i

Influence of Gender and Ankle Injury History

to Weight Bearing Dorsiflexion among
semiprofessional Basketball Players
By
PST/17/016

PST/17/026

PST/17/037

The Dissertation submitted to

GENERAL SIR JOHN KOTELAWALA DEFENCE UNIVERSITY

SRI LANKA

In partial fulfillment of the requirement for the award of the degree

Of

Bachelor of Science in Physiotherapy

April 2021
 ii

ABSTRACT

Introduction: Ankle injuries are most common in sports field. Weight bearing
dorsiflexion range can be affected in ankle injuries. Weight bearing lunge test is used to
assess weight bearing dorsiflexion. By using this test as standard testing protocol can
minimize development of further sport related ankle injuries. But the test for basketball
players with ankle injuries has not studied yet. Therefore the current study was aimed to
examine the weight bearing dorsiflexion of basketball players related to their gender ,
ankle injury history and leg dominance .

Method: A quasi experimental design study was conducted .34 participants were
recruited and initially 2 were excluded. Therefore 32 participants were included to the
study with 20 male and 12 female basketball players in Colombo Blues basketball team
and Kotelawela Defence University basketball team. The average of age is 21.8 years (18-
25 age range). Demographic data ,informations about the sports ,injury history of the
participants were obtained using an interview administered assessment form. The Weight
Bearing Dorsiflexion was measured using digital inclinometer. Data was statistically
analyzed using SPSS software.

Results: The study included 53.1% players with ankle injuries and 15 players with no
ankle injury histories. According to the study female Weight Bearing Dorsiflexion range
is smaller than the male Weight Bearing Dorsiflexion which had no significance
difference (p>0.05). There is a fair significant difference in Weight Bearing Dorsiflexion
and ankle injury history (p<0.01) among players according to the outcomes of the study.
Significant differences were emphasized that there is an influence in dominance to
weight bearing dorsiflexion of basketball players (p<0.05).When analyzing the
prevalence of receiving physiotherapy after ankle injury, there is 33.3% frequency of
taking physiotherapy treatments and 66.7% frequency of not taking physiotherapy
treatments .

Conclusion: The first study that is investigated Weight Bearing Dorsiflexion in

basketball players. No significant difference was found between gender and Weight
Bearing Dorsiflexion .A significant difference was determined between ankle injury
history and Weight Bearing Dorsiflexion. Comparing to contralateral uninjured limb
 iii

WBDF of Basketball players with a unilateral injury history have smaller WBDF.
Furthermore the significant difference was found in leg dominance and Weight Bearing
Dorsiflexion .when considering physiotherapy treatments, among basketball players
utility of taking physiotherapy is law .Therefore it is recommended that assessment of
WBDF in ankle joint in clinical practice and treatments for better performances in
basketball.

Key words: Weight bearing Dorsiflexion, Basketball Players, Gender, Ankle Injury, Leg
Dominance, Physiotherapy Utility
 iv

Table of content

ABSTRACT .........................................................................................................................ii
Table of content .................................................................................................................. iv
LIST OF TABLES .............................................................................................................vii
LIST OF FIGURES ..........................................................................................................viii
LIST OF ABBREVIATIONS ............................................................................................. ix
CHAPTER 01 ...................................................................................................................... 1
1.1.Introduction ................................................................................................................ 1
1.1.1.Background .......................................................................................................... 1
1.1.1.1 Basketball and ankle injury........................................................................... 1
1.1.1.2 Ankle and its motion ..................................................................................... 2
1.1.1.3 Ankle and ankle related injuries ................................................................... 3
1.1.1.4 Weight Bearing Dorsiflexion ........................................................................ 4
1.1.1.5 Weight Bearing Dorsiflexion Test ................................................................ 4
1.1.2. Justification, Aims & objectives ......................................................................... 6
1.2. Objectives .................................................................................................................. 7
1.2.1. General objective ................................................................................................ 7
1.2.2. Specific Objectives ............................................................................................. 7
CHAPTER 02 ...................................................................................................................... 8
Literature Review................................................................................................................. 8
2.1. Prevalence of basketball with ankle injury. .............................................................. 8
2.3 prevalence of weight bearing dorsiflexion with gender ........................................... 10
2.5 Importance of weight bearing dorsiflexion (WBDF) range of motion in basketball
........................................................................................................................................ 11
2.6 Weight bearing lunge test (WBLT) -the test reliability and validity ....................... 12
CHAPTER 03 .................................................................................................................... 15
Materials and Methodology ............................................................................................... 15
3.1 Study design ............................................................................................................. 15
3.2 Inclusion and exclusion criteria................................................................................ 16
3.2.1. Inclusion criteria ............................................................................................... 16
3.2.2. Exclusion criteria .............................................................................................. 16
 v

3.3. Recruitment of participants and Ethical clearance .................................................. 16

3.4.Data collection instruments/tools ............................................................................. 17
3.4.1 Data collection ................................................................................................... 17
3.4.2.1. Interview-administrated questionnaire form .............................................. 18
3.4.2.2. Measurement of weight bearing dorsiflexion ............................................ 18
3.7 Ethical issues ............................................................................................................ 22
3.7.1 Ethical clearance ................................................................................................ 22
3.7.2. Consent ............................................................................................................. 22
3.7.3 Termination of study participation .................................................................... 23
3.7.4 Risks, hazards and discomfort ........................................................................... 23
3.7.5 Potential benefits ............................................................................................... 23
3.7.6 Confidentiality ................................................................................................... 23
3.7.7 Dissemination of the study findings .................................................................. 23
CHAPTER 4 ...................................................................................................................... 24
Results ................................................................................................................................ 24
4.1 Analysis of the demographic details of the participants. ......................................... 24
4.1.1 Age of the participants ....................................................................................... 24
4.1.2 Gender of the participants.................................................................................. 25
4.2 Prevalence of having ankle injury history of the participants .................................. 25
4.3. Analysis of weight bearing dorsiflexion (WBDF) range of motion measurements.
........................................................................................................................................ 26
4.3.1 Objective-1 – Establishment of normative data for WBDF .............................. 28
4.3.2. Analysis of WBDF according to the gender ..................................................... 29
4.3.3. Analysis of WBDF according to the unilateral injury history .......................... 30
4.3.4 Analysis of WBDF according to limb dominancy ............................................ 32
4.4. Analysis of frequency for participants who has undergone physiotherapy
treatments after an ankle injury .................................................................................. 34
CHAPTER 5 ...................................................................................................................... 35
Discussion .......................................................................................................................... 35
5.1 Impact ....................................................................................................................... 38
5.2 Limitations ............................................................................................................... 39
CHAPTER 06 .................................................................................................................... 40
Conclusion and Recommendations .................................................................................... 40
6.1 Conclusion................................................................................................................ 40
 vi

6.2.Further study ............................................................................................................ 40

REFERENCES .................................................................................................................. 41
Appendix ............................................................................................................................ 45
Appendix 1 – Interview administered questioner form - English .................................. 45
General Questionnaire .................................................................................................... 45
Appendix 2 – Interview administered questioner form – Sinhala.................................. 47
Appendix 3 – Interview administered questioner form - Tamil ..................................... 49
Appendix 4 –Consent form – English ............................................................................ 51
Appendix 5 –Consent form – Sinhala ............................................................................ 52
Appendix 6 –Consent form – Tamil.............................................................................. 54
Appendix 7 –Information sheet – English..................................................................... 56
Information Sheet - English ........................................................................................ 56
Appendix 8–Information sheet – Sinhala ...................................................................... 59
Appendix 9–Information sheet – Tamil ........................................................................ 61
Appendix:10 -Ethical clearance letter ................................................................................ 65
 vii

LIST OF TABLES

Table 1- frequency table of ankle injury ............................................................................ 26

Table 2 : analysis of normative data of all groups WBDF (⁰)............................................ 28

Table 3 – descriptive data objective 2 WBDF (⁰) in males and females ........................... 29

Table 4 – Gender vise independent sample t-test analysis ................................................ 29

Table 5- Objective 3- descriptive data- unilateral injury history WBDF (⁰) ..................... 30

Table 6- Paired t- test analysis of the uninjured and injured limb ..................................... 31

Table 7: Objective 4- Paired sample statistics of dominant and non-dominant limb

analysis for WBDF (º)........................................................................................................ 32

Table 8: Paired t test analysis of WBDF for dominant and non-dominant limbs .............. 32
 viii

LIST OF FIGURES

Figure: 1 – Basketball Game................................................................................................ 2

Figure: 2 – Anatomy of the Ankle Joint .............................................................................. 3
Figure: 3 – Weight bearing lunge test .................................................................................. 5
Figure: 4 – Marking the reference line that places the inclinometer ................................. 19
Figure: 5 – Measuring the WBDF ..................................................................................... 20
Figure: 6- Digital Inclinometer .......................................................................................... 20
Figure: 7-Procedure of WBLT ........................................................................................... 21
Figure 8: Age distribution of the sample ........................................................................... 24
Figure 9: Gender distribution of the sample ...................................................................... 25
Figure 10: Participant flow diagram .................................................................................. 27
Figure: 11- Error plot for WBDF in male and female basketball players (mean± SD) ..... 30
Figure:12 – Error plot for WBDF in injured and uninjured basketball players (mean±SD)
............................................................................................................................................ 32
Figure: 13- Error plot for WBDF in dominant and non-dominant limbs(mean±SD) ........ 33
Figure 14: Frequency of taking physiotherapy treatments after ankle injury .................... 34
 ix

LIST OF ABBREVIATIONS

WBDF – Weight Bearing Dorsiflexion

WBLT – Weight Bearing Lunge Test

ROM – Range of Motion

KDU – Kotelawala Defence University

SPSS - Statistical package for social sciences

CI - Confident interval

SD - Standard Deviation

DF - Dorsiflexion

RTP - Return to Performance

 1

CHAPTER 01

Introduction and objectives

1.1.Introduction
1.1.1.Background

1.1.1.1 Basketball and ankle injury

Participation in sports gives many positive effects such as improve body composition and
cardiorespiratory function as well as improvement in psychosocial wellbeing However it
has its downside mainly attributed due to the increase in risk of sport related injuries.
(Foss, Myer and Hewett, 2014). Basketball which is one of the most popular sports in the
world,was invented by James Naismith more than a century ago. (Andreoli et al., 2021)
Basketball is a fast sport which requires improved body composition, cardiorespiratory
function and, high amounts of strength. (Andreoli et al., 2021). It is a sport which requires
high physical activities such as repetitive jumps during games and training, abrupt
changes in direction, running and deceleration (Andreoli et al., 2021)

This high demand of physical activity and the constant need to make jumps puts a huge
impact and strain on joints in the lower body, which could often lead to ankle injuries
among these players. Lower limb injuries account up to 60% of total injuries in
basketball. (van der Does et al., 2015)

A research done by (Cumps, Verhagen and Meeusen, 2007) shows ankle sprain and knee
overuse injuries are the most common type of injuries among senior basketball players.
According to (E. GrossJ, Goodloe and NunleyII, 2020) the most common joint which is
injured in basketball is the ankle joint among adult basketball players groups aged 25 and
over.
 2

Figure: 1 – Basketball Game

1.1.1.2 Ankle and its motion

Ankle joint is a complex joint in the human body, which is made out of the talocalcaneal,
tibiotalar and transverse-tarsal joints. It is consisted of twelve extrinsic muscles providing
its motion and these muscles are divided in to four components named anterior, lateral,
posterior, and deep posterior compartment. (Brockett and Chapman, 2016) Dorsiflexion
and inversion of the foot are provided by the tibialis anterior and the extensor hallucis
longus. Dorsiflexion and eversion are provided by peroneus tertius while Extensor
digitorum longus muscle produces dorsiflexion. . (Brockett and Chapman, 2016). The
lateral compartment muscles provide plantar flexion and eversion of the foot. The muscles
of the posterior compartment contribute to plantar flexion of the foot while the plantar
flexion and inversion are provided by three deep posterior muscles. (Brockett and
Chapman, 2016) Plantar flexion and dorsiflexion are the key movements of the ankle joint
which occurs in a sagittal plane and movements of abduction and adduction occurs in the
transverse plane. With the combination of these motions across both the subtalar and
tibiotalar joints create three-dimensional motions of the ankle. (Brockett and Chapman,
2016).
 3

Ankle dorsiflexion occurs naturally during many lower limb tasks in basketball. During the
movement, the tibia moves forward over the foot as the tibialis plateau glides anteriorly on
the taller dome. Based on the results of previous research there is no clinical significance
in leg dominance relating to asymmetries that exist in ankle dorsiflexion. (E Dolan and R
Gordon, 2018)

Figure: 2 – Anatomy of the Ankle Joint

1.1.1.3 Ankle and ankle related injuries

Ankle injuries are defined as damage of tissues, ligaments, tendons or bones at the ankle
joints. (Fong et al., 2007). These injuries occur when the joint is twisted or pressured too
far out of its normal position leading to fractures, sprains, strains, tendon injury and
subluxations.

Sprain is the most common type of injury among athletes and sporting personal (Xia,
2018). .Sprains are referred to partial or complete tears in ligaments of ankle joint and
usually occurs by excessive inversion on the plantar flexed in the weight bearing foot.
 4

(Xia, 2018). Ankle sprain can be divided as an inward reverse sprain and outward reverse
sprain and there is a significant high risk of sustaining a lateral ankle sprain through
outward reverse sprain. (Xia, 2018). Some of the symptoms in ankle injury includes
severe pain, local swelling, tenderness, and joint hematoma resulting in subcutaneous
congestion which leading a limp. However, a number of studies have shown that
residual symptoms could last for months to years following the injury
( Anandacoomarafam,2021).A lateral ligament rupture leads to instability making the
joint unstable. (Hu, 2017)

1.1.1.4 Weight Bearing Dorsiflexion

Ankle dorsiflexion movement occurs naturally during lower limb tasks in basketball.
Normally during the movement the tibia moves forward over the foot as the tibialis plateau
glide anteriorly on taller dome. Based on the results of previous articles there is no clinical
significance in leg dominance relating to asymmetric that exits in ankle dorsiflexion (E
Dolan and R Gordon, 2018)

1.1.1.5 Weight Bearing Dorsiflexion Test

The weight-bearing lunge test is used to assess the dorsiflexion ROM(Range Of Motion) at
the ankle joint. Obtaining the Maximus lunge distance and inclinometer angle are valid
assessment tools to conduct this test (fong et al, 2011).

(Cejudo, Sainz de Baranda, Ayala and Santonja, 2014) has mentioned that ankle
dorsiflexion measures obtained from the new version of WBLT (Weight Bearing Lunge
Test) has excellent test-retest reliability scores. According to previous research the
Weight Bearing Lunge Test can be used as an outcome measure to prospectively track the
effects of lower extremity injury and rehabilitation on weight-bearing dorsiflexion
asymmetry among athletes and sporting personal. (Cejudo, Sainz de Baranda, Ayala and
Santonja, 2014)

.
 5

Figure: 3 – Weight bearing lunge test

 6

1.1.2. Justification, Aims & objectives

Although basketball is not popular compared to cricket in Sri Lanka, it is still played to
some extent in a competitive level mainly among schools and between institutions with in
the country. When considering the factors contributing to restrictions to participate in a
basketball match, injuries are on the top. Once an injury occurred, the player will not be
able to return to the sport for a considerable period of time which will affects the entire
team and the competitiveness of the sport.

Research has indicated that ankle injury players have reduced performances. However
range of motions in ankle joint can be changed with proper physiotherapy treatment. To
our knowledge, no research has been conducted to find out the relationship between ankle
injury histories, gender, and weight bearing dorsiflexion (WBDF) range. In our research,
we are hoping to analyze how WBDF is affected by ankle injury history and gender .Where
the prevalence of ankle injuries among basketball players and their awareness towards
physiotherapy will be determined. Weight-bearing lunge test will be used to measure the
range of WBDF.

More ever we are hoping to include the influence of limb dominancy to WBDF. Previous
literature studies have suggested that leg dominancy as an important factor to WBDF for
future research topics. The frequency of taking physiotherapy treatments of basketball
players with ankle injuries will be analyzed in the study.

Hence the results of our study will assist the physiotherapists who work in the sports field
to develop better training programs to improve performances among basketball players by
managing WBDF range as needed. . This research will help to improve the quality of
performances in basketball players and fill the literature which is lack in a Sri Lankan
context.
 7

1.2. Objectives
1.2.1. General objective

To determine the relationship between the ankle injury history, gender, and weight
bearingdorsiflexion (WBDF) in Kotelawela Defence University basketball team and
Colombo Blues Basketball Team Colombo Sri Lanka.

1.2.2. Specific Objectives

1. To established normative data of WBDF for basketball players in KDU and

Colombo blues basketball team
2. To identify the differences between gender in WBDF.
3. To compare the difference in WBDF between basketball players with a
presence and absence of ankle injury
4. To compare the difference between the dominant and non-dominant limb
5. To determine the prevalence of ankle injury history in basketball players.
6. To determine the prevalence of physiotherapy treatments among basketball
players with an ankle injury
 8

CHAPTER 02

Literature Review

2.1. Prevalence of basketball with ankle injury.

Ankle injuries are commonest among basketball players. (Hu, 2017) have documented
that basketball players are more prone to get ankle injuries due to their process of
movements. 3100 players with the age between 13 to 32 years were recruited to the study
during the period of 2011 to 2015 for stochastic analysis. Collection of data has done by
using a observational method and a survey method. Results have demonstrated direct
influence of poor safety consciousness and insufficient preparation during training toward
the ankle ligament injury. Finally the study concluded that the ankle is the site of most
common injury among basketball players.

Another study conducted by (E Dolan and R Gordon, 2018) has conducted to identify the
effects of limb dominance and weight bearing dorsiflexion asymmetry.67 football players
with and without previous ankle injury has evaluated for WBDF asymmetry .Dominant
leg was defined as the kicking leg and lower limb injury history were also collected .In
results has demonstrated that 7 (99%) showed no asymmetry, 16 (43%) exhibited higher
dorsiflexion range on the non-dominant limb and ,14 (38%) had greater dorsiflexion
range on the dominance side .Among 67 football players, where the kicking leg was used
as the dominant leg found no clinical significance in leg dominance and asymmetries in
ankle dorsiflexion.

2.2. Prevalence of ankle injuries and gender

According to (Tummala et al., 2018). This study has done in descriptive epidemiology
study design. They have included NCAA ISP men’s and women’s collegiate basketball
players with injury. Data was qualified from 2004 through 2014 academic years. Here
the activity and position of injury were examined. Based on injuries per athlete exposure
(AE) ankle injury rates were calculated. Determine the gender difference injury
proportion ratio (IRS) was concluded. According to the results most of ankle injury were
happened in preseason (female, 1.45/1000 AES; male 2.00/100 AES), contact related
 9

(female 50.4%/ males 57.6%) and treated conservatively (female 98.5%; male 99.3%)
and who had new injury (female 78.0%; male 78.9%). Considering injury types most
common injury type tears in lateral ligament complex (female, 83.5%; male,80.01%).
Tars in deltoid (female 5.6%; male7.2%).among the players in competition the highest
rate of ankle injuries are experienced by guards. (female; 50.1%, male 43.3%). There the
ankle injuries rate was significant lower in female than male (IPR, 0.81[95%CI, 0.75-
0.88])

And another study done in 2005 looked in to basketball injury rates and patterns
according to the gender and the type of exposure. (Borowski, Yard, Fields and Comstock,
2008). This epidemiological study has done during 2005 to 2007 in 100 national U.S
High school .O thousand five hundred and eighteen injuries were noticed in thousand
athletes for an rate of I injury was 1.94 per 1000 athletes .Also they have documented
39.7% of ankle and foot injuries . Results have explored that rate of injury among girls
greater than boys. Concluded that the injury patterns in basketball vary by gender,
However in the estimated results the prevalence of ankle injury among female players
were slightly higher (43.2%) than male payers (35.9%).

(Hosea, Carey and Harrer, 2000)an epidemiological study has done to identify gender
related injury pattern of ankle joint. The study has carried out a period of two years
among scholastic and collegiate basketball players. Ninety five institutions have
participated to the study with eleven thousand seven hundred eighty athletes. During the
two years of period four hundred and ninety four (494, 72%) ankle injuries were
documented out of total one thousand three hundred and eighty four lower extremity
injuries. In the conclusion the study emphasize the risk for an ankle injury was
significantly greater for female athlete (p= 0.0001).

The study has conducted by (Gulbrandsen et al., 2019) to evaluate anatomical structure
injured, gender, and rate of injury, mechanism, and prognosis of ankle injuries in soccer
players. The epidemiological study has carried out from 2004 to 2014 by online injury
surveillance and the injury rate and ratios the calculated on a basis of injuries per
thousand athletes. The results have shown men and women had same injury rate (RR=
1.02,95%CI 0.94,1.11). However the study has concluded males were more likely to
sustain ankle injuries than females.
 10

2.3 prevalence of weight bearing dorsiflexion with gender

(Miller, Fawcett and Rushton, 2020) have conducted a quasi-experimental design study to
examine the relationship between weight bearing dorsiflexion and gender. This study had
55 participants with 27 males and 28 females. WBDF was measured by WBLT procedure
using an inclinometer and results showed that females have less weight bearing dorsiflexion
compared to males.

2.4. Prevalence of weight bearing dorsiflexion with ankle injury

A study has carried to explore the range of motion, posterior talar glide , and ankle joint
laxity in athletes population who were under previous ankle sprain, the population was
choose the players who had perilous ankle injuries ( with in last 6 months) and who had
return to the sport practices. There were seven women and five men. The age categories
were 18-22 years, men (19.8º± 1.3) women (19.3º± 1.4) years. As the sample size they
mainly included only unilateral ankle injury players. Injured and uninjured limbs were
compared on the factors called laxity of joint, dorsiflexion range and posterior talar glide.
To dorsiflexion assessing they mainly used MANOVA and fluid filled bubble
inclinometer. Dorsiflexion was measured in four different positions, standing straight
knee, prone bend knee, sitting straight knee, and standing bend knee positions. Then the
result were significantly high joint laxity at talocrural and subtalar joint of limbs with
ankle injury histories. There were no significant difference was found in ankle
dorsiflexion (Denegar, Hertel and Fonseca, 2002)

(Halabchi et al., 2016) has conducted a research to review the prevalence of some
intrinsic risk factors among professional football and basketball players with or without a
history of recurrent ankle sprain. The study has recruited one hundred and six basketball
and football players. 48 basketball players and 58 football players has participated to the
study and 58.5% ankle injury percentage has evident among basketball palters in
dominant leg. The study has concluded that they ankle ligament laxity, balance and ankle
plant flexion has related to recurrent ankle injury in athletes.

(Burns and Crosbie, 2005) has conducted a research to measure the difference of WBDF
of pes cavus and pes planus feet compared to the normal feet.There were 34 participants
 11

included with various types of foot. The measurement has taken by using WBLT.The
results of the study has demonstrated the lunge angle of the pes cavus group was smaller
than the normal and pes planus group .The difference was significant
(p<0.001).According to this study there is a significant asymmetries in WBDF among pes
cavus and pes planus.

2.5 Importance of weight bearing dorsiflexion (WBDF) range of motion in

basketball
A study done to examine the relationship between the low range of motion of ankle
dorsiflexion and the patellar tendinopathy among seventy five elite junior level basketball
players found that the players with low range of ankle dorsiflexion (less than36.5) had
high risk of developing patellar tendinopathy (18.5%-29.5%) compared to those with
greater range of ankle dorsiflexion. (1.8%-2.1%). This study concludes that the low range
of ankle dorsiflexion has significant influence to developing patellar tendinopathy
(Backman and Danielson, 2011)

Another study examined the co-relation between athlete’s functional performance

(running, jumping, changing direction) and functional movements (weight bearing
dorsiflexion test, star excursion balance test), using basketball players. The conclusion of
this investigation was that the asymmetries in weight bearing dorsiflexion lead to reduction
in ability to change direction (r = -0.52) performance which is an important factor in
basketball. Furthermore the study concludes that the low range of ankle dorsiflexion lead
to an alter in the multidirectional running performance. (Skok O, Serna, R Rhea and J
Marín, 2015)

Another study conducted to examine the relationship between WBDF range of motion
and single-legged landing biomechanics in persons with chronic ankle instability. The
results confirmed that there was a moderate correlation between maximum dorsiflexion (r
=0.49) and ankle displacement (r=0.47) during landing. Furthermore the results showed
that the persons with low dorsiflexion demonstrated a more erect landing posture and
greater GFR.(Ground Force Reaction) (Hoch, Farwell, Gaven and Weinhandl, 2015)
 12

2.6 Weight bearing lunge test (WBLT) -the test reliability and validity

A study which was done to determine the concurrent validity of standard measures
compared to the laboratory outcome measures while performing WBLT using fifty
participants measured the dorsiflexion range of motion with four different measurement
techniques (inclinometer at tibial tuberosity, inclinometer at 15cm distal to tibial tuberosity,
maximum lunge distance, dorsiflexion angle using 2D capture system).The results showed
a remarkable correlation between each technique and reference standard and concluded
that WBLT have a high correlation with reference standard . (Hall and Docherty, 2020)

(Powden, Hoch and Hoch, 2015) has conducted a study to critically appraise the reliability
and responsive of the WBLT in DROM assessing. This was done by synthesizing the
previous 12 researches which were met the eligibility criteria. Here the reliability was
examined through ICC (intraclass correlation coefficients and through (MPC) minimal
data table changes the responsiveness was examined.

Inter-clinician reliability was examined with 9 studies and intra clinician reliability was
examined with 12 studies. The results of this study demonstrated strong evidence for inter
clinician reliability (ICC=0.80-0.99) as well as intra clinician reliability (ICC=0.65-0.99)
and validity of WBLT to assess dorsiflexion range of motion.

(Bennell et al., 1998) conducted a study which aimed to evaluate inter rater and intra rater
reliability of WBLT with 13 healthy subjects has recommended that for dorsiflexion
lunge test procedure ( distance from the great toe to the wall and angle between tibial shaft
and vertical using inclinometer) techniques have excellent reliability to measure
dorsiflexion range of motion in physiotherapy practice. According to the results the intra
rater correlation coefficient ranged from 0.97-0.98 and inter rater coefficient ranged 0.97-
0.99.

2.7. Leg dominance and ankle injury

(Niu et al., 2011) has conducted the research with 16 healthy adult. To explore the
effectiveness of kinematics and kinetics in ankle EMG (electromyogram) between non-
dominant and dominate legs in drop landing mechanism. Among the 16 participants there
 13

were 8 males and 8 females who are in age category (23.8º±3.1) years, weight (53.6º± 16.5
kg). Right side was the dominate side of all the participants. The dominant side was
revealed as the site they used to kick a ball. There was no history of lower limb surgery,
degenerative diseases, and other disturbances in vestibular and neurological diseases. They
were allocated to drop from platforms which were in three various heights (0.72m, 0.32m,
0.52m). they measured ground reaction force, EMG of gastrocnemius, tibialisanterior,
kinematics of ankle joint in lower limbs. In dominant side measurement was highly
significant in ankle dorsiflexion and abduction of ankle joint. In non-dominant side
according to the results there is a protective mechanism. Comparing to dominant side
during drop landing ankle in dominant side has a high value of injury risk when compared
to the non-dominant.

(Rabin, Kozol, Spitzer and Finestone, 2014) A cross sectional study has conducted to
examine the relationship between ROM of DF and lower extremity quality of movement,
there were included 55 male participants who were healthy. ROM of DF was measured in
non-weight bearing and weight bearing conditions. They have used universal goniometer
and fluid filled inclinometer. The measurement was bilaterally performed to each
participant. The study has mentioned in the results among participants who had
movements with moderate quality had limited weight bearing and non-weight bearing
ROM. (P=0.001 for weight bearing, p=0.02 for non-weight bearing. Non weight bearing
ankle DF range and weight bearing DF range on both limbs were correlated with
movement quality. (p<0.01 dominant, p<0.05 non dominant) they have concluded that DF
ROM in ankle joint was associated with the movement quality among male participants
who were healthy. In males the association of movement quality and ROM of DF is
weaker than female. Healthy male with lower quality had explored less DF ROM in
dominant side.

2.8 Importance of physiotherapy in ankle injuries

Prior research done by reviews on databases such as MEDLINE, EMBASE, CINAHL,

PEDro, Doconline concluded that, exercise therapy using wobble board is effective for
functional instability and prevention of ankle injuries . It was reported that manual
mobilization has positive impact on ankle dorsiflexion range of motion improvement.
: (van der Wees et al., 2006)
 14

Moreover van Rijn et al., 2010 has conducted a review of 11 studies looking in to the
effectiveness of additional supervised exercises compared with conventional treatment in
patients with acute lateral ankle sprains. Although both methods work, only moderate or
limited improvements are found in supervised exercises to conventional treatments
compared to conventional treatments alone. Furthermore, limited evidence are found to
support that supervised treatments are better than conventional treatments treating patients
with severe ankle injuries. The literature reveals that conventional treatments alone are
beneficial in treating ankle injuries.

2.9. Utility of physiotherapy service

A recent study by (Weerasekara and Hiller, 2017) mentioned that almost 14%of the
community in Sri Lanka was affected by ankle disorders. A higher proportion of males
(n=87,53.0%)than females (n=77,47.0%)had ankle injuries histories according to their
findings. It was reported a very law utility of physiotherapy service considering the study.
 15

CHAPTER 03

Materials and Methodology

3.1 Study design

This study used a quasi – experimental design (Field, 2009). One of the researchers had
collected all data for one parameter who was blinded to limb status (injured/ uninjured) in
order to minimize bias. All the limbs had assigned into experimental group according to
gender and previous ankle injury (Field, 2009).

Objective 1

For the first objective all the participants were included. Each limb was considered as an
individual to build normative data for injured and uninjured limbs. Each limbs were
assigned to groups according to previous injury (injured, uninjured).Only uninjured limbs
were allocated to established normative data for gender, which was done to minimize
confounding variables and grouped according to gender.

Objective 2

A between- subject design was used to assess the second objective. All uninjured limbs
were assigned to groups according to gender. Each limb was considered as an individual
allowing inclusion of participants with bilateral uninjured limbs, to uphold the assumption
of statistical analysis (Hoekstra, Kiers, & Johnson, 2012). Although a study has conducted
by Menz (2004) has suggested that using bilateral uninjured limb could affect data due to
asymmetries between limbs. However, a study conducted by Hoch and McKeon (2011) has
investigated asymmetry between bilateral uninjured limbs using the WBLT. This study
showed a 0.1cm difference between limbs but this difference exists within the measurement
error of the test procedure (0.4cm) (Powden, Hoch, & Hoch, 2015). Because of that,
inclusion of bilateral limbs in this study can be justified in terms of increasing the statistical
power in this small sample. (Miller, Fawcett and Rushton, 2020)

Objective 3

Assuming a within subject design, only participants with unilateral previous injury were
included to this objective. Both injured and uninjured has paired together considering a
with-in subject design.(Mann, 2003). This matching of limbs decreased the error related
with potential confounding variables such as age, height, limb length and foot length (Menz
 16

(2004) which might affect internal validity (Portney & Watkins, 2009), emphasizing that
these differences are due to injury history.

Objective 4

Same as objective 3 assuming a with in subject design participant’s dominant and non-
dominant limbs were paired and compare the rang of motions of WBDF as it suggested by
(Miller, Fawcett and Rushton, 2020).

3.2 Inclusion and exclusion criteria

3.2.1. Inclusion criteria

 Players without ankle injury histories and players with ankle injury histories
who had not participate at least one week of practice after injury
 The subjects who grant the consent following receiving the information about
the research

3.2.2. Exclusion criteria

 Intolerable pain during the measurement gaining procedures.
 Complaint of pain more than 6 in the NPS of any joint which was used in the
test procedures
 The subjects who didn’t grant the consent.
 The subjects with a history of any fractures ,current ankle injuries,
neurological disorders, cardio-vascular diseases
 The persons with abnormal foot arches , foot deformities (pes cavus and pes
planus)
 If they are on medical advices not to participate in any format temporary

3.3. Recruitment of participants and Ethical clearance

Ethical clearance for the study was obtained from the ethical review committee of
Kotelawela Defence University (KDU), and the permission to conduct the study was
obtained from KDU sports officer and Colombo Blues Basketball club. Basketball players
who fulfilled the inclusion and exclusion criteria were selected to take part in the study.
 17

All basketball players were provided with an information sheet (in all three languages)
containing all the necessary information regarding the study (annexure 1). The participants
were provided more details regarding the study if they need more details. All the
participants were given a consent form (annexure 2) to obtain the written consent. The
procedure and other relevant protocols of the study were clearly explained to the
participants and participants are free to ask any question about the research. If any problems
or complaints came related to the study the contact details of all investigators of the study
were available in the information sheet.

Participants made their own decision whether they participate for the studyor not and they
were also informed that their participation was not compulsory. Basketball players who
gave their written consent were recruited to the study. A total of 34 participants were
recruited form General Sir Kotelawala Defense University and Colombo Blues Basketball
Club through convenience sampling

All the participants were free to withdraw from the study at any given point without giving
reasons, after informing any member of the research group. If any participant had any
discomfort during the research study, they were also free to withdraw from the study.

3.4.Data collection instruments/tools

3.4.1 Data collection
Data collection including taking measurements and recording was conducted by three
trained investigators under the supervision of the research supervisor.

After we got their written consent and verbal consent to participate to the study the
subjective information including demographic data, sport related data, and ankle injury
information were obtained using Interview-administrated questionnaire form (Appendix
1,2,3)

Next the participants were observed by one member and collected all the necessary
measurements. Players were asked to remove footwear before taking measurements. All
the test measurements were taken in the same measurement place for all the players. WBDF
measurements of all players were taken by the same investigator of the research group.
 18

Documentation of WBDF measurement was recorded by other investigator of the group.

WBDF range was measured by weight bearing lunge test.

3.4.2. Obtaining Measurements and examination findings

3.4.2.1. Interview-administrated questionnaire form

This questioner was designed for the purpose of collecting demographic data, information
about the sport, ankle injury history. (Appendix 1,2,3). The questioner was pre tested
before being used as the data collection tool.

The examination findings of the basketball players including WBDF measurement were
added to the same assessment form. This form for all the participants was filled by one
investigator of the group.

Here we asked from the player the dominant side limb. Also we asked the preferred limb
to take a jump before the landing and the limb which is landed at the first after a jump for
the further confirmation.

3.4.2.2. Measurement of weight bearing dorsiflexion

Weight Bearing Lunge Test

WBLT was performed using an inclinometer, measuring the angle between the tibial shaft
and the vertical. The angle was measured at 15cm below the tibial tuberosity (Hall and
Docherty, 2020) considering its excellent methodological quality, validity and reliability
(Powden, Hoch and Hoch, 2015). The procedure of measurement is shown in figure 1.

A reference line was marked on the wall using a tape on the floor and a
corresponding vertical line on the wall, 90degrees perpendicular to the floor which
was used to take measurements of all the participants.The lines remained during all
testing sessions. The Also a reference mark was drawn on the tibial shaft using a
non-permanent marker at 15cm below the tibial tuberosity on the anterior border of
the tibia. (Hall and Docherty, 2020).To getting the WBDF measurement, the center
of the inclinometer was placed on reference mark. That ensure the accuracy of the
each measurement (Hall & Docherty, 2017) .The test procedure was demonstrated
and standard instructions was given to the player. The digital inclinometer was
calibrated to 0 before taking each measurement by placing onto a flat surface
 19

Then the participant was instructed to place the hands on the wall in front of them
and was instructed to lunge the front knee forward to touch the vertical line on
the wall with their knee maintaining the heel contact with the ground to control
the subtalar joint (Bennell et al., 1998). The contralateral limb placed behind the
testing limb and the toes in contact with the ground and hip facing forward with
the comfortable position. Then the participant was instructed to take the lunged
foot further back from the wall in order to get the maximum WBDF prior to heel
lift. At maximum range the inclinometer was placed on the reference mark on the
tibia and the measurement was noted. WBDF measurements were recorded in
degrees. The test was repeated three times for each limb and one maximum
measurement recorded as it showed excellent reliability compared to taking
average value (Chisholm, Birmingham, Brown, MacDermid, & Chesworth,
2012). All the tests were performed by one person in order to minimize the
handling errors.

Figure: 4 – Marking the reference line that places the inclinometer

 20

Figure: 5 – Measuring the WBDF

3.5. Data collection tools

1. Interview-administrated questionnaire
Demographic data, information about the sports, injury history was collected using a
Interview-administrated questionnaire.

2. Digital inclinometer
The measurements of WBDF range were obtained using digital inclinometer.

3. Measuring tape
Measuring the point where the inclinometer to be placed.

Figure: 6- Digital Inclinometer

 21

Investigator mark a reference point on the tibia 15cm below the tibial
tuberosity. Reference line also marked along the wall and floor 90º
perpendicular

The inclinometer is calibrated to º before taking each measurement by

placing onto a flat surface

Ask the participant to places his/her hands on the wall in front of them

participant is asked to lunge the front knee forward to touch the vertical
line on the wall with their knee by maintaining the heel contact with
ground

The contralateral limb is kept behind the limb with the toes in contact with
the ground and hips directing forwards towards the wall

If participant maintains heel contact with the floor asked him/her to move
the foot further back from the wall to attain maximum WBDF before heel
lift

The inclinometer is placed on the reference point and the

measurement is noted.

The measurement is recorded in degrees on the participant’s

information sheet

Figure: 7-Procedure of WBLT

 22

3.6. Data entry and analysis

Data entry and analysis was done using the SPSS (Statistical Package for Social
Sciences) statistical analysis software, version 23.Descriptive analysis calculating
mean standard deviation (SD) and 95% confidence intervals (CI) for WBDF. For
objective 2 each limb was considered as individual. An independent t – test was
used to compare male and female uninjured limbs (Field, 2009). For objective 3
participants with unilateral injury were included and a paired t- test was used to
find the statistical significance (Field, 2009).

3.7 Ethical issues

3.7.1 Ethical clearance

Ethical clearance was obtained from Ethical Review Committee, Faculty of

Medicine, General Sir John Kotelawala Defense University.

Permission to conduct the data collection was obtained from basketball team of
General Sir John Kotelawala Defense University and Colombo blues basketball
club.

3.7.2. Consent

The participants were provided the information sheet including information about
the study, aims, methods of obtaining measurements and benefits of the study in
all three languages (Appendix 7, Appendix 8, Appendix9). Each participant was
given the information sheet according to their preferred language. A written
informed consent was taken from each participant before participated to the
study. It could be filled in three languages (Appendix 4, Appendix 5, Appendix
6)

The procedure and other relevant protocols of the study were clearly explained to
the participants and participants are free to ask any question about the research. If
any problems or complaints came related to the study the contact details of all
investigators of the study were available in the information sheet. Participants made
their own decision whether they participate for the study or not and they were also
informed that their participation was not compulsory. Participants who granted their
 23

consent were included to the research.

3.7.3 Termination of study participation
All the participants were free to withdraw their consent to participate in this study at any
timeowing to any of their reasons after informing any member of the research group.
If any participant had any discomfort during the research study, they were also free to
withdraw from the study.

3.7.4 Risks, hazards and discomfort

Any risks, hazards or discomfort were not reported during the study. In case of any physical
or psychological discomfort during or after the study period, the participants would have
been directed to the medical officer and to the sport practitioners/ trainersor physiotherapist
in charge.

3.7.5 Potential benefits

Any financial benefits were not gained by the participants. At the end of taking
measurements, the participants were given a feedback on their results. The data was
beneficial for the participants in their further rehabilitation programs.

3.7.6 Confidentiality

Data such as name, personal residence, and telephone number were collected for
identification and to contact if the research results are to be disseminated. To ensure
privacy, information of the participants and the measurements of the tests were separately
taken .Confidentiality and anonymity was highly secured throughout the research study.
All the hard copies of data was secured using locks and key while the soft copies of datawas
secured using passwords. Only the principle investigators had the access to the data.
Furthermore any data will not be released at any point without the permission from the
participants. All data would be permanently deleted and disposed after seven years from
completing the study.

3.7.7 Dissemination of the study findings

At the end of the research project the scientific data will be presented at a scientific
conference and the research will be published in a peer review journal.
 24

CHAPTER 4

Results

A description of results of the study is explained in this chapter. The objectives of the
study were considered to report the results. 32 basketball players were included and 2
were excluded from the initial sample of 34.

4.1 Analysis of the demographic details of the participants.

The age, gender and the dominant leg of the participants were analyzed using descriptive
statistics, and the results are displayed below.

4.1.1 Age of the participants

The population was between 18-25 years with the mean age of 21.8 years. (SD=±2.01)

Figure 8: Age distribution of the sample

 25

Age distribution of the sample highest age was 25years and the lowest age was 18 years,
the mean of the distribution was 21.75years, and the mode was 22 years.

4.1.2 Gender of the participants

Twenty (62.5%) male players and twelve (37.5%)female players were included in the
total sample of 32 players.

Figure 9: Gender distribution of the sample

4.2 Prevalence of having ankle injury history of the participants

The prevalence of having ankle injury history among the participants was analyzed using
descriptive statistics.
 26

All 32 participants were allocated to the study including players with no ankle injury
history, both unilateral and bilateral injury history was included to find the prevalence of
ankle injuries

Table 1- frequency table of ankle injury

Frequency Percentage
Players with no 17 53.1%
ankle injury history

Players with ankle 15 46.9%

injury history

4.3. Analysis of weight bearing dorsiflexion (WBDF) range of motion measurements.

All 32 participants were recruited and blinded to limb status, treating each limb as
individual.
 27

34Participants /68 limbs recruited

Excluded:(n=2
participants/4limbs)

Not meeting inclusion criteria

(n= 2/4 limbs were excluded)

Allocation

Objective 3

Objective 2 Included=13
participants
Included =47 limbs
Excluded due to
Objective bilateral injury
1: Excluded due to injury history
history ( n=
n=64 limbs (n=
17limbs) 2participants)
-excluded due to
bilateral no injury
history
(n=15participants)

Analysed: (n= Analysed: (n=47 Analysed: (n=13

64limbs) limbs) limbs)

Figure 10: Participant flow diagram

 28

4.3.1 Objective-1 – Establishment of normative data for WBDF

All 64 limbs were included and grouped according to the gender and ankle injury history.
(players with ankle injury history was grouped as “Injured” and players with no ankle
injury history was grouped as “Uninjured”

Table 2 : analysis of normative data of all groups WBDF (⁰)

Group Number of Mean SD 95%CI
participants
Male 36 46.1 2.5 45.3, 46.9

Female 28 44.6 2.6 43.7, 45.7

Injured 17 44.0 2.3 42.9, 45.1

Uninjured 47 46.0 2.6 45.2, 46.7

Total 64 45.4 2.6 44.8, 46.1

Mean WBDF values for basketball players of KDU and Colombo blues club were
45.4º±2.6 (95%CI 44.8º, 46.1º). Females had a smaller WBDF compare to males with
greater variability. (44.5º ± 2.6º 95% CI 43.7º, 45.7º for females and 46.1º ± 2.5º 95%
CI 45.3º, 46.9º for males)

Injured limbs had a lesser range of WBDF with smaller variability compared to uninjured
(44.0º± 2.3º 95% CI 42.9º, 45.1º for injured and 46.0º ± 2.6º 95% CI 45.2º, 46.7 º for
uninjured
 29

4.3.2. Analysis of WBDF according to the gender

Forty seven uninjured were allocated in this analysis (male – 24 and female – 23) with
descriptive data presented.

Table 3 – descriptive data objective 2 WBDF (⁰) in males and females

Male Female
Number 24 23

Mean 46.6 45.7

SD 2.6 2.0

95% CI 45.5,47.6 44.9,46.6

Table 4 – Gender vise independent sample t-test analysis

t- value 1.26

mean difference 0.8

Sig. ( 2 tale) 0.2

Descriptively, females showed smaller WBDF compare to males. Male group

demonstrated slightly greater variability compare to the females (female- 45.7⁰ ± 2.0
95% CI 44.9⁰,46.6⁰ , males- 46.6⁰±2.6 95% CI 45.5⁰,47.6⁰)

However this difference was not statistically significant (t= 1.26, p= 0.2) (table – 4)
 30

Figure: 11- Error plot for WBDF in male and female basketball players (mean± SD)

4.3.3. Analysis of WBDF according to the unilateral injury history

Thirteen participants had unilateral injury history (males – 10, females- 3). Descriptive
data are displayed in table 5.

Table 5- Objective 3- descriptive data- unilateral injury history WBDF (⁰)

Mean SD 95% CI

Uninjured 47.2 1.5 46.4,48.0

Injured 44.3 2.5 43.0,45.6

 31

Table 6- Paired t- test analysis of the uninjured and injured limb

Mean -2.8

t- value -6.9

Sig. ( 2 tale) 0.001

SD 1.4

95%CI 0.5,0.9

The difference between uninjured and injured limb the participants with unilateral ankle
injury history was statistically significant (uninjured 47.2⁰ ±1.5 95% CI 46.4⁰, 48.0⁰,
injured 44.3⁰± 95% CI 43.0, 45.6⁰) t value =-6.9, p= 0.001)
WBDF (º)
 32

Figure:12 – Error plot for WBDF in injured and uninjured basketball players
(mean±SD)

4.3.4 Analysis of WBDF according to limb dominancy

Seventeen participants were included for the analysis.

Table 7: Objective 4- Paired sample statistics of dominant and non-dominant limb

analysis for WBDF (º)

Mean SD 95% CI

Dominant limb 46.2 2.5 45.2,47.4

Non dominant limb 45.5 2.6 44.2,46.7

Table 8: Paired t test analysis of WBDF for dominant and non-dominant limbs

Mean 0.75

SD 1.2

t- value 2.5

Sig. ( 2 tale) 0.02

The WBDF range of motions for Dominant limb and non- dominant limb
(46.2⁰±2.595%CI45.2⁰,47.4⁰, 45.5⁰±2.695%CI44.2⁰,46.7⁰).The result was statistically
significant (t-2.5,p=0.02)
 33

WBDF (º)

Figure: 13- Error plot for WBDF in dominant and non-dominant limbs(mean±SD)
 34

4.4. Analysis of frequency for participants who has undergone physiotherapy

treatments after an ankle injury

Total of 15 participants were had included in the analysis. There were 5 players who had
done physiotherapy and 10 players who have not done any physiotherapy treatment.

Figure 14: Frequency of taking physiotherapy treatments after ankle injury

 35

CHAPTER 5

Discussion

The following chapter contains a detail discussion on result of our research finding based
on the existing literature. Basketball is a popular sport all over the world which is played
by both males and females. Ankle dorsiflexion movement occurs naturally during many
lower limb tasks and the impact on this is high in basketball. Hence ,Ankle injuries are the
commonest type of injury among basketball players (Hu, 2017). Prevalence of such injuries
among basketball players are at 78.43% (Ellapen et al., 2012).. (Tummala et al., 2018)
where lateral ligament complex is the most common among these injuries.

WBDF is a factor with assistance, which is so important for the landing

mechanism .Another study (Hoch, Farwell, Gaven and Weinhandl, 2015)
conducted to examine the relationship between single-legged landing
biomechanics and WBDF range of motion in persons with chronic ankle
instability. The results has concluded that the persons with low dorsiflexion
demonstrated a more erect landing posture ,specially in stiff landing. (Zhang,
Bates, & Dufek, 2000).

Prior studies done to observe the relationship between ankle injuries and WBDF in normal
population and has found that uninjured limbs have a larger WBDF than the injured limbs
in elite artistic gymnasts(Miller, Fawcett and Rushton, 2020). In (Tummala et al., 2018)
they have determined the relationship between gender and ankle injury history among
basketball players, where they have concluded that prevalence of ankle injury among
female players (43.2%) were slightly higher compared to male payers (35.9%)(Borowski,
Yard, Fields and Comstock, 2008).

The main aim of our study was to explore the relationship between gender and ankle injury
history of basketball players to WBDF .This is the first study to report WBDF in basketball
players in Sri Lanka
 36

Players aged over 16 years with mean age 21.75 were included in the study which
supported to establish the connection between ageed and an increased prevalence of ankle
injuries. . Twenty (62.5%) male players and twelve (37.5%) female players were
included. The results indicate the mean value in WBDF of basketball players were
(45.4⁰±2.6) and was similar in value to the gymnasts (45.1⁰±6.0 ) (Miller, Fawcett and
Rushton, 2020) using same test procedure.

The uninjured players were included to compare WBDF against gender .Out of a total of
forty seven uninjured players 24 were male and 23 were female .The mean values of
WBDF ranges were male (46.6⁰),( ±2.6 ) and (45.7⁰),(±2.0 )for female. According to the
results there was smaller WBDF ranges in females more than the males. However the
difference was not significant.(p=0.2 ).Previous researches looking into this has
concluded that there is a difference in WBDF range between males and females (Female
: 45.1º±6.8) (Male : 45.6º±5.3) (Miller, Fawcett and Rushton, 2020) Another study
emphasizes that the risk for an ankle injury was significantly greater for female athlete
(p<0.05). (Hosea, Carey and Harrer, 2000)

This difference of WBDF between males and females may be due to biological
structural difference between the two genders or the verification of power and strength of
the muscles.

Our next objective was to find the influence of ankle injury history to WBDF range.
Recurrent ankle injuries occur in the ankle ligament laxity and during balance and ankle
plant flexion flexion (Denegar, Hertel and Fonseca, 2002). There were 15 players with
ankle injury history . Two were excluded due to bilateral injuries. A total of thirteen
participants had unilateral injury history (males – 10, females- 3).Mean value of WBDF
ranges among injured players were ( 44.3⁰ ) (±2.5) and it was (47.2⁰ ) ( ± 1.5) among
contralateral uninjured players ( p ˂0.05) .The result suggests that injured limb had a
smaller WBDF compare to contralateral uninjured limb. It was statically significant in
value .
 37

(Miller, Fawcett and Rushton, 2020) has conducted study to explore the relationship
between weight bearing dorsiflexion and ankle injury history in elite artistic
gymnasts.There were 55 participants .There the mean of WBDF in injured ( 45.1⁰ ) (
±6.0) and uninjured mean (47.4⁰ ) (±5.7 ).The result in WBDF to injured and uninjured
limb was statistically significant (p=0.003 ). In our study, this could be attributed
specifically using a validated reliable test procedure, qualitative methodology, and
enough sample size.

The difference between WBDF and ankle injury history may be due to the anatomical
structural damage or it could be due to not having enough treatment for longer period of
time , or it could be simply due to the influence in functional activity in the lower limb.
(Backman and Danielson, 2011) has done a study to examine the relationship between
the patellar tendinipathy and ankle range of motion with seventy five elite basketball
players .They have concluded that the low range of ankle dorsiflexion has significant
influence to developing patellar tendinopathy.

Furthermore the results of our study showed that the mean WBDF in the dominant limb
was 46.2⁰ ( ±2.5 ) and the mean value in the non-dominant limb was 45.5⁰ ( ±2.6).In
the study of (Miller, Fawcett and Rushton, 2020) ) they have mentioned that limb
dominance ,as a important factor, which should be included in future research designs on
the topic of WBDF. In (Halabchi et al., 2016) () has mentioned that among there
population 58.5% ankle injury percentage has evident among basketball palters in
dominant leg . A study conducted by (E Dolan and R Gordon, 2018) among football
players, where the kicking leg was used as the dominant leg found no clinical significance
in leg dominance and asymmetries in ankle dorsiflexion. Accoring to our study there is
difference between dominant and non-dominant limb WBDF range (t=2.5) (p
˂0.05)t=2.5,P=0.02)

According to our results the frequency of taking physiotherapy treatments after an ankle
injury was 33.3% and frequency of not taking physiotherapy was 66.3%. . We found that
utility of physiotherapy service were low and this is in par with the findings of
(Weerasekara and Hiller, 2017) Moreover the previous literature has revealed that
conventional treatments alone are beneficial in order to treat ankle injuries among patients
(van Rijn et al., 2010).
 38

So the rehabilitation in ankle after ankle injury or ankle disorder it is important in

basketball players to pay attention to maintain and improve the WBDF range of motion
.Prior evidence has concluded there is a benefit in WBDF improvement by treatments of
physiotherapy. .(van der Wees et al., 2006)

So mainly ankle WBDF ROM reduction can be a main factor to reduction of sport
performance.This findings may influence clinicians in return to training and activity
selection as with return to performance ( RTP), planning, decision making.Decision of
returning to the play should center around functional range which influence to sport
performance and activities of the player.

5.1 Impact
Our study has contributed to fill the knowledge gap on WBDF and its variations among
basketball players, where we found a significant difference in WBDF range of motion
among the players who had previous ankle injury history.

The results of our study suggests that even the basketball players who takes part in
competitions and practices still display a deficit in WBDF range between limbs.
Hence,caution should be taken in evaluating 100% symmetry and ranges in motion after a
basketball player returns to the full training following an injury and this is highly important
when it comes to improving their performance through improvements in running, jumping
and in changing in direction .

Ankle injury is the commonest injury type in basketball players. . (Hu, 2017)
So mainly ankle WBDF ROM reduction can be a main factor to reduction of sport
performance. This findings may influence clinicians in return to training and activity
selection as with return to performance (RTP), planning, decision making. Decision of
returning to the play should center around functional range which influence to sport
performance and activities of the player.

So the rehabilitation in ankle after ankle injury or ankle disorder it is important in

basketball players to pay attention to maintain and improve the WBDF range of motion
.prior evidence has concluded there is a benefit in WBDF improvement by treatments of
physiotherapy. (van der Wees et al., 2006)
 39

5.2 Limitations

The study has limited by the sample size of basketball players due to the COVID 19
pandemic situation prevailed in Sri Lanka during the data collection process.Therefore with
a larger sample size would have given us better, ststistically significant results..The study
revealed statistically significant difference between uninjured and injured limbs .However
the study did not examine the minimal perceptible change in this population .

.
 40

CHAPTER 06

Conclusion and Recommendations

6.1 Conclusion
This is the first study to investigate WBDF among basketball players. Study provides
normative data for the population, determining that males have larger WBDF range
comparing to females. However the difference was not statistically significant. The study
demonstrated that injured players has a smaller WBDF range of motion in the ankle
comparing to uninjured ankle. There is a strong involvement in dominancy of the limbs
because the difference of dominant and non-dominant limb WBDF is statistically
significant. According to the finding’s of the study the utility of physiotherapy among
basketball players for the ankle injury treatments is low. Finally the finding suggests the
importance of identifying the risk of injury and RTP (Return to Performance) and
planning among basketball players

6.2.Further study

Further study be conducted to examine whether the length of injury ,other foot
biomechanics (pes cavus,pes planus and foot arches), influences the defects in WBDF
range of motion in the injured compared to uninjured ankle and male compared to female.

Further study should investigate to observe that about the influence of previous injuries
affect to landing strategy, peak VGRF and how it affects to each sport activity
performance concerning to the position of players.

More ever further study can be developed to compare WBDF among the players who had
done physiotherapy treatments and who had not done physiotherapy treatments
 41

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(Cejudo, Sainz de Baranda, Ayala and Santonja, 2014)

Andreoli, C., Chiaramonti, B., Biruel, E., Pochini, A., Ejnisman, B. and Cohen, M.,
2021. Epidemiology of sports injuries in basketball: integrative systematic review.

Backman, L. and Danielson, P., 2011. Low Range of Ankle Dorsiflexion Predisposes for
Patellar Tendinopathy in Junior Elite Basketball Players. The American Journal of Sports
Medicine, 39(12), pp.2626-2633.

Basketball Injuries, 2005–2007. The American Journal of Sports Medicine, 36(12),

pp.2328-2335.
Bennell, K., Talbot, R., Wajswelner, H., Techovanich, W., Kelly, D. and Hall, A., 1998.
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Burns, J. and Crosbie, J., 2005. Weight bearing ankle dorsiflexion range of motion in
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Cejudo, A., Sainz de Baranda, P., Ayala, F. and Santonja, F., 2014. A simplified version
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 42

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nCgt35vP9Em1P3tqo5-u-
5oV1g:1617169094229&source=lnms&tbm=isch&sa=X&ved=2ahUKEwj6rZyr6NnvAh
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Ewjtydqq7NnvAhVWm0sFHQuvCG4Q2-
cCegQIABAB&oq=basketball+match+wa&gs_lcp=ChJtb2JpbGUtZ3dzLXdpei1pbWcQ
ARgAMgIIADIGCAAQCBAeOgQIIxAnOgQIABBDOgQIABAYUJauAVidygFg39EBa
ABwAHgAgAGHA4gBywySAQcwLjcuMS4xmAEAoAEBoAEFwAEB&sclient=mobil
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zIECAAQDTIECAAQDToHCCMQ6gIQJzoECAAQQzoFCAAQsQM6BAgjECc6AggA
OgYIABAKEBhQrKoUWNDHFGCR_BRoBHAAeACAAZ8BiAG3CpIBBDAuMTCY
AQCgAQGwAQXAAQE&sclient=mobile-gws-wiz-
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[Accessed 31 March 2021].
 43

Gulbrandsen, M., Hartigan, D., Patel, K., Makovicka, J., Tummala, S. and Chhabra, A.,
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Epidemiology of Ankle Injuries in Men’s and Women’s Collegiate
Basketball. Orthopaedic Journal of Sports Medicine, 6(11), p.232596711880540.
 44

van der Does, H., Brink, M., Benjaminse, A., Visscher, C. and Lemmink, K., 2015. Jump
Landing Characteristics Predict Lower Extremity Injuries in Indoor Team

van der Wees, P., Lenssen, A., Hendriks, E., Stomp, D., Dekker, J. and de Bie, R., 2006.
Effectiveness of exercise therapy and manual mobilisation in acute ankle sprain and
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Lanka. BMC Musculoskeletal Disorders, 18(1).
 45

Appendix

Appendix 1 – Interview administered questioner form - English

General Questionnaire

Name ………………………………………………………………………………

Age _ …………………

Dominant leg - ………………….

Nationality –………………….

Living area –………………….

Gender _ male female

Sport history

Duration - ………………………

Sessions of practicing - ………………………

Hours involving practicing - ………………………

Adequate rest - yes no

Achievements – ………………………

About injury

Ankle injury - yes no

Date –

How many times has got injured in the ground –…………………….

How long the player not participate the practicing after injury -……………………..

Medical diagnosis - ………………………………………………………………….

 46

Ankle injury type – unilateral bilateral

Did the player get first aid after injury - yes no

Did the player get physiotherapy after injury – yes no

Weight bearing dorsiflexion

Right Left

Date - ……………….. signature - ……………………………….

 47

Appendix 2 – Interview administered questioner form – Sinhala

f;dr;=re m;%sldj

ku (-

jhi(-

yqre w; (-

cd;sh (-

mosxÑ m%foaYh (-

ia;%S mqreI Ndjh (- ia;%S mqreI

l%Svd b;sydih (-

fldmuK ld,hl isg l%Svdfõ ksr; jkafka o@

mqyqKq jk jdr .Kk

m%udKj;a úfõlhla ,efnkjdo@

ch.%yK

wdndO ms<sn`o j

j,¨lr wdndO we; (- Tõ ke;

oskh (-

fldmuK jdr .Kkla wdndOhg ,la jQjdo@

fldmuK ld,mrdihla wdndO fya;=fjka mqyqKq ùï i`oyd iyNd.S fkdõkso@

frda. ks¾Kh (-

j,¨lr wdndO we;af;a"

tla mdohl muKla mdo folu

l%Svlhd m%:udOdr j,g fhduq jQjdo@

Tõ ke;

fN!;Ñls;ail m%;sldr j,g fhduq jQjdo@

Tõ ke;

WDBF w.h
ol=K ju
 48

oskh (- …………………….. w;aik (-……………………

 49

Appendix 3 – Interview administered questioner form - Tamil

இலைப் பு- கப் Fவ் ன மகள் வ் கள்

(குழு அங் கததவர் ஒர் வர் ை்

ந் ரப் பப் பட மவல்் டும் )

1. கபயர
………………………………………………………………
…..

2. வயF …………………………………………………………………..

3. ப ை ……………………………………………………………………..

4. ப டட ைை ………………………………………………………..

5. வதிவிடம …………………………………………………………

6. ட்மக தர ட்மக தர கள …………………………………..

7. ந டு ……………………………………………………………………..

8. தந் ைத அை் ைF த் ய் / ப் Fக் வைர் கபயர்

…………………………………………………………………………….

9. மந ய கத டரப ன விபரங கள

……………………………………………………………………………………….

10. விைளய டடுவிபரங கள

 விைளய டடு

 க ைஅளவு

 வ் ைளய் ட்டு அமரவ

் கள்

 விைளய டும லைிததிய ைம

 மப் Fம் ன ஒய் வு

 கவற
றிகள
 50

11.ஒவ

வ ைமகள

12. விபதைத பறறி

 விபததின வரை று

 திகதி

 விபததின வழிமுைற

 எததைன முைற வ் பதF நடந் Fள் ளF

 எவ வளவு க ைம இநத விபததின க லரம க

விைளய டடிைஈடுபடவிை ைை

13. மருதFவக் கல்் டுப் டிப் பு

ைககய பபம ……………………………

திகதி……………………………………….
 51

Appendix 4 –Consent form – English

Part A)

Please underline the correct answer

1. Have you read the information sheet? Yes/ no

2. Have you had the opportunity to discuss about the study? Yes/ no
3. Have you had the opportunity to ask any question about this study? Yes/no
4. Have you received satisfactory answers to all the questions? Yes/no
5. Have you received enough details about the study? Yes/no
6. Which group member explained the study to you ……………..
7. Do you understand that you are free to withdraw from the study at any time
without having to give a reason and without having a problem in participation
school basketball team? Yes/no
8. Information held by the investigators relating to your participation in this study
may be examined by other research assistants. All personal details will be treated
as strictly confidential. Do you give permission for these individuals to have
access to your records?yes/no
9. Have you had sufficient time to make a decision whether to participate in this
study?yes/no
10. Do you agree to take part in this study willingly? Yes/ no
Participant’s signature………………………… Date………
Name (BLOCK CAPITALS)……………………………………………
Date………………………….
Part B)

To be completed by the investigator

I have explained the study to the above participant and he/she has indicated willingness to
participate in this study.

Signature of investigator……………………………………..

Name (BLOCK CAPITALS)……………………… Date ………

 52

Appendix 5 –Consent form – Sinhala

wjir m;%sldj

w& fldgi' whÿïlre úiska msrúh hq;=h'

ksjeros ms,s;=r háka brla w`oskak'

01 Tn f;dr;=re m;%sldj lshjk ,oafoa o@

Tõ$ke;

02 Tng fuu wOHkh ms,sn`o j idlÉPd lsÍug iy m%Yak weiSug wjia:djla ,enqkso ?

Tõ$ke;

03 fuu m¾fhaIKh ms<sn`o j Tng we;s m%Yak weiSug Tng wjia:djla ,enqkd o ?

Tõ$ke;

04 Tnf.a iEu m%Yakhla i`oyd u iEySulg m;aúh yels ms,s;=re ,enqks o ?

Tõ$ke;

05 fuu wOhkh ms<sn`o wjYH muK f;dr;=re Tng oek.ekSug yelsúlsKs o@

Tõ$ke;

06 Tng wOHkh meyeos,s lf,a ljqreka o ?

07 Tng wjYH ´kE u wjia:djl fuu wOHkfhka Tng bj;a úh yels nj iy tu

bj;a ùug fya;= meyeos,s lsÍu wjYH fkdjk nj Tn okakjd o ?

Tõ$ke;

08 fuu wOHkhg Tfí orejd iyNd.S ùu iïnkaOj úu¾Ilhska i;=j we;s f;dr;=re
fjk;a m¾fhaIk iyhlhska úiska mÍlaId lrkq ,efí' ish¨ u mqoa.,sl f;dr;=re oeä
ryiH f,i i,lkq ,efí' fuu mqoa.,hskga Tfí orejdf.a jd¾;d fj; m%fõY ùug
Tng wjir ;sfí o@

Tõ$ke;

09 Tng ;SrK .ekSu i`oyd wjYH muK fõ,dj ,enqKs o@

Tõ$ke;

10 fuu wOHkhg iyNd.S ùug Tn tl`. jkafkao?

Tõ$ke;

iyNd.Sjkakdf.a ku :-
 53

iyNd.Sjkakdf.a w;aik : -
oskh :-
wd& fldgi' wkafõIl úiska msrúh hq;=h'
ud úiska fuu wOHkh ms<sn`oj by; kï i`oyka whg meyeos,s lrk ,os' weh$Tyq
úiska fuu wOHkh i`oyd odhl ùug leue;a; m%ldY lrk ,os'

wkafõYlf.a ku : -

w;aik :-

oskh :-
 54

Appendix 6 –Consent form – Tamil

ஒபபுதை பததிரம (தைிழ )

பகுதி அ
(கபறமற ர அை ைF ப Fக வைர ை ந ரபபபபட மலவ டும )

ட்ர ய ன விைடயின கீழ மக டிடுக

1. நீ ங கள அை ைF உங களF பிளைள பததிரதைத வ சிதத ர

? ஆம /இை ைை

2. நீ ங கள அை ைF உங களுைடய பிளைள இநத ஆய

ைவபபறறி எங களுடன கைநFைரய டின ர ? ஆம /இை

ைை
3. நீ ங கள அை ைF உங களுைடய பிளைள ஆய வு பறறிய

மகளவிகைள எங கள டம முன ைவதத ர ? ஆம /இை ைை

4. . நீ ங கள அை ைF உங களுைடய பிளைள ஆய வு பறறிய

திருபதிகரம ன பதிை கைள கபறறுககக ல்் ட ர ? ஆம

/ இை ைை

5. நீ ங கள அை ைF உங களுைடய பிளைள ஆய ைவ பறறிய

மப Fம ன தகவை கைள கபறறுககக ல்் ட ர ? ஆம

/இை ைை
6. எநத குழு உறுபபினர ஆய ைவப பறறி உங களுைடய

பிளைளககு விளககின ர

7. நீ ங கள இநத ஆய விலிருந எபமப Fம க லரைிை ை மை

கவள மயறை ம மறறும உங களுைடய ப டட ைை

கூைடபபநத டட லஅ யிை எநதவித பிடரசிைனயும இன றி

பங குகபறை ம என பைதஅறிவீர ? ஆம / இை ைை

8. உங களுைடய பிளைளயின தகவை கள ள ன ஆய வ ளரக

மூைம படிககபபடும மமலும தகவை ரகசியம மலபபபடும
இதறகு நீ ங கள அFமதி அள ககிறீரகள ? ஆம / இை ைை
 55

9. இநத ஆய விை பங குபறறுவதறகு உர ய முடிைவ

எடுபபதறகு உங களுைடய பிளைளககு மதைவய ன மநரம

இருநதத ? ஆம / இை ைை

10. நீ ங கள முழுமனFடன உங களுைடய குழநைதைய இநத

ஆய விை பங குகபற ட்ம மதிபபிரகள ? ஆம / இை ைை

பங குகபறுபவர ன ைககய பபம

…………………………………….
திகதி…………………………………….

கபயர (ஆங கிை கபர ய எழுதFககள ை )

பகுதி ஆ
ஆய வ ளர ை ந ரபபபபட மலவ டும

கபறுபவருககு இநத ஆய வு கத டரப ன முழு தகவை

கைளயும கதள வுபடுததிமனன . அவர இநத ஆய விை பங

குபறற முழு
ட்ம மததைதயும கதர விதத ர.்

ைககய பபம ……………………………………………….

ஆய வ ளர ன கபயர
திகதி
 56

Appendix 7 –Information sheet – English

Information Sheet - English

We are undergraduate students of the degree programme-BSc.in Physiotherapy of

Faculty of Allied Health Sciences - Kotelawala Defence University, Rathmalana.
We would like to invite you to take part in the research study titled “Influence of
ankle injury history and gender to weight bearing dorsiflexion in basketball
players and how it affects to functional limitation and physical performances of
players.’’

1. Purpose of the study

The purpose of this research is to find out the if there a relationship between
gender and ankle injury history to WBDF in basketball players and if it limits their
physical performances .As it is a responsibility of sport physiotherapist to make a
player functionally independent in ground after an injury this will be a great help
for them to do rehabilitation

2 Voluntary participation

Your participation in this study is voluntary. You are free to not participate at all
or to withdraw from the study at any time despite consenting to take part earlier.
There will be no loss of the quality of practicing or any other study related
matters. If you decide not to participate or withdraw from the study you may do so
at any time.

3.Procedures, durations of the study and participant’s responsibilities

The purpose and our requirements for the research will be explained to you by a
researcher in our team. If you fulfill the criteria of our study and grant the consent
to take part in the study we will proceed further.

You will have to participate for the research only once and there will be no follow
up. Data collection and measurements will be done by the investigators in our
group
 57

4.Potential benefits

Through the findings of this research the participants will be get no financial

Benefits

5.Risks, Hazards and discomfort

No any risk, hazards to the participants by granting the consent to participate in

this research. But there can be small discomfort for the participants due to the time
that they have to spend for this study.

Well organized method to minimized time wastage, will be evaluated throughout the
procedures.

6.Reimbursements

You will not be paid for participating in this research.

7.Confidentiality

Confidentiality of all records is guaranteed and no information by which you can be

identified will be released or published. These data will never be used in such a way
that you could be identified in any way in any public presentation or publication
without your express permission.

All the hard copies of data will be kept under lock and key method while soft copies
will be stored in one machine under password protection. All the collected data will
be stored confidentially for up to seven years and after that it will be destroyed.

8.Termination of study participation

You may withdraw your consent to participate in this study at any time, with no
penalty or effect on your training. Please notify the investigator as soon as you
decide to withdraw your consent.

9.Clarification
 58

If you have questions about any of the procedures or information please feel free to
ask any of the persons listed below.

G.W.T.Premakumara 0719278370 tharangaprema@gmail.com

P.P.Kodagoda 0705851853 prasanjik@gmail.com

M.H.A.Jayasekara 0702574573 arunageejayasekara@gmail.co

m
 59

Appendix 8–Information sheet – Sinhala

f;dr;qrqe m;%sldj

r;au,dk fckrd,a YS%u;a fcdaka fld;,dj, wdrlaIl úYAj úoHd, iufi!LH

mSG" fN!;Ñls;ail Wmdê mdGud,dj yodrk isiqka jk wm “ndialÜ fnda,a l%Svlhskaf.a
j,¨lr wdndO b;sydifha n,mEu iy ia;%S mqreI Ndjh weight bearing dorsiflexion
(WBDF) i`oyd n,mdkafka flfiao” hk ud;Dldjg wod,j osh;a lsÍug kshñ;
m¾fhaIK wOHkh i`oyd iyNd.S jk f,i wms Tng wdrdOkd lsÍug leue;af;uq'

01 wOHk wruqKq (-

fuu wOHkfha mrud¾:h jkafka ndialÜ fnda,a l%Svlhkaf.a ia;%S - mqreINdjh

j,¨lr wdndOhka yd Tjqkaf. WBDF w.hka w;r iïnkaO;djla ;sfío hkak ks¾Kh
lsÍuhs' l%Svlfhl= l%Svd N+ñfha oS l%svdlsÍu yd M,odhS whqßka l%SvdlsÍug ie,eiaùu
l%SvdfN!;Ñls;ailjrhdf.a j.lSuhs' wdndO iqj lsÍu iy mqkre;a;dmkh lsÍfï oS
fuu wOHk m%;sM, fnfyúka bjy,a jkq we;'

02 iafõÉPd iyNd.S;ajh (-

fuu wOHkhg Tfí iyNd.S;ajh iafõÉPdfjka isÿ fõ' fmr iyNd.S;ajh

;yjqre lr ;snqko Tng lsisfia;a iyNd.S fkdùug fyda wOHkfhka ´kE u úfgl
bj;a ùug mQ¾K ksoyi ;sfí'

03 l%shdmámdáh" wOHk ld,h iy iyNd.S jkakkaf.a j.lSï (-

wmf.a lKavdhï idudcslfhl= úiska m¾fhaIKfha wruqKq iy wjHY;d Tng

meyeos,s lrkq we;' Tn wmf.a wOHkfha ks¾Kdhl imqrd wOhkhg iyNd.S ùug
leue;a; ,ndfokafka kï wms ;jÿrg;a bosßhg wOHk lghq;= f.khkafkuq'

Tng m¾fhaIK i`oyd iyNd.S ùug isÿjkafka tla jrla muKla jk w;r miq
úmrula isÿ fkdfõ' o;a; /ia lsÍu iy ñkqï wmf.a lKavdhfï úu¾Ilhska úiska isÿ
lrkq we;'

04 wfmalaIs; m%;s,dN fuu m¾fhaIKfha fidhd.eksï ;=,k

s a iyNd.S jkakkag uQ,H
m%;s,dN fkd,efí'

05 wjOdkï yd wmyiq;d (-

Fuu m¾fhaIKhg iyNd.S ùfuka lsisÿ wjOdkula fkdue;' kuq;a fuu

wOHkh i`oyd iyNd.S ùug .;jk ld,h fya;=fjka iq¨ wmyiq;djla we;súh yelsh'
ld,h kdia;sùu wju lsßu i`oyd fyd`oska ixúOdkh jQ l%ufõohla ilia fldg we;'

06 m%;smqrKhka (-

fuu m¾fhaIkhg iyNd.S ùu i`oyd Tng uqo,a f.jkq fkd,efí'

07 ryiHNdjh (-

ish¨ u jd¾;d j, ryiHNdjh iy;sl lrkq ,nkq w;r Tnj y`ÿkd.; yels
wkaofï lsisÿ f;dr;=rla uqod yßkq fkd,efí'
 60

o;a; j, oDv msgm;a ish,a, u w`.=¨ iy h;=re l%uh hgf;a ;nd we;s w;r
uDÿ msgm;a uqrmo wdrlaIdj hgf;a mß.Klhl .nvd fõ'

08 wOHkh iyNd.S;ajh iy wjika lsÍu (-

Tnf.a mqyqKj
q g lsisÿ n,mEula fkdue;sj ´kE u fudfyd;l fuu wOHkhg
iyNd.S ùug yels w;r wjYH ´ke u úfgl Tnf.a leue;a; b,a,d wialr .;
yelsh'

Tn tfia lrkafka kï lreKdlr mÍlaIlg okajkak'

09 meyeos,s lsßu (-

Tng lsih s ï l%shdmámdáhla fyda f;dr;=rla ms,sn`oj .eg¨jla we;af;a kï

my; ,ehsi;
a = .; lr we;s ´kE u wfhl=f.ka úuikak'

cS'ví,sõ'à'fm%aul=udr (- 0719278370

mS'mS'fldaodf.dv (- 0705851853

tï'tÉ'ta'chfialr (-0702574573
 61

Appendix 9–Information sheet – Tamil

தகவல் பத்திரம் (ஆங் கிலம் )

நாங் கள் ககாத்தலாவல பாFகாப் பு பல் கலலக்கழகத்தில்

இலலந் த சுகாதார பீடத்தில் பி.எஸ் சி இயன் மருத்Fவம்

கதாடரபான பட்டதாரி படிப் லப மமற் ககால்்் டு இருக்கிமறாம்

. நாங் கள் மமற் ககாள் ளும் ஆய் வில் நீ ங் கள் கலந் F

ககாள் ளுமாறு தாழ் லமயுடன் மகட்டுக்ககாள் கிமறாம் .

"கூலடப் பந் F விலளயாட்டு

மற் றும் உடல் ரீதியான ககயற் திறன் எவ் வாறு பாதிப் பலடகிறF

மற் றும் பால் ரீதியான மவறுபாடுகள் எவ் வாறு விபத்தில்

தாக்கம் ககலுத்FகிறF

1.ஆய் வின் மநாக்கம

பால் மவறுபாடுகள் விபத்Fக்களில் எவ் வாறு தாக்கம்

ககலுத்FகிறF

மற் றும் அவரகளின் விலளயாட்டு திறலமகலள எவ் வாறு

தலடககய் கிறF. இF ஒரு இயன் மருத்Fவரின் கடலமயாகும

மமலும் லள மற் றவரக ளின் Fலலயின் றி விலளயாட்டு வீரரக

நடமாட ககய் வதற் கு மற் றும் குல்ப் படுத்தல் எவ் வாறு தாக்கம
ககலுத்FகிறF.

நடமாட ககய் வதற் கு மற் றும் குல்ப் படுத்தல் எவ் வாறு தாக்கம
 62

ககலுத்FகிறF.

இந் த ஆய் வில் பங் குபற் றுவF கட்டாயமானF அல் ல. நீ ங் கள்

இந் த ஆய் விலிருந் F எப் மபாF மலவ் டுமானாலும்

கவளிமயறமுடியும்

3.ஆய் வின் க்ட்டதிட்டங் கள் / காலவலரயலற / ஆய் வில் பங்

குகபற் ற கடலமகள்

இந் த ஆய் வில் பங் குகபற அதன் மநாக்கம் மற் றும் மதலவயான

விடயங் கள் பற் றி எங் கள் ஆய் வுக்குழுவின் உறுப் பினர் ஒருவர்

உங் களுக்கு விளக்குவார. நீ ங் கள் இந் த ஆய் வில் ஒமரஒரு

முலறமட்டுமம பங் குபற் ற முடியும் .

4.நீ ங் கள் கபற் றுக் ககாள் ளக்கூடிய லாபங் கள

இந் த ஆய் வில் பங் குகபறுவதன் மூலம் நீ ங் கள் எந் தவித

லபரீதியான பரிவரத்தலனகலள கபறமுடியாF

5.இந் த ஆய் வில் பங் கு கபற் ற அதில் உள் ள சிக்கல் கள் அல் லF

உங் களுக்கு ஏற் படக்கூடிய நஷ் டங் கள்

இந் த ஆய் வில் பங் குகபறுவதன் மூலம் உங் களுக்கு

எந் தவலகயிலும் சிக்கல் கள் ஏற் படாF. சிறிதளவு மநரவிரயம்

மட்டுமம ஏற் படும் இயன் ற அளவு எங் களால்

முகாலமத்Fவபடுத்திக் ககாள் ளமுடியும்
 63

6. திருப் பிச் சசலுத்Fதல்

இந் த ஆய் வின் மூலம் நீ ங் கள் எந் தவிதமான லாபங் கலளயும்

கபறமுடியாF

7.ரகசியங் கலள மபணும் தன் லம

உங் களுலடய தகவல் கள் ரகசியமாகப் மலபப் படும் .

கஅசுப் பதிப் பில் உள் ள தகவல் கள் ஒழுங் கான முலறயில்

அலமாரிகளில் கமமிக்கப் படும் . லகனி மயப் படுத்தப் பட்ட

தகவல் கள் கடவுக்சீட்டின் மூலம் கமமிக்கபபடு ம்

் . எநத்

வலகயிலும கவளிமயறாF என் பFடன் , ஏழுவருடங் கள்

கமமிக்கப் பட்டு பின் பு அளிக்கப் படும்

8.இந் த ஆய் வில் இருந் F கவளிமயறும் வழிமுலறகள்

இந் த ஆய் வில் இருந் F இலடநடுவில் நீ ங் கள் கவளிமயற விரும்

பினால் அதன் மூலம் உங் களுக்கு எந் த லத் டப் லபமும

அறவிடப் பட மாட்டாF என் பFடன் நீ ங் கள் கவளிமயற

விரும் பும் மபாF எங் கள் ஆய் வுக்குழுவின் உறுப் பினலர

கதாடரபுககாள் வதன் மூலம் கவளிமயறலாம்

9.மமலதிக தகவல் கலள கபற

 64

இந் த ஆய் வு கதாடரபான மமலதிகதகவல் கள் அல் லF

ந் மதகங் கள் இருப் பின் எந் த மநரத்திலும் எங் களF குழு

உறுப் பினலர கதாடரபு் ககாள் ளமுடியும்

G.W.T. 0719278370 tharangaprema@gmail.co

பிரரமகுமார் m

P.P. 0705851853 prasanjik@gmail.com

ரæ்ாடாசæ்ாட

M.H.A. கசயரசæர் 0702574573 arunageejayasekara@gm

ail.com
 65

Appendix:10 -Ethical clearance letter

66