1
|
Quirk DA, Chung J, Schiller G, Cherin JM, Arens P, Sherman DA, Zeligson ER, Dalton DM, Awad LN, Walsh CJ. Reducing Back Exertion and Improving Confidence of Individuals with Low Back Pain with a Back Exosuit: A Feasibility Study for Use in BACPAC. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:S175-S186. [PMID: 36794907 PMCID: PMC10403307 DOI: 10.1093/pm/pnad003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Low back pain (LBP) is hallmarked by activity limitations, especially for tasks involving bending. Back exosuit technology reduces low back discomfort and improves self-efficacy of individuals with LBP during bending and lifting tasks. However, the biomechanical efficacy of these devices in individuals with LBP is unknown. This study sought to determine biomechanical and perceptual effects of a soft active back exosuit designed to assist individuals with LBP sagittal plane bending. To understand patient-reported usability and use cases for this device. METHODS Fifteen individuals with LBP performed two experimental lifting blocks once with and without an exosuit. Trunk biomechanics were measured by muscle activation amplitudes, and whole-body kinematics and kinetics. To evaluate device perception, participants rated task effort, low back discomfort, and their level of concern completing daily activities. RESULTS The back exosuit reduced peak back extensor: moments by 9%, and muscle amplitudes by 16% when lifting. There were no changes in abdominal co-activation and small reductions maximum trunk flexion compared to lifting without an exosuit. Participants reported lower task effort, back discomfort, and concern about bending and lifting with an exosuit compared to without. CONCLUSIONS This study demonstrates a back exosuit not only imparts perceptual benefits of reduced task effort, discomfort, and increased confidence in individuals with LBP but that it achieves these benefits through measurable biomechanical reductions in back extensor effort. The combined effect of these benefits implies back exosuits might be a potential therapeutic aid to augment physical therapy, exercises, or daily activities.
Collapse
Affiliation(s)
- D Adam Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Gregory Schiller
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Jason M Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Philipp Arens
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - David A Sherman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Emma R Zeligson
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Diane M Dalton
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Lou N Awad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Conor J Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| |
Collapse
|
2
|
Zhang Q, Chen W, Liang J, Cheng L, Huang B, Xiong C. Influences of dynamic load phase shifts on the energetics and biomechanics of humans. ROYAL SOCIETY OPEN SCIENCE 2023; 10:230636. [PMID: 37650053 PMCID: PMC10465206 DOI: 10.1098/rsos.230636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023]
Abstract
Using load-suspended backpacks to reduce vertical peak dynamic load exerted on humans can reduce metabolic costs. However, is it possible to further reduce metabolic cost by modulating dynamic load phase shift? If so, is anti-phase better than the others? In this study, we investigated the biomechanics, energetics and trunk response under phase shifts. Nine subjects wearing an active backpack with 19.4 kg loads walked on a treadmill at 5 km h-1 with four phase shift trials (T1-T4) and a load-locked trial (LK). Our results show that anti-phase trial (T3) assists ankle more and reduces the moment and gastrocnemius medialis activity, while T4 assists knee more and reduces the moment and rectus femoris activity. Due to the load injecting more mechanical energy into human in T3 and T4, the positive centre-of-mass work is significantly reduced. However, the gross metabolic rate is lowest in T4 and 4.43% lower than in T2, which may be because the activations of erector spinae and gluteus maximus are reduced in T4. In addition, T3 increases trunk extensor effort, which may weaken the metabolic advantage. This study provides guidance for improving assistance strategies and human-load interfaces and deepens the understanding of the energetics and biomechanics of human loaded walking.
Collapse
Affiliation(s)
- Qinhao Zhang
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China
| | - Wenbin Chen
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China
| | - Jiejunyi Liang
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China
| | - Longfei Cheng
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China
| | - Bo Huang
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China
| | - Caihua Xiong
- Institute of Medical Equipment Science and Engineering, State Key Laboratory of Intelligent Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan 430074, People's Republic of China
| |
Collapse
|
3
|
Sturdy JT, Rizeq HN, Silder A, Sessoms PH, Silverman AK. WALKING SLOPE AND HEAVY BACKPACK LOADS AFFECT TORSO MUSCLE ACTIVITY AND KINEMATICS. J Electromyogr Kinesiol 2023; 70:102769. [PMID: 37004379 DOI: 10.1016/j.jelekin.2023.102769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/28/2023] Open
Abstract
The independent effects of sloped walking or carrying a heavy backpack on posture and torso muscle activations have been reported. While the combined effects of sloped walking and backpack loads are known to be physically demanding, how back and abdominal muscles adapt to walking on slopes with heavy load is unclear. This study quantified three-dimensional pelvis and torso kinematics and muscle activity from longissimus, iliocostalis, rectus abdominis, and external oblique during walking on 0° and ± 10° degree slopes with and without backpack loads using two different backpack configurations (hip-belt assisted and shoulder-borne). Iliocostalis activity was greater during downhill and uphill compared to level walking, but longissimus was only greater during uphill. Rectus abdominis activity was greater during downhill and uphill compared to level, while external oblique activity decreased as slopes progressed from down to up. Longissimus, but not iliocostalis, activity was reduced during both backpack configurations compared to walking with no pack. Hip-belt assisted load carriage required less rectus abdominis activity compared to using shoulder-borne only backpacks; however, external oblique was not influenced by backpack condition. Our results revealed different responses between iliocostalis and longissimus, and between rectus abdominis and external obliques, suggesting different motor control strategies between anatomical planes.
Collapse
Affiliation(s)
- Jordan T Sturdy
- Department of Mechanical Engineering, Colorado School of Mines, United States.
| | - Hedaya N Rizeq
- Warfighter Performance Department, Naval Health Research Center, United States; Military and Veterans Health Solutions, Leidos, Inc, United States
| | - Amy Silder
- Warfighter Performance Department, Naval Health Research Center, United States
| | - Pinata H Sessoms
- Warfighter Performance Department, Naval Health Research Center, United States
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, United States; Quantitative Biosciences and Engineering Program, Colorado School of Mines, United States
| |
Collapse
|
4
|
Nonlinear Analyses Distinguish Load Carriage Dynamics in Walking and Standing: A Systematic Review. J Appl Biomech 2022; 38:434-447. [PMID: 36170973 DOI: 10.1123/jab.2022-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 11/18/2022]
Abstract
Load carriage experiments are typically performed from a linear perspective that assumes that movement variability is equivalent to error or noise in the neuromuscular system. A complimentary, nonlinear perspective that treats variability as the object of study has generated important results in movement science outside load carriage settings. To date, no systematic review has yet been conducted to understand how load carriage dynamics change from a nonlinear perspective. The goal of this systematic review is to fill that need. Relevant literature was extracted and reviewed for general trends involving nonlinear perspectives on load carriage. Nonlinear analyses that were used in the reviewed studies included sample, multiscale, and approximate entropy; the Lyapunov exponent; fractal analysis; and relative phase. In general, nonlinear tools successfully distinguish between unloaded and loaded conditions in standing and walking, although not in a consistent manner. The Lyapunov exponent and entropy were the most used nonlinear methods. Two noteworthy findings are that entropy in quiet standing studies tends to decrease, whereas the Lyapunov exponent in walking studies tends to increase, both due to added load. Thus, nonlinear analyses reveal altered load carriage dynamics, demonstrating promise in applying a nonlinear perspective to load carriage while also underscoring the need for more research.
Collapse
|
5
|
Impact of Backpacks on Ergonomics: Biomechanical and Physiological Effects: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116737. [PMID: 35682317 PMCID: PMC9180465 DOI: 10.3390/ijerph19116737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/24/2022]
Abstract
(1) Background: the effects of load carriage packs on human gait biomechanics, physiology and metabolism depend on the weight carried, the design of the pack and its interaction with the user. (2) Methods: An extensive search in the PubMed database was performed to find all the relevant articles using the following keywords: backpack, rucksack, backpack ergonomy and sports backpack; 60 articles were included. (3) Results and significance: Double pack (DP) and T-pack (TP) designs are recommended solutions for school children, compared with backpacks (BP). For soldiers and hikers, a backpack remains the best compromise. A hip belt is recommended for BPs as well as for the back of DPs. Shorter and stiffer shoulder straps combined with a higher and tighter load placement on the back provide the best combination in terms of balance, muscle activation and energy expenditure. It is, therefore, possible to determine guidelines for designing the optimal load carriage system, depending on the application. (4) Conclusions: based on the available evidence, DP and TP are advantageous in terms of posture. DP is better than conventional BPs in terms of balance and muscle activation, but has the disadvantage of limited visibility, thermal sensation and obstructed ventilation. In general, it is desirable not to exceed 40% of body mass (BM).
Collapse
|
6
|
Dicks ND, Mahoney SJ, Kramer M, Lyman KJ, Christensen BK, Pettitt RW, Hackney KJ. Increased velocity at VO 2max and load carriage performance in army ROTC cadets: prescription using the critical velocity concept. ERGONOMICS 2021; 64:733-743. [PMID: 33258417 DOI: 10.1080/00140139.2020.1858186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to evaluate the effects of using the critical velocity (CV) concept to prescribe two separate high-intensity interval training (HIT) exercise programs aimed at enhancing CV and load carriage performance. 20 young adult participants (male = 15, female = 5) underwent a 4-week training period where they exercised 2 d wk-1. Participants were randomly assigned into two groups: (1) HIT or (2) Load Carriage-HIT (LCHIT). Pre- and post-training assessments included running 3-minute All-Out Test (3MT) to determine critical velocity (CV) and distance prime (D') and two load carriage tasks (400 and 3200 m). There were significant increases in CV (p = 0.005) and velocity at V˙ O2max (vV˙ O2max) (p = 0.037) among the sample but not between training groups. Improvements were observed in 3200 m load carriage performance time (p < 0.001) with a 9.8 and 5.4% decrease in the LCHIT and HIT groups, respectively. Practitioner summary: Critical velocity has shown efficacy as a marker for performance in tactical populations. With the addition of load carriage, there is a reduction in the individual's CV. The CV-concept-prescribed exercises (HIT and LCHIT) 2 days per week for 4 weeks showed improvements in CV, vV˙ O2max and load carriage performance. The use of the CV concept provides a method to prescribe HIT to increase running and load carriage performances in tactical populations.
Collapse
Affiliation(s)
- Nathan D Dicks
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
- Department of Nutrition, Dietetics and Exercise Science, Concordia College, Moorhead, MN, USA
| | - Sean J Mahoney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Mark Kramer
- Physical Activity, Sport and Recreation Research Focus Area, North West University, Potchefstroom, South Africa
| | - Katie J Lyman
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Bryan K Christensen
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Robert W Pettitt
- Office of Research & Sponsored Projects, Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| |
Collapse
|
7
|
Sturdy JT, Sessoms PH, Silverman AK. A backpack load sharing model to evaluate lumbar and hip joint contact forces during shoulder borne and hip belt assisted load carriage. APPLIED ERGONOMICS 2021; 90:103277. [PMID: 33011587 DOI: 10.1016/j.apergo.2020.103277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Abstract
Musculoskeletal injuries of the lumbar spine occur frequently among military service members and are associated with heavy backpack loads. Musculoskeletal modeling and simulation facilitate biomechanical evaluation to compare different backpack designs. We developed a backpack attachment model that can be tuned to represent various load distributions between the torso and pelvis. We generated walking simulations to estimate muscle and joint contact forces of unloaded walking and while carrying 38 kg using shoulder-borne backpacks and hip belt-assisted backpacks for six U.S. Marines. Three-dimensional peak and average lumbar (L4-L5) and hip joint contact forces over the stance phase were compared between each load condition. Axial L4-L5 and axial and anterior hip joint contact forces were greater during both backpack conditions compared to the unloaded condition. Joint contact forces were similar between backpack conditions. Future studies incorporating additional participants, walking conditions, and backpack load distributions are suggested for further model development and backpack design evaluation.
Collapse
Affiliation(s)
- Jordan T Sturdy
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, 80401, USA
| | - Pinata H Sessoms
- Warfighter Performance, Naval Health Research Center, San Diego, CA, 92106, USA
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, 80401, USA.
| |
Collapse
|
8
|
Alabdulkarim SA, Farhan AM, Ramadan MZ. Development and Investigation of a Wearable Aid for a Load Carriage Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030749. [PMID: 31991625 PMCID: PMC7037516 DOI: 10.3390/ijerph17030749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 12/04/2022]
Abstract
Anterior load carriage tasks are common and can lead to musculoskeletal disorders such as lower back pain. The objectives of this study were to develop a wearable carriage aid and examine its effectiveness on physical demands while considering the potential moderating influence of the carried load. The study consisted of two within-subject factors: device and load. For the former, two levels were tested: with and without the device worn. For the latter, two loads were examined: 15 and 30% of each individual’s body mass. Sixteen participants walked on a treadmill for five minutes at a constant speed for each condition. Physical demands were quantified using objective (EMG-based) and subjective (discomfort) measures. Wearing the device reduced static and median anterior deltoid, trapezius, and biceps brachii muscle activations. Increasing the carried load increased most physical demand measures. Two significant Device×Load interactions were observed; for the anterior deltoid and trapezius median activation measures, the influence of increasing load was lower when the device was worn. While slightly increasing perceived discomfort in the lower back, wearing the device reduced shoulder, neck, and hand/wrist discomfort. While the study demonstrated a potential for the device, future work is required under more realistic and diverse testing conditions.
Collapse
|
9
|
Dual-task and anticipation impact lower limb biomechanics during a single-leg cut with body borne load. J Biomech 2017; 65:131-137. [DOI: 10.1016/j.jbiomech.2017.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/31/2017] [Accepted: 10/15/2017] [Indexed: 11/23/2022]
|
10
|
Tian M, Park H, Li J, Koo H, Xu Q. Effects of load carriage and work boots on lower limb kinematics of industrial workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2017; 24:582-591. [PMID: 28693378 DOI: 10.1080/10803548.2017.1334336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Load and footwear condition are two crucial elements varying the kinematic responses during walking, which probably lead to chronic injury. Fifteen healthy male individuals with no obvious gait abnormalities participated in this study. Apart from a no-load condition, four external load conditions with two load levels were investigated. Work boots were compared with running shoes to determine footwear effects. Significant impacts were found for lower limb range of motion at certain joints when carrying loads. A greater hip and ankle flexion-extension while wearing the work boots indicated that participants needed to lift the leg higher to complete toe clearance off the walking surface. Work boots also increased the vertical excursion of the center of body mass, which may impact body balance and induce falling. No significant influencing pattern of carrying modes was found, which was probably due to the light load and relatively stable mode of shoulder carrying.
Collapse
Affiliation(s)
- Miao Tian
- a College of Fashion and Design , Donghua University , China.,b Key Laboratory of Clothing Design and Technology , Ministry of Education , China
| | - Huiju Park
- c Department of Fiber Science and Apparel Design , Cornell University , USA
| | - Jun Li
- a College of Fashion and Design , Donghua University , China.,b Key Laboratory of Clothing Design and Technology , Ministry of Education , China
| | - Heekwang Koo
- c Department of Fiber Science and Apparel Design , Cornell University , USA
| | - Qinwen Xu
- c Department of Fiber Science and Apparel Design , Cornell University , USA
| |
Collapse
|
11
|
Muslim K, Nussbaum MA. The effects of a simple intervention on exposures to low back pain risk factors during traditional posterior load carriage. APPLIED ERGONOMICS 2017; 59:313-319. [PMID: 27890142 DOI: 10.1016/j.apergo.2016.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 08/22/2016] [Accepted: 09/08/2016] [Indexed: 06/06/2023]
Abstract
Traditional posterior load carriage (PLC), typically performed without the use of an assistive device, is associated with a high prevalence of low back pain (LBP). However, there are few studies that have evaluated potential interventions to reduce exposures to LBP risk factors. This work examined the effects of a simple, potentially low-cost intervention using an assistive device (i.e., carrying aid) on exposures to factors related to LBP risk during PLC. Torso kinematics and kinetics, slip risk, and ratings of perceived discomfort (RPD) were obtained during simulated PLC on a walkway. Consistent with earlier results, increasing load mass substantially increased torso flexion and lumbosacral flexion moment, as well as RPDs in all anatomical regions evaluated. Using the carrying aid with a higher load placement resulted in substantially lower mean lumbosacral moments when carrying the heaviest load. In contrast, using the carrying aid with a lower load placement resulted in substantially higher torso flexion angles, higher mean lumbosacral moments when carrying heavier loads, and higher peak lumbosacral moments across all load masses. With use of the carrying aid, both higher and lower load placement resulted in significantly lower RPDs in the elbows and hands compared to the control condition. In summary, use of a carrying aid with higher load placement may be beneficial in reducing the risk of LBP during PLC. Future studies are needed, though, to improve the device design and to enhance external validity.
Collapse
Affiliation(s)
- Khoirul Muslim
- Industrial Engineering, Institute of Technology Bandung, Bandung, West Java, 40134, Indonesia
| | - Maury A Nussbaum
- Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, 24061, USA.
| |
Collapse
|
12
|
Noll M, Silveira EA, de Avelar IS. Evaluation of factors associated with severe and frequent back pain in high school athletes. PLoS One 2017; 12:e0171978. [PMID: 28222141 PMCID: PMC5319774 DOI: 10.1371/journal.pone.0171978] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/30/2017] [Indexed: 01/09/2023] Open
Abstract
Several studies have shown that half of all young athletes experience back pain (BP). However, high intensity and frequency of BP may be harmful, and the factors associated with BP severity have not been investigated in detail. Here, we investigated the factors associated with a high intensity and high frequency of BP in high school athletes. We included 251 athletes (173 boys and 78 girls [14-20 years old]) in this cross-sectional study. The dependent variables were a high frequency and high intensity of BP, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, anthropometric, behavioural, and postural factors and the level of exercise. The effect measure is presented as prevalence ratio (PR) with 95% confidence interval (CI). Of 251 athletes, 104 reported BP; thus, only these athletes were included in the present analysis. Results of multivariable analysis showed an association between high BP intensity and time spent using a computer (PR: 1.15, CI: 1.01-1.33), posture while writing (PR: 1.41, CI: 1.27-1.58), and posture while using a computer (PR: 1.39, CI: 1.26-1.54). Multivariable analysis also revealed an association of high BP frequency with studying in bed (PR: 1.19, CI: 1.01-1.40) and the method of carrying a backpack (PR: 1.19, CI: 1.01-1.40). In conclusion, we found that behavioural and postural factors are associated with a high intensity and frequency of BP. To the best of our knowledge, this study is the first to compare different intensities and frequencies of BP, and our results may help physicians and coaches to better understand BP in high school athletes.
Collapse
Affiliation(s)
- Matias Noll
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiás, Brazil
- Instituto Federal Goiano, Goiás, Brazil
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiás, Brazil
| | - Ivan Silveira de Avelar
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiás, Brazil
| |
Collapse
|