specific skills are a stronger predictor of football performance than general measures of athletic ability. This highlights the need for exercise programs for the training and rehabilitation football players to be designed to improve football-specific skills in order to optimally impact on football performance and facilitate return to sport. Balance exercises are also important to include in this population. Balance has been shown to be affected following injury and it has been suggested that decreased balance increases risk of injury. Therefore, it is necessary to address deficits in balance in order to decrease risk of future injures and avoid negatively impacting on football performance. doi:10.1016/j.jsams.2009.10.091 91 Links between musculoskeletal screening and lower back/lower limb injury in Australian first class cricketers: A 3 year prospective study K. Sims 1,∗ , M. Portus 1 , M. Pfitzner 2 , P. Farhart 1,2,3 , J. Orchard 3 1 Cricket
Australia practitioner, Adelaide 3 Cricket New South Wales 2 Private
What is the relationship between physical capacity, skill and performance among football players? M. Smith 1,∗ , R. Wilson 2 , T. Russell 1 1 The
University of Queensland, School of Health and Rehabilitation Sciences 2 The University of Queensland, School of Integrative Biology Introduction: Training to improve sporting performance typically involves prescription of exercises to challenge and progress physical capacity and skill. However, when an individual is recovering from an injury, it is common for more emphasis to be placed on improving physical capacity than sport-specific skill, and the relationship between physical capacity and skill is not always clear. The primary aim of this study was to investigate the relationship between physical capacity, skill and performance measures in football players. Methodology: Thirty male football players aged 17–31 years participated in 16 different physical capacity and skill tasks which included tests of power, endurance, balance, flexibility, agility, ball control and accuracy. Morphology measurements were also taken and players participated in one-on-one football games which were used as a measure of overall football performance. Statistical models were used
Introduction: The aim of this research was to investigate whether a battery of musculoskeletal tests could be used to prospectively identify injuries in Australian first class cricketers. Methodology: Musculoskeletal physiotherapy screening procedures consisting primarily of measures of joint range of motion were standardized across 6 states. These were then performed pre-season over 3 consecutive seasons from 2006–2008 giving 121,102 and 123 screens respectively. This information was then collated with injury surveillance data over the course of the three seasons and univariate (one way ANOVA) and multivariate (discriminant analysis) statistics were performed to determine whether it was possible to predict lower back/lower limb injury based on the screening results. Results/Conclusions: Players who suffered from lower back or lower limb injury were found to have significantly reduced left hip external rotation (p = 0.002) and left ankle dorsiflexion (p = 0.005) compared to the non injured group. They also exhibited significantly increased right 1st metatarsophalangeal extension (p = 0.01) and shoulder/thoracic extension in prone (p = 0.002). Using these