Straight Leg Raise Test: Influence of Lumbosant© and Assistant Examiner in Hip, Pelvis Tilt and Lumbar Lordosis

Description of ROM-SPORT I Battery: Keys to Assess Lower Limb Flexibility

Limited range of motion (ROM) is considered one of the most important intrinsic and modifiable risk factors for the most common sports-related injuries. In addition, controlling and monitoring an athlete's ROM is a strategy to achieve optimal ROM and improve athletic performance in sports, especially those that require high ROM in the major joints. Therefore, assessing ROM (pre-participation, during a rehabilitation process, on return to play, etc.) is important not only as a method to prevent sports injuries, but also as a quantitative determinant of the potential of athletic performance. However, despite the variety of different ROM assessment methods described in the literature, there is no consensus on which methods are best suited for this goal. Recently, the ROM-SPORT I battery has been shown to have advantages over other ROM assessment methods. This tool has not yet been fully described in detail for researchers, sports professionals, and clinicians to learn. The main objective of this study is to describe the ROM-SPORT I battery tests in detail using the following criteria: test description, simplicity of the test procedure, low need for human and material resources, predictive validity, and reliability.

Sagittal Integral Morphotype of Competitive Amateur Athletes and Its Potential Relation with Recurrent Low Back Pain

Athletes have higher thoracic and lumbar curvature in standing than the reference values of the non-athletic population. The sagittal integral morphotype method (SIM) assessment has not previously been applied to competitive amateur athletes (CAA). The propose of the present study was to determine the SIM of CAA treated at a sports-medicine center and to identify spinal misalignments associated with recurrent low back pain (LBP). An observational analysis was developed to describe the SIM in 94 CAA. The thoracic and lumbar curvatures of the CAA were measured in standing, sitting, and trunk forward flexion. Association analysis (Pearson’s chi-square and Cramér’s V tests) was then performed to identify the SIM misalignments associated with LBP. Effect size was analyzed based on Hedges’ g. The most common thoracic SIMs in CAA were total hyperkyphosis (male = 59.02%; female = 42.42%) and static hyperkyphosis (male = 11.48%; female = 6.06%). Hyperlordotic attitude (female = 30.30%; male = 4.92%), static-functional hyperkyphosis (male = 16.39%; female = 3.03%), and structured hyperlordosis (female = 21.21%; male = 1.64%) were the most common lumbar SIMs. Hyperlordotic attitude, static functional lumbar hyperkyphosis, and structured hyperlordosis were associated with LBP in male and female athletes.

Sagittal standing spinal alignment and back pain in 8 to 12-year-old children from the Region of Murcia, Spain: The ISQUIOS Program

BACKGROUND

The child's spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP).

OBJECTIVE

The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children.

METHODS

This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children's parents or legal guardians filled in a questionnaire according to the children's responses about the BP suffered in the previous week and the preceding year.

RESULTS

The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009-1.160, p= 0.028).

CONCLUSIONS

To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.

Assessment of the Range of Movement of the Lower Limb in Sport: Advantages of the ROM-SPORT I Battery

Range of movement (ROM) assessment is an important strategy to increase physical-technical performance and minimize the risk of sports-related injuries. Currently, there is no consensus regarding which ROM assessment method is the most appropriate. The main objective of this study was to perform a systematic review of the test batteries available for the assessment of lower limb ROM; additionally, we compare the ROM-SPORT I battery with those previously reported in the literature. The systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The identification of publications was made by using the databases SciELO, Medline, Scopus, PubMed, and Web of Science. Based on the inclusion criteria, sixteen publications were selected and analyzed. The ROM-SPORT I battery is the most valid of the analyzed methods. This battery evaluates the ROM of eleven lower limb movements. The inclinometer with a telescopic arm and a box is a simpler, more comfortable, and faster procedure than others. The Lumbosant support and use of two examiners are essential to avoid compensatory movements to obtain reliable measurements during ROM assessment. The ROM-SPORT I is a field-based battery of tests that may be used by sports professionals, clinics, and researchers in applied settings to accurately assess and monitor lower extremity ROM.

Asymmetry and Tightness of Lower Limb Muscles in Equestrian Athletes: Are They Predictors for Back Pain?

Athletes may suffer from low back pain (LBP). Some studies have considered restricted range of motion (ROM) as a risk factor for LBP in athletes; however, ROM has not been evaluated in equestrian athletes (EAs) with LBP. The aims of this research in EAs were (I) to analyze the relationship between lower limb ROM (tightness and asymmetry) and LBP and (II) to determine the reference values for lower limb ROM indicating high risk of LBP. Forty-three young (9–18 years old) EAs were voluntarily recruited in technical training camps. The EAs were assessed for 11 passive lower limb ROMs using the ROM-SPORT I Battery. LBP data were taken at the end of a 1-year period through a questionnaire. Binary logistic regression and receiver operating characteristic curves were calculated. Sixty-seven percent of EA had suffered LBP. Hip adduction (OR = 1.347, medium; p = 0.015) and knee flexion (OR = 1.109, small; p = 0.023) were predictors of LBP in EAs. A hip adduction of 26° and knee flexion of 128° were found to be the optimal cutoff values for predictive screening of EAs at high risk of LBP.

External and Total Hip Rotation Ranges of Motion Predispose to Low Back Pain in Elite Spanish Inline Hockey Players

Low back pain (LBP) is a common ailment in competitive athletes. Although the association between limited range of motion (ROM) and prevalence of LBP has been widely investigated in other sports, there is no research about this topic in inline hockey (IH). The main purposes of this study in IH players were (1) to analyze the association between hip ROM and LBP and (2) to establish a diagnostic cutoff for ROM of high risk of LBP. Twenty elite IH players from the two Spanish National Teams (male and female) were assessed for passive maximum hip ROMs; the movement evaluated were the hip external [HER] and internal [HIR] rotation, hip flexion with flexed [HF-KF] and extended [HF-KE] knee, hip adduction with flexed hip [HAD-HF], hip abduction with neutral [HAB] and flexed [HAB-HF] hip, and hip extension [HE]. LBP was retrospectively monitored for the last 12 months before the date of ROM assessment by using a questionnaire. The data were analyzed via a binary logistic regression and receiver operating characteristic curves. The 70% of players had developed LBP during the retrospective study period. Significant differences between LBP group and asymptomatic group for HER (p = 0.013, d [Cohen’s effect size] = 1.17) and hip total rotation [HTR] (p = 0.032, d [Cohen’s effect size] = 1.05) were observed. The cutoff points with the greatest discriminatory capacity were 56.5° for HER and 93° for HTR ROMs.

Lower-Limb Flexibility Profile Analysis in Youth Competitive Inline Hockey Players

During puberty, the growth of the bones is faster than that of the muscles, which may result in muscular tightness. Muscular tightness and asymmetry have been associated with an increase in injury incidence. The assessment of a joint range of motion (ROM) could help to identify athletes classified as high injury risk. The objectives of the present study were to describe the lower-extremity flexibility profile (LEFP) of youth competitive inline hockey players using the ROM-SPORT battery (I) and to identify muscular tightness and asymmetry (II). Seventy-four young players were examined for maximum passive ankle, knee, and hip ROMs. Muscle asymmetry or tightness was classified according to cutoff scores previously described. The LEFP of the 74 players was 10.8° for hip extension, 26° for hip adduction, 33.6° for ankle dorsiflexion, 38.6° for ankle dorsiflexion with knee flexed, 36.7° for hip abduction, 46° for hip internal rotation, 60.6° for hip external rotation, 65.1° for hip abduction with the hip flexed, 66.3° for hip flexion with the knee extended, 119.7° for knee flexion, and 133.7° for hip flexion. The individual analysis of the flexibility values identified tightness in all players for one or more movement, except for hip abduction. A low prevalence of asymmetries was observed (range: 5.4% to 17.6% of players) depending on the ROM.