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100 Abstracts / Journal of Science an

porting Federations, and thus have a complete sports injuryapture for Qatari athletes. Part of our role is also to increasexercise rates in the Qatari population as, with increasingesternisation of the country, there are increased rates of

besity and diabetes. Aspetar has excellent radiology servicesn-site, can generally provide patient radiology, includingRI, within 3–5 days, and the images are stored electroni-

ally. This allows us to have specific diagnoses for all patientonsultations, and to review radiology electronically at anyime. We aimed to conduct an audit of common and specificiagnoses of both athlete and non-athlete presentations to ourutpatient department. We conducted a retrospective audit onutpatient hospital services for the past 7 months of operationJuly 1 st 2008 to January 31 st 2009). All patient files wereeviewed by a Sports Physician and the diagnosis recordedas based on patient notes and radiological findings. Anyiscrepancy was discussed with the treating sports medicineoctor, to clarify the diagnosis. Specific sports injury ratesere calculated from this audit. The most common injuries

n athletes are: ankle sprains, muscle strains (hamstring andalf muscles), ligament injuries (MCL and ACL knee), andupraspinatus tendinipathy/ bursitis. Non-athlete consulta-ions represent 35% of outpatient services at our facility andhe most common injuries are: back pain (lumbar and cervi-al), supraspinatus tendinipathy/bursitis, patellofemoral kneeain/osteoarthritis, and tibialis posterior tenosynovitis. Theseesults represent a complete picture of all athletic injuries inatar, due to the unique capture rate of Aspetar NSMP for

ports injuries. The noted common sports injuries in Qatarithletes are in keeping with other literature on sports injuries.he common injuries in non-athletes may be due to manyociocultural factors including daily prayer in a repetitiveexed posture, and also footwear choice. There are somenique challenges in increasing exercise, including inciden-al exercise, in the local population. These would include:he abundance of services provided by an inexpensive labourorce, the extreme desert climate, and clothing considerationsn a muslim country. We will present information on methodsf addressing these challenges, some of which are applicableo Australia’s multicultural population.

oi:10.1016/j.jsams.2009.10.205

05

he use of visual and auditory biofeedback in the assess-ent, analysis and rehabilitation of the lower limb sports

njuries

. Kaplan

Jerusalem Physiotherapy and Sports Medicine Institute

Introduction: One of the primary objectives of early reha-ilitation in sportspersons who have undergone lower limburgery is to return them to weight-bearing as quickly asossible. Auditory biofeedback has been utilized in stroke

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cine in Sport 12 (2010) e1–e232

ehabilitation, transtibial amputation and the implantation ofrtificial joints in order to provide performance-relevant cueso both patient and clinician about the occurrence, duration,nd location of a force component of motor performance. Itas not previously been reported in sports injury rehabilita-ion.

Objectives: To present a new weight-bearing auditorynd visual biofeedback insole device (SmartstepTM) usingumerous case studies in order to exhibit both the computerssessment and auditory feedback responses in sportspersonsollowing lower limb surgery.

Method: Participants will be introduced to the conceptf visual and auditory lower limb biofeedback and how aorce-sensing insole can be utilized to provide immediateeedback to the patient and the clinician via a portable, minia-ure microprocessor control unit for data storage. Participantsill be shown how gait performances records can be objec-

ively analyzed, visually displayed and stored and how lowerimb biofeedback can significantly and rapidly improve gaitunction in standing, walking and step climbing. Participantsill experience hands on practice of how to utilize a comput-

rized insole biofeedback device for measuring objectivelyeight-bearing in the lower limb.Results: Whilst using the new patient-customized audi-

ory feedback device, accurate weight-bearing comparisonsetween bilateral lower limbs were recorded. In most cases,fter a single session utilizing the feedback device, weight-earing values were objectively and statistically improvednd in some cases maintained, without the feedback deviceeing further employed.

Conclusions: Sportspersons need to return to full weight-earing rapidly following lower limb surgery. Use of the newatient-customized auditory biofeedback device provides aore accurate and rapid rehabilitation tool than previous

eported methods. It may further prove to be a reliable andalid instrument for evaluating athletes prior to returningo sports after injury, especially in those cases where thereas a significant load difference between the affected andnaffected lower limb.

oi:10.1016/j.jsams.2009.10.206

06

pen vs closed kinetic chain exercises following anteriorruciate ligament reconstruction: The great debate

. Kaplan

Jerusalem Physiotherapy and Sports Medicine Institute

Background: Until recently, it was widely believed thatpen-kinetic chain (OKC) knee extensor resistance training

as harmful to the graft following Anterior Cruciate ligament

econstructive (ACLR) surgery and was less effective thanlosed-kinetic chain exercises (CKCE) in improving func-ional return to sporting activity. This however was based on

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Abstracts / Journal of Science an

ew high quality controlled trials, and in most cases repre-ented a more speculative approach to the subject.

Aims: To conduct a comprehensive systematic literatureeview on the subject matter and to summarize the relevantndings of the high quality randomized control trials (RCT)

hat investigated whether in fact OKC exercises were indeedore harmful.Methods: A literature search of MEDLINE (January

966–February 2009), PEDro (to February 2009), EMBASE1974–February 2009), CINAHL (1982–February 2009) andhe Cochrane data base was conducted using the followingearch terms: “Open-kinetic chain exercises”, “Closed kinetichain exercises”, “ACL rehabilitation”.

Results: Seventeen papers were found relevant to the sub-ect matter and were reviewed. Of these, seven were RCT.uadriceps strength is significantly enhanced with the addi-

ion of OKC exercises as opposed to CKC exercises alone.here were no significant differences regarding knee laxity or

eg function between patients who trained using OKC versusKC exercises. Maximum ACL strain values obtained dur-

ng squatting (CKC) did not differ from those obtained duringctive flexion–extension (OKC). No difference in knee painas found between OKC and CKC resistance exercises at

wo and six weeks respectively. Biomechanical studies havehown that peak strains on the graft were similar betweenKC and CKC exercises. There is evidence of a signifi-

ant increase in tensile strength for tendons exposed to cyclictress compared to stress-deprived tendon.

Conclusions: The data suggests that there are no clinicallyignificant differences in the functional improvement result-ng from the choice of OKC or CKC exercises in the earlyeriod after surgery. It therefore seems that the great concernbout the safety of OKC knee extensor training in the earlyeriod after ACLR surgery may not be well founded.

oi:10.1016/j.jsams.2009.10.207

07

eight-bearing deficits following anterior cruciate liga-ent reconstruction

. Kaplan

Jerusalem Physiotherapy and Sports Medicine Institute

Introduction: Asymmetric gait patterns persist up to oneear after anterior cruciate ligament reconstruction (ACLR).arly normal gait restoration has shown not only to be safe,ut important in order to rapidly regain normal muscle func-ion and to significantly lower post-surgical complications.here are no short-term studies quantifying different weight-earing deficits following ACLR, nor if differences exist

etween the various surgical procedures and replacementraft choices in the acute-phase (0–3 weeks) post surgery.

Aims: To determine to what extent weight-bearing isffected during gait in the acute-phase (0–3 weeks) following

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cine in Sport 12 (2010) e1–e232 e101

CLR, as well as whether there exist different weight-bearingeficits between various surgical procedures and replace-ent graft choices in the acute-phase (0–3 weeks) followingCLR.

Materials and methods: The percentage bodyeight/weight-bearing (PBW/WB) values and gait char-

cteristics in the acute post-surgical stage (0–3 weeks) of5 patients who had undergone ACLR were measured,tilizing a new, innovative computerized air-insole auditoryiofeedback system (SmartstepTM). The entire group wasub-grouped into those patients who underwent only aamstrings graft reconstruction, those who underwentn allograft reconstruction, and finally those who had aamstring graft reconstruction combined with a medialeniscus suture.Results: The average entire-foot, hind-foot and fore-foot

BW/WB values of the operated group were all statisti-ally significantly lower than the normal group (p < 0.05).he most marked difference being that of the hind-footBW/WB value. The combined hamstrings graft/medialeniscus repair group exhibited a statistically significant

ifference in the percentage time spent in both the stancend swing phases, as compared to the norm (p < 0.05). Thellograft group scored the best on all PBW/WB values.

Conclusions: Clinicians involved in post-ACLR rehabili-ation should place more emphasis on encouraging hind-footeight-bearing as early on as possible following ACLR. Ini-

ial results may indicate the choice of the allograft over thether graft types in terms of post-surgical pain and functionaleight-bearing ability in the short-term.

oi:10.1016/j.jsams.2009.10.208

08

ehabilitation and functional restoration in an eliteolfer—A case study

. Haynes ∗, M. McGrath, D. Darbyshire

Bluearth Institute

Introduction: The unique features of golf action andelated functional movements provide many physical chal-enges to golfers of all levels. The asymmetric diagonaloads experienced in golf specific actions are particularlyvident during driving and can produce high load forcesn the segmentally linked human frame. There is also aigh degree of lumbo-pelvic and shoulder pain and dys-unction in regular golfers. Golf action then presents ahallenge to the clinician in understanding the underlyinglobal factors related to specific segmental pain and dysfunc-ion presentations. This case study looks at the progressive

ehabilitation protocol for a shoulder injury in an elite inter-ational golfer focusing on a shared care approach involvinghysical therapist (chiropractor), conditioning specialist andolf coach.