COMMUNITY-BASED REHABILITATION IMPLEMENTATION FRAMEWORK TO ADDRESS INJURIES AMONG RUNNERS IN UNDER-RESOURCED COMMUNITIES: DELPHI CONSENSUS

Background: Athletes in low socioeconomic communities generally present with poor health outcomes as compared to those in privileged communities. Runners in under-resourced communities of South Africa have presented with a high prevalence and risks of sports-related injuries and this has a negative impact on their quality of life and level of participation. Therefore, a need to develop sustainable and effective community-based rehabilitation programmes to meet the needs of athletes in these communities has been identified.

Purpose: To develop the community-based rehabilitation implementation framework for sports-related injuries among runners in under-resourced communities, using South African communities as an example.

Methods: This paper focused on the use of the Delphi technique in building consensus on the appropriate rehabilitation implementation framework. Sport medicine experts (including sports physicians, physiotherapists, biokiniticists, sports therapists, psychologists, nutritionists/dieticians, podiatrists) in treating and rehabilitating sports-related injuries were recruited to participate. The Delphi process consisted of three rounds to obtain a consensus among experts. Experts identified the framework items. A researcher then compiled the items in the form of a questionnaire. The questionnaire was then sent to participants to make comments and rate each item using a four-point Likert scale.

Results: Nineteen experts participated in the study: 3 physicians, 5 physiotherapists, 3 sports therapists, 2 biokineticists, 2 podiatrists, 2 dieticians, and 2 psychologists. Ten were females and nine were males of which 13 were aged 36 – 55 years. Most experts were based in South African (15) with 11 – 20 years of clinical experience. The Delphi process yielded four core rehabilitation implementation framework items. These were:
1) the establishment of transdisciplinary rehabilitation teams,
2) upskilling of available clinicians, their assistants, and trainers,
3) implementation of a CBR programme at low-level/no-cost and
4) referral of cases to secondary/tertiary institution for further management.

Conclusion(s): The consensus was reached for a comprehensive community-based rehabilitation implementation framework aimed at addressing the specific needs of runners in under-resourced communities. Further studies to test the feasibility of the agreed-upon intervention is recommended.

Implications: The outcomes of the study provide useful new knowledge in the rehabilitation of sports injuries among athletes in low socioeconomic communities where there is a scarcity of rehabilitation resources. This study will assist researchers to conduct intervention studies to determine for the effectiveness of this proposed rehabilitation framework.

Funding, acknowledgements: I would like to thank both the University of the Witwatersrand and the University of KwaZulu-Natal for funding this project.

Keywords: Sports injuries, Rehabilitation framework, Under-resourced communities

Topic: Sport & sports injuries

Did this work require ethics approval? Yes

Institution: Univrsity of KwaZulu Natal, Durban, South Africa

Committee: Biomedical Research Ethics Committee

Ethics number: BFC377/15