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Currie BM, Drew MK, Hetherington M, Waddington G, Brown NAT, Toohey LA. Diving Into the Health Problems of Competitive Divers: A Systematic Review of Injuries and Illnesses in Pre-elite and Elite Diving Athletes. Sports Health 2024:19417381241255329. [PMID: 38828690 DOI: 10.1177/19417381241255329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
CONTEXT The Olympic sport of diving involves the competitive disciplines of 3 m springboard and 10 m platform. Although it is generally accepted that lumbar spine injuries are common in diving athletes, the existing literature of health problems in diving athletes remains scarce. OBJECTIVE To identify the incidence, prevalence, and type of health problems that occur in competitive diving athletes. DATA SOURCES Medline, EMBASE, SportsDiscus, PsycINFO, and Google Scholar. STUDY SELECTION Studies written in English investigating elite or pre-elite competitive diving (springboard, platform) injuries and/or illnesses were eligible. Two independent reviewers screened for inclusion by title, abstract, and full text in accordance with the eligibility criteria. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION Data extraction was completed by 1 author using a structured form. A second author then independently reviewed and verified the extracted data, any discrepancies were resolved through consensus. RESULTS The search identified 2554 potential articles, with 28 studies meeting eligibility criteria. The surveillance setting of most studies was restricted to competition-based events, with the reported injury incidence proportion ranging from 2.1% to 22.2%. The reported injury incidence rate ranged from 1.9 to 15.5 per 1000 athlete-exposures. Injuries to the shoulder, lower back/lumbar spine, trunk, and wrist/hand were reported most frequently. The prevalence of low back pain was reported as high as 89% (lifetime), 43.1% (period), and 37.3% (point). The illness incidence proportion ranged from 0.0% to 22.2%, with respiratory and gastrointestinal illness reported most frequently. CONCLUSION Up to 1 in 5 diving athletes sustain an injury and/or illness during periods of competition. A reporting bias was observed, with most cohort studies limiting surveillance to short competition-based periods only. This limits the current understanding of the health problems experienced by diving athletes to competition periods only and requires expansion to whole-of-year surveillance.
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Affiliation(s)
- Benjamin M Currie
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia
- Diving Australia, Brisbane, Australia
- Queensland Academy of Sport, Sport Performance Innovation and Knowledge, Brisbane, Australia
| | - Michael K Drew
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia
- Athlete Performance Health, Australian Institute of Sport, Bruce, Australia
| | | | - Gordon Waddington
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia
- Sports Medicine, AIS Operations, Australian Institute of Sport, Bruce, Australia
| | - Nicholas A T Brown
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia
| | - Liam A Toohey
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia
- Athlete Performance Health, Australian Institute of Sport, Bruce, Australia
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Zapata KA, Carreon LY, Jo CH, Ramo BA. The Oswestry Disability Index is reflective of pain interference and mobility in children. Spine Deform 2024; 12:329-334. [PMID: 38206487 DOI: 10.1007/s43390-023-00807-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/09/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE The 9-item Oswestry Disability Index version 2.1a (ODI-9) has never been formally validated in children. Our primary purpose was to evaluate the ODI-9 using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Pain Interference (PI) and Mobility Computer Adapted Test (CAT) and Pain Catastrophizing Scale for Children (PCS-C) as anchors to determine concurrent validity in children. METHODS We retrospectively reviewed cross-sectional patient-reported outcomes data using a convenience sample of children referred to a tertiary pediatric orthopedic institution for any spine condition from April 2021 to April 2022. The ODI-9, PI, and Mobility were completed at clinic intake in 2,097 children (1453 girls, 644 boys) aged 14.2 ± 2.6 years (range 5-18 years) during the same visit. The ODI-9 was administered when children or caregivers responded "yes" to the presence of back pain. The PCS-C was administered only when pain intensity was rated as "very severe" or "the worst imaginable" on Item 1 of the ODI-9 (n = 51). RESULTS Average ODI-9 scores were 18.3% ± 14.8%, indicating minimal disability (ODI-9 ≤ 20%). Moderate, statistically and clinically significant associations were seen between the ODI-9 and PI (r = 0.68, p < 0.001), the ODI-9 and Mobility (r = - 0.68, p < 0.001), and the ODI-9 and PCS-C (r = 0.59, p < 0.001). CONCLUSION Worse ODI-9 scores correlate with worse PROMIS PI scores, worse PROMIS Mobility scores, and worse PCS-C scores. The associations were moderate (PROMIS PI [r = 0.68], PROMIS Mobility [r = - 0.68], PCS-C [r = 0.59]).
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Wan ZY, Zhang J, Shan H, Liu TF, Song F, Samartzis D, Wang HQ. Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study. Global Spine J 2023; 13:599-608. [PMID: 33843321 DOI: 10.1177/21925682211000707] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE Recently, there has been a rise in children and adolescents developing low back pain and/or sciatica. Degenerative lumbar spine MRI phenotypes can occur in this population but reports have been sporadic and the true incidence of such spine changes remains debatable. As such, the study aimed to address the epidemiology of MRI phenotypes of the lumbar spine in this young population. METHODS 597 children and adolescents with lumbar MRIs were included in the study. T1- and T2-weighted lumbar images from L1/2 to L5/S1 were analyzed in axial and sagittal planes. Global phenotype assessment was performed of each level and based on established nomenclature protocols. RESULTS The cohort consisted of 57.3% (342) boys and 42.7% (255) girls, with a mean age of 10.75 ± 5.25 years (range: 0 to 18 years). The prevalence of imaging findings of lumbar disc degeneration (LDD) and lumbar disc herniation (LDH) were 2.2% (95% CI: 0.93-3.43) and 5.8% (95%CI: 2.58-8.99), respectively. There was significant difference between each disc segment from L1/2 to L5/S1 for both LDD and LDH. Schmorl's nodes were noted in 16 cases (2.7%, youngest case as 15 years), with 11 boys (68.8%) and most frequent segment as L3/4. Modic changes and high-intensity zones were absent in this cohort. CONCLUSIONS LDD can emerge as early as the first decade of life with Schmorl's nodes, without additional specific phenotypes, including Modic changes and high-intensity zones. The study provides valuable information of a unique age group that is often under-represented but equally important as adults.
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Affiliation(s)
- Zhong-Yuan Wan
- Department of Orthopedics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jun Zhang
- Department of Orthopedics, Baoji Central Hospital, Baoji, Shaanxi Province, People's Republic of China
| | - Hua Shan
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
| | - Tang-Fen Liu
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
| | - Fang Song
- Department of Stomatology, PLA Rocket Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Dino Samartzis
- Department of Orthopaedic Surgery, 2468Rush University Medical Center, Chicago, IL, USA
| | - Hai-Qiang Wang
- Institute of Integrative Medicine, 107652Shaanxi University of Chinese Medicine, Xi'an, Shaanxi Province, People's Republic of China
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Narita T, Okubo Y, Nomura T, Kaneoka K. Entry phase in men's backward dive pike: association between the shoulder joint and trunk angles. J Sports Med Phys Fitness 2023; 63:292-298. [PMID: 35686868 DOI: 10.23736/s0022-4707.22.14006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND A high prevalence of lower back pain has been observed in competitive divers. Hyperextension of the lumbar vertebrae during water entry is considered the main mechanism behind the incidence of lower back pain in divers. Therefore, this study aimed to investigate the influence of the shoulder angle on the entry alignment. METHODS Posture angles of 13 male drivers (age: 16.8±2.9 years) who were invited to the national training camp in 2012 by Japan Swimming were recorded at the time of water entry via 201B using a high-speed camera. RESULTS A negative correlation was observed between shoulder joint flexion and trunk extension angles on water entry. In addition, the trunk angle was significantly different between groups. For the lower back pain group, 210.4±5.7°, and in the non-lower back pain group, 199.9±9.0°, angles were observed with a larger extension of the trunk on water entry in the lower back pain group. CONCLUSIONS The alignment on water entry was associated with the occurrence of lower back pain. Which suggested that enough shoulder flexibility can prevent the incidence of lower back pain.
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Affiliation(s)
- Takaya Narita
- Faculty of Culture and Sport Policy, Toin University of Yokohama, Yokohama, Japan -
| | - Yu Okubo
- Faculty of Health and Medical Care, Saitama Medical University, Moroyama, Japan
| | | | - Koji Kaneoka
- Faculty of Sport Sciences, Waseda University, Nishitokyo, Japan
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Witwit WA, Hebelka H, Swärd Aminoff A, Abrahamson J, Todd C, Baranto A. No Significant Change in MRI Abnormalities or Back Pain Prevalence in the Thoraco-Lumbar Spine of Young Elite Skiers Over a 2-Year Follow-Up. Open Access J Sports Med 2022; 13:69-76. [PMID: 36003328 PMCID: PMC9394653 DOI: 10.2147/oajsm.s366548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Young athletes are at increasing risk for spinal column injuries due to overloading the spine with excessive sports activities, with potential development of complications later in life. Purpose The purpose of this 2-year follow-up study of young elite skiers and non-athletes was to investigate any potential change in the thoraco-lumbar findings on MRI and to outline any change in back pain prevalence with continuing sporting activity and age. Study Design Longitudinal cross-sectional study. Methods MRI of the thoraco-lumbar spine was performed on 30 skiers (mean age 20 years, female 43%) and 16 non-athletes (mean age 19, female 75%), available for the 2-year follow-up. The intervertebral discs were evaluated for signal, height, bulge/herniation, and additionally according to Pfirrmann classification, and the endplates were graded according to endplate defect score. Any of the following disc findings was defined as disc degenerative change: reduced signal, reduced height, bulge, or herniation. All participants answered a specific back pain questionnaire. Results No significant difference in spinal column abnormalities, nor back pain, was found between baseline and 2-year follow-up in neither skiers nor controls. There was significantly higher prevalence of disc degenerative changes in skiers (73%) than in non-athletes (44%, p=0.05). Skiers (63%) had significantly more Pfirrmann grade ≥3 discs compared to non-athletes (25%) (p=0.03). There was no significant difference in number of endplates with score ≥4 between skiers and non-athletes (50% vs 38%, p=0.40) nor in lifetime prevalence of back pain between skiers (46%) and non-athletes (40%). Conclusion There was no significant change over time of the spinal column MRI abnormalities, nor back pain prevalence, during a 2-year follow-up of skiers and non-athletes. Young skiers had significantly higher prevalence of spine abnormalities compared with non-athletes. There was no significant difference of the back pain lifetime prevalence in skiers compared with non-athletes.
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Affiliation(s)
- Wisam A Witwit
- Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neuroradiology, Yale University, New Haven, CT, USA
| | - Hanna Hebelka
- Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Swärd Aminoff
- Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefin Abrahamson
- Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Carl Todd
- Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Adad Baranto
- Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Hill L, Mountjoy M, Miller J. Non-shoulder Injuries in Swimming: A Systematic Review. Clin J Sport Med 2022; 32:256-264. [PMID: 33852442 DOI: 10.1097/jsm.0000000000000903] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/17/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The shoulder is the most common injury in swimming, followed by the knee and spine. The repetitive nature of swimming training may predispose a swimmer to injury. Several risk factors have been previously identified, but the level of evidence and level of certainty that these risk factors predispose a swimmer to injury risk has yet to be evaluated critically in a systematic review. DESIGN Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DATA SOURCES Data were obtained through PubMed, Cochrane, and Google Scholar. The database search was limited to articles that were published between January 1980 and December 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Level I, II, and III studies were included in this review. All studies must have been conducted in swimmers or swimming, a description of the specific pathology and provide at least one identified risk factor with an association (P < 0.05). RESULTS A total of 19 critically appraised articles identified 28 potential risk factors for musculoskeletal injuries in swimmers. The risk factors were grouped by the anatomical region: neck and back, pelvis and hip, and the knee. Only 2 risk factors were appraised at a moderate level of certainty, both occurring in the knee. The remaining 26 identified risk factors were appraised at a low level of certainty. There is a clear lack of research surrounding nonshoulder injuries in swimmers.
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Affiliation(s)
- Lee Hill
- Division of Gastroenterology and Nutrition, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
- Department of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Margo Mountjoy
- Federation International de Natation (aquatics) (FINA) Sports Medicine, Lausanne, Switzerland; and
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Jim Miller
- Federation International de Natation (aquatics) (FINA) Sports Medicine, Lausanne, Switzerland; and
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Benedikter C, Abrar DB, Konieczny M, Schleich C, Bittersohl B. Patterns of Intervertebral Disk Alteration in Asymptomatic Elite Rowers: A T2* MRI Mapping Study. Orthop J Sports Med 2022; 10:23259671221088572. [PMID: 35464905 PMCID: PMC9019338 DOI: 10.1177/23259671221088572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Repetitive loading of the back puts elite rowers at risk for acute and chronic back injuries. Hypothesis: That asymptomatic elite rowers would demonstrate characteristic intervertebral disk (IVD) alterations on T2* magnetic resonance imaging (MRI) mapping compared with asymptomatic nonrowers. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study included 20 asymptomatic elite rowers (mean age, 23.4 ± 3.03 years; 9 women, 11 men) studied at 2 different times, once before (t1) and once after (t2) the competition phase. MRI including T2* mapping was performed on a 3-T scanner. The authors derived normative T2* data from a previous study on 40 asymptomatic volunteers (20 men, 20 women) who were not competitive rowers; based on complete T2* data sets, 37 controls were included. T2* values were compared between groups in 4 lumbar IVDs, and midsagittal T2* values were compared in 5 zones: anterior annulus fibrosus (AF), anterior nucleus pulposus (NP), central NP, posterior NP, and posterior AF. The Pfirrmann grade was used for morphological assessment of disk degeneration. Statistical analysis was conducted using the Mann-Whitney U test, Wilcoxon matched-pairs test, and Spearman rank correlation coefficient. Results: Lower T2* values were noted in the rower group compared with the controls (37.08 ± 33.63 vs 45.59 ± 35.73 ms, respectively; P < .001). The intersegmental comparison revealed lower mean T2* values among rowers (P ≤ .027 for all). The interzonal comparison indicated significantly lower mean T2* values for the rowers in all zones except for the anterior NP (P ≤ .008 for all). Lower mean T2* values were observed for the rowers at t1 versus t2 (39.25 ± 36.19 vs 43.97 ± 38.67 ms, respectively; P = .008). The authors noted a higher level of IVD damage according to Pfirrmann assessment in the rower cohort (P < .001); the Pfirrmann grade distributions of rowers versus controls, respectively, were as follows: 51.3% versus 73.7% (grade 1), 20.5% versus 19.5% (grade 2), 21.8% versus 6.8% (grade 3), 5.1% versus 0% (grade 4), and 1.3% versus 0% (grade 5). The authors also noted a correlation between low T2* and high Pfirrmann grade at t1 (r =–0.48; P < .001) and t2 (r =–0.71; P < .001). Conclusion: The cohort of elite rowers revealed more degenerative IVD changes compared with controls. The T2* values suggest that repetitive loading of the spine has demonstrable short-term and possibly permanent effects on the lumbar IVD.
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Affiliation(s)
- Chiara Benedikter
- Department of Orthopedics and Trauma Surgery, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Daniel Benjamin Abrar
- Department of Diagnostic and Interventional Radiology, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Markus Konieczny
- Department of Orthopedics and Trauma Surgery, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Bernd Bittersohl
- Department of Orthopedics and Trauma Surgery, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
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Yu HJ, Wadi L, Say I, Paganini-Hill A, Chow D, Jafari AH, Farhan SD, Del Sol SR, Mobayed O, Alvarez A, Hasso A, Li SS, Do H, Berkeley D, Lee YP, Su LMY, Rosen C, Fisher M. Magnetic Resonance Imaging Findings in High School Football Players: Brain and Cervical Spine. Neurotrauma Rep 2022; 3:129-138. [PMID: 35403100 PMCID: PMC8985528 DOI: 10.1089/neur.2021.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Football exposes its players to traumatic brain, neck, and spinal injury. It is unknown whether the adolescent football player develops imaging abnormalities of the brain and spine that are detectable on magnetic resonance imaging (MRI). The objective of this observational study was to identify potential MRI signatures of early brain and cervical spine (c-spine) injury in high school football players. Eighteen football players (mean age, 17.0 ± 1.5 years; mean career length, 6.3 ± 4.0 years) had a baseline brain MRI, and 7 had a follow-up scan 9–42 months later. C-spine MRIs were performed on 11 of the 18 subjects, and 5 had a follow-up scan. C-spine MRIs from 12 age-matched hospital controls were also retrospectively retrieved. Brain MRIs were reviewed by a neuroradiologist, and no cerebral microbleeds were detected. Three readers (a neuroradiologist, a neurosurgeon, and an orthopedic spine surgeon) studied the cervical intervertebral discs at six different cervical levels and graded degeneration using an established five-grade scoring system. We observed no statistically significant difference in disc degeneration or any trend toward increased disc degeneration in the c-spine of football players as compared with age-matched controls. Further research is needed to validate our findings and better understand the true impact of contact sports on young athletes.
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Affiliation(s)
- Hon J. Yu
- Department of Radiological Sciences, University of California Irvine, Irvine, California, USA
| | - Lara Wadi
- Department of Neurology, University of California Irvine, Irvine, California, USA
| | - Irene Say
- Department of Orthopedic Surgery, University of California Irvine, Irvine, California, USA
| | - Annlia Paganini-Hill
- Department of Neurology, University of California Irvine, Irvine, California, USA
| | - Daniel Chow
- Department of Radiological Sciences, University of California Irvine, Irvine, California, USA
| | | | - Saifal-Deen Farhan
- Department of Orthopedic Surgery, University of California Irvine, Irvine, California, USA
| | - Shane Rayos Del Sol
- Department of Neurology, University of California Irvine, Irvine, California, USA
| | - Osama Mobayed
- Department of Neurology, University of California Irvine, Irvine, California, USA
| | - Andrew Alvarez
- Department of Orthopedic Surgery, University of California Irvine, Irvine, California, USA
| | - Anton Hasso
- Department of Radiological Sciences, University of California Irvine, Irvine, California, USA
| | - Scott Shunshan Li
- Department of Radiological Sciences, University of California Irvine, Irvine, California, USA
| | - Hung Do
- Canon Medical Systems USA, Tustin, California, USA
| | | | - Yu-Po Lee
- Department of Orthopedic Surgery, University of California Irvine, Irvine, California, USA
| | - Lydia Min-Ying Su
- Department of Radiological Sciences, University of California Irvine, Irvine, California, USA
| | - Charles Rosen
- Department of Orthopedic Surgery, University of California Irvine, Irvine, California, USA
| | - Mark Fisher
- Department of Neurology, University of California Irvine, Irvine, California, USA
- Department of Pathology & Laboratory Medicine, University of California Irvine, Irvine, California, USA
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Millet GP, Brocherie F, Burtscher J. Olympic Sports Science-Bibliometric Analysis of All Summer and Winter Olympic Sports Research. Front Sports Act Living 2021; 3:772140. [PMID: 34746779 PMCID: PMC8564375 DOI: 10.3389/fspor.2021.772140] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/27/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction: The body of scientific literature on sports and exercise continues to expand. The summer and winter Olympic games will be held over a 7-month period in 2021-2022. Objectives: We took this rare opportunity to quantify and analyze the main bibliometric parameters (i.e., the number of articles and citations) across all Olympic sports to weigh and compare their importance and to assess the structure of the "sport sciences" field. The present review aims to perform a bibliometric analysis of Olympic sports research. We quantified the following topics: (1) the most investigated sports; (2) the main journals in which the studies are published; (3) the main factors explaining sport-specific scientific attractiveness; (4) the influence of being in the Olympic programme, economic weight, and local influences on research output; and (5) which research topic is the most investigated across sports. Methods: We searched 116 sport/exercise journals on PubMed for the 40 summer and 10 winter Olympic sports. A total of 34,038 articles were filtered for a final selection of 25,003 articles (23,334 articles on summer sports and 1,669 on winter sports) and a total of 599,820 citations. Results and Discussion: Nine sports [football (soccer), cycling, athletics, swimming, distance & marathon running, basketball, baseball, tennis, and rowing] were involved in 69% of the articles and 75% of the citations. Football was the most cited sport, with 19.7 and 26.3% of the total number of articles and citations, respectively. All sports yielded some scientific output, but 11 sports (biathlon, mountain biking, archery, diving, trampoline, skateboarding, skeleton, modern pentathlon, luge, bobsleigh, and curling) accumulated a total of fewer than 50 publications. While ice hockey is the most prominently represented winter sport in the scientific literature, winter sports overall have produced minor scientific output. Further analyses show a large scientific literature on team sports, particularly American professional sports (i.e., baseball, basketball, and ice hockey) and the importance of inclusion in the Olympic programme to increasing scientific interest in "recent" sports (i.e., triathlon and rugby sevens). We also found local/cultural influence on the occurrence of a sport in a particular "sport sciences" journal. Finally, the relative distribution of six main research topics (i.e., physiology, performance, training and testing, injuries and medicine, biomechanics, and psychology) was large across sports and reflected the specific performance factors of each sport.
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Affiliation(s)
- Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Franck Brocherie
- Laboratory Sport Expertise and Performance (EA 7370), French Institute of Sport, Paris, France
| | - Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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10
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Chandran A, Morris SN, D'Alonzo BA, Boltz AJ, Robison HJ, Collins CL. Epidemiology of Injuries in National Collegiate Athletic Association Women's Swimming and Diving: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:711-718. [PMID: 34280282 DOI: 10.4085/1062-6050-724-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years. BACKGROUND Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns. METHODS Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. RESULTS The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries. SUMMARY Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | | | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
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11
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Lagerstrand K, Baranto A, Hebelka H. Different disc characteristics between young elite skiers with diverse training histories revealed with a novel quantitative magnetic resonance imaging method. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2082-2089. [PMID: 34013394 DOI: 10.1007/s00586-021-06869-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/05/2021] [Accepted: 05/02/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate if there are differences in thoraco-lumbar disc characteristics between elite skiers and non-athletic controls as well as between different types of elite skiers, with diverse training histories, using a novel quantitative MRI method. METHODS The thoraco-lumbar spine of 58 elite skiers (age = 18.2 ± 1.1 years, 30 males) and 26 normally active controls (age = 16.4 ± 0.6 years, 9 males) was examined using T2w-MRI. Disc characteristics were compared quantitatively between groups using histogram and regional image analyses to determine delta peak and T2-values in five sub-regions. RESULTS A statistical difference in the delta peak value was found between skiers and controls (p <0.001), reflecting higher degree of disc degeneration. The histogram analysis also revealed that the type of training determines where and to what extent the changes occur. Alpine skiers displayed lumbar changes, while mogul skiers displayed changes also in the thoracic spine. Alpine skiers with diverse training dose differed in delta peak value (p = 0.005), where skiers with highest training dose displayed less changes. Regional T2-value differences were found in skiers with divergent training histories (p <0.05), reflecting differences in disc degeneration patterns, foremost within the dorsal annulus. CONCLUSION Differences in quantitative disc characteristics were found not only between elite skiers and non-athletic controls but also between subgroups of elite skiers with diverse training histories. The differences in the disc measures, reflecting tissue degradation, are likely related to type and intensity of the physical training. Future studies are encouraged to explore the relation between disc functionality, training history and pain to establish adequate prevention and rehabilitation programs.
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Affiliation(s)
- K Lagerstrand
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Medical Physics and Techniques, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - A Baranto
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - H Hebelka
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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12
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Zemková E, Kováčiková Z, Zapletalová L. Is There a Relationship Between Workload and Occurrence of Back Pain and Back Injuries in Athletes? Front Physiol 2020; 11:894. [PMID: 32792989 PMCID: PMC7394240 DOI: 10.3389/fphys.2020.00894] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 07/02/2020] [Indexed: 12/25/2022] Open
Abstract
The back is subjected to a great deal of strain in many sports. Up to 20% of all sports injuries involve an injury to the lower back or neck. Repetitive or high impact loads (e.g., running, gymnastics, skiing) and weight loading (e.g., weightlifting) affect the lower back. Rotation of the torso (e.g., golf, tennis) causes damage to both, the lumbar and thoracic spine. The cervical spine is most commonly injured in contact sports (e.g., boxing, football). One of the factors that increases the odds of injuries in athletes is excessive and rapid increases in training loads. In spite of currently emerging evidence on this issue, little is known about the balance between physiological loading on the spine and athletic performance, versus overloading and back pain and/or injury in athletes. This scoping review aims (i) to map the literature that addresses the association between the training load and the occurrence of back pain and/or injury, especially between the Acute:Chronic Workload Ratio (ACWR) and back problems in athletes of individual and team sports, and (ii) to identify gaps in existing literature and propose future research on this topic. A literature search of six electronic databases (i.e., MEDLINE, PubMed, Web of Science, SCOPUS, SportDiscus, and CINAHL) was conducted. A total of 48 research articles met the inclusion criteria. Findings identified that fatigue of the trunk muscles induced by excessive loading of the spine is one of the sources of back problems in athletes. In particular, high training volume and repetitive motions are responsible for the high prevalence rates. The most influential are biomechanical and physiological variations underlying the spine, though stress-related psychological factors should also be considered. However, limited evidence exists on the relationship between the ACWR and back pain or non-contact back injuries in athletes from individual and team sports. This may be due to insufficiently specified the acute and chronic time window that varies according to sport-specific schedule of competition and training. More research is therefore warranted to elucidate whether ACWR, among other factors, is able to identify workloads that could increase the risk of back problems in athletes.
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Affiliation(s)
- Erika Zemková
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sports, Comenius University in Bratislava, Bratislava, Slovakia.,Sports Technology Institute, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Bratislava, Slovakia.,Institute of Physiotherapy, Balneology and Medical Rehabilitation, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia
| | - Zuzana Kováčiková
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Ludmila Zapletalová
- Institute of Physiotherapy, Balneology and Medical Rehabilitation, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia
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13
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Wong JS, Lalam R, Cassar-Pullicino VN, Tyrrell PN, Singh J. Stress Injuries of the Spine in Sports. Semin Musculoskelet Radiol 2020; 24:262-276. [DOI: 10.1055/s-0040-1709484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractSpine sports stress injuries account for a significant amount of time loss at play in athletes, particularly if left unrecognized and allowed to progress. Spondylolysis makes up most of these stress injuries. This article focuses on spondylolysis, bringing together discussion from the literature on its pathomechanics and the different imaging modalities used in its diagnosis. Radiologists should be aware of the limitations and more importantly the roles of different imaging modalities in guiding and dictating the management of spondylolysis. Other stress-related injuries in the spine are also discussed including but not limited to pedicle fracture and apophyseal ring injury.
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Affiliation(s)
- Jenn Shiunn Wong
- Department of Radiology, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - Radhesh Lalam
- Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Victor N. Cassar-Pullicino
- Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | | | - Jaspreet Singh
- Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
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14
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Peterhans L, Fröhlich S, Stern C, Frey WO, Farshad M, Sutter R, Spörri J. High Rates of Overuse-Related Structural Abnormalities in the Lumbar Spine of Youth Competitive Alpine Skiers: A Cross-sectional MRI Study in 108 Athletes. Orthop J Sports Med 2020; 8:2325967120922554. [PMID: 32528992 PMCID: PMC7263161 DOI: 10.1177/2325967120922554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Alpine ski racing is known as a sport with unfavorable spinal loads and high rates of back overuse injuries at the elite level. However, little is known about overuse-related structural abnormalities occurring in the spine of youth athletes. Purpose: To describe the prevalence of abnormal magnetic resonance imaging (MRI) findings in the lumbar spine of youth competitive alpine skiers within the U16 category (under 16 years) with respect to sex, height growth, multifidus size, increasing age, and clinical relevance. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 108 youth competitive alpine skiers aged 13 to 15 years underwent MRI examination of the lumbar spine and measurement of the multifidus cross-sectional area on a 3-T Magnetom Prisma scanner. Complementary assessments included the determination of anthropometrics and biological maturation. Athletes were classified as symptomatic when, pursuant to the Oslo Sports Trauma Research Center questionnaire on health problems, at least 1 substantial back overuse–related health problem episode had been registered during the 12 months before the MRI examination. Results: Of the analyzed youth skiers, 37.0% presented with ≥1 abnormal MRI finding in the lumbar spine. The most prevalent findings in both sexes were disc degeneration (23.1%), Schmorl nodes (19.4%), end plate changes (10.2%), and pars interarticularis anomalies (10.2%); the pars interarticularis anomalies occurred exclusively in males. A smaller relative lumbar multifidus cross-sectional area was related to more frequent occurrence of disc protrusions (P = .018; R2 = 0.116) and end plate changes (P = .024; R2 = 0.096). Overall, the occurrence of abnormal MRI findings in the lumbar spine increased with age (P = .034; R2 = 0.054). Disc degeneration (particularly disc dehydration and disc protrusion) were significantly more prevalent in symptomatic versus asymptomatic athletes (P < .05 for all). Conclusion: As early as age 15 years or younger, competitive alpine skiers demonstrated distinct overuse-related structural abnormalities in the lumbar spine, with some of them being clinically relevant and restrictive of sports participation. As sex, height growth, multifidus size, and increasing age seem to play an important role for the occurrence of such abnormalities, considering these factors might be essential for prevention.
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Affiliation(s)
- Loris Peterhans
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Christoph Stern
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter O Frey
- University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Mazda Farshad
- Spine Surgery, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Spine Centre, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Reto Sutter
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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15
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Witwit W, Thoreson O, Swärd Aminoff A, Todd C, Jonasson P, Laxdal G, Hebelka H, Baranto A. Young football players have significantly more spinal changes on MRI compared to non‐athletes. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Wisam Witwit
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Radiology St. Joseph Mercy Oakland Hospital Pontiac Michigan
| | - Olof Thoreson
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Anna Swärd Aminoff
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Carl Todd
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Pàll Jonasson
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Orkuhúsið Orthopedic Clinic Reykjavik Iceland
| | | | - Hanna Hebelka
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Radiology Sahlgrenska University Hospital Gothenburg Sweden
| | - Adad Baranto
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Orthopaedics Sahlgrenska University Hospital Gothenburg Sweden
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16
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Abdalkader M, Guermazi A, Engebretsen L, Roemer FW, Jarraya M, Hayashi D, Crema MD, Mian AZ. MRI-detected spinal disc degenerative changes in athletes participating in the Rio de Janeiro 2016 Summer Olympics games. BMC Musculoskelet Disord 2020; 21:45. [PMID: 31959161 PMCID: PMC6972034 DOI: 10.1186/s12891-020-3057-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/09/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro. Methods Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann’s classification. Grade II and III were considered as mild, grade IV as moderate, and grade V as severe disc degeneration. Data were analyzed according to the location of the degenerative disc, type of sport, age-groups, and gender of the athletes. Results One hundred out of 11,274 athletes underwent 108 spine MRI’s (21 C, 6 T, and 81 L) (53% Females (F), 47% Males (M)). The frequency of DDD was 40% (42% F, 58% M) over the entire spine (28% mild, 9% moderate and 3% severe). There were 58% (12%F, 88%M) of the cervical spine discs that showed some degree of degeneration (44% mild, 13.5% moderate and 1% severe). Athletics, Boxing, and Swimming were the sports most affected by DDD in the Cs. There were 12.5% of the thoracic discs that showed some degree of degeneration, all were mild DDD and were exclusively seen in female athletes. There were 39% (53% F, 47% M) of the lumbar discs with DDD (26% mild, 9% moderate, and 4% severe). Conclusion Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines. Recognition of these conditions is important to develop training techniques that may minimize the development of degenerative pathology of the spine.
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Affiliation(s)
- Mohamad Abdalkader
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland.,Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Orthopedic Surgery, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Mohamed Jarraya
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Department of Radiology, Brigham and Woman Hospital, Boston, MA, USA
| | - Daichi Hayashi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - Michel D Crema
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA.,Institute of Sports Imaging, French National Institute of Sports (INSEP), Paris, France
| | - Asim Z Mian
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA, 02118, USA
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17
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Sundell C, Bergström E, Larsén K. Low back pain and associated disability in Swedish adolescents. Scand J Med Sci Sports 2019; 29:393-399. [PMID: 30421820 PMCID: PMC7379313 DOI: 10.1111/sms.13335] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/28/2018] [Accepted: 11/05/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Low back pain (LBP) defined as ache or pain in the lowest part of the back is a common experience among people all over the world. The lifetime prevalence is reported to be as high as 84%, and the prevalence of LBP seems to be almost the same among adolescents as among adults. The risk for having LBP later in life if you experienced LBP in adolescence is high. MATERIAL AND METHODS In this cross-sectional study of 2550 students aged 16-20 years, we used the Standardized Nordic Questionnaire for the analysis of musculo-skeletal symptoms. We studied gender difference, prevalence, and disability of Low back pain. We also studied differences in LBP in adolescent athletes depending on hours spent on sports or physical activity. RESULTS Significantly, more girls than boys had had problems sometimes during their life. Those who participated in sports reported LBP to a significantly higher extent than those who were physically inactive in their spare time. Gender and spare time sports were important risk factors for getting LBP some time in life. There was a higher risk for girls to have low back pain problems more than 30 days or daily the last year if they had had low back pain some time earlier in life. CONCLUSION This study shows that low back pain (LBP) is common among Swedish adolescents, more common among girls than boys. High sport activity was associated with the risk of having LBP, length of time with LBP, and disability due to LBP.
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Affiliation(s)
- Claes‐Göran Sundell
- Department of Community Medicine and RehabilitationUmeå UniversityUmeåSweden
| | - Erik Bergström
- Department of Clinical Science, PediatricsUmeå UniversityUmeåSweden
| | - Karin Larsén
- Department of Surgery and Perioperative Sciences, Clinical PhysiologyUmeå UniversityUmeåSweden
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18
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Farahbakhsh F, Rostami M, Noormohammadpour P, Mehraki Zade A, Hassanmirazaei B, Faghih Jouibari M, Kordi R, Kennedy DJ. Prevalence of low back pain among athletes: A systematic review. J Back Musculoskelet Rehabil 2019; 31:901-916. [PMID: 29945342 DOI: 10.3233/bmr-170941] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The prevalence of low back pain (LBP) in athletes across a variety of time frames and sports is not known. OBJECTIVES To systematically collate and appraise studies on the prevalence of LBP in athletes and stratify by point, one year and life-time prevalence. METHODS A comprehensive search was conducted in February 2016. The following sources were individually searched: PubMed (1950 to present), Ovid SP Medline (1950 to present), ISI (1982 to present) and Google Scholar; Surveys were included if they aimed to report the prevalence of LBP amongst the athletes. Two reviewers independently evaluated the methodological quality of the studies. RESULTS The literature search generated 4379 records. Title and/or abstracts were reviewed by two investigators and full-texts of 201 relevant articles were selected for further evaluation. Studies were included if they reported the prevalence of LBP in an athletic population (any level of participation in sports and any age range) and were written in English. Furthermore, to adequately assess the prevalence rate, studies had to report the number of athletes with LBP as a percentage of the total number of athletes. Studies that did not contain necessary data to calculate prevalence rate including case reports and non-original studies were excluded and 41 studies entered the bias assessment step. A bias assessment was applied to the methodology of 41 studies, and 36 with low to moderate risk for bias were included in this review. LBP in athletes was shown to have a point prevalence ranging from 10% to 67%, a one-year prevalence ranging from 17% to 94%, and a life-time prevalence ranging from 33% to 84%. The highest prevalence of LBP was found among skiers, floorball players and rowers and the lowest were found in shooters, golfers and triathletes. CONCLUSION Like general population, LBP is quite prevalent among athletes. There is a lack of sound data on the prevalence and mechanism of LBP in some popular sports such as volleyball, swimming and track and field. The lack of standardization of research methods and outcome measurement tools are significant problems in literature. Researchers need to use standard and internationally acceptable definitions for LBP and related functional disability. Investigators are encouraged to conduct epidemiologic studies, along with search for possible mechanism of LBP, by recruitment of large sample population of the athletes who are selected through randomization of the national population and adopt recent recommendations for a standard definition of LBP.
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Affiliation(s)
- Farzin Farahbakhsh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rostami
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Noormohammadpour
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mehraki Zade
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Hassanmirazaei
- Iran Football Medical Assessment and Rehabilitation Center (IFMARC), Tehran, Iran.,Department of Sport and Exercise Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - David J Kennedy
- Department of Orthopaedics, Stanford University, Stanford Orthopedics, Redwood City, CA, USA
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Yamashita K, Sugiura K, Manabe H, Ishihama Y, Tezuka F, Takata Y, Sakai T, Maeda T, Sairyo K. Accurate diagnosis of low back pain in adult elite athletes. THE JOURNAL OF MEDICAL INVESTIGATION 2019; 66:252-257. [DOI: 10.2152/jmi.66.252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kazuta Yamashita
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Kosuke Sugiura
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Hiroaki Manabe
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Yoshihiro Ishihama
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Fumitake Tezuka
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Yoichiro Takata
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Toshinori Sakai
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Toru Maeda
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
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20
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Modic changes-Their associations with low back pain and activity limitation: A systematic literature review and meta-analysis. PLoS One 2018; 13:e0200677. [PMID: 30067777 PMCID: PMC6070210 DOI: 10.1371/journal.pone.0200677] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 07/02/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous systematic reviews have reported positive associations between Modic changes (MCs) and low back pain (LBP), but due to their narrow scope and new primary studies, there is a need for a comprehensive systematic review. Our objectives were to investigate if MCs are associated with non-specific LBP and/or activity limitation and if such associations are modified by other factors. METHODS A protocol for this review was registered at PROSPERO prior to commencing the work (PROSPERO record: CRD42015017350). The MEDLINE, CINAHL and EMBASE databases were searched for relevant studies from first record to June 15th 2016. Prospective or retrospective cross-sectional cohort studies and case-control studies including people of all ages from general, working and clinical study populations were eligible for inclusion. Risk of bias assessment and data extraction for associations and potential modifiers were completed independently by pairs of reviewers. Meta-analysis was performed for homogeneous studies and presented as odds ratios (OR) with 95% CI. RESULTS In all, 5210 citations were identified and 31 studies were included. One study had low risk of bias. Fifteen studies (48%) reported statistically significant positive associations between MCs and LBP and one study found a statistically significant negative association. Meta-analysis performed for studies using concordant pain with provocative discography as the clinical outcome resulted in an OR of 4.01 (1.52-10.61). One of seven studies reported a statistically significant positive association between MCs and activity limitation. Lumbar disc level and disc degeneration were found to modify the association between MCs and LBP. CONCLUSIONS The results from this comprehensive systematic review indicate that the associations between MCs and LBP-related outcomes are inconsistent. The high risk of bias and the heterogeneity in terms of study samples, clinical outcomes and prevalence estimates of MCs and LBP may explain these findings. It is likely that new studies with low risk of bias will affect the direction and strength of these associations.
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21
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Todd C, Aminoff AS, Agnvall C, Thoreson O, Swärd L, Karlsson J, Baranto A. No difference in prevalence of spine and hip pain in young Elite skiers. Knee Surg Sports Traumatol Arthrosc 2018; 26:1959-1965. [PMID: 29204863 PMCID: PMC6061433 DOI: 10.1007/s00167-017-4733-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/25/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the prevalence between back and hip pain in young Elite skiers. METHODS Sample group (n = 102), consisted of young Elite skiers (n = 75) and age-matched non-athletes (n = 27), all completed a three-part back and hip pain questionnaire, Oswestry Disability Index and EuroQoL to evaluate general health, activity level, back and hip pain prevalence. RESULTS No significant differences were shown for lifetime prevalence of back pain in the skiers (50%) compared with controls (44%) (n.s.). Duration of back pain for the skiers showed (30%) > 1 year, whilst (46%) > 5 years. A significant difference was shown with increased Visual Analogue Scale back pain levels for skiers 5.3 (SD 3.1) compared with controls 2.4 (SD 1.9, p = 0.025). No significant differences were shown for lifetime prevalence of hip pain in skiers (21%) compared with controls (8%) (n.s.). CONCLUSION Young Elite skiers are shown not to have increased lifetime prevalence for back and hip pain compared with a non-athletic control group. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden.
- The Carl Todd Clinic, 5 Pickwick Park, Park Lane, Corsham, SN13 0HN, UK.
| | - Anna Swärd Aminoff
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Cecilia Agnvall
- Sportsmedicine Åre and Åre Ski High School, Göthenburg, Sweden
| | - Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Leif Swärd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Göthenburg, Sweden
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22
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Witwit WA, Kovac P, Sward A, Agnvall C, Todd C, Thoreson O, Hebelka H, Baranto A. Disc degeneration on MRI is more prevalent in young elite skiers compared to controls. Knee Surg Sports Traumatol Arthrosc 2018; 26:325-332. [PMID: 28409199 PMCID: PMC5754419 DOI: 10.1007/s00167-017-4545-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/07/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE Evidence-based facts regarding spine abnormalities and back pain are needed in order to develop rehabilitation programs and prevent spine injuries in young skiers. The aim therefore is to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain, as well as the association between them, in young skiers compared to non-athletes. METHODS Seventy-five young elite alpine and mogul skiers, age range 16-20 years, were compared with 27 non-athletic controls. All subjects underwent spinal MRI and answered back pain questionnaires. RESULTS Fifty-six percent of skiers had at least one disc Pfirrmann grade ≥3 compared to 30% of controls (p = 0.027). Schmorl's nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared to controls (0%) (p < 0.001). When all parameters were combined together, skiers had significantly higher rate of radiological changes than controls, 82% compared to 54% (p = 0.007). The mean number of discs with Pfirrmann grade ≥3 was 1.1 per individual in skiers (median 1, range 0-6) versus 0.6 in controls (median 0, range 0-3). There was no significant difference in lifetime prevalence of back pain between skiers (50%) and controls (44%) (n.s.). MRI abnormalities in skiers did not correlate with lifetime prevalence of back pain. Skiers had a better health perception than controls (p = 0.026). CONCLUSION Alpine skiers have more degenerative disc changes compared to non-athletes, but these changes do not correlate with the lifetime prevalence of back pain. Lifetime prevalence of back pain is not significantly different between the groups; however, skiers report more severe pain on VAS score. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Wisam A. Witwit
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Peter Kovac
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Anna Sward
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cecilia Agnvall
- Sportsmedicine Åre and Åre Ski High School, Ostersund, Sweden
| | - Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanna Hebelka
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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23
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Kędra A, Kolwicz-Gańko A, Kędra P, Bochenek A, Czaprowski D. Back pain in physically inactive students compared to physical education students with a high and average level of physical activity studying in Poland. BMC Musculoskelet Disord 2017; 18:501. [PMID: 29183373 PMCID: PMC5706389 DOI: 10.1186/s12891-017-1858-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was (1) to characterise back pain in physically inactive students as well as in trained (with a high level of physical activity) and untrained (with an average level of physical activity) physical education (PE) students and (2) to find out whether there exist differences regarding the declared incidence of back pain (within the last 12 months) between physically inactive students and PE students as well as between trained (with a high level of physical activity) and untrained (with an average level of physical activity) PE students. METHODS The study included 1321 1st-, 2nd- and 3rd-year students (full-time bachelor degree course) of Physical Education, Physiotherapy, Pedagogy as well as Tourism and Recreation from 4 universities in Poland. A questionnaire prepared by the authors was applied as a research tool. The 10-point Visual Analogue Scale (VAS) was used to assess pain intensity. Prior to the study, the reliability of the questionnaire was assessed by conducting it on the group of 20 participants twice with a shorter interval. No significant differences between the results obtained in the two surveys were revealed (p < 0.05). RESULTS In the group of 1311 study participants, 927 (70.7%) respondents declared having experienced back pain within the last 12 months. Physically inactive students declared back pain frequency similar to the frequency declared by their counterparts studying physical education (p > 0.05). Back pain was more common in the group of trained students than among untrained individuals (p < 0.05). Back pain was mainly located in the lumbar spine. CONCLUSIONS A frequent occurrence of back pain (70.7%) was noted in the examined groups of students. The percentage of students declaring back pain increased in the course of studies (p < 0.05) and, according to the students' declarations, it was located mainly in the lumbar spine. No significant differences regarding the incidence of back pain were found between physically inactive students and physical education students (p > 0.05). The trained students declared back pain more often than their untrained counterparts (p < 0.05).
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Affiliation(s)
- Agnieszka Kędra
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty of Physical Education and Sport, ul. Akademicka 2, 21-500, Biala Podlaska, Poland.
| | - Aleksandra Kolwicz-Gańko
- Jozef Rusiecki University College in Olsztyn, Faculty of Physiotherapy, ul. Bydgoska 33, 10-243, Olsztyn, Poland
| | - Przemysław Kędra
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty of Tourism and Sport, ul. Akademicka 2, 21-500, Biala Podlaska, Poland
| | - Anna Bochenek
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty of Physical Education and Sport, ul. Akademicka 2, 21-500, Biala Podlaska, Poland
| | - Dariusz Czaprowski
- Jozef Rusiecki University College in Olsztyn, Faculty of Physiotherapy, ul. Bydgoska 33, 10-243, Olsztyn, Poland
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24
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Trzciński D, Myszka A, Piontek J. High stature and body mass might affect the occurrence of Schmorl’s nodes. ANTHROPOLOGICAL REVIEW 2017. [DOI: 10.1515/anre-2017-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Schmorl’s nodes are vertical herniation of intervertebral discs into the body of neighbouring vertebral endplate. Notwithstanding extensive studies, no consensus has been reached in the subject of their possible etiology. It is hypothesized that physical stress, trauma and high axial loading are the key factors in the occurrence of this pathology. The main objective of the current work is to reevaluate the relationship between stature and body mass and Schmorl’s nodes. For this purpose, skeletal samples from Lithuania (44 males and 19 females) and Poland (97 males and 60 females) were used. The study confirmed that Schmorl’s nodes are age-independent, and more frequent in males (12.63% on the superior and 19.32% on the inferior surface of vertebrae) than in females (6.23% and 12.29% respectively). Obtained results also suggest that high stature (e.g. Spearmann correlation for superior: R=0.20 p=0.017, and inferior: R=0.31 p=0.000 surface of vertebrae) and body mass (R=0.25, p=0.002 and R=0.32, p<0.001, respectively) are factors that increase the risk of Schmorl’s nodes. Authors hypothesize that the afore-mentioned body size traits alter loadings acting on intervertebral discs, and rigidity of the spine.
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Affiliation(s)
- Dawid Trzciński
- Department of Human Evolutionary Biology, Institute of Anthropology , Adam Mickiewicz University in Poznań , Poland
| | - Anna Myszka
- Department of Human Evolutionary Biology, Institute of Anthropology , Adam Mickiewicz University in Poznań , Poland
| | - Janusz Piontek
- Department of Human Evolutionary Biology, Institute of Anthropology , Adam Mickiewicz University in Poznań , Poland
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25
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Abstract
Competitive diving is a sport that has evolved over time to become an admired present-day aquatic sport, especially in the Olympic setting. Despite its popularity, sparse research has been written as it applies to our understanding of competitive diving injuries. This article attempts to discuss common principles of competitive diving as they relate to the sport, especially as it relates to the extreme physical forces encountered by the diver and also the repetitive nature of diving. Next, these principles will be applied in the context of musculoskeletal and medical diving specific injuries.
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Affiliation(s)
- Nathaniel S Jones
- 1Department of Orthopaedic Surgery and Rehabilitation and Department of Family Medicine, Loyola University Medical Center Maywood, Chicago, IL
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26
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Thoreson O, Ekström L, Hansson HA, Todd C, Witwit W, Swärd Aminoff A, Jonasson P, Baranto A. The effect of repetitive flexion and extension fatigue loading on the young porcine lumbar spine, a feasibility study of MRI and histological analyses. J Exp Orthop 2017; 4:16. [PMID: 28500483 PMCID: PMC5429315 DOI: 10.1186/s40634-017-0091-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 05/05/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The biomechanical mechanisms of failure of FSUs have been studied but the correlation of repetitive flexion and extension loadings to the initial phase of fatigue in young FSUs are still not known. The purpose of the study was to examine the fatigue results of low magnitude repetitive flexion and extension loading on porcine lumbar Functional Spinal Units (FSUs) with Magnetic Resonance Imaging (MRI) and histology. METHODS Eight FSUs were subject to repetitive pivot flexion and eight to extension loading by a protocol of 20 000 cycles at 1 Hz with a load of 700 N. All loaded FSUs (N = 16) were examined with MRI and histology post loading. Three FSUs were examined with MRI as controls. Further three FSUs were non loaded histology controls. RESULTS Fifteen (94%) of the loaded FSUs have decreased MRI signal in the growth zone of the superior vertebra and 12 (75%) in the inferior vertebrae. Fourteen (88%) FSUs have increased signal in the superior vertebral body. Fourteen (88%) FSUs have a reduced signal in all or any endplate. The histology morphometry displayed that the unstained parts of the epiphyseal growth zone were larger among the loaded FSUs (mean 29% vs 4%) and that the chondrocytes in the endplate and growth zones had abnormal structure and deformed extracellular matrix. CONCLUSION Repetitive loading of young porcine FSUs in both extension and flexion causes concurrent MRI and histological changes in the growth zones and endplates, which could be a first sign of fatigue and an explanation for the disc, apophyseal and growth zone injuries seen among adolescent athletes.
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Affiliation(s)
- Olof Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Orthopaedics, Sahlgrenska University Hospital/Sahlgrenska, SE-413 45, Gothenburg, Sweden.
| | - Lars Ekström
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans-Arne Hansson
- Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,The Carl Todd Clinic, 5 Pickwick Park, Park Lane, Corsham, SN13 0HN, UK
| | - Wisam Witwit
- Department of Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Swärd Aminoff
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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27
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Abstract
A 10-year-old girl with a 2-week history of atraumatic back pain presented to the emergency department with difficulty ambulating and a history of 2 episodes of urinary incontinence in the past week. Her examination was significant for pain with movement, tenderness to palpation in the lower thoracic spine, and no neurological deficits. In this case, the child was found to have a Schmorl node at T8 in the superior aspect of the vertebral body. Schmorl nodes are protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent that is more commonly reported in the adult population. In this child, radiographic findings were normal, with no evidence of the Schmorl node. The diagnosis was made by magnetic resonance imaging. The child's symptoms significantly resolved with ibuprofen anti-inflammatory therapy. In children with atraumatic back pain lasting greater than 2 weeks with a sudden increase in severity and associated with a neurological deficit, advanced imaging is strongly recommended.
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28
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Takatalo J, Karppinen J, Näyhä S, Taimela S, Niinimäki J, Blanco Sequeiros R, Tammelin T, Auvinen J, Tervonen O. Association between adolescent sport activities and lumbar disk degeneration among young adults. Scand J Med Sci Sports 2017; 27:1993-2001. [DOI: 10.1111/sms.12840] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 12/16/2022]
Affiliation(s)
- J. Takatalo
- Medical Research Center Oulu; University of Oulu and Oulu University Hospital; Oulu Finland
- Center for Life Course Health Research; University of Oulu; Oulu Finland
| | - J. Karppinen
- Medical Research Center Oulu; University of Oulu and Oulu University Hospital; Oulu Finland
- Center for Life Course Health Research; University of Oulu; Oulu Finland
- Finnish Institute of Occupational Health; Oulu Finland
| | - S. Näyhä
- Center for Environmental and Respiratory Health Research; University of Oulu; Oulu Finland
| | - S. Taimela
- Department of Orthopedics and Traumatology; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - J. Niinimäki
- Research Unit of Medical Imaging, Physics and Technology; University of Oulu; Oulu Finland
| | - R. Blanco Sequeiros
- Research Unit of Medical Imaging, Physics and Technology; University of Oulu; Oulu Finland
| | - T. Tammelin
- LIKES Research Center for Sport and Health Sciences; Jyväskylä Finland
| | - J. Auvinen
- Medical Research Center Oulu; University of Oulu and Oulu University Hospital; Oulu Finland
- Center for Life Course Health Research; University of Oulu; Oulu Finland
| | - O. Tervonen
- Research Unit of Medical Imaging, Physics and Technology; University of Oulu; Oulu Finland
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29
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The usefulness of radiological grading scales to predict pain intensity, functional impairment, and health-related quality of life after surgery for lumbar degenerative disc disease. Acta Neurochir (Wien) 2017; 159:271-279. [PMID: 27873048 DOI: 10.1007/s00701-016-3030-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 11/09/2016] [Indexed: 01/06/2023]
Abstract
PURPOSE The goal of this study is to determine the relationship of radiological grading scales of lumbar degenerative disc disease (DDD) with postoperative pain intensity, functional impairment, and health-related quality of life (HRQoL). METHODS Response to surgical treatment at 6 weeks (W6) on the visual analogue scale (VAS) for back and leg pain, Oswestry-Disability (ODI) and Roland-Morris Disability Index (RMDI), Timed Up and Go (TUG) test, EuroQol (EQ) 5D, and Short-Form Health-Survey (SF-12) physical component summary (PCS) was compared between patients with different Modic (MOD) and Pfirrmann (PFI) grades. Longitudinal outcomes at day 3 (D3), W6, 6 months (M6), and 1 year (Y1) were compared. RESULTS The study included 338 patients (mean age, 58.6 years), of which n = 202 (59.8%) had MOD 1-3 and n = 217 (64.2%) PFI 4-5 changes. Patients with MOD 1-3 were as likely as patients without MOD changes to be treatment-responders at W6 in terms of VAS leg pain, ODI, RMDI, TUG, EQ5D, and SF-12 PCS. Similarly, patients with PFI 4-5 were as likely as patients with PFI 1-3 changes to be treatment-responders at W6. Longitudinal outcomes were similar at D3, W6, M6, and Y1 between patients with and without MOD changes. Patients with PFI 4-5 fared similar to those with PFI 1-3 except for inferior HRQoL on the SF-12 PCS metric at Y1. CONCLUSIONS There was no distinct relationship between commonly used radiological grading scales of lumbar DDD with clinical outcome. Therefore, no prognosis should be made on the grounds of preoperative PFI and MOD classifications for patients undergoing spine surgery for lumbar DDD.
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30
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Heidari J, Hasenbring M, Kleinert J, Kellmann M. Stress-related psychological factors for back pain among athletes: Important topic with scarce evidence. Eur J Sport Sci 2016; 17:351-359. [PMID: 27838957 DOI: 10.1080/17461391.2016.1252429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Health issues represent a frequent problem for athletes, as this particular demographic is repeatedly confronted with physically and psychologically stressful situations. Back pain (BP) materialises as comparatively common health problem being regarded as functionally limiting and psychologically straining burden for athletes. According to research conducted on athletes with BP, biomechanical and physiological mechanisms emerge as influential, whereas stress-related psychological factors appear to be neglected. For athletic injuries, the essential impact of psychological processes on injury occurrence and return from injury has already been corroborated. Hence, the aim of this literature review is to: (1) introduce a conceptual differentiation between injuries and BP; (2) summarise the results obtained regarding stress-related psychological aspects for injuries; and (3) connect the injury research to the state-of-the-art evidence regarding stress-related factors for BP among athletes. A distinction between injuries and BP could be established based on previous definitions, despite the fact that a considerable overlap between both concepts prevails. Injuries can be attributed to a physical origin, whereas BP frequently lacks this physical criterion. For BP, our enquiry yielded four studies including psychological measures of stress - with two studies specifically examining the association between BP and psychological stress among athletes longitudinally. Abundant findings from the general population support the importance of considering psychological and specifically stress-related factors in BP prevention and rehabilitation, but evidence related to the athletic field remains elusive. Further scientific investigations with a wider methodological approach are needed to deepen the knowledge about the crucial relationship between psychological stress, BP, and athletes.
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Affiliation(s)
- Jahan Heidari
- a Unit of Sport Psychology, Faculty of Sport Science , Ruhr University Bochum , Germany
| | - Monika Hasenbring
- b Department of Medical Psychology and Medical Sociology , Ruhr University Bochum , Germany
| | - Jens Kleinert
- c Department of Health and Social Psychology , German Sport University , Cologne , Germany
| | - Michael Kellmann
- a Unit of Sport Psychology, Faculty of Sport Science , Ruhr University Bochum , Germany.,d School of Human Movement and Nutrition Sciences , The University of Queensland , St Lucia , Australia
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31
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Abstract
OBJECTIVE Young athletes not uncommonly complain of back pain. Many patient-reported outcome measures are used to evaluate back pain, but none have been designed specifically to assess young, athletic patients. The Micheli Functional Scale (MFS) was developed to measure impairment due to back pain in this population. This study examined the reliability, validity, and responsiveness of the MFS used in routine clinical assessments. DESIGN Retrospective Cohort Study. SETTING Pediatric sports medicine specialty clinic. INTERVENTIONS Patients presenting with a chief concern of back pain over 1 year (n = 93) were enrolled in the study. Study subjects were administered the MFS and the revised Oswestry Disability Index (ODI) at each visit as part of routine clinical care. MAIN OUTCOME MEASURES Reliability of the MFS was assessed by calculating Cronbach alpha (α). Concurrent validity was determined by measuring Spearman coefficient (rs) for the correlations between the MFS and ODI. RESULTS Ninety-three patients (50 female, 43 male), mean age 14.1 ± 2.3 years were enrolled and 242 clinic encounters (71 initial/171 follow-up visits) analyzed. The MFS had acceptable item reliability (α = 0.786) and concurrent validity: the MFS and ODI were strongly and positively correlated [rs = 0.824 (P < 0.001)]. The MFS was comparatively more reliable and valid when used in follow-up versus initial visits. CONCLUSIONS The MFS is a reliable and valid instrument in assessing young athletes with back pain, although the instrument has different performance characteristics on initial versus follow-up assessments. Further work is needed to refine the MFS to enhance the instrument's reliability, validity, and responsiveness. CLINICAL RELEVANCE This study provides further insight into an outcome measure of clinical use in evaluating young athletes with back pain.
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32
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Thoreson O, Kovac P, Swärd A, Agnvall C, Todd C, Baranto A. Back pain and MRI changes in the thoraco-lumbar spine of young elite Mogul skiers. Scand J Med Sci Sports 2016; 27:983-989. [PMID: 27367529 DOI: 10.1111/sms.12710] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/30/2022]
Abstract
Athletes have a higher prevalence of LBP and spinal abnormalities on Magnetic Resonance Imaging (MRI) compared to non-athletes. The objective of this study was to investigate the amount of spinal MRI abnormalities and the lifetime prevalence of low back pain (LBP) in 16 young elite Mogul skiers compared to 28 non-athletes in the corresponding age in a cross-sectional design. LBP was assessed by a questionnaire consisting of a part regarding previous or present back pain, the Oswestry disability index, and the EuroQol questionnaire. MRI examinations from Th5 to sacrum were conducted to evaluate spinal pathologies. The Mogul skiers had significantly more MRI abnormalities (like disc degeneration) in mean (7.25 vs 3.78, P < 0.023) compared to the controls. No significant difference was seen regarding the lifetime LBP prevalence between the groups (50% vs 42%, P = 0.555). No correlation could be found between disc degeneration and back pain in this study. Young elite Mogul skiers, compared to an age-matched control group of non-athletes, have an increased risk of developing spinal abnormalities potentially due to the different high loads that they are subjected to in their sport. Future relationship between the MRI abnormalities and LBP cannot be verified by this study design.
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Affiliation(s)
- O Thoreson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P Kovac
- Radiology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A Swärd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.,Sportsmedicine Åre and Åre Ski High School, Åre, Sweden
| | - C Agnvall
- Sportsmedicine Åre and Åre Ski High School, Åre, Sweden
| | - C Todd
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.,The Carl Todd Clinic, Corsham, UK
| | - A Baranto
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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Prien A, Mountjoy M, Miller J, Boyd K, van den Hoogenband C, Gerrard D, Cherif MY, Lu Y, Nanousis K, Ortiz Liscano EI, Shahpar FM, Junge A. Injury and illness in aquatic sport: how high is the risk? A comparison of results from three FINA World Championships. Br J Sports Med 2016; 51:277-282. [PMID: 27313172 DOI: 10.1136/bjsports-2016-096075] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/24/2016] [Accepted: 05/31/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Epidemiological information on injury/illness is required to develop effective injury prevention strategies. AIM To assess the frequency and characteristics of injuries/illnesses (1) in the 4 weeks prior to and (2) during the Fédération Internationale de Natation (FINA) World Championships 2015 compared with 2013 and 2009. METHOD (1) Athletes answered a retrospective questionnaire, and (2) the medical staff reported injuries/illnesses prospectively during the championships. RESULTS (1) A quarter of responding athletes reported symptoms in the 4 weeks prior to the championships. More than half of all affected athletes presented with substantial severity, 80% took medication, 70% had overuse injuries and 30% did not modify their training regime despite symptoms. At the start of the championships, 70% of affected participants were still symptomatic. (2) During the championships, injury and illness incidence was 12.9 per 100 athletes. The most common injuries were shoulder sprains (5.7%) and muscle cramps of the lower back (5.7%). The most common illnesses were infections of the respiratory (33.9%) and gastrointestinal tract (23.5%). Risk factors included discipline and age, but not gender. Incidence was highest in athletes competing in high diving (HD), water polo (WP) and diving (DIV) for injuries, and WP and swimming (SW) for illnesses. The significantly higher incidence of injuries and illnesses at the FINA World Championships 2015 compared with 2013 and 2009 was most probably due to a similarly improved response rate of the medical staff. CONCLUSIONS In aquatic sports, surveillance and health promotion should focus on prevention of out-of-competition overuse injuries and athlete education.
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Affiliation(s)
| | - Margo Mountjoy
- Department of Family Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.,Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland.,International Olympic Committee (IOC), Lausanne, Switzerland
| | - Jim Miller
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland.,Medicine Department, University of Virginia, Charlottesville, and Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kevin Boyd
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | - Cees van den Hoogenband
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | - David Gerrard
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | - Mohamed Yahia Cherif
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | - Yifan Lu
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | - Kyriakos Nanousis
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | | | - Farhad Moradi Shahpar
- Fédération Internationale de Natation (FINA) Sports Medicine Committee, Lausanne, Switzerland
| | - Astrid Junge
- Medical School Hamburg (MSH), Hamburg, Germany.,FIFA Medical Assessment and Research Centre (F-MARC), Zurich, Switzerland.,Schulthess Clinic, Zurich, Switzerland
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34
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Müller J, Müller S, Stoll J, Fröhlich K, Otto C, Mayer F. Back pain prevalence in adolescent athletes. Scand J Med Sci Sports 2016; 27:448-454. [DOI: 10.1111/sms.12664] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- J. Müller
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - S. Müller
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - J. Stoll
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - K. Fröhlich
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - C. Otto
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
| | - F. Mayer
- Sports Medicine & Sports Orthopaedics; University Outpatient Clinic; University of Potsdam; Potsdam Germany
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Naghdi S, Ansari NN, Yazdanpanah M, Feise RJ, Fakhari Z. The validity and reliability of the functional rating index for evaluating low back pain in athletes. Scand J Med Sci Sports 2015; 25:840-5. [PMID: 25809588 DOI: 10.1111/sms.12447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 02/05/2023]
Abstract
The purpose of the present study was to determine the reliability and validity of the Functional Rating Index (FRI) for athletes with low back pain (LBP). In this cross-sectional and prospective cohort study, the validated Persian FRI (PFRI) was tested in 100 athletes with LBP and 50 healthy athletes. From the athletes with LBP, data were recollected among 50 athletes with a 7-day interval to examine test-retest reliability. The content validity was excellent, and the athletes with LBP responded to all items with no floor or ceiling effects. The discriminative validity was supported by a statistically significant difference in PFRI total scores between the athletes with LBP and healthy athletes. The concurrent criterion validity was good (rho = 0.72). The construct, convergent validity was good (r = 0.83). The internal consistency reliability estimate was high (Cronbach's α = 0.90). Factor analysis demonstrated a single-factor structure with an explained variance of 52.22%. The test-retest reliability was excellent, indicated by an ICC(agreement) of 0.97, and the agreement observed in the Bland and Altman plot demonstrated no systematic bias. It is concluded that the PFRI has excellent psychometric properties for assessing athletes with LBP.
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Affiliation(s)
- S Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - N Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - M Yazdanpanah
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - R J Feise
- Institute of Evidence-Based Chiropractic, Scottsdale, Arizona, USA
| | - Z Fakhari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Santana J, Fregel R, Lightfoot E, Morales J, Alamón M, Guillén J, Moreno M, Rodríguez A. The early colonial atlantic world: New insights on the African Diaspora from isotopic and ancient DNA analyses of a multiethnic 15th-17th century burial population from the Canary Islands, Spain. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:300-12. [DOI: 10.1002/ajpa.22879] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 09/09/2015] [Accepted: 09/21/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Jonathan Santana
- State University of Peninsula de Santa Elena; La Libertad Ecuador
- G.I. Tarha. Deparment of Historical Sciences; Las Palmas de Gran Canaria Spain
| | - Rosa Fregel
- Department of Genetics; Stanford University; Stanford United States of America
| | | | | | | | | | | | - Amelia Rodríguez
- G.I. Tarha. Deparment of Historical Sciences; Las Palmas de Gran Canaria Spain
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Betsch M, Furian T, Quack V, Rath B, Wild M, Rapp W. Effects of athletic training on the spinal curvature in child athletes. Res Sports Med 2015; 23:190-202. [PMID: 25669887 DOI: 10.1080/15438627.2015.1005297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to examine the spinal posture in young athletes depending on training intensity. The spinal curvature of 245 children, age 8 to 12 years, was evaluated using rasterstereography. According to their weekly training time group 1 (mean age: 9.54 ± 1.18) did 2-6, group 2 (mean age: 9.49 ± 0.87) did 6-15 and group 3 (mean age: 9.68 ± 0.87) did over 15 hours of training. Group 1 had a significantly higher weight (p = 0.028) (33.86 ± 7. kg) than those of the more active groups (30.67 ± 6.49 kg and 29.46 ± 4.33 kg). The mean kyphotic angle decreased significantly (p < 0.001) with the amount of training per week from 46.86 ± 8.2° in group 1 to 40.08 ± 8° in group 3. We also found a significant decrease (p = 0.047) in lateral deviation with training from group 1 with 5.3 ± 3 mm to group 2 with 4.1 ± 1.6 mm. The results of our study suggest that higher training time can be associated with lower weight and decreases in thoracic kyphosis and lateral deviation of the spine.
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Affiliation(s)
- Marcel Betsch
- a Department of Orthopaedics , University Hospital RWTH Aachen , Germany
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38
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Kerr ZY, Baugh CM, Hibberd EE, Snook EM, Hayden R, Dompier TP. Epidemiology of National Collegiate Athletic Association men's and women's swimming and diving injuries from 2009/2010 to 2013/2014. Br J Sports Med 2015; 49:465-71. [PMID: 25633831 DOI: 10.1136/bjsports-2014-094423] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent injury data for collegiate-level swimming and diving are limited. This study describes the epidemiology of men's and women's swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010 to 2013/2014 academic years. METHODS Injuries and athlete-exposure (AE) data reported within 9 men's and 13 women's swimming and diving programmes were analysed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis and mechanism were reported with 95% CIs. RESULTS The ISP captured 149 and 208 injuries for men's and women's swimming and diving, respectively, leading to injury rates of 1.54/1000 and 1.71/1000 AEs. Among females, divers had a higher injury rate (2.49/1000 AEs) than swimmers (1.63/1000 AEs; IRR=1.53; 95% CI 1.07 to 2.19). Injury rates for male divers (1.94/1000 AEs) and swimmers (1.48/1000 AEs) did not differ (IRR=1.33; 95% CI 0.85 to 2.31). Most injuries occurred to the shoulder, resulted in strains and were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000 AEs) than male swimmers (0.66/1000 AEs; IRR=1.58; 95% CI 1.14 to 2.19). Overuse injury rates for female divers (0.54/1000 AEs) and male divers (0.46/1000 AEs) did not differ (IRR=1.16; 95% CI 0.40 to 3.34). Injury rates in 2012/2013-2013/2014 were lower than those in 2009/2010-2011/2012 for women's swimming (IRR=0.70; 95% CI 0.52 to 0.95) and diving (IRR=0.56; 95% CI 0.30 to 1.08), respectively. No time trends existed for men's swimmers or divers. CONCLUSIONS Shoulder, strain and overuse injuries were common in collegiate men's and women's swimming and diving. Female swimmers were more likely to suffer an overuse injury than male swimmers. In addition, divers may have higher injury rates than swimmers, although small reported numbers warrant additional research.
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Affiliation(s)
- Zachary Y Kerr
- NCAA Injury Surveillance Program, Datalys Center for Sports Injury Research and Prevention, Inc., Indianapolis, Indiana, USA
| | - Christine M Baugh
- Harvard Interfaculty Initiative in Health Policy, Harvard University, Cambridge, Massachusetts, USA Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Elizabeth E Hibberd
- Department of Health Science, University of Alabama, Tuscaloosa, Alabama, USA
| | - Erin M Snook
- NCAA Injury Surveillance Program, Datalys Center for Sports Injury Research and Prevention, Inc., Indianapolis, Indiana, USA
| | - Ross Hayden
- NCAA Injury Surveillance Program, Datalys Center for Sports Injury Research and Prevention, Inc., Indianapolis, Indiana, USA
| | - Thomas P Dompier
- NCAA Injury Surveillance Program, Datalys Center for Sports Injury Research and Prevention, Inc., Indianapolis, Indiana, USA
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Narita T, Kaneoka K, Takemura M, Sakata Y, Nomura T, Miyakawa S. Critical factors for the prevention of low back pain in elite junior divers. Br J Sports Med 2013; 48:919-23. [PMID: 23620474 DOI: 10.1136/bjsports-2012-091875] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIM During competitive diving, divers jump up from 1 to 3 m springboards or 5 to 10 m platforms and dive into the water. The impact forces are very large in the water entry phase, and, as such, microtraumatic injuries are common due to the tremendous physical stress placed on the diver. Low-back pain (LBP) is the most frequently reported symptom in divers. This study aimed to extract possible risk factors related to LBP from physical and technical characteristics in Japanese elite junior divers. METHODS Eighty-three elite junior divers (42 men and 41 women) in Japan were included in this study. LBP was assessed by a questionnaire, interview and physical examination during a national training camp. Morphological data, physical fitness and diving skills were also evaluated. The factors related to LBP were extracted by using logistic-regression analysis and the forward-selection method (likelihood ratio). RESULTS A total of 37.3% (31 reports) of back pain occurred in the lumbar region. Shoulder flexibility (OR 0.919; 95% CI 0.851 to 0.992) and age (OR 0.441; 95% CI 0.239 to 0.814) were recognised as factors related to LBP in male-elite junior divers, whereas only age (OR 0.536; 95% CI 0.335 to 0.856) was a factor in female-elite junior divers. CONCLUSIONS Our results suggest that shoulder flexibility is important for preventing LBP in elite-male junior divers, since they require full shoulder flexion during the water entry phase. Limited shoulder flexibility could cause lumbar hyperextension when adjusting for the angle of water entry.
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Affiliation(s)
- Takaya Narita
- Department of Physical Therapy, Health Science University, , Fujikawaguchiko-Town, Japan
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Burke KL. Schmorl's nodes in an American military population: frequency, formation, and etiology. J Forensic Sci 2011; 57:571-7. [PMID: 22150628 DOI: 10.1111/j.1556-4029.2011.01992.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This research investigates the frequency of Schmorl's nodes in differing populations, with new data from a skeletal sample from the Central Identification Laboratory (CIL) at the Joint Prisoner of War/Missing in Action Accounting Command, while also reviewing the etiology of Schmorl's node formation. Processes implicated in Schmorl's node formation include trauma, old age, disease, intrinsic abnormalities, and biomechanical factors, and they correlate with Schmorl's node formation to varying degrees. A survey of research from the anthropology and medical literature revealed Schmorl's node population frequencies ranging from 8 to 80%. The current study consists of two samples, one derived from CIL case reports and one analyzing skeletal remains. The case report sample yielded a Schmorl's node frequency of 19.8%. The examined sample yielded a frequency of 73.7%. The disparate frequencies reported are likely due mainly to differences in completeness and observability. It is likely that trauma was a major factor in the formation of Schmorl's nodes in the CIL study.
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Affiliation(s)
- Kelly L Burke
- Cultural Surveys Hawai'i, Inc., PO Box 1114, Kailua, HI 96734, USA.
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Jonasson P, Halldin K, Karlsson J, Thoreson O, Hvannberg J, Swärd L, Baranto A. Prevalence of joint-related pain in the extremities and spine in five groups of top athletes. Knee Surg Sports Traumatol Arthrosc 2011; 19:1540-6. [PMID: 21559845 DOI: 10.1007/s00167-011-1539-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 04/28/2011] [Indexed: 01/05/2023]
Abstract
PURPOSE Joint-related pain conditions from the spine and extremities are common among top athletes. The frequency of back pain has, however, been studied in more detail, and the frequency of low-back pain in top athletes in different high-load sports has been reported to be as high as 85%. Sport-related pain from different joints in the extremities is, however, infrequently reported on in the literature. METHODS Seventy-five male athletes, i.e. divers, weight-lifters, wrestlers, orienteers and ice-hockey players and 12 non-athletes (control group) were included in the study. A specific self-assessed pain-oriented questionnaire related to the cervical, thoracic and lumbar spine, as well as the various joints, i.e. shoulders, elbows, wrists, hips, knees and ankles, was filled out by the athletes and the non-athletes. RESULTS The overall frequency of pain reported by the athletes during the last week/last year was as follows; cervical spine 35/55%; thoracic spine 22/33%; lumbar spine 50/68%; shoulder 10/21%; elbow 7/7%; wrist 7/8%; hip 15/23%; knee 22/44%; and ankle 11/25%. The corresponding values for non-athletes were cervical spine 9/36%; thoracic spine 17/33%; lumbar spine 36/50%; shoulder 0/9%; elbow 9/0%; wrist 0/0%; hip 9/16%; knee 10/9%; and ankle 0/0%. A higher percentage of athletes reported pain in almost all joint regions, but there were no statistically significant differences (n.s.), with the exception of the knees (P = 0.05). Over the last year, athletes reporting the highest pain frequency in the lumbar spine were ice-hockey players and, in the cervical spine, wrestlers and ice-hockey players. The highest levels of knee pain were found among wrestlers and ice-hockey players, whereas the highest levels for wrist pain were found among divers, hip pain among weight-lifters, orienteers and divers and ankle pain among orienteers. For the thoracic spine, shoulder and elbow regions, only minor differences were found. CONCLUSION There was no statistically significant difference in prevalence of pain in the neck, spine and joints between top athletes in different sports or between athletes and non-athletes. However, pain in one spinal region was correlated to reported pain in other regions of the spine. Moreover, pain in the spine was also correlated to pain in the shoulders, hips and knees.
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Affiliation(s)
- Pall Jonasson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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Low back pain in adolescent female rowers: a multi-dimensional intervention study. Knee Surg Sports Traumatol Arthrosc 2011; 19:20-9. [PMID: 20549188 DOI: 10.1007/s00167-010-1173-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Accepted: 05/10/2010] [Indexed: 10/19/2022]
Abstract
The aim of this study was to determine whether a multi-dimensional intervention programme was effective in reducing the incidence of low back pain (LBP) and the associated levels of pain and disability in schoolgirl rowers. This non-randomised controlled trial involved an intervention (INT) group consisting of 90 schoolgirl rowers from one school and a control (CTRL) group consisting of 131 participants from three other schools. All participants in the INT group underwent a multi-dimensional programme that consisted of an individualised exercise programme based on an individual musculoskeletal screening (Week 1) and a LBP education session conducted by a physiotherapist (Week 2) and performed an off-water-conditioning programme conducted by a Physical Education teacher. All exercises were undertaken during the season. Primary outcome variables collected at Start-season, Mid-season, End-season and Post-season included the incidence of LBP and related levels of pain and disability. Secondary outcome variables from the bio-psycho-social domain were measured at Start-season and End-season in the INT group only. The INT group had a lower incidence of LBP at Mid-season and End-season and displayed significantly better results than the CTRL group for improvers and non-improvers with respect to the levels of pain and disability. The INT group following the intervention also displayed improved physical fitness levels, sat with significantly less anterior tilt of the pelvis and lumbar kyphosis when in their usual sitting posture and demonstrated positive changes in their behaviour. The multi-dimensional approach to reducing the incidence of LBP, pain and disability in schoolgirl rowers in this study was effective. Several secondary outcome variables measured in the INT group considered to be of importance in LBP significantly improved. These included physical fitness (aerobic conditioning, lower limb and back muscle endurance and sit and reach flexibility) and seated posture (usual and slump sitting).
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Abstract
Injuries can counter the beneficial aspects related to sports activities if an athlete is unable to continue to participate because of residual effects of injury. We provide an updated synthesis of existing clinical evidence of long-term follow-up outcome of sports injuries. A systematic computerized literature search was conducted on following databases were accessed: PubMed, Medline, Cochrane, CINAHL and Embase databases. At a young age, injury to the physis can result in limb deformities and leg-length discrepancy. Weight-bearing joints including the hip, knee and ankle are at risk of developing osteoarthritis (OA) in former athletes, after injury or in the presence of malalignment, especially in association with high impact sport. Knee injury is a risk factor for OA. Ankle ligament injuries in athletes result in incomplete recovery (up to 40% at 6 months), and OA in the long term (latency period more than 25 years). Spine pathologies are associated more commonly with certain sports (e.g. wrestling, heavy-weight lifting, gymnastics, tennis, soccer). Evolution in arthroscopy allows more accurate assessment of hip, ankle, shoulder, elbow and wrist intra-articular post-traumatic pathologies, and possibly more successful management. Few well-conducted studies are available to establish the long-term follow-up of former athletes. To assess whether benefits from sports participation outweigh the risks, future research should involve questionnaires regarding the health-related quality of life in former athletes, to be compared with the general population.
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Affiliation(s)
- Nicola Maffulli
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, UK.
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Thoreson O, Baranto A, Ekström L, Holm S, Hellström M, Swärd L. The immediate effect of repeated loading on the compressive strength of young porcine lumbar spine. Knee Surg Sports Traumatol Arthrosc 2010; 18:694-701. [PMID: 20012017 DOI: 10.1007/s00167-009-1001-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 11/13/2009] [Indexed: 10/20/2022]
Abstract
The human spine is exposed to repeated loading during daily activities and more extremely during sports. Despite this, there remains a lack of knowledge regarding the immediate effects on the spine due to this mode of loading. Age-specific spinal injury patterns has been demonstrated and this implies differences in reaction to load mode and load history The purpose of the present study was to investigate the impact of cyclic pre-loading on the biomechanical properties and fracture patterns of the adolescent spine in an experimental model. Eight functional spinal units from four young porcine spines were harvested. The functional spinal units were cyclic loaded with 20,000 cycles and then axially compressed to failure. The compression load at failure, ultimate stress and viscoelastic parameters were calculated. The functional spinal units were examined with plain radiography, computer tomography and MRI before and after the loading, and finally macroscopically and histologically. The median compression load at failure in this study was 8.3 kN (range 5.6-8.7 kN). The median deformation for all cases was 2.24 mm (range 2.30-2.7 mm) and stiffness was 3.45 N/mm (range 3.5-4.5 N/mm). A fracture was seen on radiograph in one case, on CT and macroscopically in seven, and on MRI and histologically in all eight cases. The cyclic loaded functional spinal units in the present study were not more sensitive to axial compression than non-cyclic loaded functional spinal units from young porcine. The endplate and the growth zone were the weakest part in the cyclic loaded functional spinal units. Disc signal reduction and disc height reduction was found on MRI. The E-modulus value found in this study was of the same order of magnitude as found by others using a porcine animal model.
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Affiliation(s)
- Olof Thoreson
- Department of Orthopaedics, The Sahlgrenska Academy at Gothenburg University and Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports: a 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc 2009; 17:1125-34. [PMID: 19305975 DOI: 10.1007/s00167-009-0767-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 02/20/2009] [Indexed: 10/21/2022]
Abstract
A total 71 male athletes (weight lifters, wrestlers, orienteers, and ice-hockey players) and 21 non-athletes were randomly selected, for a baseline MRI study. After 15 years all the participants at baseline were invited to take part in a follow-up examination, including a questionnaire on back pain and a follow-up MRI examination. Thirty-two athletes and all non-athletes had disc height reduction at one or several disc levels. Disc degeneration was found in more than 90% of the athletes and deterioration had occurred in 88% of the athletes, with the highest frequency in weight lifters and ice-hockey players. 78% of the athletes and 38% of the non-athletes reported previous or present history of back pain at baseline and 71 and 75%, respectively at follow-up. There was no statistically significant correlation between back pain and MRI changes. In conclusion, athletes in sports with severe or moderate demands on the back run a high risk of developing disc degeneration and other abnormalities of the spine on MRI and they report high frequency of back pain. The study confirmed our hypothesis, i.e. that most of the spinal abnormalities in athletes seem to occur during the growth spurt, since the majority of the abnormalities demonstrated at follow-up MRI after the sports career were present already at baseline. The abnormalities found at young age deteriorated to a varying degree during the 15-year follow-up, probably due to a combination of continued high load sporting activities and normal ageing. Preventive measures should be considered to avoid the development of these injuries in young athletes.
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Hangai M, Kaneoka K, Hinotsu S, Shimizu K, Okubo Y, Miyakawa S, Mukai N, Sakane M, Ochiai N. Lumbar intervertebral disk degeneration in athletes. Am J Sports Med 2009; 37:149-55. [PMID: 18799691 DOI: 10.1177/0363546508323252] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Several studies have reported that physical loading related to competitive sports activities is associated with lumbar intervertebral disk degeneration. However, the association between types of sports activities and disk degeneration has not been clarified. HYPOTHESIS The frequencies of disk degeneration may vary with the competitive sport because of the different postures and actions specific to each sport. STUDY DESIGN Cross-sectional study (prevalence); Level of evidence, 3. METHODS Study participants were 308 well-trained university athletes (baseball players, basketball players, kendo competitors, runners, soccer players, swimmers) and 71 nonathlete university students (reference group). Disk degeneration was evaluated using T2-weighted magnetic resonance imaging. A self-reported questionnaire concerning low back pain was also conducted. RESULTS The proportions of the participants who had disk degeneration among the baseball players (odds ratio, 3.23) and the swimmers (odds ratio, 2.95) were significantly higher than among the nonathletes using logistic regression analysis. When all patients were grouped together, the association between lifetime experience of low back pain and participants with disk degeneration was significant, and a linear association between the degree of severest low back pain experienced and participants with disk degeneration, analyzed by a Cochran-Mantel-Haenszel test, was also significant. CONCLUSION Continuous competitive baseball and swimming activities during youth may be associated with disk degeneration. Furthermore, the study indicates that the experience of severe low back pain might be a predictor of disk degeneration in youth. The authors hope that preventive measures and management to protect against disk degeneration and low back pain in athletes will be established by further studies based on these results.
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Affiliation(s)
- Mika Hangai
- Department of Orthopaedic Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2008; 17:1407-22. [PMID: 18787845 DOI: 10.1007/s00586-008-0770-2] [Citation(s) in RCA: 321] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 08/15/2008] [Accepted: 08/24/2008] [Indexed: 12/13/2022]
Abstract
The prevalence of "vertebral endplate signal changes" (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 x 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.
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Alyas F, Turner M, Connell D. MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players. Br J Sports Med 2007; 41:836-41; discussion 841. [PMID: 17640926 PMCID: PMC2465278 DOI: 10.1136/bjsm.2007.037747] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To describe magnetic resonance imaging (MRI) findings in the lumbar spine in asymptomatic elite adolescent tennis players, to serve as the baseline for a future prospective longitudinal cohort study. DESIGN Observational study. SETTING Institutional, national tennis centre. PARTICIPANTS 33 asymptomatic elite adolescent tennis players, mean (SD) age, 17.3 (1.7) years (18 male, 15 female). METHODS Sagittal T1, T2, STIR, and axial T2 weighted MRI images were reviewed for the presence of abnormalities by two radiologists in consensus. Abnormalities included disc degeneration, disc herniation, pars lesions (fracture or stress reaction), and facet joint arthropathy. RESULTS Five players (15.2%) had a normal MRI examination and 28 (84.8%) had an abnormal examination. Nine players showed pars lesions (10 lesions; one at two levels) predominately at the L5 level (9/10, L5; 1/10, L4). Three of the 10 lesions were complete fractures; two showed grade 1 and one grade 2 spondylolisthesis, both of which resulted in moderate narrowing of the L5 exit foramen. There were two acute and five chronic stress reactions of the pars. Twenty three patients showed signs of early facet arthropathy occurring at L5/S1 (15/29 joints) and L4/5 (12/29 joints). These were classified as mild degeneration (20/29) and moderate degeneration (9/29), with 20/29 showing sclerosis and 24/29 showing hypertrophy of the facet joint. Synovial cysts were identified in 14 of the 29 joints. Thirteen players showed disc desiccation and disc bulging (mild in 13; moderate in two) most often at L4/5 and L5/S1 levels (12 of 15 discs). CONCLUSIONS Abnormalities were frequent, predominately in the lower lumbar spine, almost exclusively at L4/5 and L5/S1 levels. Pars injuries and facet joint arthroses were relatively common.
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Affiliation(s)
- F Alyas
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, London, UK
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Walsh JC, Quinlan JF, Stapleton R, FitzPatrick DP, McCormack D. Three-dimensional motion analysis of the lumbar spine during "free squat" weight lift training. Am J Sports Med 2007; 35:927-32. [PMID: 17307893 DOI: 10.1177/0363546506298276] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Heavy weight lifting using a squat bar is a commonly used athletic training exercise. Previous in vivo motion studies have concentrated on lifting of everyday objects and not on the vastly increased loads that athletes subject themselves to when performing this exercise. HYPOTHESIS Athletes significantly alter their lumbar spinal motion when performing squat lifting at heavy weights. STUDY DESIGN Controlled laboratory study. METHODS Forty-eight athletes (28 men, 20 women) performed 6 lifts at 40% maximum, 4 lifts at 60% maximum, and 2 lifts at 80% maximum. The Zebris 3D motion analysis system was used to measure lumbar spine motion. Exercise was performed as a "free" squat and repeated with a weight lifting support belt. Data obtained were analyzed using SAS. RESULTS A significant decrease (P < .05) was seen in flexion in all groups studied when lifting at 40% maximum compared with lifting at 60% and 80% of maximum lift. Flexion from calibrated 0 point ranged from 24.7 degrees (40% group) to 6.8 degrees (80% group). A significant increase (P < .05) was seen in extension when lifting at 40% maximum was compared with lifting at 60% and 80% maximum lift. Extension from calibrated 0 point ranged from -1.5 degrees (40% group) to -20.3 degrees (80% group). No statistically significant difference was found between motion seen when exercise was performed as a free squat or when lifting using a support belt in any of the groups studied. CONCLUSION Weight lifting using a squat bar causes athletes to significantly hyperextend their lumbar spines at heavier weights. The use of a weight lifting support belt does not significantly alter spinal motion during lifting.
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Affiliation(s)
- James C Walsh
- Cappagh National Orthopaedic Hospital, Finglas, Dublin, Republic of Ireland.
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