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Deodato M, Saponaro S, Šimunič B, Martini M, Murena L, Buoite Stella A. Trunk muscles' characteristics in adolescent gymnasts with low back pain: a pilot study on the effects of a physiotherapy intervention including a postural reeducation program. J Man Manip Ther 2024; 32:310-324. [PMID: 37649443 PMCID: PMC11216269 DOI: 10.1080/10669817.2023.2252202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Trunk muscles' function and characteristics are of great importance for both static and dynamic tasks in different sports, and abnormalities of trunk flexors and extensors might be associated with low back pain (LBP). The aim of this study was to provide a comprehensive evaluation of the functional, morphological and contractile properties in trunk flexors and extensors of young gymnasts with and without LBP. METHODS Young gymnasts (14/25 females, 14-18 y) were screened for the presence of chronic LBP. Abdominal and lumbar muscles were tested for function (McGill's endurance tests), thickness (ultrasound), and contractile responses (tensiomyography). An 8-sessions physiotherapy intervention including postural reeducation was performed by a subsample of 10 subjects with LBP. RESULTS LBP was found to be associated to higher flexors-to-extensors endurance ratio (OR 11.250, 95% CI: 1.647-76.849, p = 0.014), reduced mean lumbar multifidus thickness (OR 16.500, 95% CI: 2.246-121.228, p = 0.006), and reduced mean erector spinae radial displacement (OR 16.500, 95% CI: 2.246-121.228, p = 0.006). The physiotherapy intervention was found to reduce LBP symptoms and it was associated with a significant improvement in the flexors-to-extensors ratio (p < 0.001). CONCLUSIONS This study provides preliminary evidence of functional, morphological, and contractile trunk muscles' alterations associated with chronic LBP in young gymnasts, and presents the effects of a postural reeducation program on symptoms and muscles' functional properties.
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Affiliation(s)
- Manuela Deodato
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- PhD Program in Neural and Cognitive Sciences, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Serena Saponaro
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| | - Miriam Martini
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Luigi Murena
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Orthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Alex Buoite Stella
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Silva TFCE, Nunes ACL, Barreto MCA, Castro SS, Jesus-Moraleida FR. Questionnaires that assess disability in children and adolescents with low back pain adhere to the concepts of the International classification of functioning, disability and health (ICF), but lack validity for this population: a systematic review. Disabil Rehabil 2024; 46:1979-1989. [PMID: 37326065 DOI: 10.1080/09638288.2023.2221901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs. METHODS We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM. RESULTS We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity. CONCLUSION Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs.
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Affiliation(s)
| | - Ana Carla Lima Nunes
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
| | | | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
- Master Program of Public Health, Physical Therapy Department, Federal University of Ceará, Fortaleza, Brazil
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Azevedo VD, Ferreira Silva RM, de Carvalho Borges SC, Fernades MDSV, Miñana-Signes V, Monfort-Pañego M, Silva Noll PRE, Noll M. Instruments for assessing back pain in athletes: A systematic review. PLoS One 2023; 18:e0293333. [PMID: 37922315 PMCID: PMC10624266 DOI: 10.1371/journal.pone.0293333] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/10/2023] [Indexed: 11/05/2023] Open
Abstract
Back pain in athletes varies with sport, age, and sex, which can impair athletic performance, thereby contributing to retirement. Studies on back pain in this population use questionnaires to assess components, such as pain intensity and location and factors associated with pain, among others. This study aimed to review validated questionnaires that have assessed back pain in athletes. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) by searching the databases Embase, MEDLINE, SPORTDiscus, CINAHL, and Scopus. The articles were selected regardless of language and date of publication. Titles and abstracts were independently selected by two reviewers; disagreements were resolved by a third reviewer. All the steps were conducted using the software Rayyan. The methodological quality of the questionnaire validation articles was assessed using a critical appraisal tool checklist proposed by Brink and Louw. The search returned 4748 articles, of which 60 were selected for this review, including 5 questionnaire validation studies. These articles were published between 2004 and 2022, which were performed in more than 20 countries, particularly Germany (14) and Sweden (5). Thirteen different instruments were identified, of which 46.1% were developed in Europe. The most commonly used questionnaires were the Oswestry Disability Index and Nordic Standardized Questionnaire. In addition, five questionnaire validation studies were selected for methodological quality assessment, with only two studies demonstrating high methodological quality. The following three instruments were identified for assessing back pain specifically in athletes: Micheli Functional Scale, Persian Functional Rating Index, and Athlete Disability Index. This review confirmed that all three instruments were specifically designed to assess this condition.
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Affiliation(s)
| | | | | | | | | | | | | | - Matias Noll
- Federal University of Goiás, Goiânia, Brazil
- Goiano Federal Institute, Itumbiara, Brazil
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Evaluation Instruments for Assessing Back Pain in Athletes: A Systematic Review Protocol. Healthcare (Basel) 2020; 8:healthcare8040574. [PMID: 33561044 PMCID: PMC7766916 DOI: 10.3390/healthcare8040574] [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: 11/04/2020] [Revised: 12/08/2020] [Accepted: 12/12/2020] [Indexed: 11/30/2022] Open
Abstract
Back pain is a public health problem that affects adolescents and adults worldwide. However, studies on back pain present inconsistent findings in part due to the use of different instruments, especially for athletes. Therefore, the objective of this systematic review protocol was to map the existing evidence on such tools. The systematic review will be conducted according to PRISMA guidelines. Five electronic databases, Embase, MEDLINE, SPORTDiscus, CINAHL, and Scopus will be searched. This review includes studies that investigated prevalence, incidence, and other variables. Titles and abstracts will be selected. Two independent reviewers will read the articles carefully and discrepancies, if any, will be dealt with by a third reviewer. All steps will be completed with Rayyan for systematic reviews and the methodological quality will be analyzed with a COSMIN checklist. Discussion: This systematic review will gather evidence on tools that assess back pain in athletes. The findings may indicate the most appropriate tools for assessing back pain. They will contribute to better reliability, safe measurements, and help to standardize a comparison tool between different studies. They will also assist in the development of specific tools for athletes. Registration: This review was submitted and registered under CRD42020201299 in PROSPERO.
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Cugusi L, Manca A, Sarritzu S, Bergamin M, Gobbo S, Di Blasio A, Massidda M, Cupisti A, Bandiera P, Deriu F. Risk factors associated with low back pain in competitive female gymnasts: A meta-analytic approach. J Sports Sci 2020; 38:2543-2552. [PMID: 32729788 DOI: 10.1080/02640414.2020.1793644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this meta-analysis was to aggregate data from studies investigating the risk factors associated with low back pain (LBP) in competitive gymnasts. Four databases were searched and studies reporting demographics, anthropometrics, functional, psychosocial and gymnastics-practice variables in competitive gymnasts with and without LBP were included. For continuous data, the weighted mean difference (MD) and confidence interval (95% CI) were calculated, while odds or risk ratio (OR, RR) were calculated for dichotomous data. Meta-analysis of six cross-sectional studies involving 284 competitive female gymnasts revealed that artistic were more likely to report LBP compared to rhythmic gymnasts (RR 1.4, 95% CI 1.04-2.0, Z=2.2, p=0.03). Data pooling revealed that age (MD 1.5 years, 95% CI 0.4-2.5, p=0.005) and body weight (MD 3.5 kg, 95% CI 0.1-6.8, p=0.04) were significantly higher in gymnasts with LBP compared to those without. Subgroup-analyses confirmed these differences in artistic but not in rhythmic gymnasts. Moreover, artistic gymnasts with LBP tended to display longer gymnastics-practice history (p=0.09) compared to those without. Increased age, body weight and, to a lesser extent, longer gymnastics-practice appear to differentiate artistic gymnasts with LBP from those without; conversely, these potential risk factors seem less relevant for rhythmic gymnasts.
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Affiliation(s)
- Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari , Sassari, Italy
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari , Sassari, Italy
| | - Sara Sarritzu
- Bachelor Degree Course in Physiotherapy, University of Cagliari , Cagliari, Italy
| | - Marco Bergamin
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova , Padova, Italy
| | - Stefano Gobbo
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova , Padova, Italy
| | - Andrea Di Blasio
- Endocrine Section, Department of Medicine and Sciences of Aging, G. d'Annunzio University of Chieti-Pescara , Chieti, Italy
| | - Myosotis Massidda
- Department of Life and Environmental Sciences, University of Cagliari , Monserrato, Italy
| | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa , Pisa, Italy
| | - Pasquale Bandiera
- Department of Biomedical Sciences, University of Sassari , Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari , Sassari, Italy
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Pimentel R, Potter MN, Carollo JJ, Howell DR, Sweeney EA. Peak sagittal plane spine kinematics in female gymnasts with and without a history of low back pain. Clin Biomech (Bristol, Avon) 2020; 76:105019. [PMID: 32402899 DOI: 10.1016/j.clinbiomech.2020.105019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/16/2020] [Accepted: 04/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Female gymnasts have a greater prevalence of back pain compared to other female athletes. There is little evidence that female artistic gymnasts with and without back pain demonstrate different movement patterns during gymnastics skills. The purpose of this study was to determine if there were differences in back movements during back walkovers and back handsprings among female artistic gymnasts. METHODS Female artistic gymnasts (8-18 years old) with and without back pain wore inertial sensors on their torso, arms, and legs while performing back walkovers (N = 14) and back handsprings (N = 15) on the floor and balance beam at their training gymnastics facilities. FINDINGS Gymnasts with back pain had similar spine peak extension, peak flexion, and range of motion during back walkovers and back handsprings compared to gymnasts without back pain. Additionally, no differences in sagittal plane spine kinematics were found between the groups at any specific time point during either the back walkover or back handspring skills. However, a large portion of the data collected was excluded during quality assurance, thus our final sample sizes are small. INTERPRETATION These findings suggest that gymnasts with back pain have similar sagittal plane movements to those without back pain. The relationship between back pain and gymnastics training load/intensity is currently unclear. We suggest future studies to investigate common artistic gymnastics skills and back pain prevalence with more participants, full-body motion analysis with kinetic measurement capabilities, and longitudinally for those demonstrating back pain.
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Affiliation(s)
- Ricky Pimentel
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; North Carolina State University, Raleigh, NC, USA; Center for Gait and Movement Analysis, Children's Hospital Colorado, Aurora, CO, USA
| | - Morgan N Potter
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - James J Carollo
- Center for Gait and Movement Analysis, Children's Hospital Colorado, Aurora, CO, USA; University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, CO, USA; University of Colorado School of Medicine, Department of Orthopedics, Aurora, CO, USA
| | - David R Howell
- University of Colorado School of Medicine, Department of Orthopedics, Aurora, CO, USA; Children's Hospital Colorado, Sports Medicine Center, Aurora, CO, USA
| | - Emily A Sweeney
- University of Colorado School of Medicine, Department of Orthopedics, Aurora, CO, USA; Children's Hospital Colorado, Sports Medicine Center, Aurora, CO, USA.
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