PAGE

2018 Shoulder Roadshow

Feature Isobel Freeman Physiotherapist Commonwealth Games

2019 Symposium

FEATURE TOPIC: Commonwealth Games

SEPNZ BULLETIN

Issue 3 June 2018

PAGE 2

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President Blair Jarratt

Vice-President Timofei Dovbysh

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PAGE 3

In t

his

is

su

e:

SEPNZ MEMBERS PAGE

See our page for committee members, links & member information 2

EDITORIAL

By SEPNZ Out-going President Hamish Ashton 4

By SEPNZ In-coming President Blair Jarrett 4

MEMBERS’ BENEFITS

Discounts 5

FEATURE

Isobel Freeman - Physiotherapist Commonwealth Games 2018 6

SITUATIONS VACANT

Wanted: Bulletin Editor 9

CONTINUING EDUCATION

2018 Shoulder Roadshow with Dr Ann Cools 10

SEPNZ SYMPOSIUM

5th Biennial SEPNZ Symposium 12

SPRINZ

Beating the Heat 13

PLANET OF THE APPS

App: SWIBO Tilt 16

ASICS

Protection Perfected—Gel-Kayano™ 25 19

CLINICAL SECTION- ARTICLE REVIEW

Pain and Fatigue in Sport: Are They So Different? 20

RESEARCH PUBLICATIONS

BJSM Volume 52, Number 12, June 2018 21

CLASSIFIEDS

Situations Vacant 22

Contents

FEATURE TOPIC: Commonwealth Games

PAGE 4

Editorial

Hi all

A number of years ago when I wrote the SEPNZ constitution I put a contingency clause in allowing the president to stay longer than the maximum 4 year term in the circumstance that there was no one willing to put their hand up. Earlier this year I was thinking that this clause would be needed. However, what I hadn’t counted on was the commitment of the current committee. Their dedication to the group, which I have never doubted, was shown by several them putting their hand up for new positions, including the presidency.

In this time of change it is great having new leadership taking us forward. All groups benefit from a change at the top. This helps to continue the momentum of the group and bring forward fresh ideas.

As mentioned in previous editorials I have been involved over the last 2 years in the PNZ changes process. What has come from this is a dedication by all SIGs and branches to work together for the better of a profession. Concepts have been developed as a base of a possible organisation, but up to now the model has still lacked specific information especially related to the

exact constitutional formula and costings to members. We have been told this information is due out shortly. As Blair mentions below, what is important as this information comes out is to ask, have we got it right? and will this make the difference to the organisation we belong to?

One of the benefits of Blair taking over the leadership is that he comes into things with a fresh pair of eyes. Though he has been privy to slightly more information than most of the membership, his understanding of the model will be little different than yours. This means questions will be asked when things are not clear or not presented well, so you as members of both SEPNZ and PNZ are clear on where we are going when decisions are made.

A final note from me – a big thanks to all my exec over the last 4 years. I have greatly appreciated the support you have given me.

Hasta la vista – I’ll be back

Hamish

Hamish Ashton, Out-Going SEPNZ President

Kia ora,

Hi. I would like to introduce myself as the new president of SEPNZ. It has been a whirlwind introduction over the last month as Hamish finally found out that an Aussie Super Rugby team can beat a NZ team so has decided to head over the ditch to support them.

The executive would like to thank Hamish for his tireless efforts for this group, and we are glad he is staying on the executive in a different capacity. Hamish has been the president of what was SPNZ and now is SEPNZ over the last 4 years and has been a member of the executive for much longer. Over this time, he has overseen a number of major successes – in 2017 we brought Karim Khan and Jill Cook over for the sell-out roadshows. Off the success of this we ran last year’s concussion road show and workshop as well as a symposium in Auckland. This year starting soon we have the shoulder roadshow in partnership with SMNZ touring seven destinations. If you haven’t seen information on this up and coming roadshow please check out the website but be quick as most venues have sold out. Our level 1 course continues to be very popular and we rolled out a new level 2 earlier this year. Hamish and now I, along with the rest of our executive, will continue to work hard to give our members value for money. However, if you have any compliments or complaints for us, there are a number of ways you can contact us either through our social media or email, so we can continue to build on what we feel you as our members want from us.

A bit about me. I grew up in Tauranga and was a graduate of Otago University School of Physiotherapy. Completing my studies, I worked with SEPNZ life member Graeme Nuttridge before heading on a 5 year UK OE. Returning to Christchurch to work with Graeme, I became the lead physiotherapist for the Canterbury Cricket and Wizards team in the summer and Canterbury Rugby metropolitan and ITM feeder team in the winter which meant a very busy working week all year round. Returning to Tauranga with a small period working closely with NZC for the world cup in Dubai I am now a director of Bureta Physio and enjoy a few more weekends off with my family. Being in the Bay I have stepped into looking after Mount Surf Club which means tirelessly hanging out on the beach…….

I have just returned from the PNZ leadership day in Wellington 25

th May. On the list was building advocacy

of physiotherapy through PNZ. I hope all of you are aware of the process before us, as part of the vision of the unification model includes unifying all branches and Special Interest Groups (SIG) back into PNZ. As an executive we are working hard to find out the implications of the proposal to unify and its advantages and disadvantages. As a membership I would encourage you to send your questions through to PNZ to get a better understanding of how the proposed changes would positively or negatively affect our members.

We hope you enjoy this latest edition.

Blair

Blair Jarratt, In-Coming SEPNZ President

PAGE 5

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There are many benefits to be obtained from being an SEPNZ member.

For a full list of members’ benefits visit http://sportsphysiotherapy.org.nz/benefits/

In each bulletin we will be highlighting individual member benefits

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PAGE 6

Feature

Isobel Freeman

PHYSIOTHERAPIST COMMONWEALTH GAMES 2018

What has been your physiotherapy journey so far?

My passion is sport (although I am an average everyday punter myself) and my ambition has always been

to work as a full-time physiotherapist with a national sports team. This goal has directed my career and is

what continually motivates me and shapes my work and study. I have had a lot of fun and many different

roles along the way, but I have remained focused towards what I wanted to achieve.

I graduated from Birmingham University, England, in 1999 with BSc (Hons) Physiotherapy. Immediately I

worked with club rugby on top of full-time hospital based employment. In addition to this I volunteered at

my local fencing club, which was my university sport. I moved to London to specialise in musculo-skeletal

physiotherapy and continued to work with rugby at club and regional levels. I also ‘put my hand up’ for any

other opportunities which included volunteer work at large events ie. marathons, badminton tournaments.

It was in a volunteer capacity that I attended my first multi-sport event as a Games physiotherapist at the

Athens 2004 Olympics based at the indoor volleyball stadium. This experience gave me a ‘taste’ of the

amazing atmosphere which is unique to the pinnacle games and I certainly wanted to be part of this again!

Following Athens, I spread my wings and travelled to the Southern Hemisphere to experience work and

travel ‘down under’ which was a great way to expand my knowledge of physiotherapy techniques and

make new friends. I returned to Europe and alternated between seasonal physiotherapy in a French ski

resort (thoroughly recommended) and London private practices. It was during this period that I became

involved with England Hockey at age group level.

I returned to New Zealand in 2009 and I haven’t looked

back since. Initially based in Taranaki gaining more sports

rugby experience, I then moved to Auckland to complete

my Masters in Health Practice in Musculoskeletal

Physiotherapy at AUT which opened many doors for me. I

was fortunate enough to travel to Samoa with the NZ

Youth Commonwealth Games team in 2015 as well as to

Europe with Adaptive Snow Sports for World

Championships in 2017. Between 2015 -2017 I was the

lead physiotherapist for the Black Ferns XV, being with the

team and winning the World Cup 2017 was one of my

career highlights so far. I am now employed full-time at

HPSNZ and am the physiotherapist for men’s hockey.

CONTINUED ON NEXT PAGE

What was your

role at the Gold

Coast

Commonwealth

Games?

Physiotherapist

Men’s Hockey

Isobel standing on

the turf, Gold Coast

Hockey Centre

Career highlight so far: Black ferns winning Women’s Rugby World Cup 2017

Photo courtesy of Sean Willis/NZ Rugby

What type of injuries do you commonly see?

Hockey (men and women) has previously accounted for

the highest use of medical services during major games

across all sports. This is likely due to a combination of

factors which include: a longer competition duration over

the games compared to most other sports, injuries

resulting from sudden contact and non-contact

mechanisms as well as overuse, a large number of

athletes (18 per team at this games).

From an injury perspective, this keeps my work

interesting, due to a wide variety of presenting

conditions. The highest annual time loss injuries are:

PAGE 7

CONTINUED ON NEXT PAGE

Feature

Isobel Freeman—Physiotherapist Commonwealth Games 2018 continued...

hamstring strains, concussion, hip pathologies resulting

in surgery and shoulder dislocations. The highest

prevalence of underlying ‘niggles’ which do not prevent

training but are continually under management are low

back pain and hip femoroacetabular impingement.

What were the key elements in successfully

minimising time loss due to injury at the games?

Fortunately, at the Commonwealth Games every player

was fully available for each game and no one was ruled

out from an injury perspective once the games began.

Understanding the demands of your sport and the

periodisation plan is an integral part of injury

management. Gathering injury statistics is essential to

be able to identify key areas and therefore focus injury

prevention strategies to those resulting in the greatest

time loss period. For example, currently we are targeting

hamstring injury prevention with an eccentric loading

programme which, although it is not decreasing the

incidence, it has resulted in a more rapid return to play.

To gain best results return to play planning should be a

combined approach between all members of the

management team, as well as the player, rather than

individual recommendations.

Who else was involved in the support team at the

games?

Within men’s hockey we travelled with our strength and

conditioner, Scott Logan, who doubled up in the role of

manager and led the team through primers, gym

sessions, recovery and kept a close eye on load

management via GPS. Both Scott and I monitored

‘wellness’ of players through a daily on-line

questionnaire consisting of eight questions with both

subjective and objective markers. This was useful on a

number of occasions to pick up player fatigue and early

signs of illness.

At the Games there was also the NZOC core health

team which comprised of doctors, physiotherapists and

massage therapists to give additional support when

required. It was great to have so many of my usual

friendly colleagues around to share the experience with.

Other NZ facilities included an extensive recovery suite

which housed hot and cold baths as well as spin bikes

and a stretching area. This was supervised by an expert

physiologist and nutritionist. There was a NZ gym area

established in the accommodation basement which was

an ideal environment for athletes to continue with their

usual routines. Psychologists were also present to

provide invaluable support to athletes.

Obviously, there were many other NZOC staff forming

the ‘wider’ support group ranging from media advisors

and uniform fitting specialists through to security staff

and project managers all of which added to the seamless

running of the New Zealand team.

Were there any challenges at the games?

One unexpected challenge that we encountered was the

high volume of walking in the village. I had heard that

this could be expected but this was my first actual

experience of what this meant. The New Zealand

accommodation was approximately 700 m from the food

hall and 800 m from the transport hub (in the same

direction). This high volume of walking was a challenge

on already tired legs and could aggravate any underlying

niggles. In view of this we adopted several strategies to

help lessen the lower limb load which included:

combined meals with heading to or from the transport

hub, using the closer ‘casual dining’ area, buying and

storing breakfast products at our accommodation,

allowing time to use the internal shuttle bus which would

drop closer to destinations. Celebrating silver with Dr Dan Exeter, Shea McAleese, Isobel

and Hugo Inglis

One of the village recovery pools

PAGE 8

Feature

Isobel Freeman—Physiotherapist Commonwealth Games 2018 continued...

Working long days is part of the territory of being support

staff for athletes at the Games and it is important to look

after yourself and ensure that you are up and ready for

each day with a smile and positive energy. My advice to

physiotherapists on tour is to plan your day and ensure

that you take breaks when possible to have time to

yourself. This might mean getting up early for a jog/swim

or having a walk and coffee mid-morning or a cup of tea

with a colleague at night. Clear communication to your

team around allocated treatment times (except in certain

acute/emergency situations) will mean that this will

minimise everyone wanting to see you at once. Having a

cut-off time for treatment (which may vary) in the evening

is a good idea to prevent fatigue creeping in.

Everyone is becoming tired at the end as well as this

being the business end of the competition so having

support staff who remain cheerful and energetic is

preferable.

Highlights of the games

From a sporting perspective, my highlight was winning

our semi-final game versus India, this meant we secured

a spot in the final and were guaranteed a medal. After

the disappointment of fourth place at the last

Commonwealth Games it was a huge relief not to be in

the bronze play off again. I was also fortunate enough to

have the opportunity to see Sophie Pascoe win her

second gold medal of the games which was very special,

not only to be amongst the crowd atmosphere and

witness a fantastic performance, but also to experience

another venue and see the physiotherapy set-up.

From a personal perspective, my highlight was simply

being amongst the atmosphere at the games including:

New Zealand accommodation hub, the village,

tournament venues, opening and closing ceremonies.

This is a unique environment including people from 71

nations and territories all mixing peacefully together to

achieve their sporting dreams. I fully embraced the ‘pin

swapping’ rituals, where appropriate, and this was a

great opportunity to chat to people from all nations. It

was an honour to be part of the New Zealand family and

to work alongside support staff and athletes who all

excel in what they do.

New Zealand hockey men’s team following the medal ceremony

PAGE 9

Wanted: Bulletin Editor

Situations Vacant

The SEPNZ Bulletin is a

show piece for

physiotherapy publications

in New Zealand.

Can you help us???

We are looking for a bulletin editor to help us put together the SEPNZ Bulletin 6 times a year.

Help will be given to get you started in the role. Publishing knowledge is not needed

Duties include:

• Contacting people to supply articles • Proof reading articles to make sure they make sense • Reminding people to send things in on time • Choosing an article to be reviewed for publication

Skills needed are basic time management and a computer

Further details on request

Contact Michael Borich - mborich@gmail.com

PAGE 10

Continuing Education

2018 Shoulder Roadshow with Dr Ann Cools

Registrations are now open for the 2018 Shoulder Roadshow. We are very fortunate to have Professor

Ann Cools from Ghent University in Belgium touring the country, doing workshops and leading the Mini

Symposiums.

All venues will be holding both a Mini Symposium and a Workshop – with the exception of Napier and

Queenstown, where only the Mini Symposium will take place.

The Mini Symposium will involve a presentation by Dr Ann Cools, along with presentations from invited

guests who also have a special interest in the shoulder region, followed by a panel discussion.

You can purchase tickets to either both events, or Mini Symposium or Workshop alone.

The Workshop will be a practical workshop focusing on treating the injured shoulder. Assessment and

exercise based approach to rehab. The Mini Symposium will be a presentation from Dr Ann Cools,

followed by a couple of invited speakers on the theory behind the injured shoulder from assessment to

investigations to treatment options and will be followed by a panel discussion

PAGE 11

Continuing Education

2018 SEPNZ and SMNZ Shoulder Roadshow

Dr Ann Cools is a physiotherapist, working as an associate professor at the Department of Rehabilitation

Sciences and Physiotherapy at the Ghent University, Belgium, and as senior researcher at the Dept of

Occupational and Physical Therapy and the Institute of Sports Medicine, Bispebjerg Hospital, University of

Copenhagen, Denmark. Her topic of research and teaching expertise, as well as her clinical work is

shoulder rehabilitation in general, and sport specific approach and scapular involvement in particular. She

finished her PhD in 2003, debating scapular involvement in sports related shoulder pain in the overhead

athlete, and she has published numerous papers in peer-reviewed international journals, wrote

contributions and chapters in several international recognized books, and gives several courses on a

national and international level. She was head of the Physical Therapy Education at the Ghent University

2008-2016, and founding member and president of the European Society of Shoulder and Elbow

Rehabilitation (EUSSER) 2008-2012. She is currently a member of the Board of the International

Congress of Shoulder and Elbow Therapists.

PAGE 12

SEPNZ Symposium

5th Biennial SEPNZ Symposium

Tauranga March 9/10th 2019 - Save the date

Key Note Speaker: Rob Whiteley

Assistant Director of Clinical Projects & Quality Aspetar

Rod Whiteley is a specialist sports physiotherapist, who was awarded a fellowship in the first cohort in Australia. He subsequently spent time on the College of Sports Physiotherapy’s board as chief examiner and has worked with a number of professional and international teams and individuals in rugby league, rugby union, baseball, football, squash, and athletics.

PAGE 13

SPRINZ

Beating the Heat

by Associate Professor Andrew Kilding, AUT Sports Performance Research Institute New Zealand

Several pinnacle sporting events are held in hot and

humid conditions that provide a challenge to the body’s

thermoregulatory abilities. The men’s marathon at the

recent Commonwealth Games highlighting once more

that the combination of heat and prolonged intense

exercise require special consideration both in terms of

the preparation of athletes, but also treatment plans

should an athlete suffer from heat illness during or after

competition.

Heat-related illnesses are a potential adverse event

that can occur when individuals exercise in hot

environments. Indeed, the combination of intense

exercise and environmental heat stress is often called

the greatest challenge to human thermoregulatory and

cardiovascular function (González-Alonso, 2012).

Manifestations of heat illness include heat rash, heat

exhaustion, heat syncope, heat cramps, and heat

stroke (Howe and Boden, 2007). In field settings the

best way to prevent heat illnesses is quick detection

followed by immediate treatment (Howe and Boden,

2007). If heat illnesses are detected quickly and acted

upon then they very rarely have any prolonged effects.

While humans can tolerate core temperatures of up to

42°C, there are risks when core temperature exceeds

40°C and heat illness can still occur with core

temperatures below 40°C, though this is only

associated with injury in field settings where there is

insufficient immediate medical help, or the diagnosis

takes too long (Casa et al. 2012). The best‑practice

guidelines for heat injury management set out by Casa

et al. (2015) are a must read for practitioners

supporting athletes competing in hot environments.

Whilst combining exercise and environmental heat

poses particular risks, the ability to perform prolonged

exercise in hot, arid environments was critical for the

survival of our hunter-gatherer ancestors. As such,

through evolution we have developed a number of key

characteristics that allow us to effectively cope with

heat stress during exercise, such as relatively hairless,

narrow frames, bipedal gaits, and an unparalled

capacity for evaporative sweat loss and therefore heat

dissipation (Bramble & Lieberman 2004). Therefore,

with appropriate preparation, athletes and exercisers

can remain healthy and successful without completely

avoiding environmental heat stress in their training and

competition.

From a performance perspective, researchers at AUT’s

Sports Performance Research Institution New Zealand

(SPRINZ) have long been interested in how heat stress

impacts human physical function and performance,

especially in athletes. Prior to both the 2016 Rio

Olympics and the recent 2018 Commonwealth Games

we replicated the types of activities and environments

that an individual would be exposed to in their sport

using our environmental chamber, and developed pre-

exercise cooling (Schulze et al. 2015), cooling during

exercise (Maunder et al. 2017), and periodised short

duration heat acclimation strategies (Casadio et al.

2016) to help athletes cope better with the heat.

We are currently interested in how heat acutely

modifies substrate metabolism during prolonged

exercise and how these effects might need to be

considered when planning nutritional strategies, both

pre- and during competition, with a view to reducing the

incidence of ‘bonking’ or depletion of the body’s

carbohydrate energy stores during endurance exercise.

It has been shown previously that when prolonged

exercise is performed in the heat, the rate at which

these finite carbohydrate stores are utilised is

accelerated (Febbraio et al. 1994), which is an

important consideration given carbohydrates stored in

muscle can become depleted to very low

concentrations during intense endurance exercise of

sufficient duration, and that this depletion is a possible

cause of fatigue (Ørtenblad et al. 2013). However, the

precise combinations of endurance exercise and

environmental heat stress under which these effects

are seen is not currently known. As such, we are

exploring how this effect is mediated by both exercise

intensity and the magnitude of the environmental

temperature to provide athletes and practitioners with

improved understanding of how a given combination of

environmental heat and endurance exercise will impact

their substrate metabolism, and therefore allow them to

plan their nutritional strategies accordingly.

It is also possible that training in hot environments may

improve the adaptive response to exercise through

heightened stress at the cellular level (Hawley et al.

2018), a suggestion no doubt supported anecdotally by

the many endurance athletes who engage in this

practice through ‘heat stress training camps’. However,

whilst promising, the research in this field is very much

CONTINUED ON NEXT PAGE

PAGE 14

SPRINZ

in its infancy and has primarily been conducted in cells

exposed to high incubator temperatures (Liu & Brooks,

2012). We have started to explore physiological and

biochemical responses to training in the heat in

strength and power athletes (Casadio et al. 2017b) but

ongoing research interest at SPRINZ is to establish the

adaptive response to exercise training performed under

environmental heat stress in other athletes. Exploring

this effect is expected to help athletes and practitioners

better understand how to use environmental heat

stress as part of training to achieve optimal

performance for NZ athletes in a range of sports

performed in temperate and hot environments.

Practical recommendations and conclusions

• The combination of intense exercise and a hot

environment is a huge stress on

thermoregulatory and cardiovascular function,

although humans are uniquely adapted to cope

with such stresses.

• Rapid diagnosis and appropriate treatment is

essential in minimising the consequences of heat

illness.

• Pre- and during exercise cooling, as well as

specific heat acclimation, are well-supported

strategies for reducing the risk of heat illness and

maximising exercise performance in hot

environments (see Casadio et al. 2017).

• Performing endurance exercise in hot conditions

alters substrate metabolism, which might have

implications for the nutritional strategies adopted

by athletes.

• The effects of purposely performing training in

hot environments to augment an adaptive

response are not completely understood and

warrant further investigation.

References Bramble, D.M. & Lieberman, D.E. Endurance running

and the evolution of Homo. Nature 432(7015), 345-352,

2004.

Casa, D.J. Armstrong, L.E, Kenny, G.P, O'Connor, F.G,

Huggins, R.A. Exertional heat stroke: new concepts

regarding cause and care. Curr Sports Med Rep 11(3):

p. 115-23, 2012.

Casa, D.J, et al., National Athletic Trainers' Association

Position Statement: Exertional Heat Illnesses. J Athl

Train 50(9): p. 986-1000, 2015.

Casadio J.R, Kilding A.E, Siegel R, Cotter J.D, Laursen

P.B. Periodizing heat acclimation in elite Laser sailors

preparing for a world championship event in hot

conditions.

Temp, 4;3(3):437-443, 2016.

Casadio J.R, Kilding, A.E, Cotter, J.D, Laursen P.B.

From Lab to Real World: Heat Acclimation

Considerations for Elite Athletes. Sports Med 47

(8):1467-1476, 2017

Casadio J.R, Storey A.G., Merien F, Kilding A.E, Cotter

J.D, Laursen P.B. Acute effects of heated resistance

exercise in female and male power athletes. Eur J Appl

Physiol 117(10):1965-1976, 2017b.

Febbraio, M.A, Snow, R.J, Stathis, C.G, Hargreaves,

M, Carey, M,F. Effect of heat stress on muscle energy

metabolism during exercise. J Appl Phys 77(6), 2827-

2831, 1994.

González-Alonso, J. Human thermoregulation and the

cardiovascular system. Exp Phys 97(3), 340-346, 2012.

Hawley, J.A., Lundby, C, Cotter, J.D, Burke, L.M.

Maximizing cellular adaptation to endurance exercise in

skeletal muscle. Cell Metab 27(5), 962-976, 2018.

Howe, A.S. and Boden, B.P. Heat-related illness in

athletes. Am J Sports Med 35(8): p. 1384-95, 2007.

Liu, C.T. & Brooks, G.A. Mild heat stress induces

mitochondrial biogenesis in C2C12 myotubes. J Appl

Phys 112(3), 354-361, 2012.

Maunder, E., Laursen P.B, Kilding A.E. Effect of ad

libitum ice-slurry and cold-fluid ingestion on cycling time

-trial performance in the heat. Int J Sp Phys Perf 12(1),

99-105, 2017.

CONTINUED ON NEXT PAGE

Beating the Heat continued...

by Associate Professor Andrew Kilding, AUT Sports Performance Research Institute New Zealand

PAGE 15

Associate Professor Andrew

Kilding leads the SPRINZ

(Sports Performance

Research Institute New

Zealand) Sports Physiology

and Nutrition Research

Group. His research interests

focus on developing and

assessing novel ways to enhance endurance

(aerobic) performance – both in individual sports

such as running, cycling and triathlon, but also in

team sports.

https://sprinz.aut.ac.nz/our-people/sports-physiology-

and-nutrition-research-group/andrew-kilding

SPRINZ

Beating the Heat continued...

by Associate Professor Andrew Kilding, AUT Sports Performance Research Institute New Zealand

Ørtenblad, N., Westerblad, H,. Nielsen, J. Muscle

glycogen stores and fatigue. J Physiol 591(18), 4405-

4413, 2013.

Schulze, E,. Daanen, H.A,. Levels, K,. Casadio, J.R,

Plews, D.J, Kilding, A.E, Siegel R, Laursen P.B. Effect

of thermal state and thermal comfort on cycling

performance in the heat. Int J Sports Physiol Perform,

10(5):655-63, 2015.

PAGE 16

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SEPNZ executive member.

Hey team, It has been a little while since I have come across any good apps that I felt I needed to share, but on a flight down to

Wellington recently I saw a small piece on a Wellington Victoria University entrepreneurial company that had re-

leased SWIBO Tilt and I decided to get in touch and give it a go. SWIBO Tilt was created to help improve the com-

pliance of proprioception training. This is achieved by creating games that can be played on a wobbleboard (or bo-

su) that are viewed on a screen. Basically, you are using the accelerometer and gyroscope in your phone as your

joystick, which connects via Bluetooth to your computer screen. You need to download the SWIBO programme onto

your computer. This is not a new concept, there have been some similar concepts used in neuro rehab before, but it

was the first New Zealand version that I am aware of. Through SWIBO Tilt not only are you gameifying exercise

which may increase compliance, you can also measure balance, and track your clients progress. You can purchase

a SWIBO Tilt board which has been designed to hold your smartphone, or use ones you already own (putting down

an antislip mat on the bosu or wobbleboard helps to keep your phone in place).

App: SWIBO Tilt

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PAGE 17

Planet of the Apps

You can also purchase a SWIBO Tilt board for $150.00 each or 10 boards

for $400.00.

The app is free to download

Requires: You will need to download SWIBO Tilt on your computer onto either

Windows (Windows 8 or Higher, Dual Core Processor, 4GB RAM) and Mac

OSX platforms (OSX 10.10 Yosemite, or newer, Dual Core Processor, 4GB

RAM and onto a phone Android version 4.1 Jellybean or higher or iO6

version 6 or higher.

What it is used for: Gamefying proprioception training, increasing compliance

Where to find it: Download from Apple store, or Android Play, check https://swibo.co.nz for

details

Android or Apple or both: Both

Pros:

• This makes wobbleboarding more fun! Exercising your senses and engaging in a bit of fun could produce a positive proprioceptive outcome.

• The benefits of video gaming have been shown to improve spatial skills, attention capacity, and proprioception (SWIBO is undergoing testing at the moment to see the effect of their games)

• With the pro version you can check clients compliance, test their balance ability

• Great for those that enjoy gaming,

• Those that have played it have enjoyed it and enjoyed challenging themselves to beat their high score

• The interface for testing looked professional

• Being able to track compliance of patients is great – and allows them to see their progress too

Cons:

• I really wanted to like this product but….This seems ridiculously expensive for what it is. The games appear very basic.

• If you are using iOS you need to have a good WiFi setup (ours isn’t)

How I use the app:

I have not continued my subscription after the 14 day trial. I will forward the link to the website for

those that I think will enjoy the app and use it. I found it was a lot more challenging using a bosu

flipped onto the air filled end. If we were to purchase the Professional version the SBIBO team

suggested we could pass the cost onto my clients.

I am going to keep watching the website though as the SWIBO team have told me there are

some better games in the pipeline.

Bring the price down and improve the games and think that SWIBO could be onto a winner. I

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PAGE 18

Planet of the Apps

For further discussion on this App check the SEPNZ LinkedIn forum page Click here

know that some of you would love it so if it is something that you are interested in please get in

touch with the SWIBO team.

Don’t just take my opinion on this product though…I gave it to Techsavvy Tim to give it a go…

This is what he said….

Techsavvy Tim’s Two cents worth:

Thanks Justin,

We had the team at SWIBO come in and give our team an overview and demonstration.

What we liked:

• There are three different games which will be appealing to a different age range of patient. One is an obstacle course you negotiate, another is a race-type game, and the last is a shooting-style game.

• The software uses the gyroscope and accelerometer in your phone and can display metrics and trends at the end of a game. This allows you to track movement on a sagittal, coronal, and transverse planes to compare errors or similarities between sides. This can be monitored over a period of time.

• As the all the SWIBO needs is a flat surface for a smartphone, you are able to look beyond lower limb rehab – we trialed controlling the board with our arms in a press up position so there is utility in upper limb and trunk rehab exercises or testing.

What we didn’t like as much:

• You have to set up clients as users and there is a limit to how many client accounts you can create per subscription. Clinics will have to work out a subscription structure that fits.

• An internet connection is required to play – great if you have no connectivity issues, not great if you do.

• It can take a bit of time to set up the client’s account and show them how to use the game so each clinic will have to figure out how this fits within their appointment time structures.

Take home message:

While this concept isn’t new, it is great to see a New Zealand

company get involved. The SWIBO team are great

communicators if you have any questions/issues and may be

able to provide a demonstration if they are in your area if you

get in touch. This was the first time we trialed a product like

this and it was interesting to see how it could fit into a clinical

setting as an assessment and/or rehabilitation tool.

Overall Rating: 3/5

PAGE 19

ASICS

PAGE 20

Clinical Section - Article Review

Athletes will often avoid or reduce their training and/or sporting participation for pain and

fatigue. Paradoxically, that ‘relative’ rest means that they avoid the very essence of what

keeps them healthy, fit and resilient. Coaches sometimes see pain and fatigue as a

‘weakness’ and when medical staff have an opposing view this can place the athlete in a

conflicted state.

(see link for figure 1)

Both pain and fatigue are potentially important

signals that the body perceives danger.

However, in the absence of pathology or signs

of maladaptation,1 these can be misinterpreted

as injury or illness. Fatigue is unavoidable2 if

physiological adaptation is to be achieved.

Interpretation of fatigue and pain may be

influenced by the central nervous system

(CNS) and this may play a large part in

determining a person’s pain experience.4

Listen carefully to the athlete: Athlete

responses are completely individual and their

fatigue or pain may coincide with other factors

creating anxiety.

Educate and reassure through behavioural

learning: Pain and fatigue can create fear

about the safety of training and lead to load

avoidance. Conversely, fear of appearing

‘weak’ can exacerbate symptoms. Identify the

contributing factors and develop strategies so

activity can be maintained while building

physical and psychological resilience (figure

1). Use positive and reflective communication

Pain and Fatigue in Sport: Are They So Different?

Kieran O’Sullivan,1,2

Peter B O’Sullivan,3,4

Tim J Gabbett5,6

British Journal of Sports Medicine May 2018 Vol 52 No 9

to help athletes understand that pain and

fatigue are multi-factorial and they need not be

barriers to achieving their goals.

Team environment: Develop good

relationships with athletes to identify what

makes them vulnerable to their interpretation

of sensations and help them achieve an

understanding of resilience to achieve athlete-

centred goals.

In conclusion, once serious pathology has

been ruled out, identification and management

of the relevant factors can be used within a

decision-making framework7,8

to enable

athletes to continue training without provoking

symptoms or unnecessarily avoiding training.

This editorial reminds clinicians that athletes

are individuals and that good communication

and education are paramount in providing

complete athlete management of injury.

A full list of references is available on request.

By Pip Sail Physiotherapist

PAGE 21

Research Publications

British Journal of Sports Medicine

www.bjsm.bjm.com

Volume 52, Number 12, June 2018

EDITORIALS

What Hippocrates called ‘Man’s best medicine’: walking is humanity’s path to a better world

Emmanuel Stamatakis, Mark Hamer, Marie H Murphy

Walking: a best buy for public and planetary health

Fiona C Bull, Adrianne E Hardman

Socially awkward: how can we better promote walking as a social behaviour?

Ruth F Hunter, Kylie Ball, Olga L Sarmiento

REVIEWS

How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: a narrative

review

Catrine Tudor-Locke, Ho Han, Elroy J Aguiar, Tiago V Barreira, John M Schuna Jr, Minsoo Kang, David A Rowe

Moving to an active lifestyle? A systematic review of the effects of residential relocation on walking, physical activity

and travel behaviour

Ding Ding, Binh Nguyen, Vincent Learnihan, Adrian E Bauman, Rachel Davey, Bin Jalaludin, Klaus Gebel

Walking on sunshine: scoping review of the evidence for walking and mental health

Paul Kelly, Chloë Williamson, Ailsa G Niven, Ruth Hunter, Nanette Mutrie, Justin Richards

What works to promote walking at the population level? A systematic review

Charlie Foster, Paul Kelly, Hamish A B Reid, Nia Roberts, Elaine M Murtagh, David K Humphreys, Jenna Panter,

Karen Milton

ORIGINAL ARTICLES

Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts

Emmanuel Stamatakis, Paul Kelly, Tessa Strain, Elaine M Murtagh, Ding Ding, Marie H Murphy

Effects of frequency, intensity, duration and volume of walking interventions on CVD risk factors: a systematic review and meta-regression analysis of randomised controlled trials among inactive healthy adults

Pekka Oja, Paul Kelly, Elaine M Murtagh, Marie H Murphy, Charlie Foster, Sylvia Titze

http://bjsm.bmj.com/content/

PAGE 22

Classifieds

TAURANGA

Back in Action Physiotherapy

Physiotherapist

We have found a great therapist to join our team but

due to expansion we are still looking for another one,

which could be you!

If you had to list all the things you want in a job …..

here is your list AND that is what we are offering!!

* Flexibility with hours

* Weekly planned CPD

* Longer sessions

* Fun staff

* Lots of sports teams

* Autonomous

* Full list

* Easy location to get to

* Varied workload

* Great patients

* Great coffee down the road

* Senior support

* Lots of laughs

* Competitive remuneration

* Work-life balance

* Learning

* Fab beaches

* Redecorated clinic

* Your own room

* Awesome admin support

* Cool city to explore

* Part or full time

* Sports team opportunities

* Focus on patient care

* Clinical reasoning sessions

Go and check us out at www.biaphysio.com.

Then it's easy – if you want to know more then drop me an email with some questions

or if you are already keen then send me your CV and we can have a chat.

info@biaphysio.com

Look forward to hearing from you soon.

Leanna Veal

Position Requirements:

NZ Work Visa

Annual Practising Certificate

TAURANGA

Bureta Physiotherapy

Physiotherapist We need another team member. Our busy

physiotherapy clinic is looking for another like minded

physio to join us in a varied job role of most clinical

physiotherapy, rehabilitation and some ACC contract

work.

This is an exciting opportunity to work in an established

sports physiotherapy and rehabilitation clinic and the

ability to learn and be exposed to the world of emerging

talent and high performance sport. For over thirteen

years Bureta Physiotherapy has been providing the

highest quality physiotherapy to a wide variety of

"everyday" patients to elite athletes with a focus on

overall health and wellness. As well as working with

sports teams our clinic holds major contracts with

APM for vocational, functional, and pain management

contracts.

Generous appointment times allow for an emphasis on

manual/manipulative physiotherapy and exercise

prescription encompassing full rehabilitation in the onsite

rehabilitation gym or one of our partnered gyms in

Tauranga. Work alongside experienced post graduate

and Masters qualified physiotherapists, a therapeutic

massage therapist, a great reception team along with

close links to local sports medicine doctors and

specialists. The successful applicant will receive on-

going support as part of our strong mentoring program

along with an allowance for CPD to assist with post

graduate study/courses and conferences.

Start date is July 2018. We are looking for an

enthusiastic, hard-working physiotherapist with excellent

communication skills, an interest in gym based

rehabilitation and a strong desire to learn and enhance

their clinical skills as well as build their reputation as a

high quality physiotherapist. The position has the ability

to involve primarily musculoskeletal and sports

physiotherapy or a mix of clinical work with contract work

under the ACC pain contract as a key worker and

vocational rehabilitation. If contract work option is

desired experience is these areas is preferred although

not essential as training will be provided.

Come see why our clinic won the Bay of Plenty Westpac

Business Awards for Customer service in 2017 and be

the best physiotherapist you can be. The ability to think

outside the box and go 'above and beyond' is a must to

work in this dynamic and energetic team.

For further information please contact Jacinta Horan

on jacinta@buretaphysio.co.nz or 021623627