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Factors Associated with Football Injuries in Malawi: Implications for Physiotherapy Intervention

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Factors Associated with Football Injuries in Malawi: Implications for Physiotherapy Intervention FACTORS ASSOCIATED WITH FOOTBALL INJURIES IN MALAWI: IMPLICATIONS FOR PHYSIOTHERAPY INTERVENTION ANDERSON MUGHOGHO Student number: 3164416 Thesis submitted in partial fulfillment of the requirements for the degree of Masters of Science in Physiotherapy, Faculty of Community and Health Sciences, Department of Physiotherapy, University of the Western Cape SUPERVISOR: Prof. Julie Phillips November 2012 KEYWORDS Football (soccer) Injuries Physiotherapy Intervention Knowledge Attitude Prevalence Incidence Malawi i ABSTRACT Background: Physiotherapists are part of the medical team involved in prevention and management of football injuries in Malawi. However, in Malawi no physiotherapist is currently involved in prevention and management of football injuries in the Malawi Super League. Aim: The aim of the study was to determine the need for physiotherapy intervention in prevention and management of football injuries. Methodology: A concurrent mixed method study design was used to collect data. A self administered questionnaire was used to collect quantitative data from football players. Qualitative data was collected through in- depth interviews from team doctors and coaches respectively. Quantitative data was analysed using the SPSS version 20.0. Descriptive data was presented in the form of percentages, means, ranges, standard deviations, and frequencies using tables, figures and graphs. A chi- square test of association and Fischer’s exact test were used to study the factors associated with football injuries against prevalence of injury. Audiotaped interviews were transcribed verbatim and expressed ideas were read several times, coded and reduced into categories and themes. Ethical clearance was granted by the University of the Western Cape and relevant authorities in Malawi. Results: A response rate of 67.5% was obtained. The mean age of football players was 21.73 (SD=3.295) years. The injury prevalence was 68.9% with 64% of injuries occurring during matches and 37% during training. The majority (84%) of the injuries were sustained in the lower limbs and 52.7% of the players who reported to have incurred an injury had recurring injuries with the ankle joint (33.3%) being the most affected part. Ligament sprain was the most common type of injury (36%) and most of the injuries (36.5%) reported were severe. No medical professional is available to manage injuries during training while team doctors are always available during matches. Recurrent injury was significantly associated injury prevalence (P=0.000). Use of protective gear was also significantly associated with injury prevalence both at training (P<0.01) and matches ii (P<0.05). Both coaches and team doctors reported that recurrent injury, psychological, player fitness, and lack of equipment were factors contributing to injury prevalence. Regarding injury management, coaches and team doctors reported sprains and strains as the most common injuries seen in the league. Furthermore, their views regarding injury prevention were sought. Team doctors perceived use of protective equipment as the main strategy of injury prevention while coaches regarded warm up as the main injury preventative strategy. Conclusion: There is need for physiotherapy intervention in prevention and management of football injuries in Malawi. iii DECLARATION I hereby declare that “The factors associated with football injuries in Malawi: Implications for physiotherapy intervention ” is my own work, that it has not been submitted for any degree or examination in any other university, and that all the sources used or quoted have been indicated and acknowledged by complete references. Signature……………………... November 2012 Anderson Mughogho Witness: ……………………… November 2012 Prof. Julie Phillips iv DEDICATION This thesis is dedicated to my late little sister HARRIET MUGHOGHO who died while 3 years old. The 3 years you shared with us will always be celebrated. May your soul keep on resting in peace, we will forever remember. v ACKNOWLEDGEMENTS First of all I am grateful to the almighty God for the gift of life, without which this work could not have been possible. I would like to express my deepest appreciation to my friend Kristin Fiskaa, her parents, and her husband Anders for their support towards my studies. I would like to place on record my sincere gratitude to my supervisor, Professor Julie Phillips for her guidance and encouragement through the process of this study. I am thankful to all Professors and staff at the physiotherapy department for their support. I am indebted to my statistician, Mr Siaka for his guidance with data analysis. In addition, I am thankful to MAP especially to Mr Ndembe the general manager for accepting my study leave request. To my friends and classmates…now that this work is over we can celebrate, we conquered the crocodiles! vi TABLE OF CONTENTS KEYWORDS .............................................................................................................................. i ABSTRACT ............................................................................................................................... ii DECLARATION ................................................................ ...................................................... iv DEDICATION ................................................................ ........................................................... v ACKNOWLEDGEMENTS ................................................................ ...................................... vi TABLE OF CONTENTS ......................................................................................................... vii LIST OF APPENDICES ........................................................................................................... xi LIST OF FIGURES ................................................................................................................. xii LIST OF TABLES ................................................................................................................. xiii ABBREVIATIONS ................................................................................................................ xiv CHAPTER ONE ........................................................................................................................ 1 1 INTRODUCTION .............................................................................................................. 1 1.1 Introduction to the chapter .......................................................................................... 1 1.2 Background information ............................................................................................. 1 1.3 Problem statement ....................................................................................................... 5 1.4 Research question ........................................................................................................ 6 1.5 Aim of the study .......................................................................................................... 6 1.6 Objectives of the study ................................................................................................ 6 1.7 Significance of the study ............................................................................................. 7 1.8 Definition of terms ...................................................................................................... 7 1.9 Outline of thesis .......................................................................................................... 8 CHAPTER TWO ..................................................................................................................... 10 2 LITERATURE REVIEW ................................................................................................. 10 2.1 Introduction ............................................................................................................... 10 2.2 Theoretical frame work ............................................................................................. 10 2.3 Football...................................................................................................................... 11 2.4 Prevalence and incidence of football injuries ........................................................... 12 2.5 Area, nature, mechanism and severity of football injuries ........................................ 14 2.6 Factors influencing football injuries ......................................................................... 16 2.6.1 Intrinsic factors .................................................................................................. 16 2.6.2 Extrinsic factors ................................................................................................. 22 2.6.3 Injury prevention strategies ................................................................................ 25 vii 2.6.4 Nutrition and water intake ................................................................................. 29 2.7 Awareness of football players regarding injury prevention ...................................... 30 2.8 Sports injury management ......................................................................................... 31 2.9 Summary of Chapter ................................................................................................ 32 CHAPTER THREE ................................................................ ................................................. 33 3 METHODOLOGY ...............................................................
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