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Thomas ZM, Wilk KE. The Golfer's Fore, Fore +, and Advanced Fore + Exercise Program: An Exercise Series and Injury Prevention Program for the Golfer. Int J Sports Phys Ther 2023; V18:789-799. [PMID: 37425113 PMCID: PMC10324324 DOI: 10.26603/001c.74973] [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: 02/27/2023] [Accepted: 03/27/2023] [Indexed: 07/11/2023] Open
Abstract
Golf is increasing in popularity with 24.8 million golfers in the U.S. in 2020, a 2% increase from the previous year. This number increased to 37.5 million in 2021 which can be further broken down to 25.1 million on course and 12.4 million participating in off course activities. Playing golf does not come without risk of injury, with an annual incidence between 15.8% and 40.9% in amateurs and 31% in professional golfers. Most injuries in golf occur due to overuse (82.6%) and only a small percentage occur from a single traumatic event (17.4%). Injuries most commonly occur at the low back followed by the wrist. Injury prevention programs have shown to be successful in other sports however to date there are no studies assessing a golfer's specific program. The purpose of this clinical commentary is to describe three individualized and unsupervised golf exercise programs (The Golfer's Fore, Fore+, and Advanced Fore+), of varying difficultly, designed to reduce the risk of injury, improve strength/mobility, and optimize performance. Level of Evidence 5.
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Affiliation(s)
| | - Kevin E Wilk
- Champion Sports Medicine Select Medical
- Director of Rehabilitative Research American Sports Medicine Institute
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2
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Lin ZJ, Peng YC, Yang CJ, Hsu CY, Hamill J, Tang WT. Lower Limb Biomechanics during the Golf Downswing in Individuals with and without a History of Knee Joint Injury. Bioengineering (Basel) 2023; 10:bioengineering10050626. [PMID: 37237695 DOI: 10.3390/bioengineering10050626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Although prevention is better than treatment, after a knee injury occurs, the adjustment of the movement technique back to the posture before the injury and the restoration of accuracy is very important for professional and amateur players. This study aimed to compare the differences in lower limb mechanics during the golf downswing between those with and without a history of knee joint injury. A total of 20 professional golfers with single-digit handicaps were recruited for this study, 10 of whom had a knee injury history (KIH+), while another 10 players were without a knee injury history (KIH-). From the 3D analysis, selected kinematic and kinetic parameters during the downswing were analyzed using an independent samples t-test with a significance level of α = 0.05. During the downswing, individuals with KIH+ exhibited a smaller hip flexion angle, smaller ankle abduction angle, and larger ankle adduction/abduction range of motion (ROM). Moreover, there was no significant difference found in the knee joint moment. Athletes with a history of knee injury can adjust the motion angles of their hip and ankle joints (e.g., by avoiding excessive forward leaning of the trunk and maintaining stable foot posture without inward or outward rotation) to minimize the impact of changes in their movement patterns resulting from the injury.
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Affiliation(s)
- Zi-Jun Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Yi-Chien Peng
- Physical Education Office, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chun-Ju Yang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Chung-Yuan Hsu
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
- Center of Traditional Chinese Medicine, Division of Chinese Acupuncture and Traumatology, Taoyuan Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts, Amherst, MA 01003, USA
| | - Wen-Tzu Tang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
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Moon HW, Kim JS. Golf-related sports injuries of the musculoskeletal system. J Exerc Rehabil 2023; 19:134-138. [PMID: 37163185 PMCID: PMC10164523 DOI: 10.12965/jer.2346128.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/02/2023] [Indexed: 05/11/2023] Open
Abstract
The purpose of this study was to evaluate the characteristics of golf-related musculoskeletal injuries. Golfers were retrospectively surveyed through a 50-item questionnaire. Golfers were divided into injured and noninjured groups according to the presence or absence of musculoskeletal injuries. Of the 208 respondents, 64.0% suffered golf-related injuries, most of which were minor injuries caused by overuse in the early 9.9 weeks. According to the anatomical distribution, the most injured parts were upper limbs, spine, trunk, and lower limbs in that order. As for the distribution by part, the hand and wrist were the most vulnerable, and the lateral elbow damage was 3 times more common than the inner elbow. Self-management for injuries was the most common treatment, and regular preventive exercise accounted for 30% of the injured. Overall, more than half of the respondents suffered from musculoskeletal injuries, self-management was the most common, and less than one-third did regular exercise to prevent injuries. Therefore, active management to prevent golf-related musculoskeletal injuries may be necessary.
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Affiliation(s)
| | - Jun-Su Kim
- Corresponding author: Jun-Su Kim, Department of Sports and Outdoors, College of Bio Convergence, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea,
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Martín-García MDM, Ruiz-Real JL, Gázquez-Abad JC, Uribe-Toril J. Golf and Health, More than 18 Holes—A Bibliometric Analysis. Healthcare (Basel) 2022; 10:healthcare10071322. [PMID: 35885848 PMCID: PMC9317188 DOI: 10.3390/healthcare10071322] [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] [Received: 06/07/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Despite golf’s contribution to health, scientific production related to golf and health has been relatively scarce. This work aims to investigate the state of the art on golf and health and to identify existing gaps and the principal and most notable potential future research trends, contributing to connecting the reality of the facilities dedicated to the practice of this sport and its contribution to raising awareness of the importance of sport in maintaining health. A total of 179 articles were analyzed following the steps for systematic reviews and meta-analysis protocols based on the PRISMA 2020 methodology and QUORUM, and a bibliometric analysis was carried out. Research to date has mainly focused on the benefits of golf in improving health, preventing illness, slowing down aging, or as rehabilitation and on exploring the risks and injuries involved in playing golf. The different ways of promoting participation or changing the image of golf by showing its healthy side are outlined as research trends in the coming years. There is a lack of exploration of the use of technology, the effects of the sport on certain disorders related to psychosocial factors, and further knowledge of the relationships between playing intentions and health. This research provides essential information for researchers who plan to work with golf in the future.
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Deckard L. A Targeted Approach to Evaluating the Golfing Athlete with Low Back Pain: A Resident's Case Report. Int J Sports Phys Ther 2021; 16:636-650. [PMID: 34123516 PMCID: PMC8169011 DOI: 10.26603/001c.23470] [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: 08/04/2020] [Accepted: 11/26/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Low back pain is one of the most common conditions occurring in the golfing population. Many approaches have been utilized throughout the years to address this condition including the concept of regional interdependence. The purpose of this case report is to describe the evaluation process and treatment approach of a golfer with low back pain using the principles of regional interdependence. CASE DESCRIPTION A thirty-year-old male with right-sided low back pain was evaluated using a comprehensive approach including golf specific movement screening and a swing evaluation. The patient had mobility restrictions in his thoracic spine and hips that appeared to be contributing to a hypermobility in the lower lumbar spine. Based on the evaluation, he was placed into the treatment-based classification (TBC) of stabilization but would also benefit from mobilization/manipulation techniques. OUTCOMES After seven visits over a four-week span, the patient's mobility and core stability both improved and he was able to play golf and workout pain free. His outcome measures also improved, including the revised Oswestry Disability index from 26% disabled to 10%, the Fear Avoidance Behavior Questionnaire (FABQ) Work from 10/42 to 3/42, and the FABQ Physical Activity from 19/24 to 6/24. DISCUSSION Evaluating and developing a plan of care to address low back pain in an avid golfer can be challenging as a variety of demands are placed on the spine during the movement. This case report describes the evaluation process and treatment approach to specifically target the demands that are required during the golf swing. Utilizing a targeted approach that includes golf specific movement screening and a swing evaluation can help guide the therapist in their treatment and improve the patient's outcome. LEVEL OF EVIDENCE Level 4.
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Skibski A, Burkholder E, Goetschius J. Transverse abdominis activity and ultrasound biofeedback in college golfers with and without low back pain. Phys Ther Sport 2020; 46:249-253. [PMID: 33059233 DOI: 10.1016/j.ptsp.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To compare transverse abdominis (TrA) muscle activity in college golfers with and without a history of low back pain (LBP) and examine the effects of ultrasound biofeedback and a functional golf-setup position on TrA activity. DESIGN Crossover study. SETTING Laboratory. PARTICIPANTS Thirty-two (n = 32) collegiate golfers were stratified into either the LBP group (n = 16, 4.6 ± 4.5 LBP episodes) or non-LBP group (n = 16, 0.1 ± 0.3 LBP episodes) based on LBP episodes in the last 6-months. MAIN OUTCOME MEASURES Ultrasound measures of TrA activity were performed during standard contractions and contractions with ultrasound biofeedback. Contraction-type order was randomized between two visits. Testing was performed in two positions, supine and golf-setup positions. RESULTS We observed no significant differences in TrA activity between the LBP and non-LBP groups. Overall, TrA activity was greater during biofeedback contractions compared to standard contractions, and TrA activity was lower in the golf-setup position compared to the supine position. CONCLUSIONS We observed no differences in TrA activity between college golfers with and without LBP. College golfers with and without LBP demonstrated a greater ability to contract their TrA with real-time ultrasound biofeedback and a lower ability to contract their TrA in the functional golf-setup position compared to the traditional supine position.
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Affiliation(s)
- Andrew Skibski
- Department of Exercise Science & Athletic Training, Adrian College, Adrian, MI, USA.
| | - Erin Burkholder
- Department of Exercise Science & Athletic Training, Adrian College, Adrian, MI, USA.
| | - John Goetschius
- Department of Health Professions, James Madison University, Harrisonburg, VA, USA.
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Edwards N, Dickin C, Wang H. Low back pain and golf: A review of biomechanical risk factors. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:10-18. [PMID: 35783335 PMCID: PMC9219256 DOI: 10.1016/j.smhs.2020.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 12/03/2022] Open
Abstract
Golf is an international sport played by a variety of age groups and fitness levels, and although golf has a low to moderate aerobic intensity level, injuries are common among professional and amateur golfers. High amounts of force experienced during the golf swing can lead to injury when golfers lack appropriate strength or technique with the lower back most commonly injured. Research has indicated that trunk muscle activation, hip strength and mobility, and pelvis and trunk rotation are associated with low back pain (LBP). Based on anecdotal evidence, golf practitioners specifically address issues in weight shift, lumbar positioning, and pelvis sequencing for golfers with LBP. This review aims to elucidate the effects of proper and improper golf swing technique on LBP and to help golf practitioners understand how to approach the alleviation of LBP in their clientele.
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Affiliation(s)
- Nathan Edwards
- School of Kinesiology, Ball State University, Muncie, United States
| | - Clark Dickin
- School of Kinesiology, Ball State University, Muncie, United States
| | - Henry Wang
- School of Kinesiology, Ball State University, Muncie, United States
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Dagher G, Papuga MO. Assessment of Resisted Trunk Rotation Exercise With and Without Kiai Double-Pulse Breathing Technique on Hockey Shot Velocity: A Pilot Study. J Chiropr Med 2019; 17:244-255. [PMID: 30846917 DOI: 10.1016/j.jcm.2018.07.001] [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: 06/01/2017] [Revised: 07/06/2018] [Accepted: 07/31/2018] [Indexed: 11/26/2022] Open
Abstract
Objective The purpose of this study was to assess the feasibility of a study to measure the effect of resisted band antirotation exercises with the use of a double-pulse (DP) breathing kiai exercise on slapshot and snap shot velocity and subjective assessment of performance. Methods Ten participants between 20 and 30 years of age who play ice hockey were recruited. The study was conducted over 3 weeks, and participants were randomized into 2 groups; group 1: resisted band antirotations with DP kiai (a shout used in martial arts) exercises, and group 2: resisted band antirotations alone. After week 1, there was a 1-week washout period, after which group 1 performed resisted band antirotations alone, and group 2 performed resisted band antirotations with DP kiai exercises. Results Data were successfully collected on all 10 participants. There appeared to be no difference between groups regarding slapshot and snap shot velocity. Conclusion The design for this study appears to be feasible. Preliminary data show that the average shot velocity before and after the intervention did not show a positive relationship between DP kiai breathing and hockey shot (slapshot and snap shot) velocity.
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Affiliation(s)
- Georges Dagher
- Research Department, New York Chiropractic College, Seneca Falls, NY
| | - Mark Owen Papuga
- Research Department, New York Chiropractic College, Seneca Falls, NY
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Smith JA, Hawkins A, Grant-Beuttler M, Beuttler R, Lee SP. Risk Factors Associated With Low Back Pain in Golfers: A Systematic Review and Meta-analysis. Sports Health 2018; 10:538-546. [PMID: 30130164 PMCID: PMC6204638 DOI: 10.1177/1941738118795425] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing. Objective: The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers. Data Sources: A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017. Study Selection: Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related low back pain. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3. Data Extraction: Studies were independently reviewed for inclusion by 2 authors, and the following data were extracted: characterization of low back pain, participant demographics, anthropometrics, biomechanics, strength/flexibility, and practice characteristics. The methodological quality of studies was appraised by 3 authors using a previously published checklist. Where possible, individual and pooled effect sizes of select variables of interest were calculated for differences between golfers with and without pain. Results: The search retrieved 73 articles, 19 of which met the inclusion criteria (12 case-control studies, 5 cross-sectional studies, and 2 prospective longitudinal studies). Methodological quality scores ranged from 12.5% to 100.0%. Pooled analyses demonstrated a significant association between increased age and body mass and golf-related low back pain in cross-sectional/case-control studies. Prospective data indicated that previous history of back pain predicts future episodes of pain. Conclusion: Individual demographic and anthropometric characteristics may be associated with low back pain, but this does not support a relationship between swing characteristics and the development of golf-related pain. Additional high-quality prospective studies are needed to clarify risk factors for back pain in golfers.
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Affiliation(s)
- Jo Armour Smith
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Irvine, California
| | | | - Marybeth Grant-Beuttler
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Irvine, California
| | | | - Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, Nevada
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Kunene SH, Luthuli H, Nkosi M, Haffejee M, Jooma I, Munro S. Mechanical lower back pain and sacroiliac joint dysfunction in golfers at two golf clubs in Durban, South Africa. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2018; 74:402. [PMID: 30135917 PMCID: PMC6093125 DOI: 10.4102/sajp.v74i1.402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022] Open
Abstract
Background Mechanical lower back pain (MLBP) and sacroiliac joint dysfunction (SIJD) are common problems among golfers. There are currently few studies on golfers regarding the relationship between MLBP and SIJD. Objective The objective of this study was to determine the prevalence of MLBP and SIJD and their association in golfers at two golf clubs in Durban, South Africa. Method A correlation design included convenience sampling. The Standardised Nordic Questionnaire for the analysis of musculoskeletal symptoms determined the prevalence of MLBP. Sacroiliac joint pain provocative tests determined the prevalence of SIJD. Institutional ethical clearance was granted and consent from participants was obtained. Data were collected over 3 weeks and SPSS was used to calculate descriptive and inferential statistics. Results There were 271 participants dominated by males (86.7%) aged between 39 and 47 years (33.2%). A total of 123 (45%) of the participants presented with MLBP and 62 (23%) with SIJD. The MLBP prevalence was moderately associated with age (χ2 = 71.22, p = 0.004) and years of experience (χ2 = 69.93, p = 0.001). The SIJD prevalence was moderately associated with age (χ2 = 55.49, p = 0.003) and poorly associated with years of experience (χ2 = 44.93, p = 0.005). Twenty-two per cent (60) had both MLBP and SIJD and 54% (146) had neither. A strong association (χ2 = 88.234, p = 0.000) between MLBP and SIJD was observed. Conclusion There was a high prevalence of MLBP and SIJD and a strong association between them. A comprehensive management approach is recommended for golfers with MLBP and SIJD. Clinical Implications This study will provide valuable knowledge that will assist clinicians, especially physiotherapists, in their clinical management of golfers with MLBP and SIJD. Intervention studies are needed to address lower back and sacroiliac joint problems reported in this study.
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Affiliation(s)
- Siyabonga H Kunene
- Department of Physiotherapy, University of the Witwatersrand, South Africa
| | - Hlengiwe Luthuli
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Mthandeni Nkosi
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Maqsood Haffejee
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Iftikaar Jooma
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
| | - Scott Munro
- Department of Physiotherapy, University of KwaZulu-Natal, South Africa
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Pieber K. Sport als Schädigungsfaktor für die Wirbelsäule. MANUELLE MEDIZIN 2018. [DOI: 10.1007/s00337-017-0346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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SADEGHISANI MEISSAM, SOBHANI VAHID, KABIR MAJIDMOHSENI, ASNAASHARI ALI, RAHMANI PEYMAN, AZIMI HADI. INVESTIGATION OF WEIGHT-BEARING SYMMETRY IN A GROUP OF ATHLETES WITH LOW BACK PAIN AND HEALTHY PEOPLE DURING GAIT. J MECH MED BIOL 2017. [DOI: 10.1142/s0219519417500865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The asymmetrical loading applied to legs was proposed as a risk factor for low back pain development. However, this proposed mechanical risk factor was not investigated in the athletes with LBP engaged in rotational demand activities. The aim of the present study was to examine symmetry of weight-bearing in patients with rotational demand activities compared to that in healthy people during gait. In total, 35 subjects, 15 males with LBP and 20 males without LBP, participated in the study. The participants were asked to walk 12 trials in gait lab. Forces applied to legs were recorded by a force plate. Then, the peaks of anteroposterior, mediolateral, and vertical forces were measured. Next, the asymmetrical loads applied to the legs were calculated. The results of our study demonstrated that people with LBP exhibit more asymmetry of vertical peak forces in heel strike and mid-stance. They also exhibited more asymmetry of loading in the anterior direction. But the mean values of ASI of mediolateral and posterior forces in these participants were not significantly different compared to those in the control group. It can be concluded that, in comparison to the healthy subjects, patients with LBP walk with a greater magnitude of asymmetrical weight-bearing at a comfortable speed.
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Affiliation(s)
- MEISSAM SADEGHISANI
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - VAHID SOBHANI
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - ALI ASNAASHARI
- Neurosurgeon, Shahrekord University of Medical Sciences, Iran
| | - PEYMAN RAHMANI
- Neurosurgeon, Shahrekord University of Medical Sciences, Iran
| | - HADI AZIMI
- Department of English Language Teaching, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shifflett GD, Hellman MD, Louie PK, Mikhail C, Park KU, Phillips FM. Return to Golf After Lumbar Fusion. Sports Health 2016; 9:280-284. [PMID: 27879299 PMCID: PMC5435149 DOI: 10.1177/1941738116680200] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Spinal fusion surgery is being increasingly performed, yet few studies have focused on return to recreational sports after lumbar fusion and none have specifically analyzed return to golf. Hypothesis: Most golfers successfully return to sport after lumbar fusion surgery. Study Design: Case series. Level of Evidence: Level 4. Methods: All patients who underwent 1- or 2-level primary lumbar fusion surgery for degenerative pathologies performed by a single surgeon between January 2008 and October 2012 and had at least 1-year follow-up were included. Patients completed a specifically designed golf survey. Surveys were mailed, given during follow-up clinic, or answered during telephone contact. Results: A total of 353 patients met the inclusion and exclusion criteria, with 200 responses (57%) to the questionnaire producing 34 golfers. The average age of golfers was 57 years (range, 32-79 years). In 79% of golfers, preoperative back and/or leg pain significantly affected their ability to play golf. Within 1 year from surgery, 65% of patients returned to practice and 52% returned to course play. Only 29% of patients stated that continued back/leg pain limited their play. Twenty-five patients (77%) were able to play the same amount of golf or more than before fusion surgery. Of those providing handicaps, 12 (80%) reported the same or an improved handicap. Conclusion: More than 50% of golfers return to on-course play within 1 year of lumbar fusion surgery. The majority of golfers can return to preoperative levels in terms of performance (handicap) and frequency of play. Clinical Relevance: This investigation offers insight into when golfers return to sport after lumbar fusion surgery and provides surgeons with information to set realistic expectations postoperatively.
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Affiliation(s)
- Grant D Shifflett
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Michael D Hellman
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Philip K Louie
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Christopher Mikhail
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Kevin U Park
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Frank M Phillips
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
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Abstract
Failed back surgery syndrome (FBSS) is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or without it radiating to the leg. The possible reasons and risk factors that would lead to FBSS can be found in distinct phases: in problems already present in the patient before a surgical approach, such as spinal instability, during surgery (for example, from a mistake by the surgeon), or in the postintervention phase in relation to infections or biomechanical alterations. This article reviews the current literature on FBSS and tries to give a new hypothesis to understand the reasons for this clinical problem. The dysfunction of the diaphragm muscle is a component that is not taken into account when trying to understand the reasons for this syndrome, as there is no existing literature on the subject. The diaphragm is involved in chronic lower back and sacroiliac pain and plays an important role in the management of pain perception.
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Affiliation(s)
- Bruno Bordoni
- Department of Cardiology, Foundation Don Carlo Gnocchi, IRCCS, Institute of Hospitalization and Care, S Maria Nascente, Milan, Italy; School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy
| | - Fabiola Marelli
- School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy
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