Browsing by Author "Schwellnus, Martin"

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    Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists – SAFER XXXIII
    (Elsevier, 2023) du Toit, François; Schwellnus, Martin; Jordaan, Esme
    Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events. 62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses.
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    Leisure athletes at risk of medical complications: outcomes of pre-participation screening among 15,778 endurance runners - SAFER VII
    (Taylor & Francis, 2018) Schwabe, Karen; Schwellnus, Martin; Swanevelder, Sonja; Jordaan, Esme; Derman, Wayne; Bosch, Andrew
    OBJECTIVE: International guidelines for pre-participation screening of masters/leisure athletes to identify those that require medical assessment exist, but have not been implemented in mass-community based sports events. We determined the prevalence of runners who, according to these guidelines, would require a medical assessment before participating in a distance running event. METHODS: Participants of the 2012 Two Oceans races (21.1 and 56 km) in South Africa (n = 15,778) completed an online pre-race medical screening questionnaire using European pre-participation screening guidelines. We determined the prevalence of runners that would require a pre-race medical assessment, based on risk factors, symptoms, and disease. RESULTS: The pre-participation “self assessment of risk” screening identified 4,941 runners (31.3%; 95% CI 30.6–32.0) that would need to undergo a full pre-participation medical assessment prior to running, if the current pre-participation screening guidelines are applied. Although musculoskeletal complaints and prescription medication use were the main triggers for a medical assessment, 16.8% (n = 2657) runners should undergo medical evaluation for suspected cardiac disease based on the questionnaire results: 3.4% (n = 538) reporting existing CVD (very high risk) and 13.4% (n = 2119) reporting multiple CVD risk factors (high risk). Other possible risk factors were reported as follows: history of chronic diseases (respiratory = 13.1%, gastro-intestinal = 4.3%, nervous system = 3.8%, metabolic/endocrine = 3.5%, allergies = 13.9%); chronic prescription medication = 14.8%, used medication before or during races = 15.6%; past history of collapse during a race = 1.4%. CONCLUSIONS: Current guidelines identified that > 30% runners would require a full medical assessment before race participation – mainly linked to runners reporting musculoskeletal conditions. We suggest a revision of guidelines and propose that pre-race screening should be considered to identify runners with a “very high,” “high,” and “intermediate risk” for medical complications during exercise. Pre-race screening and educational intervention could be implemented to reduce medical complications during exercise.
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    Match injury incidence during the Super Rugby tournament is high: a prospective cohort study over five seasons involving 93 641 player-hours
    (BMJ Publishing Group, 2018) Schwellnus, Martin; Jordaan, Esme; Janse van Rensburg, Charl; Bayne, Helen
    OBJECTIVES: To determine the incidence and nature of injuries in the Super Rugby tournament over a 5-year period. METHODS: 482 male professional rugby union players from six South African teams participating in the Super Rugby tournament were studied (1020 player-seasons). Medical staff of participating teams (2012–2016 tournaments) recorded all time loss injuries (total injuries and match injuries) and exposure hours (93 641 total playing hours; 8032 match hours). Injury incidence, injured player proportion, severity (time lost), anatomical location, tissue type and activity/phase during which injury occurred are reported. RESULTS: The overall incidence of match injuries (per 1000 player-hours; 95% CI) for each year was as follows: 2012 (83.3; 69.4–99.2); 2013 (115.1; 98.7–133.5); 2014 (95.9; 80.8–113.1), 2015 (112.3; 96.6–129.9) and 2016 (93.2; 79.9–107.9). The injured player proportion for each year was as follows: 2012 (54.6%); 2013 (49.4%); 2014 (52.0%); 2015 (50.0%); and 2016 (39.8%). The thigh, knee, head/face and shoulder/ clavicle are the most frequently injured locations, and muscle/tendon and joint/ligament injuries account for the majority of injuries. Most injuries (79%) occur in contact situations, in particular during a tackle (54%). CONCLUSION: The incidence of match injuries and the injured player proportion in South African teams competing in the Super Rugby tournament is high. Match injury incidence is consistently higher than previously reported for senior male rugby players at elite/ professional level. Targeted risk management strategies are therefore needed in the Super Rugby tournament to manage risk of injury.
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    Pre-race self-reported medical conditions and allergies in 133 641 Comrades ultramarathon (90km) runners - SAFER XXIII
    (The Physician and Sportsmedicine, 2023) Jordaan, Esme; Brill, Stephan; Schwellnus, Martin; Sewry, Nicola
    Objectives: To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an Increased risk of race-day medical encounters (MEs). Methods: Data from two voluntary open-ended pre-race medical screening questions (Q1 – history of allergies; Q2 - history of chronic medical conditions/prescription medication use) were collected in 133 641 Comrades Marathon race entrants (2014-2019). Race-day ME data collected prospectively over 6 years are reported as incidence (per 1000 starters) and incidence ratios (IR: 95%CI’s).
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    Prerace medical screening and education reduce medical encounters in distance road races: SAFER VIII study in 153 208 race starters
    (BMJ Publishing Group, 2018) Schwellnus, Martin; Swanevelder, Sonja; Derman, Wayne; Borjesson, Mats; Schwabe, Karen; Jordaan, Esme
    OBJECTIVES To examine the efficacy and feasibility of an online prerace medical screening and educational intervention programme for reducing medical complications in long-distance races. METHODS This was an 8-year observational study of medical encounter rates among 153 208 Two Oceans race starters (21.1 and 56 km) in South Africa. After the first 4-year control (CON) period, we introduced an online prerace medical screening (based on European pre-exercise screening guidelines) and an automated educational intervention programme. We compared the incidence of medical encounters (per 1000 starters; all and serious life threatening) in the CON versus the 4-year intervention (INT) period. RESULTS In comparison to the CON period (2008–2011: 65 865 starters), the INT period (2012–2015: 87 343 starters) had a significantly lower incidence (adjusted for age group, sex, race distance) of all medical encounters by 29% (CON=8.6 (7.9–9.4); INT=6.1 (5.6–6.7), p<0.0001), in the 21.1 km race by 19% (CON=5.1 (4.4–5.9); INT=4.1 (3.6–4.8), p=0.0356) and in the 56 km race by 39% (CON=14.6 (13.1–16.3); INT=9.0 (7.9–10.1), p<0.0001). Serious life-threatening encounters were significantly reduced by 64% (CON=0.6 (0.5–0.9); INT=0.2 (0.1–0.4); p=0.0003) (adjusted for age group and sex). Registration numbers increased in the INT period (CON=81 345; INT=106 743) and overall % race starters were similar in the CON versus INT period. Wet-bulb globe temperature was similar in the CON and INT periods. CONCLUSION All medical encounters and serious life-threatening encounters were significantly lower after the introduction of a prescreening and educational intervention programme, and the programme was feasible.
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    Symptom number and reduced preinfection training predict prolonged return to training after sars-cov-2 in athletes: Aware IV
    (Lippincott, Williams & Wilkins, 2023) Snyders, Carolette; Schwellnus, Martin; Jordaan, Esme
    Symptom Number and Reduced Preinfection Training Predict Prolonged Return to Training after SARS-CoV-2 in Athletes: AWARE IV. Med. Sci. Sports Exerc., Vol. 55, No. 1, pp. 1-8, 2023. Purpose: This study aimed to determine factors predictive of prolonged return to training (RTT) in athletes with recent SARS-CoV-2 infection. Methods: This is a cross-sectional descriptive study. Athletes not vaccinated against COVID-19 (n = 207) with confirmed SARS-CoV-2 infection (predominantly ancestral virus and beta-variant) completed an online survey detailing the following factors: demographics (age and sex), level of sport participation, type of sport, comorbidity history and preinfection training (training hours 7 d preinfection), SARS-CoV-2 symptoms (26 in 3 categories; “nose and throat,” “chest and neck,” and “whole body”), and days to RTT. Main outcomes were hazard ratios (HR, 95% confidence interval) for athletes with versus without a factor, explored in univariate and multiple models. HR < 1 was predictive of prolonged RTT (reduced % chance of RTT after symptom onset). Significance was P < 0.05. Results: Age, level of sport participation, type of sport, and history of comorbidities were not predictors of prolonged RTT.