Rehabilitation approaches to anterior knee pain among runners: A scoping review

Community-based rehabilitation implementation framework to address patellofemoral pain amongst runners in under-resourced communities: Delphi consensus

BACKGROUND

Runners in under-resourced communities in parts of South Africa present with a high prevalence of patellofemoral pain (PFP), which affects their level of participation in sporting activities. Therefore, a specific rehabilitation approach is necessary to manage the PFP-related needs of these runners within their means and reach.

OBJECTIVE

To develop a community-based rehabilitation (CBR) implementation framework for PFP amongst runners in under-resourced communities.

METHOD

Our study used the Delphi technique to develop an appropriate rehabilitation implementation framework for PFP in community-based settings. Sport medicine experts, involved in the treatment and rehabilitation of PFP, were recruited to participate. The Delphi process consisted of three rounds to attain consensus amongst the experts on the components and elements that could be contained in a rehabilitation implementation framework for the management of PFP. Experts rated the framework items using a five-point Likert scale.

RESULTS

A total of 19 experts participated in our study: 10 were females and 9 were males of whom 13 were aged between 36 and 55 years. Most were local experts (15) with 11-20 years of clinical experience. Four core rehabilitation implementation items were identified through the Delphi process. 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 or no-cost and (4) referral of cases to secondary or tertiary institutions for further management.

CONCLUSION

Consensus was reached for a comprehensive CBR implementation framework aimed at addressing the specific needs of runners with PFP in under-resourced communities.

CLINICAL IMPLICATIONS

A further study to test the feasibility of the agreed-upon intervention is recommended.

Siyabonga: a humble hero making a difference with his hands… and his heart

Siyabonga Kunene’s athletic build and confident stance belie his humble roots. Born in an impoverished area of South Africa, he soon learnt the benefits of an education. He is now a PhD-qualified sports physiotherapist making a significant contribution in both academic and clinical realms. Remaining true to his origins and the inspirational words of Nelson Mandela, Siyabonga has created a framework for managing patellofemoral pain in under-resourced athletes. He has established himself as a physiotherapy lecturer at his university and has been appointed to national teams in his professional capacity. However, his focus primary remains on treating those with a passion for sport who would not normally be able to access high-level athletic care.