Association between lower back pain and lower extremity pain among young volleyball players: A cross-sectional study

Prevalence and associated factors of non-traumatic knee pain in high school volleyball players: a cross-sectional study

OBJECTIVES

This study aimed to determine the prevalence of knee pain among high school volleyball attackers, identify associated factors, and explore the relationship between knee pain and lower back pain (LBP).

METHODS

A cross-sectional study involving 82 high school volleyball attackers (15-17 years) used questionnaires, interviews, and field-based assessments to collect data on demographics, volleyball-specific factors, flexibility, and jumping ability. Logistic regression analysis was used to identify factors associated with knee pain.

RESULTS

The prevalence of knee pain was 19.5%. Factors significantly associated with knee pain were a history of LBP (OR, 4.64; 95% CI, 1.28 to 16.8; p = 0.019) and flexibility determined by the absolute difference in heel-buttock distance (OR, 1.37; 95% CI, 1.02 to 1.83; p = 0.037). Participants with knee pain had more volleyball experience and a higher proportion of players who competed as starters in the previous year. Both groups reported approximately 18 hours of practice per week during the school year and around 27 hours during school holidays, with no significant difference observed.

CONCLUSION

Factors associated with knee pain include a history of LBP and reduced flexibility on the heel-buttock distance test. The study highlights the need for a comprehensive approach, considering the coexistence of LBP and focusing on improving anterior thigh flexibility.

Obesity and overweight as risk factors for low back pain in children and adolescents: a meta-analysis

BACKGROUND

Childhood obesity and overweight are associated with musculoskeletal pain, but the association between low back pain (LBP) and overweight/obesity in this population needs clarification. The objective of this meta-analysis is to ascertain the relationship between LBP and obesity/overweight in children and adolescents.

METHODS

Various databases and specialized journals were queried from inception to October 2022. Encompassed were all studies examining the association between overweight or obesity and LBP among participants aged 6 to 18 years. The ROBINS-E tool was employed to assess bias. Random-effects models were used to pool results across studies, with location-scale models used to search for moderator variables where evidence of heterogeneity was found.

RESULTS

In total, 34 studies were incorporated. Four studies had a low risk of bias, while the remaining studies had some concerns. Nine studies evinced an association between overweight and LBP, in contrast to normal weight, yielding an OR of 1.13 (95% CI 1.10-1.16) and no heterogeneity. Eight studies demonstrated a similar association between obesity and LBP compared to normal weight, with an OR of 1.27 (95% CI 1.20-1.34) and no heterogeneity. Ten studies established an association between overweight/obesity and LBP compared to normal weight, yielding an OR of 1.18 (95% CI 1.14-1.23) and no heterogeneity. Finally, nineteen studies showcased an association between body mass index (BMI) and LBP, with an OR of 1.19 (95% CI 1.03-1.39) with evidence of heterogeneity. For this last analysis, we compared the mean BMI in groups and transformed results to log OR, and then retransformed to OR.

CONCLUSION

Overweight and obesity may be risk factors for LBP in children and adolescents. The association between LBP and obesity appears to be stronger than with overweight. However, the analysis revealed considerable heterogeneity and risk of bias across studies.

Incidence, prevalence and risk factors for low back pain in adolescent athletes: a systematic review and meta-analysis

OBJECTIVE

To investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Medline, Embase, CINAHL via EBSCO, Web of Science, Scopus.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports.

RESULTS

There were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I²=0%) for 2 years, 36.0% (95% CI 4% to 68%, I²=99.3%) for 12 months and 14% (95% CI 7% to 22%, I²=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I²=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I²=56%) for last 3 months and 16% (95% CI 9% to 23%, I²=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, overweight/high body mass index, older adolescent age, female sex and family history of LBP. The most common morphology reported was spondylolysis. Methodological quality was deemed high in 73% of cross-sectional studies and in 30% of cohort studies. Common reasons for downgrading at quality assessment were use of non-validated survey instruments and imprecision or absence of LBP definition.

SUMMARY/CONCLUSION

LBP is common among adolescent athletes, although incidence and prevalence vary considerably due to differences in study methodology, definitions of LBP and data collection.

PROSPERO REGISTRATION NUMBER

CRD42020157206.

Lower Back Injuries in NCAA Female Volleyball Athletes: A 5-Year Epidemiologic Characterization

BACKGROUND

Although lower back injuries (LBIs) are common among National Collegiate Athletic Association (NCAA) female volleyball athletes, their incidence and etiology has not been well-defined.

PURPOSE

To describe the epidemiology of LBIs in collegiate female volleyball athletes over a 5-year period from the academic years 2009 to 2010 and 2013 to 2014.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

The incidence and characteristics of spine injuries were identified utilizing the NCAA Injury Surveillance Program database. Rates of injury were calculated as the number of injuries by the total number of athlete-exposures (AEs). AEs were defined as any student participation in any single NCAA-sanctioned practice or competition. The injury rate was computed as the number of injuries per the total number of AEs and reported as a ration of injuries per 10,000 exposures. The ratio was then reported as overall number as well as stratified for event, time of season, and athletic NCAA division. Incidence rate ratios were then calculated to compare rates between event type. Results with 95% CIs that did not include 1.0 were considered statistically significant.

RESULTS

An estimated 3384 LBIs occurred in NCAA female volleyball players during this 5-year time frame. These LBIs occurred at a rate of 4.89 injuries per 10,000 AEs. LBIs were 2.76 times more likely in preseason when compared with regular season. More injuries occurred in practice (85%) when compared with competition (15%). The outside hitter and middle blocker were the most commonly position to sustain an LBI. Almost 70% of injuries were new injuries, and another 29% were recurrent injuries. The most common mechanism of injury was equally split between contact (50.4%) and overuse (45.5%) injuries, whereas the remaining mechanisms of injury were secondary for unknown reasons (4.14%). Most players returned to play within 24 hours (72.3%) followed by 1 to 6 days (16.4%), and finally 7 to 12 days (11.3%). No patient required surgical intervention.

CONCLUSION

The rate of LBIs was high (4.89/10,000 AEs) and injuries commonly recurred (29.2%). Most injuries were new, with most athletes returning to play with 24 hours.

Low Back Pain in School-Aged Martial Arts Athletes in Japan: A Comparison among Judo, Kendo, and Karate

Martial arts, such as judo, kendo, and karate, are popular worldwide, not only among adults but also among children and adolescents. Although low back pain (LBP) is considered to be a common problem in these sports, it has been scarcely studied, especially in young athletes. The purpose of this study was to elucidate the point prevalence of and factors related to LBP among school-aged athletes in judo, kendo, and karate. A cross-sectional study was conducted in school-aged athletes (age, 6-15 years; n = 896) using a self-reported questionnaire. Multiple logistic regression models were used to assess the factors related to LBP along with the odds ratio (OR) and 95% confidence interval (95% CI). Variables included in the analysis were sex, age, body mass index, team level, number of days and hours of training, frequency of participation in games, practice intensity, and lower extremity pain. The prevalence of LBP was 6.9% in judo, 4.7% in kendo, and 2.9% in karate. Older age was significantly associated with LBP in judo (adjusted OR, 2.12 [95% CI, 1.24-3.61]), kendo (1.77 [1.27-2.47]), and karate (2.22 [1.14-4.33]). Lower extremity pain was significantly associated with LBP in judo (6.56 [1.57-27.34]) and kendo (21.66 [6.96-67.41]). Coaches should understand the characteristics of LBP in each martial art to develop strategies to prevent LBP among school-aged martial arts athletes.