1
|
Zemková E, Amiri B, Horníková H, Zapletalová L. Potential neurophysiological and biomechanical risk factors for sport-related back problems: A scoping review. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:123-138. [PMID: 38708324 PMCID: PMC11067771 DOI: 10.1016/j.smhs.2023.12.006] [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: 09/24/2023] [Revised: 12/17/2023] [Accepted: 12/25/2023] [Indexed: 05/07/2024] Open
Abstract
This scoping review aims (1) to map the literature dealing with neurophysiological and biomechanical aspects of back problems in athletes in order to identify valid risk-factors for their prevention, plus (2) to identify gaps in the existing research and propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar. The main neurophysiological risk factors identified leading to back problems in athletes are neuromuscular imbalance, increased muscle fatigability, muscle dysfunction and impaired motor control, whilst biomechanical risk factors include maladaptive spinal, spinopelvic and lower limb kinematics, side-to-side imbalances in axial strength and hip rotation range of motion, spinal overloading and deficits in movement pattern. However, most studies focused on back pain in the lumbar region, whereas less attention has been paid to thoracic and cervical spine problems. The range of sports where this topic has been studied is relatively small. There is a lack of research in sports in which the core muscles are highly involved in specific movements such as lifting weights or trunk rotations. A limited number of studies include female athletes and master athletes of both genders. In addition to chronic back pain patients, it is equally important to conduct research on healthy athletes with a predisposition to spine problems. Investigators should focus their empirical work on identifying modifiable risk factors, predict which athletes are at risk for back problems, and develop personalized sport-specific assessment tools and targeted prevention strategies for them. This review was registered using the Open Science Framework Registries (https://osf.io/ha5n7).
Collapse
Affiliation(s)
- Erika Zemková
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
- Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Slovakia
| | - Banafsheh Amiri
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
| | - Henrieta Horníková
- Department of Track and Field and Sport Conditioning, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
| | - Ludmila Zapletalová
- Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Slovakia
| |
Collapse
|
2
|
Carraro A, Gilic B, Bertolo R, Albergoni A, Sarto F, Roklicer R, Sarto D. Lower back pain in young climbers: a retrospective cross-sectional study. Front Sports Act Living 2023; 5:1328811. [PMID: 38186399 PMCID: PMC10770867 DOI: 10.3389/fspor.2023.1328811] [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: 10/27/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Objective The popularity of sport climbing has been growing since its inclusion in the Olympic Games program, which led to more people practicing it on recreational, amateur, and professional levels. Strenuous climbing training sessions and competitions might lead to frequent and serious musculoskeletal injuries and complaints among competitive climbers. This study aimed to investigate the prevalence of low back pain (LBP) and to explore the influence of various risk factors on LBP in adolescent climbers. Methods The sample included 180 competitive climbers (46.6% males) aged 13-19 years competing in under-16 (48.3%) or under-20 categories. Data collection was carried out using the Nordic Musculoskeletal Questionnaire (NMQ) and the Graded Chronic Pain Scale (GCPS). Results A total of 74.4% of the entire sample of participants (male = 75%; female = 74%) reported lower back complaints throughout the past twelve months, and only 15.5% during the last seven days. A major part of complaints was classified as low intensity-low disability (Grade I, 62.8%; male = 72.6%; female = 54.2%). Under-20 competitors reported a small but significantly higher percentage of almost all NMQ measures compared to under-16 athletes. Conclusions This study found a relatively high prevalence of LBP, although complaints were of limited severity and did not affect climbers' regular training practice. Moreover, climbers did not differ in LBP prevalence according to sex, while climbers from the older age group reported higher complaints and seeking medical attention than younger climbers. Future studies should prospectively monitor the influence of climbing on LBP in youth climbers.
Collapse
Affiliation(s)
- Attilio Carraro
- Faculty of Education, Free University of Bozen-Bolzano, Bozen, Italy
| | - Barbara Gilic
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Riccardo Bertolo
- Associazione Sportiva Dilettantistica Opera Verticale, Scorzè, Venezia, Italy
| | - Andrea Albergoni
- Faculty of Education, Free University of Bozen-Bolzano, Bozen, Italy
| | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Roberto Roklicer
- Faculty of Education, Free University of Bozen-Bolzano, Bozen, Italy
| | - Diego Sarto
- School of Human Movement Sciences, University of Padova, Padova, Italy
| |
Collapse
|
3
|
Diz JBM, Dutra MTP, Feijó IC, Sogno ALM, Silva FR, Carnevale GDEF, Moreira BDES, Silva CFM. LOW BACK PAIN ESTIMATES IN PROFESSIONAL SOCCER: A SYSTEMATIC REVIEW AND META-ANALYSIS. ACTA ORTOPEDICA BRASILEIRA 2023; 31:e266012. [PMID: 38115872 PMCID: PMC10726716 DOI: 10.1590/1413-785220233105e266012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/22/2022] [Indexed: 12/21/2023]
Abstract
Objective To evaluate the epidemiological and clinical characteristics of low back pain (LBP) in adult professional soccer players. Methods Systematic review and meta-analysis. Results The review included 44 studies. The pooled prevalence of LBP during ≤ 1 season was 1% (95%CI = 0-4%) in men. The pooled point prevalence of LBP was 25% (95%CI = 16-36%) in men and 28% (95%CI = 20-37%) in women. The pooled past-year prevalence of LBP was 34% (95%CI = 24-44%) in men. The pooled lifetime prevalence of LBP was 32% (95%CI = 25-39%) in men and 50% (95%CI = 32-69%) in women. The pooled frequency of LBP/total number of injuries was 2% (95%CI = 1-3%) in men and 4% (95%CI = 2-5%) in women. The pooled incidence rate of LBP/1,000 player-hours of exposure was 0.30 (95%CI = 0.17- 0.53) in men and 0.32 (95%CI = 0.06 -1.87) in women. The recurrence of LBP ranged from 3% to 63% in men. The intensity of LBP ranged from 1.68 (2.39) to 4.87 (2.14) points on a 0-10 scale (minimum = 0 and maximum = 8 points). The severity of LBP (days absent from professional activities due to pain) ranged from 2 (0) to 10 (19) days (minimum = 1 and maximum = 28 days). Conclusion Adult elite soccer players have a substantial prevalence of LBP. The frequency and incidence of LBP (compared with other conditions and sports) seems to be low. Estimates of the recurrence, intensity, and severity of LBP are uncertain. Level of Evidence II, Systematic Review of Level II Studies.
Collapse
|
4
|
Puranik S, Shenoy S. Surface electromyography analysis of core stabilizing muscles during isometric shoulder contractions in athletes with low back pain. J Bodyw Mov Ther 2023; 36:364-369. [PMID: 37949585 DOI: 10.1016/j.jbmt.2023.04.019] [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: 08/10/2021] [Revised: 10/14/2022] [Accepted: 04/11/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The study was carried out in the athletes with and without Low Back Pain (LBP) to determine the surface electromyography activity of core stabilizing muscles while performing isometric shoulder and trunk contractions. STUDY DESIGN Cross-sectional study. METHODS This study enlisted the participation of 40 athletes. Group A included 20 athletes (18 males and 2 females) without LBP, and Group B included 20 athletes (12 males and 8 females) with LBP. Athletes with LBP were assessed using the Modified Oswestry Disability Questionnaire (MODQ) and Visual Analog Scale (VAS) to determine their level of disability and pain severity, respectively. EMG activity of the rectus abdominis, external oblique, longissimus, and multifidus was recorded in both groups as they performed bilateral isometric shoulder and trunk contractions. RESULTS In the LBP group, EMG activity of the rectus abdominis and external oblique muscles was significantly lower (P < 0.05). The LBP group had significantly more multifidus activity (P = 0.03) than the NLBP group. Among all the exercises, bilateral isometric shoulder extension contraction activated the rectus abdominis, right external oblique, and longissimus group of muscles significantly more (P < 0.05) in both groups. In both groups, bilateral isometric shoulder flexion contraction resulted in significantly higher multifidus muscle activation (P = 0.002). CONCLUSION The activation of core stabilizing muscles was altered in athletes with LBP. When athletes are unable to contract and activate trunk muscles owing to pain, upper extremity exercises can be used to activate these muscles.
Collapse
Affiliation(s)
- Surabhi Puranik
- MYAS-GNDU Department of Sports Sciences and Medicine, Guru Nanak Dev University, Amritsar, India.
| | - Shweta Shenoy
- MYAS-GNDU Department of Sports Sciences and Medicine, Guru Nanak Dev University, Amritsar, India
| |
Collapse
|
5
|
Nakai Y, Oe K, Matsuno R, Kiyama R, Kawada M, Takeshita Y, Miyazaki T, Araki S. Effect of Self-Myofascial Release of the Lower Back on Myofascial Gliding, Lumbar Flexibility, and Abdominal Trunk Muscle Strength: A Crossover Study. Sports (Basel) 2023; 11:147. [PMID: 37624127 PMCID: PMC10460077 DOI: 10.3390/sports11080147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Roller massage has been recognized as an effective intervention for managing various conditions. However, data on the effects of roller massage on the dynamic mechanisms of the myofascial and soft tissues of the lower back are limited. This study aimed to examine the effect of the self-myofascial release of the lower back on myofascial gliding, lumbar flexibility, and abdominal trunk muscle strength using a roller massager. This crossover study included 24 college athletes who underwent three interventions-roller massage, static stretching, and control (rest). Before and after the intervention, lumbar and fascial gliding were evaluated using ultrasonography. Long-seat anteflexion (lumbar flexibility) and abdominal trunk muscle strength were assessed. The movement velocities of the subcutaneous tissue and the multifidus muscle over time were calculated using echo video analysis software, and gliding was estimated using the cross-correlation coefficient between the velocities. Gliding, lumbar flexibility, and abdominal trunk muscle strength showed significant intervention-by-time interactions. Roller massage significantly improved gliding, lumbar flexibility, and abdominal trunk muscle strength. The self-myofascial release of the lower back using a roller massager improved the lumbar/fascia gliding, lumbar flexibility, and abdominal trunk muscle strength compared to static stretching.
Collapse
Affiliation(s)
- Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima City 899-4395, Japan
| | - Katsutoshi Oe
- Department of Mechanical and Electrical Engineering, Faculty of Engineering, Nippon Bunri University, 1727 Ichiki, Oita City 870-0397, Japan;
| | - Ryuko Matsuno
- Kirishima Orthopedics Clinic, 8-31 Kokubuchuoh, Kirishima City 899-4341, Japan;
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan; (R.K.); (M.K.); (Y.T.)
| | - Masayuki Kawada
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan; (R.K.); (M.K.); (Y.T.)
| | - Yasufumi Takeshita
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan; (R.K.); (M.K.); (Y.T.)
| | - Takasuke Miyazaki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan;
| | - Sota Araki
- Course of Physical Therapist, Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi Aoba-ku, Sendai City 981-8522, Japan;
| |
Collapse
|
6
|
Dekkers T, O'Sullivan K, Collins K, McVeigh JG, Roe M, Murphy JC, Blake C. The epidemiology of back injuries in elite Gaelic football athletes: An 8-year prospective study. Phys Ther Sport 2022; 57:105-111. [PMID: 35981446 DOI: 10.1016/j.ptsp.2022.07.009] [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: 03/17/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To describe the epidemiology of back injury in elite male Gaelic football athletes between 2008 and 2016. DESIGN Prospective cohort study. SETTING Injury data from the National GAA Injury Surveillance Database. PARTICIPANTS Elite male Gaelic football athletes. MAIN OUTCOME MEASURES Incidence of injury as a rate per 1000 h of exposure. RESULTS 38 datasets were analysed. Out of a total of 1606 time-loss injuries, 76 were back injuries (4.73%, 95% CI 3.80%-5.88%). The incidence of back injuries in match play was 1.72 (CI 95% 1.21 to 2.45) and in training was 0.2 (CI 95% 0.14 to 0.28) injuries per 1000 h of exposure. The majority of back injuries (63.16%, CI 95% 51.93-73.12) were new, as opposed to recurrent (35.53% CI 95% 25.7-46.74). Most back injuries were acute (51.32%, CI 95% 40.29-62.22), compared to chronic (31.58%, CI 95% 22.23-42.7) or overuse (11.84%, CI 95% 6.36-21.00). The majority of back injuries occurred during non-contact player activities (n = 60, 78.94% CI 95% 68.50-86.60). CONCLUSIONS Back injury rates in Gaelic football are similar to soccer and Australian football but less than rugby union. Further research is needed to understand the factors leading to the onset and recurrence of back injury in Gaelic football athletes.
Collapse
Affiliation(s)
- Thomas Dekkers
- Gaelic Sports Research Centre, Technological University Dublin, Dublin, Ireland; Evolve Health, Skibbereen, Co.Cork, Ireland
| | - Kieran O'Sullivan
- School of Allied Health, University of Limerick, Limerick, Ireland; Ageing Research Centre, University of Limerick, Limerick, Ireland; Sports and Human Performance Centre, University of Limerick, Limerick, Ireland
| | - Kieran Collins
- Gaelic Sports Research Centre, Technological University Dublin, Dublin, Ireland
| | - Joseph G McVeigh
- School of Clinical Therapies, University College Cork, Cork, Ireland
| | - Mark Roe
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Catherine Blake
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Ansari S, Sharma S. Prevalence and risk factors of chronic low back pain in university athletes: a cross-sectional study. PHYSICIAN SPORTSMED 2022:1-10. [PMID: 35914545 DOI: 10.1080/00913847.2022.2108351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AIM This study aimed to establish the prevalence of chronic low back pain (CLBP) in university-level athletes and to examine the influence of age, sex, body mass index (BMI), sports discipline, sleep, anxiety, and depression on CLBP. The secondary purpose was to check the association of certain variables in athletes having CLBP with the sports discipline and chronicity of LBP. METHODS A total of 340 players (100% response rate) from different sports, aged 18-30 years with at least 1 year of participation in sports at the university level were screened for the present study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their demographic variables, personal and pain-related factors. The study was registered on the clinical trials registry, India (CTRI/2021/09/036675). RESULTS The results revealed the sport-wise point prevalence as follows: cricket (18.5%), basketball (15.6%), volleyball (20.0%), football (11.4%), badminton (7.7%) and tennis (7.7%). A higher number of years at university-level participation (>4 years), smoking, anxiety and BMI (>25 kg/m2) are risk factors for CLBP. The type of LBP, the intensity of the pain (current and last week), variation of the pain intensity, disability, intake of oral medications, physiotherapy for CLBP, number of missed days of training and number of missed matches are not significantly related to the chronicity of LBP or the sports discipline. Only the number of missed days of training had a significant association with the chronicity of LBP. CONCLUSIONS CLBP is a common complaint in Indian university athletes, and our findings indicate the necessity for a specific prevention program.
Collapse
Affiliation(s)
- Sumbul Ansari
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India
| | - Saurabh Sharma
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India
| |
Collapse
|
9
|
Brown RB. Non-Specific Low Back Pain, Dietary Salt Intake, and Posterior Lumbar Subcutaneous Edema. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159158. [PMID: 35954516 PMCID: PMC9368517 DOI: 10.3390/ijerph19159158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022]
Abstract
Low back pain is the world’s leading disability, but the etiology of the majority of low back pain is non-specific with no known cause. Moreover, overuse of opioids to treat low back pain is a widespread problem. This paper proposes that non-specific low back pain may be associated with excessive intake of dietary salt, potentially mediated by posterior lumbar subcutaneous edema. In addition to pain, symptoms of edema include swelling, tightness, and stiff joints, which are common complaints of people with low back pain, along with restricted lumbar range of motion and impaired mobility. Many global populations consume excess sodium chloride, which can lead to fluid overload in hypervolemia, and cause swelling and temporary weight gain associated with low back pain. Numerous conditions comorbid with low back pain are also potentially mediated by excessive salt intake, including migraine headache, hypertension, cardiovascular disease, venous thromboembolism, liver disease, respiratory disorders, chronic kidney disease, pregnancy complications, and multiple sclerosis. Novel approaches to identify and prevent the cause of non-specific low back pain have potential to reduce disability worldwide by reducing low back pain prevalence. More research is needed to confirm the involvement of dietary salt and posterior lumbar subcutaneous edema in non-specific low back pain.
Collapse
Affiliation(s)
- Ronald B Brown
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| |
Collapse
|
10
|
Understanding Sex-Based Kinematic and Kinetic Differences of Chasse-Step in Elite Table Tennis Athletes. Bioengineering (Basel) 2022; 9:bioengineering9060246. [PMID: 35735489 PMCID: PMC9219934 DOI: 10.3390/bioengineering9060246] [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: 05/12/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 12/05/2022] Open
Abstract
With the progress and innovation of table tennis technology, individualized training programs may deserve special attention. This study aimed to analyze elite table tennis athletes in chasse-step, with a particular focus on sex-based biomechanical differences. A total of 36 (18 males and 18 females) elite table tennis athletes performed topspin forehand of chasse-step. Angles and moments of hip, knee, and ankle joints were calculated using OpenSim (v4.2) with marker trajectories and ground reaction forces were measured via Vicon motion capture system and AMTI in-ground force platform. Males had greater hip and knee flexion angles during the entire motion phase and greater internal rotation angles of the hip during the forward swing phase. The joint stiffness of knee in males was greater than females in the frontal plane. Females in the forward swing phase showed greater hip flexion, adduction, and internal rotation moments than males. It was suggested that the difference may be due to the limitation of anatomical structures in sexes. Male table tennis athletes should strengthen lower extremity muscle groups to improve performance, while female table tennis athletes should focus on hip joint groups to avoid injury. The sex differences presented in this study could help coaches and athletes to develop individualized training programs for table tennis.
Collapse
|
11
|
Schäfer R, Schäfer H, Platen P. Perturbation-based trunk stabilization training in elite rowers: A pilot study. PLoS One 2022; 17:e0268699. [PMID: 35587490 PMCID: PMC9119454 DOI: 10.1371/journal.pone.0268699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/03/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction
Low back pain is a major health issue in elite rowers. High training volume, frequent flexion movements of the lower spine and rotational movement in sweep rowing contribute to increased spinal strain and neuropathological patterns. Perturbation-based trunk stabilization training (PTT) may be effective to treat neuromuscular deficits and low back pain.
Methods
All boat classes (8+, 4+/-, 2-) of the male German national sweep rowing team participated in this non-randomized parallel group study. We included 26 athletes (PTT: n = 12, control group: n = 14) in our analysis. Physical and Sports therapists conducted 16 individualized PTT sessions á 30–40 minutes in 10 weeks, while the control group kept the usual routines. We collected data before and after intervention on back pain intensity and disability, maximum isometric trunk extension and flexion, jump height and postural sway of single-leg stance.
Results
We found less disability (5.3 points, 95% CI [0.4, 10.1], g = 0.42) for PTT compared to control. Pain intensity decreased similar in both groups (-14.4 and -15.4 points), yielding an inconclusive between-group effect (95% CI [-16.3, 14.3]). Postural sway, strength and jump height tend to have no between- and within-group effects.
Conclusion
Perturbation-based trunk stabilization training is possibly effective to improve the physical function of the lower back in elite rowers.
Collapse
Affiliation(s)
- Robin Schäfer
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
- * E-mail:
| | - Hendrik Schäfer
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
12
|
Marineau Belanger E, Boon DM, Descarreaux M, Abboud J. The effect of low back pain on neuromuscular control in cyclists. J Sports Sci 2022; 40:1255-1264. [PMID: 35389326 DOI: 10.1080/02640414.2022.2061819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study was designed to identify neuromuscular adaptations of low back pain (LBP) cyclists , and the impact of a cycling effort on spinal shrinkage. Forty-eight trained cyclists rode their road bike on a smart trainer for 1-hour. Surface electromyography (EMG) recorded muscle activity of the lumbar erector spinae (LES), 3D motion analysis system recorded kinematic of the trunk, and stadiometry measured spinal height. Statistical comparisons were made using repeated measure ANOVAs. The LBP group presented increase in pain levels throughout the effort (p < 0.001). A significant group difference was only observed for the thoracic angle (p = 0.03), which was less flexed for LBP. The one-hour cycling effort (time effect) significantly increased the trunk flexion (p < 0.001) and thoracic flexion (p < 0.001) for both groups. Significant lower LES activation (35% less) was observed at the end of the effort as well as a decrease in spinal height (p = 0.01) for both groups. Neuromuscular adaptations to cycling effort is identified by a decrease in LES EMG amplitude and an increase flexion of the trunk. Adaptation to pain is seen by an increase in thoracic flexion. Despite these adaptations, LBP cyclists could not ride their bike pain-free.
Collapse
Affiliation(s)
- Emile Marineau Belanger
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Dan-Mihai Boon
- parcours neuroscience du mouvement, Université de Paris-Est CréteilFaculté de biologie-santé.,Institut Franco-Européen de Chiropraxie, Campus Paris, France
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| |
Collapse
|
13
|
Khan RR, Riaz S, Rashid S, Sulman M. Effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy. Pak J Med Sci 2021; 37:1451-1455. [PMID: 34475929 PMCID: PMC8377889 DOI: 10.12669/pjms.37.5.4200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives: To determine the effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy. Methods: A quasi experimental trial was conducted from April to September 2020 among sixty patients of chronic lumbosacral radiculopathy at Ibn e Siena Hospital, Multan. Participants were divided into two groups. Group-A (Supine) participants received lumbar traction in supine lying along with conventional treatment. Group-B (Prone) underwent the same treatment except the lumbar traction being applied in prone lying position. Participants were evaluated twice: at pre- treatment (week 0) and at the post treatment (week 2). Oswestry Disability Index and Numeric Pain Rating Scale were used as outcome measure. Data was analyzed on SPSS 23. Results: The mean (±S.D) age of the patients was 39±5.7 vs. 40±5.3 years in supine vs. prone group respectively. Mean ODI score was 25.2±6.13 vs. 26.0±6.26 at the start of treatment in supine vs. prone position respectively while it was 19.45±7.12 vs. 11.05±4.40 at end of treatment in supine vs. prone position respectively. Mean NPRS score was 7.73±1.23 vs. 7.67±0.96 at start of treatment in supine vs. prone position respectively while it was 4.63±0.89 vs. 3.13±0.90 at the end of treatment in supine vs. prone position respectively. Conclusion: Lumbar traction in prone lying position is more effective than lumbar traction in supine lying position for the treatment of chronic lumbosacral radiculopathy.
Collapse
Affiliation(s)
- Rehan Ramzan Khan
- Dr. Rehan Ramzan Khan, MSPT-OMPT. Assistant Professor, Multan College of Physiotherapy, Multan Medical and Dental College (MMDC), Multan, Pakistan
| | - Saima Riaz
- Dr. Saima Riaz, MSPT-OMPT, PhD Assistant Professor, Riphah College of Rehabilitation & Allied Health Sciences, Riphah International University (RIU), Lahore, Pakistan
| | - Sajid Rashid
- Prof. Dr. Sajid Rashid, PhD. Multan College of Physiotherapy, Multan Medical and Dental College (MMDC), Multan, Pakistan
| | - Muhammad Sulman
- Dr. Muhammad Sulman, MSPT-OMPT. Senior Lecturer, Department of Physiotherapy, University of Sialkot, Sialkot, Pakistan
| |
Collapse
|
14
|
Gause PR, Godinsky RJ, Burns KS, Dohring EJ. Lumbar Disk Herniations and Radiculopathy in Athletes. Clin Sports Med 2021; 40:501-511. [PMID: 34051943 DOI: 10.1016/j.csm.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lumbar disk herniation is the most common surgical condition of the spine. High-level athletes participate in activities that place extreme loads on the intervertebral disks. These repetitive loads may lead to an elevated risk for degenerative disk disease, which in turn predisposes to disk herniations. Treatment algorithms for athletes with disk herniations are similar to those in the nonathletic population; however, success in the athletic population is often measured in the ability to return to play. Both nonoperative and operative treatment show a high success rate in return to play in athletes treated for disk herniations.
Collapse
Affiliation(s)
- Paul R Gause
- Spine Institute of Arizona, 9735 North 90th Place, Scottsdale, AZ 85258, USA.
| | - Ryan J Godinsky
- Spine Institute of Arizona, 9735 North 90th Place, Scottsdale, AZ 85258, USA
| | - Keven S Burns
- Spine Institute of Arizona, 9735 North 90th Place, Scottsdale, AZ 85258, USA
| | - Edward J Dohring
- Spine Institute of Arizona, 9735 North 90th Place, Scottsdale, AZ 85258, USA
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Androulakis-Korakakis P, Gentil P, Fisher JP, Steele J. Comparison of Isolated Lumbar Extension Strength in Competitive and Noncompetitive Powerlifters, and Recreationally Trained Men. J Strength Cond Res 2021; 35:652-658. [PMID: 29979273 DOI: 10.1519/jsc.0000000000002722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
ABSTRACT Androulakis-Korakakis, P, Gentil, P, Fisher, JP, and Steele, J. Comparison of isolated lumbar extension strength in competitive and noncompetitive powerlifters, and recreationally trained men. J Strength Cond Res 35(3): 652-658, 2021-Low-back strength has been shown to significantly impact performance in a plethora of sports. Aside from its effect on sport performance, low-back strength is strongly associated with low-back pain. A sport that heavily involves the lower-back musculature is powerlifting. This study looked to compare isolated lumbar extension (ILEX) strength in competitive and noncompetitive powerlifters, and recreationally trained men. Thirteen competitive powerlifters (CPL group; 31.9 ± 7.6 years; 173.4 ± 5.5 cm; 91.75 ± 18.7 kg), 10 noncompetitive powerlifters (NCPL group; 24 ± 3.5 years; 179 ± 4.8 cm; 92.39 ± 15.73 kg), and 36 recreationally trained men (RECT group; 24.9 ± 6.5 years; 178.5 ± 5.2 cm; 81.6 ± 10.0 kg) were tested for ILEX. Isolated lumbar extension strength was measured at every 12° throughout subject's full range of motion (ROM) and expressed as the following: "strength index (SI)" calculated as the area under a torque curve from multiple angle testing, average torque produced across each joint angle (AVG), and maximum torque produced at a single angle (MAX). Deadlift and squat strength were measured using 1 repetition maximum for the competitive and noncompetitive powerlifters. The following powerlifting characteristics were recorded for the competitive and noncompetitive powerlifters: primary deadlift stance, primary squat bar position, use of belt, use of performance-enhancing drugs, and use of exercises to target the lower-back musculature. Significant between-group effects were found for subject characteristics (age, stature, body mass, and ROM). However, analysis of covariance with subject characteristics as covariates found no significant between-group effects for SI (p = 0.824), AVG (p = 0.757), or MAX (p = 0.572). In conclusion, this study suggests that powerlifting training likely has little impact on conditioning of the lumbar extensors.
Collapse
Affiliation(s)
| | - Paulo Gentil
- Faculty of Physical Education, Federal University of Goiás, Goiânia, Brazil
| | - James P Fisher
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, United Kingdom; and
| | - James Steele
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, United Kingdom; and
| |
Collapse
|
17
|
Titze C, Fett D, Trompeter K, Platen P, Gajsar H, Hasenbring MI. Psychosocial subgroups in high-performance athletes with low back pain: eustress-endurance is most frequent, distress-endurance most problematic! Scand J Pain 2021; 21:59-69. [PMID: 32892188 DOI: 10.1515/sjpain-2020-0053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/25/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES In non-athletes, fear-avoidance and endurance-related pain responses appear to influence the development and maintenance of low back pain (LBP). The avoidance-endurance model (AEM) postulates three dysfunctional pain response patterns that are associated with poorer pain outcomes. Whether comparable relationships are present in athletes is currently unclear. This cross-sectional case-control study explored frequencies and behavioral validity of the AEM-based patterns in athletes with and without LBP, as well as their outcome-based validity in athletes with LBP. METHODS Based on the Avoidance-Endurance Fast-Screen, 438 (57.1% female) young adult high-performance athletes with and 335 (45.4% female) without LBP were categorized as showing a "distress-endurance" (DER), "eustress-endurance" (EER), "fear-avoidance" (FAR) or "adaptive" (AR) pattern. RESULTS Of the athletes with LBP, 9.8% were categorized as FAR, 20.1% as DER, 47.0% as EER, and 23.1% as AR; of the athletes without LBP, 10.4% were categorized as FAR, 14.3% as DER, 47.2% as EER, and 28.1% as AR. DER and EER reported more pronounced endurance- and less pronounced avoidance-related pain responses than FAR, and vice versa. DER further reported the highest training frequency. In athletes with LBP, all dysfunctional groups reported higher LBP intensity, with FAR and DER displaying higher disability scores than AR. CONCLUSIONS The results indicate that also in athletes, patterns of endurance- and fear-avoidance-related pain responses appear dysfunctional with respect to LBP. While EER occurred most often, DER seems most problematic. IMPLICATIONS Endurance-related pain responses that might be necessary during painful exercise should therefore be inspected carefully when shown in response to clinical pain.
Collapse
Affiliation(s)
- Christina Titze
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
| | - Daniela Fett
- Department of Sports Medicine and Sports Nutrition, Ruhr-University of Bochum, Bochum, Germany
- Federal Institute of Sports Science (BISp), Bonn, Germany
| | - Katharina Trompeter
- Department of Sports Medicine and Sports Nutrition, Ruhr-University of Bochum, Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Ruhr-University of Bochum, Bochum, Germany
| | - Hannah Gajsar
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
| | - Monika I Hasenbring
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
- Faculty of Health Science, University of Southern Denmark, J.B. Winsløws Vej 19, 3, DK-5000, Odense, Denmark
| |
Collapse
|
18
|
Low-Back Pain and Knee Position-Related Differences on Postural Control Measures During a One-Legged Stance in Athletes. J Sport Rehabil 2020; 30:631-637. [PMID: 33238243 DOI: 10.1123/jsr.2020-0095] [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: 03/02/2020] [Revised: 06/22/2020] [Accepted: 09/07/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Chronic low-back pain (CLBP) may be associated with changes in postural balance in athletes as poor postural control during sports practice. OBJECTIVE To compare the postural control of athletes with and without CLBP during 2 one-legged stance tasks and identify the center of pressure (COP) cutoff values to determine the main differences. Designed: A cross-sectional study. SETTING Laboratory of functional evaluation and human motor performance. PARTICIPANTS A total of 56 male athletes, 28 with and 28 without CLBP (mean age = 26 y). INTERVENTION The one-legged stance with knee extension and with the knee at 30° flexion tasks were measured and analyzed on a force platform. The participants completed three 30-second trials (30 s of rest between each trial). MAIN OUTCOME MEASURES The COP parameters: the area of COP, mean COP sway velocity in both the anteroposterior and mediolateral directions, and total COP displacement were computed, and a receiver operating characteristics curve analysis was applied to determine the group differences. RESULTS Athletes with CLBP had poorer postural control (P < .01) in both tasks. The 30° knee flexion reported more postural instability than the knee extension for all COP parameters (a large effect size d = 0.80).The knee extension cutoffs identified were >7.1 cm2 for the COP area, >2.6 cm/s for the COP sway velocity in the anterior-posterior direction, and >3.2 cm/s for the mediolateral direction. Whereas, the 30° knee flexion cutoffs were >10.9 cm2 for the COP area, >2.9 cm/s for the COP sway velocity in the anterior-posterior direction, and >4.1 cm/s for the mediolateral direction. Both measures showed enough sensitivity and specificity (ie, area under the curve = 0.88 in and 0.80, respectively) to discriminate both groups. CONCLUSIONS The athletes with CLBP had poorer postural control than the healthy athletes and obtained specific cutoff scores from the COP values.
Collapse
|
19
|
Zack O, Barak Y, Finestone AS, Krakov A, Slodownik D, Alperovitch-Najenson D, Moshe S. Occupational influences on Spondylolysis and Spondylolisthesis in a cohort of 18-year-old male military conscripts. BMC Musculoskelet Disord 2020; 21:720. [PMID: 33153454 PMCID: PMC7643341 DOI: 10.1186/s12891-020-03747-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reported prevalence of spondylolysis (SL) in the adult population is 6-7%. Data concerning adolescent-onset spondylolisthesis (SLS) and the impact of certain activities on it is scarce. We examined the risk of clinical progression of SL and SLS as a function of primary severity and occupational strain among military recruits. METHODS Based on the Israel defense Force (IDF) central human resources database, we identified 1521 18-year-old males inducted to the IDF with SL/SLS between the late nineteen nineties and early two-thousands. We followed changes in the SL/SLS status during the 3 years of obligatory military service. Disease severity was classified as Cat2: radiological findings of SL without clinical findings; Cat3: painful SL or asymptomatic grade 1 SLS; Cat4: grade 1 SLS with pain; Cat5: Grade 2 SLS. The soldiers were subdivided into the following occupational categories: administrative, combat, maintenance, and driving. The purpose was to compare the progression rates in different medical categories and job assignments. RESULTS There were 162 recruits in Cat2, 961 in Cat3, and 398 recruits in Cat4. The overall progression rate to Cat5 (grade 2 SLS) was 1.02%. Significant progression rates were seen amongst administrative soldiers with a relatively higher risk of progression from Cat4 (painful-grade-1 SLS: 2.2%) vs. Cat3 (asymptomatic SLS: 0.5%, relative risk = 4.7, p < 0.02). Other occupational categories did not exhibit significant progression rates. CONCLUSION Progression of SL/SLS was highest in Cat4, i.e. for recruits already diagnosed with painful SLS (i.e. with a more severe baseline disorder). Progression did not correlate with military occupation. We recommend further follow-up studies that include, aside from progression rates, incidence rates of newly diagnosed grade 2 SL during military service.
Collapse
Affiliation(s)
- Oren Zack
- The Israel Defense Forces, Medical Corps, Tel-Aviv, Israel
- Department of Occupational and Environmental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv university, Tel-Aviv, Israel
| | - Yair Barak
- The Israel Defense Forces, Medical Corps, Tel-Aviv, Israel
| | - Aharon S. Finestone
- Department of Orthopedics, Shamir Medical Center, Zerifin, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ayala Krakov
- Department of Occupational and Environmental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv university, Tel-Aviv, Israel
- Department of Occupational Medicine, Hashfela and Jerusalem district, Maccabi Healthcare Services, 15 Rothschild St., Rishon Letzion, Israel
| | - Dani Slodownik
- Department of Occupational and Environmental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv university, Tel-Aviv, Israel
- Department of Dermatology, Tel Aviv Sourascky Medical Center, Tel Aviv, Israel
| | - Deborah Alperovitch-Najenson
- Department of Occupational and Environmental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv university, Tel-Aviv, Israel
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shlomo Moshe
- Department of Occupational and Environmental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv university, Tel-Aviv, Israel
- Department of Occupational Medicine, Hashfela and Jerusalem district, Maccabi Healthcare Services, 15 Rothschild St., Rishon Letzion, Israel
| |
Collapse
|
20
|
Derrouiche A, Feki F, Zaïri F, Taktak R, Moulart M, Qu Z, Ismail J, Charfi S, Haddar N, Zaïri F. How pre-strain affects the chemo-torsional response of the intervertebral disc. Clin Biomech (Bristol, Avon) 2020; 76:105020. [PMID: 32416404 DOI: 10.1016/j.clinbiomech.2020.105020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/22/2020] [Accepted: 04/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The role of the axial pre-strain on the torsional response of the intervertebral disc remains largely undefined. Moreover, the chemo-mechanical interactions in disc tissues are still unclear and corresponding data are rare in the literature. The paper deals with an in-vitro study of the pre-strain effect on the chemical sensitivity of the disc torsional response. METHODS Fifteen non-frozen 'motion segments' (two vertebrae and the intervening soft tissues) were extracted from the cervical spines of mature sheep. The motion segments were loaded in torsion at various saline concentrations and axial pre-strain levels in order to modulate the intradiscal pressure. After preconditioning with successive low-strain compressions at a magnitude of 0.1 mm (10 cycles at 0.05 mm/s), the motion segment was subjected to a cyclic torsion until a twisting level of 2 deg. at 0.05 deg./s while a constant axial pre-strain (in compression or in tension) is maintained, the saline concentration of the surrounding fluid bath being changed from hypo-osmotic condition to hyper-osmotic condition. FINDINGS Analysis of variance shows that the saline concentration influences the torsional response only when the motion segments are pre-compressed (p < .001) with significant differences between hypo-osmotic condition and hyper-osmotic condition. INTERPRETATION The combination of a compressive pre-strain with twisting amplifies the nucleus hydrostatic pressure on the annulus and the annulus collagen fibers tensions. The proteoglycans density increases with the compressive pre-strain and leads to higher chemical imbalances, which would explain the increase in chemical sensitivity of the disc torsional response.
Collapse
Affiliation(s)
- Amil Derrouiche
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), 59000 Lille, France
| | - Faten Feki
- Sfax University, ENIS, Materials Engineering and Environment Laboratory (LGME), 3038 Sfax, Tunisia
| | - Fahmi Zaïri
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), 59000 Lille, France.
| | - Rym Taktak
- Sfax University, ENIS, Materials Engineering and Environment Laboratory (LGME), 3038 Sfax, Tunisia
| | | | - Zhengwei Qu
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), 59000 Lille, France
| | - Jewan Ismail
- Lille University, Civil Engineering and geo-Environmental Laboratory (ULR 4515 LGCgE), 59000 Lille, France
| | - Slim Charfi
- Habib Bourguiba Hospital, Pathology department, 3038 Sfax, Tunisia
| | - Nader Haddar
- Sfax University, ENIS, Materials Engineering and Environment Laboratory (LGME), 3038 Sfax, Tunisia
| | - Fahed Zaïri
- Ramsay Générale de Santé, Hôpital privé Le Bois, 59000 Lille, France
| |
Collapse
|
21
|
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
| |
Collapse
|
22
|
McCarthy CJ, Potter L, Oldham JA. Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial. BMJ Open Sport Exerc Med 2019; 5:e000514. [PMID: 31673401 PMCID: PMC6797393 DOI: 10.1136/bmjsem-2019-000514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2019] [Indexed: 11/04/2022] Open
Abstract
Background Spinal manipulation is commonly used to treat back pain. The application of spinal manipulation has traditionally involved an element of targeting the technique to a level of the spine where the proposed movement dysfunction is sited. We evaluated the effects of a targeted manipulative thrust versus a thrust applied generally to the lumbar region. Methods A randomised controlled clinical trial in patients with low back pain following CONSORT (Consolidated Standards of Reporting Trials) guidelines. Sixty subjects were randomly allocated to two groups: one group received a targeted manipulative thrust (n=29) and the other a general manipulation thrust (GT) (n=31) to the lumbar spine. Thrust was either localised to a clinician-defined symptomatic spinal level or an equal force was applied through the whole lumbosacral region. We measured pressure-pain thresholds (PPTs) using algometry and muscle activity (magnitude of stretch reflex) via surface electromyography. Numerical ratings of pain and Oswestry Disability Index scores were collected. Results Repeated measures of analysis of covariance revealed no between-group differences in self-reported pain or PPT for any of the muscles studied. Summary A GT procedure-applied without any specific targeting-was as effective in reducing participants' pain scores as targeted approaches. Trial registration number ISRCTN11994230.
Collapse
Affiliation(s)
- Christopher J McCarthy
- School of Physiotherapy, Manchester Metropolitan University, Manchester, UK.,Manchester Metropolitan University, Manchester, UK
| | - Louise Potter
- Department of Anaesthesia, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Jackie A Oldham
- Health Innovation, Manchester Oxford Road Corridor, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| |
Collapse
|
23
|
Nowotny AH, Calderon MG, de Souza PA, Aguiar AF, Léonard G, Alves BMO, Amorim CF, da Silva RA. Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial. BMJ Open Sport Exerc Med 2018; 4:e000452. [PMID: 30555717 PMCID: PMC6267311 DOI: 10.1136/bmjsem-2018-000452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/14/2018] [Accepted: 10/03/2018] [Indexed: 02/07/2023] Open
Abstract
Background Chronic low back pain (CLBP) is an important disorder in athletes that may negatively affect their performance in competitions. The literature usually recommends physiotherapy based on exercises for back pain management in athletes. Recent evidence suggests that interventions based on lumbar muscle stabilisation exercises (LMSE) and back endurance-resistance exercises (BERE) may improve back pain and function performance. However, it is still unclear which type of exercise is more effective for the treatment of CLBP in athletes. Objective To compare the efficacy of LMSE versus BERE in athletes with CLBP. Design The study is a 2-arm, prospectively registered, randomised controlled trial. Setting The physical therapy clinical and biomechanics laboratory of the UNOPAR University. Participants 32 male athletes with CLBP, age between 18 and 40 years old, recruited from the local community. Intervention An 8-week intervention programme will be carried out with LMSE s versus BERE. Measurements Trunk neuromuscular patterns during balance tasks (unipodal and over a ball) using electromyography and force platform parameters, pain, disability, fear and avoidance will be assessed by a blinded assessor at baseline and at follow-up after 8 weeks of intervention period. Limitations The absence of blinding intervention and the exclusion of female athletes, seated sports and swimmers will affect the internal and external validity of the study. Conclusions The results of this study will elucidate which of these two interventions promote better results in trunk neuromuscular pattern, back pain and function in male athletes with CLBP.
Collapse
Affiliation(s)
| | | | | | - Andreo Fernando Aguiar
- Doctoral and Masters Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Londrina-PR, Brazil
| | - Guillaume Léonard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Research Center on Aging, Institute of Geriatrics, Université de Sherbrooke, Québec, Canada
| | - Bruno Mazziotti Oliveira Alves
- Master and Doctoral Program in Physical Therapy, University of City of São Paulo, UNICID, São Paulo, Brazil.,Paris Saint-Germain Departament of Physical Therapy and Biomechanics, Paris Saint-Germain Football Club, Paris, France
| | - Cesar Ferreira Amorim
- Master and Doctoral Program in Physical Therapy, University of City of São Paulo, UNICID, São Paulo, Brazil.,Département des Sciences de la Santé, Programme de physiothérapie de l'université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada.,Physical Therapy and Neuroscience Departments, Wertheims' Colleges of Nursing and Health Sciences and Medicine, Florida International University (FIU), Miami, Florida, United States
| | - Rubens Alexandre da Silva
- Doctoral and Masters Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Londrina-PR, Brazil.,Département des Sciences de la Santé, Programme de physiothérapie de l'université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
| |
Collapse
|
24
|
Abstract
ABSTRACT As acupuncture is growing in popularity in Brazil and worldwide, it is necessary to study the benefits and possibilities of this type of treatment more in depth, especially as it is believed to produce fast results with few side effects and does not involve substances banned in sports. Thus, it seems like a good option to be considered as main or adjuvant therapy in sports-related injuries. In order to gain more knowledge about this subject, this article is an integrative review analyzing the publications of the period between January 2012 and January 2017 on the Cochrane and Pubmed platforms that analyzed acupuncture in the treatment of sports injuries. We found 49 articles, 11 of which fulfilled the inclusion criteria: two case reports, three clinical trials and six literature reviews. Although all the articles analyzed produced favorable results with the use of the therapeutic technique in question, flaws in the designs of the studies and the difficulty of creating a placebo control group in acupuncture hinder the qualification of the articles on evidence rating scales. Therefore, it is suggested to the researchers that further studies be published with experimental animal models and observational studies, and that STRICTA recommendations be followed to improve the level of evidence of acupuncture research. Level of Evidence II; Systematic review of level II studies.
Collapse
|
25
|
Moreno Catalá M, Schroll A, Laube G, Arampatzis A. Muscle Strength and Neuromuscular Control in Low-Back Pain: Elite Athletes Versus General Population. Front Neurosci 2018; 12:436. [PMID: 30018531 PMCID: PMC6037821 DOI: 10.3389/fnins.2018.00436] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/11/2018] [Indexed: 12/15/2022] Open
Abstract
The purpose of the study was to investigate the athletic-based specificity of muscle strength and neuromuscular control of spine stability in chronic non-specific low-back pain (LBP). Thirty elite athletes and 29 age-matched non-athletes with (15 athletes and 15 non-athletes) and without LBP (15 athletes and 14 non-athletes) participated in the study. Muscle strength was measured during maximal isometric trunk flexion and trunk extension contractions. The neuromuscular control of spine stability was analyzed by determining trunk stiffness, trunk damping, and onset times of the lumbar and thoracic erector spinae muscles after sudden perturbations (quick release experiments) as well as maximum Lyapunov exponents (local dynamic stability) using non-linear time series analysis of repetitive lifting movements. LBP was assessed using the visual analog scale. We found lower maximal trunk extension moments (p = 0.03), higher trunk damping (p = 0.018) and shorter onset times (p = 0.03) of the investigated trunk muscles in LBP patients in both athletes and non-athletes. Trunk stiffness and the local dynamic stability did not show any differences (p = 0.136 and p = 0.375, respectively) between LBP patients and healthy controls in both groups. It can be concluded that, despite the high-level of training in athletes, both athletes and non-athletes with LBP showed the same deconditioning of the lumbar extensor muscles and developed similar strategies to ensure spine stability after sudden perturbations to protect the spine from pain and damage. The findings highlight that specific training interventions for the trunk muscles are not only crucial for individuals of the general population, but also for well-trained athletes.
Collapse
Affiliation(s)
- María Moreno Catalá
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Berlin, Germany
| | - Arno Schroll
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Berlin, Germany
| | - Gunnar Laube
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Berlin, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Berlin, Germany
| |
Collapse
|
26
|
Farahbakhsh F, Akbari-Fakhrabadi M, Shariat A, Cleland JA, Farahbakhsh F, Seif-Barghi T, Mansournia MA, Rostami M, Kordi R. Neck pain and low back pain in relation to functional disability in different sport activities. J Exerc Rehabil 2018; 14:509-515. [PMID: 30018941 PMCID: PMC6028206 DOI: 10.12965/jer.1836220.110] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 05/14/2018] [Indexed: 12/14/2022] Open
Abstract
This population-based, cross-sectional study aimed to determine the frequency of neck pain, low back pain (LBP) and also the LBP related functional disability in five sport categories including football, volleyball, basketball, wrestling, and other sports in one of the Iranian sport Olympiads. The prevalence of neck pain and LBP in different time points was evaluated with the use of an interview questionnaire. A visual analogue scale was used to evaluate the athlete's current pain. Furthermore, the functional disability related to LBP was assessed by the Athletes Disability Index Questionnaire (ADI). A total of 452 male athletes aging between 12 and 20 were screened. Three hundred seventy-seven participants responded to the questionnaires in which their mean age (standard deviation) was 15.95 (1.25). Collectively, the life-time prevalence of neck pain and LBP in all the athletes was 38.8% and 42.0%, respectively. The highest risk of neck pain at all-time points was observed among basketball players compared to other sport groups (P<0.05). The risk of LBP in most time points was the least among wrestlers (P<0.05). The ADI score was significantly higher among basketball players (13.89%) compared to volleyball players and wrestlers (P<0.05). Our study revealed a high prevalence of neck pain and LBP among Iranian young male athletes. A higher risk of neck pain and LBP among basketball players predisposes this sport at high risk of developing spine injuries which needs further consideration.
Collapse
Affiliation(s)
- Farzin Farahbakhsh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Akbari-Fakhrabadi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardalan Shariat
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farbod Farahbakhsh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tohid Seif-Barghi
- Department of Sports and Exercise Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rostami
- 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, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
27
|
Abstract
Background Back pain is a frequent health problem in the general population. The epidemiology of back pain in the general population is well researched, but detailed data on the prevalence and risk factors of back pain in athletes are rare. Objective The primary objective was to review articles about back pain in athletes to provide an overview of its prevalence in different sports and compare its prevalence among various types of sports and the general population. Data Sources A comprehensive search of articles published through May 2015 was conducted. Two independent reviewers searched six databases from inception (PubMed®, Embase, MEDLINE®, Cochrane Library, PsycINFO and PSYNDEX), using specifically developed search strategies, for relevant epidemiological research on back pain in 14- to 40-year-old athletes of Olympic disciplines. The reviewers independently evaluated the methodological quality of reviewed articles meeting the inclusion criteria to identify potential sources of bias. Relevant data were extracted from each study. Results Forty-three articles were judged to meet the inclusion criteria and were included in the assessment of methodological quality. Of these, 25 were assessed to be of high quality. Lifetime prevalence and point prevalence were the most commonly researched episodes and the lower back was the most common localization of pain. In the high-quality studies, lifetime prevalence of low back pain in athletes was 1–94%, (highest prevalence in rowing and cross-country skiing), and point prevalence of low back pain was 18–65% (lowest prevalence in basketball and highest prevalence in rowing). Conclusion The methodological heterogeneity of the included studies showed a wide range of prevalence rates and did not enable a detailed comparison of data among different sports, within one discipline, or versus the general population. Based on the results of this review, however, it seems obvious that back pain requires further study in some sports. Electronic supplementary material The online version of this article (doi:10.1007/s40279-016-0645-3) contains supplementary material, which is available to authorized users.
Collapse
|
28
|
Belz J, Heidari J, Levenig C, Hasenbring M, Kellmann M, Kleinert J. Stress and risk for depression in competitive athletes suffering from back pain - Do age and gender matter? Eur J Sport Sci 2018; 18:1029-1037. [PMID: 29741992 DOI: 10.1080/17461391.2018.1468482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Back pain (BP), a prominent problem for competitive athletes, is a primary reason for limitations in athletic performance and daily life restrictions. As studies on the relationship between psychological variables and BP in athletes are scarce, the aim of this study was to investigate stress and depression in competitive athletes with BP. In a cross-sectional design, data of 154 competitive athletes (51% female; Mage = 18.81 years, SDage = 5.05 years) were collected, assessing Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being and the two BP parameters BP Intensity and Disability. Two multiple linear regressions were conducted to predict (1) BP Intensity and (2) Disability from Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being. Multiple linear regressions demonstrated that Performance stress (β = .21, p = .01) was the only significant predictor of BP Intensity (F1,142 = 6.68, p = .01, R2 = .05), whilst Risk for depression (β = .24, p = .01) was the only significant predictor of Disability (F1,142 = 8.46, p = .01, R2 = .06). Neither gender nor age explained a significant amount of variance in the models. Study results showed that, as in the general population, the variables stress and depression are related to BP in competitive athletes. In particular, BP intensity was found to be associated with stress and BP-related disability was associated with depression, whereas age and gender showed no association with the BP parameters. A longitudinal investigation is warranted to determine the direction of the observed relationships.
Collapse
Affiliation(s)
- Johanna Belz
- a Department of Health & Social Psychology , German Sport University Cologne , Cologne , Germany
| | - Jahan Heidari
- b Unit of Sport Psychology, Faculty of Sport Science , Ruhr University Bochum , Bochum , Germany
| | - Claudia Levenig
- c Department of Medical Psychology and Medical Sociology , Ruhr University Bochum , Bochum , Germany
| | - Monika Hasenbring
- c Department of Medical Psychology and Medical Sociology , Ruhr University Bochum , Bochum , Germany
| | - Michael Kellmann
- b Unit of Sport Psychology, Faculty of Sport Science , Ruhr University Bochum , Bochum , Germany.,d School of Human Movement and Nutrition Sciences , The University of Queensland , St Lucia , Australia
| | - Jens Kleinert
- a Department of Health & Social Psychology , German Sport University Cologne , Cologne , Germany.,e German Research Centre of Elite Sport - Momentum , German Sport University Cologne , Cologne , Germany
| |
Collapse
|
29
|
Balling M, Holmberg T, Petersen CB, Aadahl M, Meyrowitsch DW, Tolstrup JS. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain: The Danish Health Examination Survey cohort 2007–2008. Scand J Public Health 2018; 47:45-52. [DOI: 10.1177/1403494818758843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aims: This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. Methods: A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007–2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. Results: During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03–1.30 and HR = 1.45, 95% CI: 1.15–1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. Conclusions: The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.
Collapse
Affiliation(s)
- Mie Balling
- University of Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Teresa Holmberg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christina B. Petersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mette Aadahl
- Centre for Clinical Research and Prevention, Frederiksberg Hospital
- Department of Public Health, University of Copenhagen, Denmark
| | | | - Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| |
Collapse
|
30
|
Bezci SE, Eleswarapu A, Klineberg EO, O'Connell GD. Contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics. J Orthop Res 2018; 36:2266-2273. [PMID: 29431237 DOI: 10.1002/jor.23870] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/24/2018] [Indexed: 02/04/2023]
Abstract
Stresses applied to the spinal column are distributed between the intervertebral disc and facet joints. Structural and compositional changes alter stress distributions within the disc and between the disc and facet joints. These changes influence the mechanical properties of the disc joint, including its stiffness, range of motion, and energy absorption under quasi-static and dynamic loads. There have been few studies evaluating the role of facet joints in torsion. Furthermore, the relationship between biochemical composition and torsion mechanics is not well understood. Therefore, the first objective of this study was to investigate the role of facet joints in torsion mechanics of healthy and degenerated human lumbar discs under a wide range of compressive preloads. To achieve this, each disc was tested under four different compressive preloads (300-1200 N) with and without facet joints. The second objective was to develop a quantitative structure-function relationship between tissue composition and torsion mechanics. Facet joints have a significant contribution to disc torsional stiffness (∼60%) and viscoelasticity, regardless of the magnitude of axial compression. The findings from this study demonstrate that annulus fibrosus GAG content plays an important role in disc torsion mechanics. A decrease in GAG content with degeneration reduced torsion mechanics by more than an order of magnitude, while collagen content did not significantly influence disc torsion mechanics. The biochemical-mechanical and compression-torsion relationships reported in this study allow for better comparison between studies that use discs of varying levels of degeneration or testing protocols and provide important design criteria for biological repair strategies. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Collapse
Affiliation(s)
- Semih E Bezci
- Department of Mechanical Engineering, University of California Berkeley, Etcheverry Hall, Berkeley, California 94720
| | - Ananth Eleswarapu
- Department of Orthopaedic Surgery, University of California Davis, Medical Center, Sacramento, California 95817
| | - Eric O Klineberg
- Department of Orthopaedic Surgery, University of California Davis, Medical Center, Sacramento, California 95817
| | - Grace D O'Connell
- Department of Mechanical Engineering, University of California Berkeley, Etcheverry Hall, Berkeley, California 94720
| |
Collapse
|
31
|
Effects of axial compression and rotation angle on torsional mechanical properties of bovine caudal discs. J Mech Behav Biomed Mater 2018; 77:353-359. [DOI: 10.1016/j.jmbbm.2017.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/06/2017] [Accepted: 09/15/2017] [Indexed: 12/30/2022]
|
32
|
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: 33] [Impact Index Per Article: 5.5] [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.
Collapse
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
| |
Collapse
|
33
|
Fett D, Trompeter K, Platen P. Back pain in elite sports: A cross-sectional study on 1114 athletes. PLoS One 2017; 12:e0180130. [PMID: 28662110 PMCID: PMC5491135 DOI: 10.1371/journal.pone.0180130] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/10/2017] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To establish the prevalence of back pain in German elite athletes; examine the influence of age, sex, sports discipline and training volume; and compare elite athletes with a physically active control group. METHODS A standardized and validated online back pain questionnaire was sent by the German Olympic Sports Confederation to approximately 4,000 German national and international elite athletes, and a control group of 253 physically active but non-elite sports students. RESULTS We received responses from 1,114 elite athletes (46.5% male and 53.1% female, mean age 20.9 years ± 4.8 years, mean height 176.5 ± 11.5 cm, mean weight 71.0 ± 10.3 kg) and 166 physically active sports students (74.7% male and 24.1 female, mean age 21.2 ± 2.0 years, mean height 180.0 ± 8.0 cm, mean weight 74.0 ± 14.5 kg). In elite athletes, the lifetime prevalence of back pain was 88.5%, the 12-month prevalence was 81.1%, the 3-month prevalence was 68.3% and the point prevalence was 49.0%, compared with 80.7%, 69.9%, 59.0% and 42.8%, respectively in the control group. The lifetime, 12-month and 3-month prevalences in elite athletes were significantly higher than in the control group. Regarding the individual sports disciplines, the prevalence of back pain was significantly higher in elite rowers, dancers, fencers, gymnasts, track and field athletes, figure skaters and marksmen, and those who play underwater rugby, water polo, basketball, hockey and ice hockey compared with the control group. The prevalence of back pain was significantly lower in elite triathletes. CONCLUSIONS Back pain is a common complaint in German elite athletes. Low back pain seems to be a problem in both elite athletes and physically active controls. A high training volume in elite athletes and a low training volume in physically active individuals might increase prevalence rates. Our findings indicate the necessity for specific prevention programs, especially in high-risk sports. Further research should investigate the optimal dose-effect relationship of sporting activity for the general population to prevent back pain.
Collapse
Affiliation(s)
- Daniela Fett
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
- * E-mail: (DF); (KT)
| | - Katharina Trompeter
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
- * E-mail: (DF); (KT)
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
34
|
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
|
35
|
Cauci S, Migliozzi F, Trombetta CS, Venuto I, Saccheri P, Travan L, Chiriacò G. Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes. BMC Sports Sci Med Rehabil 2017; 9:4. [PMID: 28184307 PMCID: PMC5294822 DOI: 10.1186/s13102-017-0069-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Abstract
Background Low back pain (LBP) is common in athletes. LBP can be detrimental to athletic performance and health. Factors predisposing to LBP in athletes remain elusive and require further studies. We investigated whether carriage of a specific genotype and/or allele of vitamin D receptor gene (VDR) FokI polymorphism (rs2228570) was a risk factor for LBP in athletes of different sports disciplines. Methods This genotype/phenotype association case-control study included 60 Italian athletes (25 females and 35 males; mean age 33.9 ± 13.3 years; body-mass-index 23.5 ± 3.5 kg/m2) of which 16.7% were swimmers, 11.7% soccer players, 11.7% volleyball players, 10.0% rugby players and other disciplines. VDR-FokI polymorphism was measured by PCR-RFLP in 24 athletes with LBP and 36 athletes without LBP episodes. Absence or presence of the FokI restriction site was denoted “F” and “f”, respectively. Other risk factors were evaluated by a questionnaire. Results The homozygous FF genotype was found in 58.3% (14/24) of athletes with LBP versus 27.8% (10/36) of athletes without LBP, adjusted OR = 5.78, 95% CI 1.41–23.8, P = 0.015. The F allele was a 2-fold risk factor to develop LBP, adjusted OR = 2.55, 95% CI 1.02–6.43, P = 0.046, while f allele was protective. Exposure to vehicle vibrations ≥2 h daily, and family history of lumbar spine pathology were significant risk factors for LBP with OR = 3.54, and OR = 9.21, respectively. Conclusions This is the first study in which an association between VDR-FokI polymorphism and LBP in athletes was found. Further research is needed to extend our results, and to clarify the biochemical pathways associated with how vitamin D modulates LBP in athletes. The VDR-FokI polymorphism should be considered when developing genetic focused studies of precision medicine on health in athletes. Electronic supplementary material The online version of this article (doi:10.1186/s13102-017-0069-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy.,Clinical Biochemistry and Molecular Biology, Department of Medical and Biological Sciences, Piazzale Kolbe 4, 33100 Udine, Italy
| | - Francesca Migliozzi
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy.,Department of Medicine, Surgery and Health Sciences, School of Medicine, University of Trieste, Trieste, 34100 Italy
| | - Carlo Simone Trombetta
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Ilaria Venuto
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Paola Saccheri
- Department of Experimental and Clinical Medical Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Luciana Travan
- Department of Experimental and Clinical Medical Sciences, School of Medicine, University of Udine, Udine, 33100 Italy
| | - Giovanni Chiriacò
- Department of Medicine, Surgery and Health Sciences, School of Medicine, University of Trieste, Trieste, 34100 Italy
| |
Collapse
|
36
|
Noll M, de Avelar IS, Lehnen GC, Vieira MF. Back Pain Prevalence and Its Associated Factors in Brazilian Athletes from Public High Schools: A Cross-Sectional Study. PLoS One 2016; 11:e0150542. [PMID: 26938456 PMCID: PMC4777545 DOI: 10.1371/journal.pone.0150542] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 02/15/2016] [Indexed: 12/19/2022] Open
Abstract
Most studies on the prevalence of back pain have evaluated it in developed countries (Human Development Index--HDI > 0.808), and their conclusions may not hold for developing countries. The aim of this study was to identify the prevalence of back pain in representative Brazilian athletes from public high schools. This cross-sectional study was performed during the state phase of the 2015 Jogos dos Institutos Federais (JIF), or Federal Institutes Games, in Brazil (HDI = 0.744), and it enrolled 251 athletes, 173 males and 78 females (14-20 years old). The dependent variable was back pain, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, exercise-level, anthropometric, strength, behavioral, and postural factors. The prevalence ratio (PR) was calculated using multivariable analysis according to the Poisson regression model (α = 0.05). The prevalence of back pain in the three months prior to the study was 43.7% (n = 104), and 26% of the athletes reported feeling back pain only once. Multivariable analysis showed that back pain was associated with demographic (sex), psychosocial (loneliness and loss of sleep in the previous year), hereditary (ethnicity, parental back pain), strength (lumbar and hand forces), anthropometric (body mass index), behavioral (sleeping time per night, reading and studying in bed, smoking habits in the previous month), and postural (sitting posture while writing, while on a bench, and while using a computer) variables. Participants who recorded higher levels of lumbar and manual forces reported a lower prevalence of back pain (PR < 0.79), whereas feeling lonely in the previous year, obesity, and ethnicity exhibited the highest prevalence ratio (PR > 1.30). In conclusion, there is no association between exercise levels and back pain but there is an association between back pain and non-exercise related variables.
Collapse
Affiliation(s)
- Matias Noll
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
- Instituto Federal Goiano–Campus Ceres, Ceres, Goiás, Brazil
| | - Ivan Silveira de Avelar
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Georgia Cristina Lehnen
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| |
Collapse
|