Abstract
Background: The evolution of sports in the 20th century has proved to be both rapid and aggressive. Elite athletes have pushed the boundaries of what was once thought to be physically possible. This has subsequently given rise to the global expansion and growth of sport science, sports medicine and interprofessional teams that focus on performance and injury prevention. Globally, sports chiropractic is still, relatively speaking, in its infancy and the term sports chiropractic is yet to find its true and internationally recognised identity. Attempts have been made to delineate sports chiropractic by various chiropractic communities around the world. However, these categorisations differ and in some cases, highlight the differing ideologies and interpretations of what a sports chiropractor can and should be.
Aim: The primary aim of this study was to determine the practice parameters of sports chiropractic and subsequently to identify the practice characteristics synonymous with sports chiropractic in South Africa. Secondarily to this aim, the study would investigate the occurrence of interprofessional teams with regards to sports chiropractic in South Africa.
Method: This study was a cross-sectional survey. South Africa currently has 90 sports chiropractors who are members of ChiroSport South Africa. Therefore, to ensure a high level of confidence and statistical viability, the study aimed for a minimum sample size of 50 participants. The questionnaire was formulated from the adaptation of two questionnaires used previously for similar studies. The online questionnaire consisted of a total of 27 questions, which was distributed under the five following domains: demographics, education, clinical practice, interprofessional work and sports chiropractic. The selected questions were adjusted for their application to the local South African landscape and context. The implications of Covid-19 and its impact on the profession with regards to sports events and practice, were also taken into account when formulating the questionnaire. The questionnaire was then subjected to content validation and face validity. Once all the feedback had been analysed and the questionnaire adjusted accordingly, the final draft of the online questionnaire was approved by Statkon. The questionnaire will require approximately 10-20 minutes to complete. The collected data was then subjected to statistical analysis with the use of descriptive statistics, Exploratory Factor Analysis and Cronbach’s alpha.
Procedure: The questionnaire was formulated through an online Google Forms format that was then compressed into an easily accessible link. This link was then attached to the information letter to be
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circulated to all the participants. The questionnaire was distributed to the target population using a three-phase approach. Phase one consisted of circulating the questionnaire via the ChiroSport South Africa emailing list. Phase two consisted of circulating the questionnaire on the ChiroSport South Africa WhatsApp group. Phase three consisted of the researcher contacting chiropractors directly and requesting permission for the questionnaire to be sent to them via WhatsApp or email.
Results: A total of 56 participants responded to the questionnaire, which resulted in a response rate of 62.22%. The study revealed that 85.7% of the participants self-identified as a sports chiropractor. The majority of the participants tended to be male (55.4%), aged between 41-50 years old (35.7%), a graduate of the University of Johannesburg (71.4%), practicing out of the Gauteng province (62.5%), involved in educational sports volunteer work and sporting events (60.8%), not directly contracted with a sports club or team (72.7%), mostly treat amateur athletes between the ages of 25 to 44 years old (76.8%), have between five or less years of sports specific experience (30.4%) and have obtained some form of additional sports specific training (71%), most commonly the International Certificate in Sports Chiropractic (ICSC) qualification from Fédération Internationale de Chiropratique du Sport (FICS). Participants of the study were all in favour of interprofessional practices, with the most utilised profession being biokinetics (11,9%). The most utilised modality was spinal manipulation and the most popular continuing education short course was kinesio-taping (28.4%). Diagnostic ultrasound was the most utilised form of imaging and majority of the participants have taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor taken the position that a sports chiropractor should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title should be a protected title that requires a set qualification that is specific to diagnosing, treating and managing sporting injuries. Furthermore, most of the participants agree that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should that sports chiropractors should be considered a complementary or alternative healthcare practitioner and should be considered a physician that focuses on the conservative management, rehabilitation, and performance optimization of the neuromusculoskeletal system in the athletic population.
Conclusion: It can be concluded that a ChiroSport South Africa members practice parameter would encompass a multi-model approach that consists of manipulations, auxiliary therapeutics, biomechanical and neurological assessments, with special attention to the athlete’s physical activity, recovery and overall wellbeing. Thus, the identity of a South African sports chiropractor can be defined as a complementary healthcare provider that focuses on the conservative management, rehabilitation and performance optimisation of the neuromusculoskeletal system in the athletic population. Furthermore, the South African sports chiropractic community favours the concept of an interprofessional practice or team and is currently implementing this notion throughout the South African sports landscape.