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Sonesson S, Lindblom H, Hägglund M. To play or not to play, that is the question: an interview study with amateur football coaches on perceptions of pain during sports participation. BMJ Open Sport Exerc Med 2024; 10:e001941. [PMID: 39006390 PMCID: PMC11243123 DOI: 10.1136/bmjsem-2024-001941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2024] [Indexed: 07/16/2024] Open
Abstract
Amateur football coaches play a key role in preventing, assessing and treating pain among their players, as they are often the first point of contact and may be the main source of advice and guidance. The objective of this study was to explore amateur football coaches' perceptions of pain during sports participation and their approach to pain management. We conducted a qualitative interview study with 20 amateur football coaches from a strategically selected sample of male and female, and junior and senior teams. A semistructured interview guide and conventional qualitative content analysis were used. One overall theme emerged: To play or not to play-coaches navigating difficult terrain with limited resources. The theme included four main categories: How can pain be understood?; Can pain be avoided?; How to manage players with pain?; What resources do we need? Different ways of understanding pain emerged, and coaches described that players have different pain thresholds. Pain was seen as a part of the game that cannot be completely avoided. In general, there was a restrictive attitude regarding pain medication, though actual consumption was not known. Coaches emphasised shared responsibility with players to achieve adequate training loads, a positive communication climate surrounding pain, and a need for education and competence. In conclusion, coaches expressed various interpretations of pain during sports participation and pain management, where they need to take on great responsibility despite limited medical competence. Coaches believed that adequate pain management is important, and their keys to reducing the risk of pain included structured and customised training, a well-balanced training load and recovery, and a positive communication climate in the team. Coaches often decide whether players experiencing pain can participate in team training and match play, emphasising the need for education support and access to medical competence.
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Affiliation(s)
- Sofi Sonesson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
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Cottrell K, Chong J. Impact of Medical Cannabis on Recovery from Playing-Related Musculoskeletal Disorders in Musicians: An Observational Cohort Study. Healthcare (Basel) 2024; 12:1335. [PMID: 38998869 PMCID: PMC11241574 DOI: 10.3390/healthcare12131335] [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: 05/16/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Playing-related musculoskeletal disorders (PRMDs) are musculoskeletal symptoms that interfere with the ability to play at the level a musician is accustomed to. Musicians have an 84% lifetime prevalence of PRMD. Many types of analgesia are inappropriate for this population due to their risks, but cannabidiol (CBD) has been shown to have anti-inflammatory properties and can reduce the perception of pain. Medical cannabis has also been shown to be safer than other analgesia in terms of serious adverse events. This study explores the impact of medical cannabis for PRMD on perceptions of pain and mental health outcomes. METHODS Participants (n = 204) completed questionnaires at baseline and six months: the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) and Depression, Anxiety and Stress Scale (DASS-21). Participants self-selected their group: non-cannabis users (n = 42), new medical cannabis users (n = 61), and long-term medical cannabis users (n = 101). Data were analyzed using paired t-tests for within-group and ANOVA for between-group differences. RESULTS At six months, there was no difference (p = 0.579) in cannabidiol dose between new (24.87 ± 12.86 mg) and long-term users (21.48 ± 12.50 mg). There was a difference in tetrahydrocannabinol (THC) dose (p = 0.003) between new (3.74 ± 4.22 mg) and long-term users (4.41 ± 5.18 mg). At six months, new cannabis users had a significant reduction in pain intensity as measured by The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM40) (p = 0.002). Non-users (p = 0.035), new users (p = 0.002), and long-term cannabis users (p = 0.009) all had significant reductions in pain interference (MPIIQM50) at six months. At six months, non-cannabis (p = 0.022) and long-term cannabis users (p = 0.001) had an improvement in DASS-21. The change in pain intensity was the only difference between groups, F(2, 201) = 3.845, p = 0.023. This difference was between long-term (0.83 ± 0.79) and new users (-2.61 ± 7.15). No serious adverse events occurred, and a minority experienced tiredness, cough, and dry mouth. DISCUSSION/CONCLUSIONS This practice-based evidence demonstrated that the multidimensional approach to care provided by the Musicians' Clinics of Canada benefited all groups at six months. Medical cannabis significantly reduced pain intensity in new users of medical cannabis with PRMD, and all groups saw improvements in pain interference. In keeping with prior studies, medical cannabis seems to be effective at reducing perceptions of pain, including for PRMD. CBD/THC dosing was within guideline recommendations, and no patients experienced any serious adverse events. Limitations include multiple factors impacting patients' decisions to opt in or out of medical cannabis. These include cost, comorbidities, and disease chronicity. In conclusion, medical cannabis reduces pain intensity in new users, and when combined with a multidimensional approach to care, patients with PRMD can see improvements in pain as well as mental wellbeing.
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Affiliation(s)
| | - John Chong
- Musicians' Clinics of Canada, Hamilton, ON L9C 7N4, Canada
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3
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Huschtscha Z, Silver J, Gerhardy M, Urwin CS, Kenney N, Le VH, Fyfe JJ, Feros SA, Betik AC, Shaw CS, Main LC, Abbott G, Tan SY, May A, Smith CM, Kuriel V, Barnard J, Hamilton DL. The Effect of Palmitoylethanolamide (PEA) on Skeletal Muscle Hypertrophy, Strength, and Power in Response to Resistance Training in Healthy Active Adults: A Double-Blind Randomized Control Trial. SPORTS MEDICINE - OPEN 2024; 10:66. [PMID: 38844675 PMCID: PMC11156829 DOI: 10.1186/s40798-024-00732-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/20/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Palmitoylethanolamide (PEA) has analgesic/anti-inflammatory properties that may be a suitable alternative to over-the-counter (OTC) non-steroidal analgesics/anti-inflammatories. While OTC pain medications can impair strength training adaptations, the mechanism of action of PEA is distinct from these and it may not negatively affect skeletal muscle adaptations to strength training. METHODS The primary aim of this study was to investigate the effects of daily PEA supplementation (350 mg Levagen + equivalent to 300 mg PEA) combined with 8-weeks of resistance training on lean body mass with secondary aims addressing strength, power, sleep, and wellbeing compared to placebo (PLA) in young, healthy, active adults. In a randomized, controlled, double-blinded trial, 52 untrained, recreationally active participants aged 18-35 y were allocated to either the PEA or PLA groups. Participants consumed either 2 × 175 mg Levagen + PEA or identically matched maltodextrin capsules during an 8-week period of whole-body resistance training. This trial assessed the pre- to post- changes in total and regional lean body mass, muscular strength (1-RM bench, isometric mid-thigh pull), muscular power [countermovement jump (CMJ), bench throw], pain associated with exercise training, sleep, and wellbeing compared with the PEA or PLA condition. RESULTS 48 Participants were included in the final intention to treat (ITT) analysis and we also conducted per protocol (PP) analysis (n = 42). There were no significant between-group differences for total or regional lean muscle mass post-intervention. There was a significantly higher jump height (CMJ) at week 10 in the PEA group compared to the PLA (Adjusted mean difference [95% CI] p-value; ITT: - 2.94 cm [- 5.15, - 0.74] p = 0.010; PP: - 2.93 cm [- 5.31, - 0.55] p = 0.017). The PLA group had higher 1-RM bench press post-intervention compared with the PEA group (ITT: 2.24 kg [0.12, 4.37] p = 0.039; PP: 2.73 kg [0.40, 5.06] p = 0.023). No significant treatment effects were noted for any of the other outcomes. CONCLUSION PEA supplementation, when combined with 8 weeks of strength training, did not impair lean mass gains and it resulted in significantly higher dynamic lower-body power when compared with the PLA condition. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR: ACTRN12621001726842p).
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Affiliation(s)
- Zoya Huschtscha
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Jessica Silver
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Michael Gerhardy
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Charles S Urwin
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Nathan Kenney
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Viet Hung Le
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Jackson J Fyfe
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Simon A Feros
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Andrew C Betik
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Christopher S Shaw
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Luana C Main
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Gavin Abbott
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Sze-Yen Tan
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Anthony May
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
- Respiratory Research@Alfred, Monash University, Melbourne, Australia
| | - Craig M Smith
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, 3216, Australia
| | - Vicky Kuriel
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia
| | - Jackson Barnard
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - D Lee Hamilton
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, 3216, Australia.
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Dreismickenbecker E, Fleckenstein J, Walter C, Enax-Krumova EK, Fischer MJM, Kreuzer M, Zinn S, Anders M. Nociceptive Processing of Elite Athletes Varies between Sport-Specific Loads: An EEG-Based Study Approach. Med Sci Sports Exerc 2024; 56:1046-1055. [PMID: 38227482 DOI: 10.1249/mss.0000000000003390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
INTRODUCTION For the downstream nociceptive processing of elite athletes, recent studies indicate that athletes probably tolerate more pain as compared with a normally active population. Phenotyping the nociceptive processing of athletes in different types of endurance sports can provide insight into training-specific effects, which may help in understanding the long-term effects of specific exercise. METHODS Twenty-six elite endurance athletes from the disciplines of rowing, triathlon, and running and 26 age- and sex-matched, recreationally active control subjects who participated in the subjective pain perception and processing of standardized noxious stimuli were investigated by EEG. This included standardized heat pain thresholds (HPT) and contact heat-evoked potentials from heat stimulation, measured with EEG as well as pinprick-evoked potentials from mechanical stimulation. RESULTS After noxious stimulation, athletes showed a higher activation of the event-related spectral perturbation (ERSP) patterns in the N2P2 EEG response at the Cz Electrode compared with the controls. After noxious contact heat stimulation, triathletes had a higher ERSP activation compared with the controls, whereas the rowers had a higher ERSP activation after noxious mechanical stimulation. Also, HPT in triathletes were increased despite their increased central activation after thermal stimulation. We found a correlation between increased HPT and training hours and years, although athletes did not differ within these variables. CONCLUSIONS Although we were able to identify differences between athletes of different endurance sports, the reasons and implications of these differences remain unclear. The study of sport-specific somatosensory profiles may help to understand the mechanisms of exercise-related long-term effects on pain processing and perception. Furthermore, sport-specific somatosensory effects may support the personalization of exercise interventions and identify risk factors for chronic pain in elite athletes.
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Affiliation(s)
| | - Johannes Fleckenstein
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe University, Frankfurt, GERMANY
| | - Carmen Walter
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt, GERMANY
| | - Elena K Enax-Krumova
- Department of Neurology, BG University Hospital Bergmannsheil gGmbH Bochum, Ruhr University Bochum, Bochum, GERMANY
| | - Michael J M Fischer
- Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, AUSTRIA
| | - Matthias Kreuzer
- Department of Anesthesiology and Intensive Care, School of Medicine, Technical University of Munich, Munich, GERMANY
| | | | - Malte Anders
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt, GERMANY
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Sidiq M, Muzaffar T, Janakiraman B, Masoodi S, Vasanthi RK, Ramachandran A, Bansal N, Chahal A, Kashoo FZ, Rizvi MR, Sharma A, Rai RH, Verma R, Sharma M, Alam S, Vajrala KR, Sharma J, Muthukrishnan R. Effects of pain education on disability, pain, quality of life, and self-efficacy in chronic low back pain: A randomized controlled trial. PLoS One 2024; 19:e0294302. [PMID: 38805446 PMCID: PMC11132453 DOI: 10.1371/journal.pone.0294302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/10/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Low back pain stands as a prevalent contributor to pain-related disability on a global scale. In addressing chronic low back pain (CLBP), there is a growing emphasis on incorporating psychological strategies into the management process. Among these, pain education interventions strive to reshape pain beliefs and mitigate the perceived threat of pain. This randomized controlled trial sought to assess the effects of pain education on various aspects, including pain levels, disability, quality of life, self-efficacy, and prognostic characteristics in individuals grappling with CLBP. METHODS The clinical trial, retrospectively registered with the Clinical Trials Registry of India (CTRI/2021/08/035963), employed a two-arm parallel randomized design. Ninety-two participants with CLBP were randomly assigned to either the standard physiotherapy care with a pain education program or the control group. Both groups underwent a 6-week intervention. Assessment of pain intensity (using NPRS), disability (using RMDQ), self-efficacy (using the general self-efficacy scale), and well-being (using WHO 5I) occurred both before and after the 6-week study intervention. FINDINGS Post-intervention score comparisons between the groups revealed that the pain education intervention led to a significant reduction in disability compared to the usual standard care at 6 weeks (mean difference 8.2, p < 0.001, effect size Cohen d = 0.75), a decrease in pain intensity (mean difference 3.5, p < 0.001, effect size Cohen d = 0.82), and an improvement in the well-being index (mean difference 13.7, p < 0.001, effect size Cohen d = 0.58). CONCLUSION The findings suggest that integrating a pain education program enhances the therapeutic benefits of standard physiotherapy care for individuals dealing with chronic LBP. In conclusion, the clinical benefits of pain education become apparent when delivered in conjunction with standard care physiotherapy during the management of chronic low back pain.
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Affiliation(s)
- Mohammad Sidiq
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Tufail Muzaffar
- Departmet of Physical Medicine & Rehabilitation, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India
| | - Balamurugan Janakiraman
- SRM College of Physiotherapy, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chennai, Tamil Nadu, India
- Madhav College of Physiotherapy, Faculty of Allied Health Sciences, Madhav University, Rajasthan, India
| | - Shariq Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India
| | | | - Arunachalam Ramachandran
- Madhav College of Physiotherapy, Faculty of Allied Health Sciences, Madhav University, Rajasthan, India
| | - Nitesh Bansal
- Jindal School of Public Health & Human Development, O P Jindal Global University, Sonipat, Haryana, India
| | - Aksh Chahal
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Faizan Zaffar Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Moattar Raza Rizvi
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research Studies, Faridabad, Haryana, India
| | - Ankita Sharma
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research Studies, Faridabad, Haryana, India
| | - Richa Hirendra Rai
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Rituraj Verma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Monika Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Sajjad Alam
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Krishna Reddy Vajrala
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Jyoti Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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Wang C, Stovitz SD, Kaufman JS, Steele RJ, Shrier I. Principles of musculoskeletal sport injuries for epidemiologists: a review. Inj Epidemiol 2024; 11:21. [PMID: 38802864 PMCID: PMC11131288 DOI: 10.1186/s40621-024-00507-3] [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: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Musculoskeletal injuries are a common occurrence in sport. The goal of sport injury epidemiology is to study these injuries at a population level to inform their prevention and treatment. MAIN BODY This review provides an overview of musculoskeletal sport injuries and the musculoskeletal system from a biological and epidemiologic perspective, including injury mechanism, categorizations and types of sport injuries, healing, and subsequent injuries. It is meant to provide a concise introductory substantive background of musculoskeletal sport injuries for epidemiologists who may not have formal training in the underlying anatomy and pathophysiology. CONCLUSION An understanding of sport injuries is important for researchers in sport injury epidemiology when determining how to best define and assess their research questions and measures.
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Affiliation(s)
- Chinchin Wang
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Steven D Stovitz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Russell J Steele
- Department of Mathematics and Statistics, McGill University, Montreal, Canada
| | - Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada.
- Department of Family Medicine, McGill University, Montreal, Canada.
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Herring SA, Putukian M, Kibler WB, LeClere L, Boyajian-O'Neill L, Day MA, Franks RR, Indelicato P, Matuszak J, Miller TL, O'Connor F, Poddar S, Svoboda SJ, Zaremski JL. Team Physician Consensus Statement: Return to Sport/Return to Play and the Team Physician: A Team Physician Consensus Statement-2023 Update. Curr Sports Med Rep 2024; 23:183-191. [PMID: 38709944 DOI: 10.1249/jsr.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Stanley A Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | | | - W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington KY
| | - Lance LeClere
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Peter Indelicato
- Department of Orthopedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL
| | | | - Timothy L Miller
- Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Fran O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sourav Poddar
- Primary Sports Medicine, University of Colorado School of Medicine, Denver, CO
| | | | - Jason L Zaremski
- Department of Physical Medicine & Rehabilitation, University of Florida Health, Gainesville, FL
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8
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Herring SA, Putukian M, Kibler WB, Leclere L, Boyajian-O'Neill L, Day MA, Franks RR, Indelicato P, Matuszak J, Miller TL, O'Connor F, Poddar S, Svoboda SJ, Zaremski JL. Team Physician Consensus Statement: Return to Sport/Return to Play and the Team Physician: A Team Physician Consensus Statement-2023 Update. Med Sci Sports Exerc 2024; 56:767-775. [PMID: 38616326 DOI: 10.1249/mss.0000000000003371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Affiliation(s)
- Stanley A Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | | | - W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington KY
| | - Lance Leclere
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Peter Indelicato
- Department of Orthopedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL
| | | | - Timothy L Miller
- Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Fran O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sourav Poddar
- Primary Sports Medicine, University of Colorado School of Medicine, Denver, CO
| | | | - Jason L Zaremski
- Department of Physical Medicine & Rehabilitation, University of Florida Health, Gainesville, FL
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9
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Keogh JAJ, Ruder MC, White K, Gavrilov MG, Phillips SM, Heisz JJ, Jordan MJ, Kobsar D. Longitudinal Monitoring of Biomechanical and Psychological State in Collegiate Female Basketball Athletes Using Principal Component Analysis. TRANSLATIONAL SPORTS MEDICINE 2024; 2024:7858835. [PMID: 38654723 PMCID: PMC11023736 DOI: 10.1155/2024/7858835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/07/2024] [Accepted: 03/23/2024] [Indexed: 04/26/2024]
Abstract
Background The growth in participation in collegiate athletics has been accompanied by increased sport-related injuries. The complex and multifactorial nature of sports injuries highlights the importance of monitoring athletes prospectively using a novel and integrated biopsychosocial approach, as opposed to contemporary practices that silo these facets of health. Methods Data collected over two competitive basketball seasons were used in a principal component analysis (PCA) model with the following objectives: (i) investigate whether biomechanical PCs (i.e., on-court and countermovement jump (CMJ) metrics) were correlated with psychological state across a season and (ii) explore whether subject-specific significant fluctuations could be detected using minimum detectable change statistics. Weekly CMJ (force plates) and on-court data (inertial measurement units), as well as psychological state (questionnaire) data, were collected on the female collegiate basketball team for two seasons. Results While some relationships (n = 2) were identified between biomechanical PCs and psychological state metrics, the magnitude of these associations was weak (r = |0.18-0.19|, p < 0.05), and no other overarching associations were identified at the group level. However, post-hoc case study analysis showed subject-specific relationships that highlight the potential utility of red-flagging meaningful fluctuations from normative biomechanical and psychological patterns. Conclusion Overall, this work demonstrates the potential of advanced analytical modeling to characterize components of and detect statistically and clinically relevant fluctuations in student-athlete performance, health, and well-being and the need for more tailored and athlete-centered monitoring practices.
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Affiliation(s)
- Joshua A. J. Keogh
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew C. Ruder
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Kaylee White
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Momchil G. Gavrilov
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Stuart M. Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jennifer J. Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew J. Jordan
- Faculty of Kinesiology, Sport Medicine Centre, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Dylan Kobsar
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
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10
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Wezenberg D, Lindblom H, Sonesson S, Hägglund M. Prevalence and intensity of pain in male and female amateur football players: A prospective cohort study. J Sci Med Sport 2024; 27:222-227. [PMID: 38331632 DOI: 10.1016/j.jsams.2024.01.006] [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: 05/09/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES To determine the prevalence and intensity of pain due to a football-related injury during activities of daily living and during training and/or match play in both male and female and youth and adult amateur players. DESIGN A prospective cohort study involving amateur football players. METHODS Players (n = 502, median age 18 years, range 14-46) responded to weekly questionnaires during one season, including the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Weekly pain prevalence and pain intensity (measured on the numeric rating scale [range 0-10]) during activities of daily living and while playing football were determined. RESULTS A total of 6601 weekly questionnaires were collected (response rate 63.7 %). Average weekly pain prevalence during activities of daily living was 17.2 % for all players, and 15.7 % among players who participated in training and/or match play. Pain prevalence during training and/or match play was 18.3 % with an average pain intensity of 4.0. In 21.3 % of cases the recorded pain intensity was >5. Sex, age, and mode of injury onset (sudden or gradual) were not significant predictors of pain intensity. CONCLUSION At a given week, one in six football players experiences pain during activities of daily living from a football-related injury. Almost one in five players reports pain while playing football, of whom >20% report a pain intensity above 5. Oftentimes, injury-related pain present while playing football transcends to activities of daily living. This warrants further monitoring and adequate management of pain within amateur football.
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Affiliation(s)
- Daphne Wezenberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Sweden; Department of Orthopedic Surgery, Linköping University Hospital, Sweden; Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
| | - Hanna Lindblom
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Sweden; Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Sweden. https://twitter.com/lindblom_hanna
| | - Sofi Sonesson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Sweden; Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Sweden. https://twitter.com/SofiSonesson
| | - Martin Hägglund
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Sweden; Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Sweden. https://twitter.com/MHgglundSWIPE
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11
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Bounds CL, Coppieters MW, Thomson HW, Larsen B, Evans K. Efficacy of Conservative Interventions for Musculoskeletal Conditions on Pain and Disability in Active Serving Military Personnel-A Systematic Review. Mil Med 2024; 189:e66-e75. [PMID: 36722165 PMCID: PMC10824481 DOI: 10.1093/milmed/usac409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/21/2022] [Accepted: 12/12/2022] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Musculoskeletal (MSK) injuries and associated pain disorders are one of the leading causes for soldiers not being medically fit for deployment, impacting force capability and readiness. Musculoskeletal pain continues to be a leading cause of disability within military services and is associated with a substantial financial burden. A better understanding of the effectiveness of MSK pain management strategies is required. This review was designed to determine the efficacy of nonsurgical interventions, such as physiotherapy, exercise, pharmacology, and multidisciplinary programs, to manage MSK conditions in active serving military populations. MATERIALS AND METHODS MEDLINE, Embase, CINAHL, and SPORTDiscus were searched to identify relevant randomized clinical trials. Recommended methods were used for article identification, selection, and data extraction. The Cochrane Risk of Bias tool and the Grade of Recommendation, Assessment, Development, and Evaluation were used to appraise the studies. Where possible, meta-analyses were performed. The review was conducted according to the PRISMA guidelines. RESULTS Nineteen articles (1,408 participants) met the eligibility criteria. Low back pain (LBP) was the most frequently investigated condition, followed by knee pain, neck pain, and shoulder pain. Early physiotherapy, exercise and adjunct chiropractic manipulation (for LBP), and multidisciplinary pain programs (physiotherapy, occupational therapy, and psychology) (for chronic MSK pain) improved pain (standardized mean difference ranged from -0.39 to -1.34; low strength of evidence). Participation in multidisciplinary pain programs, adjunct chiropractic manipulation, and early physiotherapy improved disability (for LBP) (standardized mean difference ranged from -0.45 to -0.86; low to very low strength of evidence). No studies evaluated pain medication. Dietary supplements (glucosamine, chondroitin sulfate, and manganese ascorbate), electrotherapy, isolated lumbar muscle exercises, home cervical traction, or training in virtual reality showed no benefit. The studies had a high risk of bias, were typically underpowered, and demonstrated high clinical heterogeneity. CONCLUSIONS Currently available randomized clinical trials do not provide sufficient evidence to guide military organizations or health care professionals in making appropriate treatment decisions to manage MSK pain in active serving military personnel. Future research is essential to enable evidence-based recommendations for the effective management of MSK pain conditions in this unique population.
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Affiliation(s)
- Courtney L Bounds
- Menzies Health Institute Queensland, Griffith University, Brisbane (Nathan), QLD 4111, Australia
| | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane (Nathan), QLD 4111, Australia
- Amsterdam Movement Sciences-Program Musculoskeletal Health, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, The Netherlands
| | - Hayley W Thomson
- Menzies Health Institute Queensland, Griffith University, Brisbane (Nathan), QLD 4111, Australia
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Southport, QLD 4125, Australia
- Griffith Sports Physiology and Performance, Griffith University, Southport QLD 4222, Australia
- Healthia Limited, Brisbane, QLD 4006, Australia
| | - Brianna Larsen
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kerrie Evans
- Griffith Sports Physiology and Performance, Griffith University, Southport QLD 4222, Australia
- Healthia Limited, Brisbane, QLD 4006, Australia
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12
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Yamashiro K, Shiiya K, Ikarashi K, Anazawa S, Makibuchi T, Baba Y, Fujimoto T, Ochi G, Omori G, Sato D. Reduced somatosensory evoked potentials and paired-pulse inhibition in the primary somatosensory cortex of athletes with chronic pain. Eur J Appl Physiol 2023; 123:2537-2543. [PMID: 37330433 DOI: 10.1007/s00421-023-05224-1] [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: 10/20/2022] [Accepted: 05/07/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Chronic pain impedes athletic training and performance. However, it is challenging to identify the precise causes of chronic pain for effective treatment. To examine possible neuroplastic changes in sensory transmission and cortical processing, we compared somatosensory evoked potentials (SEPs) and paired-pulse inhibition (PPI) in primary sensory cortex (S1) between athletes with chronic pain and control athletes. METHODS Sixty-six intercollegiate athletes (39 males and 27 females) were recruited for this study, 45 control athletes and 21 reporting persistent pain for > 3 months. Sensory-evoked potentials were induced in S1 by constant-current square-wave pulses (0.2-ms duration) delivered to the right median nerve, while PPI was induced by paired stimulation at interstimulus intervals of 30 and 100 ms (PPI-30 and PPI-100 ms, respectively). All participants were randomly presented with total 1,500 (each 500 stimuli) single stimuli and stimulus pairs at 2 Hz. RESULTS Both N20 amplitude and PPI-30 ms were significantly lower in athletes with chronic pain compared to control athletes, while P25 amplitude and PPI-100 ms did not differ significantly between groups. CONCLUSION Chronic pain in athletes is associated with substantially altered excitatory-inhibitory balance within the primary somatosensory cortex, possibly due to reduced thalamocortical excitatory transmission and suppressed cortical inhibitory transmission.
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Affiliation(s)
- Koya Yamashiro
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
| | - Kanako Shiiya
- Field of Health and Sports, Graduate School of Niigata, University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Koyuki Ikarashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Sayaka Anazawa
- Field of Health and Sports, Graduate School of Niigata, University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Taiki Makibuchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Field of Health and Sports, Graduate School of Niigata, University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Yasuhiro Baba
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Tomomi Fujimoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Genta Ochi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
| | - Daisuke Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan
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13
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Keogh JAJ, Waddington EE, Masood Z, Mahmood S, Palanisamy AC, Ruder MC, Karsan S, Bishop C, Jordan MJ, Heisz JJ, Kobsar D. Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations-A scoping review. Scand J Med Sci Sports 2023; 33:2125-2148. [PMID: 37551046 DOI: 10.1111/sms.14460] [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: 03/11/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Lower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic biopsychosocial models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes. METHODS A systematic search of MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. Fifty-one articles were included in this review. RESULTS Significant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self-reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self-reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s). CONCLUSION This review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from biopsychosocial modeling. In doing so, this framework of biopsychosocial preventive and prognostic patient-centered practices may provide an actionable means of optimizing health, well-being, and sport performance in competitive athletes.
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Affiliation(s)
- Joshua A J Keogh
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Emma E Waddington
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Zaryan Masood
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Sobia Mahmood
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Anil C Palanisamy
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Matthew C Ruder
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Sameena Karsan
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Chris Bishop
- London Sports Institute, Middlesex University, London, UK
| | - Matthew J Jordan
- Faculty of Kinesiology, Sport Medicine Centre, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer J Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Dylan Kobsar
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
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14
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Holden S, Lee H, van Middelkoop M, Rathleff MS. Exploring the pain and disability continuum in adolescents with non-traumatic anterior knee pain: a mediation analysis using individual participant data of prospective studies. Br J Sports Med 2023; 57:1388-1394. [PMID: 37699655 DOI: 10.1136/bjsports-2023-107177] [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] [Accepted: 08/09/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVE To use individual patient data (IPD) to investigate if the effect of pain on sports-related disability is mediated through physical (lower extremity isometric strength) or psychological (depression/anxiety and knee confidence) factors in adolescents with non-traumatic anterior knee pain. METHODS This study included four datasets from a previously harmonised IPD dataset. Prior to analysis, the protocol and analysis approach were predefined and published on Open Science Framework. Potential mediators were pre-sepcified as isometric knee and hip strengths, self-reported anxiety/depression and confidence in the knee, allmeasured at 12 weeks after baseline evaluation. Mediation analyses were undertaken using the CMAVerse package in RStudio using the regression-based approach to decompose the total effect of the exposure (pain at baseline evaluation) on the outcome (sports-related disability at 6 months) into the 'indirect effect' (the portion of the total effect acting through the mediators) and the 'direct effect'. RESULTS Two-hundred and seventy-nine adolescents with non-traumatic knee pain were included in the analysis. Median age was 13 (range 10-19), and 72% were women. Baseline pain was associated with sports-related disability at 6 months. There was no evidence of the association being mediated by any of the proposed mediators (total natural indirect effect for strength 0.01 (-1.14 to 1.80) and psychological factors 0.00 (-0.66 to 2.02)). CONCLUSION We found an effect of pain on sports-related disability at 6 months which appears to be independent of lower extremity muscle strength, or depression/anxiety and knee confidence in adolescents with non-traumatic anterior knee pain.
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Affiliation(s)
- Sinead Holden
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Hopin Lee
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Michael Skovdal Rathleff
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for General Practice at Aalborg University, Aalborg University, Aalborg, Denmark
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
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15
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Marth AA, Auer TA, Bertalan G, Gebert P, Kirchenberger T, Geisel D, Hamm B, Keller S. Low back pain in adolescent rowers: Association to muscle changes detected by magnetic resonance imaging. J Sports Sci 2023; 41:1558-1563. [PMID: 37979193 DOI: 10.1080/02640414.2023.2283289] [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: 04/10/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
Adult elite rowers are at risk of developing low back pain (LBP). However, LBP data on adolescent elite rowers is currently insufficient. Therefore, the aim of this study was to assess LBP prevalence, LBP intensity and training characteristics in male adolescent elite rowers and a healthy control group. Twenty rowers (mean age 15.8 ± 1.2 years) and a non-athletic control group matched by age and gender (n = 13) were prospectively enrolled and underwent LBP assessment with a validated questionnaire and magnetic resonance imaging (MRI) of the lumbar spine muscles, which included a T2-mapping sequence. From the quantitative image data, T2 relaxation times were calculated. The prevalence of LBP in the last 24 hours and 3 months in the rowing group was 55.0% and 85.0%, respectively, compared to 23.1% and 30.8% in the control group (p < 0.001). Rowers had significantly longer T2 relaxation times of the paraspinal muscles compared to controls (p ≤ 0.041). LBP intensity was associated with longer T2 relaxation times (p < 0.001). Adolescent rowers had a higher prevalence of LBP compared to an age-matched control group. The observed increase in T2 relaxation might be explained by muscle soreness due to strenuous exercise, which is correlated with short-term pain intensity.
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Affiliation(s)
- Adrian A Marth
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timo A Auer
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gergely Bertalan
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Pimrapat Gebert
- Institute for Biometry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timo Kirchenberger
- Department of Sports Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sarah Keller
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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16
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Chauvineau M, Pasquier F, Poirier C, Le Garrec S, Duforez F, Guilhem G, Nedelec M. Higher training loads affect sleep in endurance runners: Can a high-heat-capacity mattress topper mitigate negative effects? J Sports Sci 2023; 41:1605-1616. [PMID: 37987739 DOI: 10.1080/02640414.2023.2285574] [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: 06/21/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
This study investigates the impact of a training program on sleep among endurance runners and the benefits of chronically using a high-heat-capacity mattress topper (HMT). Twenty-one trained male athletes performed a 2-week usual training regimen, sleeping on a Low-heat-capacity Mattress Topper (LMT), followed by 2-week overload and taper periods. From overload, participants were assigned into two groups based on the mattress topper used: HMT (n = 11) or LMT (n = 10). Irrespective of the group, overload increased general stress and stress-reaction symptoms evaluated by questionnaires, with no decline in performance on a graded-exercise treadmill test, the majority of participant being "non-overreached" (n = 14). From a daily perspective, each additional 100 A.U. in training load, assessed using the session rating of perceived exertion, was associated with an impairment in subsequent sleep efficiency (β = -0.2%; p < 0.01), wake after sleep onset (β = +0.4 min; p < 0.05) and sleep onset latency (β = +0.5 min; p < 0.05), which was unaffected by HMT use. Practitioners should be aware of sleep needs, especially during excessive training loads, whereas implementing individualised sleep strategies. Further studies should be conducted on potential benefits of HMT among athletes in various sleep conditions.
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Affiliation(s)
- Maxime Chauvineau
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | - Florane Pasquier
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | - Canelle Poirier
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | | | | | - Gaël Guilhem
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | - Mathieu Nedelec
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
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Fagher K, Dahlström Ö, Lexell J. Mental health, sleep, and pain in elite Para athletes and the association with injury and illness-A prospective study. PM R 2023; 15:1130-1139. [PMID: 36270015 DOI: 10.1002/pmrj.12917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/19/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The interest in the health of Para athletes continues to increase. Still, there are few studies that have evaluated health parameters beyond injury and illness in this athlete population. OBJECTIVE To assess (1) the weekly proportion of elite Para athletes reporting anxiety/depression, low sleep levels (≤7 hours), and pain over 52 weeks; (2) and to explore whether these health parameters are associated with the risk for a sports injury or illness. DESIGN A 52-week prospective study, part of the Sports-related Injury and Illness in Paralympic Sport Study (SRIIPSS). SETTING A total of 107 Swedish elite Para athletes with physical, visual, and intellectual impairment participated. MAIN OUTCOME MEASURES Data on self-reported anxiety/depression, sleep levels, pain, and injuries/illnesses were collected weekly. Comparisons of these parameters preceding an injury/illness were made using Friedman's analysis of variance (ANOVA). RESULTS The proportion of athletes reporting weekly anxiety/depression was 34.1%; 60.9% of athletes reported sleeping ≤7 hours and 49.9% reported pain. In exploratory analyses, there were no significant differences between weeks before an injury for any of the variables. There were significant differences in levels of sleep over the weeks, where sleep levels were significantly higher (>10 hours) 4 weeks prior to an illness (p = .016). CONCLUSION This cohort of elite Para athletes reported relatively high levels of anxiety/depression, low sleep levels, and pain, which is a concern. High sleep levels and the risk for illness might be an indication of overtraining, which commonly leads to persistent fatigue and an increased susceptibility to infections. Monitoring of the health of elite Para athletes is recommended to be able to improve performance and health in this population.
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Affiliation(s)
- Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Örjan Dahlström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Athletics Research Center, Linköping University, Linköping, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
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18
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Haupenthal A, Bufon T, Dos Santos MC, Matte LM, Dell'Antonio E, Franco FM, do Amaral NCP, Dos Santos Costa L, Nunes GS. Injuries and complaints in the Brazilian national volleyball male team: a case study. BMC Sports Sci Med Rehabil 2023; 15:77. [PMID: 37403144 DOI: 10.1186/s13102-023-00687-3] [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: 12/05/2022] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The literature reports a vast amount of epidemiological information on injuries in volleyball athletes. However, little is known about the incidence of injuries in elite athletes of international level participating in major competitions, such as world championships and Olympic games. The objective of the study was to analyse the incidence of injuries in elite professional volleyball athletes, and the prevalence of complaints reported by athletes. METHODS This is a case study in which data were collected between April 2018 and August 2021. All the athletes called to play for the Brazilian national male volleyball team during the analysis period participated. From the athletes' medical records, the occurrence of injuries (injurious events that lead to a time off from activities) and complaints (discomforts that did not lead to a time off from activities) were analysed. Frequency data were used to calculate incidence, prevalence and ratios. RESULTS From 41 athletes who played for the team during the analysed period, 12 athletes had 28 injuries and 38 athletes reported 402 complaints. For injuries, an incidence of seven injuries/1,000 h of competition and two injuries/1,000 h of training was observed. The average recovery time of the athletes was 10 days. The regions with the highest prevalence of injuries were the knee (111/1,000 athletes) and ankle (69/1,000 athletes). For complaints, 402 complaints required 1,085 treatment sessions, with the regions with the highest prevalence of complaints being the knee (261/1,000 complaints) followed by the shoulders (236/1,000 complaints). Athletes aged above 23 years and those playing as middle blockers and outside hitters presented a higher prevalence of injuries and complaints. CONCLUSIONS Almost one-third of the athletes had injuries and almost all athletes reported complaints during the study period. Injuries and complaints were more prevalent in the knees. Complaints caused a high demand for the healthcare team. To manage risk of injuries for overload, specific injury prevention strategies are needed and should be included as an essential component of the training plan for elite volleyball players.
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Affiliation(s)
- Alessandro Haupenthal
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil
| | - Thainá Bufon
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil
| | - Matheus Cardoso Dos Santos
- Clínica Personal Fisio, Florianópolis, SC, Brazil
- Healthcare Department, Brazilian Volleyball Confederation, Rio de Janeiro, RJ, Brazil
| | - Luiza Marx Matte
- Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Av. Roraima, 1000, Santa Maria, RS, CEP 97105-900, Brazil
| | - Elisa Dell'Antonio
- College of Health and Sport Science, Santa Catarina State University, Florianópolis, SC, Brazil
| | - Felipe Malzac Franco
- Healthcare Department, Brazilian Volleyball Confederation, Rio de Janeiro, RJ, Brazil
| | | | - Lucas Dos Santos Costa
- Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Av. Roraima, 1000, Santa Maria, RS, CEP 97105-900, Brazil
| | - Guilherme S Nunes
- Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Av. Roraima, 1000, Santa Maria, RS, CEP 97105-900, Brazil.
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Wall J, McGowan E, Meehan W, Wilson F. "Back pain is part of sport … I'm just gonna have to live with it": Exploring the lived experience of sport-related low back pain in adolescent athletes. Phys Ther Sport 2023; 62:71-78. [PMID: 37423050 DOI: 10.1016/j.ptsp.2023.05.005] [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: 01/17/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES To examine the lived experience of adolescent athletes reporting an episode of sport-related low back pain (LBP), including effects on daily life, relationships with parent/guardians, teammates, and coaches with relation to LBP, experiences of management/treatment, and understanding of LBP. DESIGN Qualitative interviewing using online video conferencing platforms. PARTICIPANTS Athletes aged 10-19 years old who experienced low back pain within the year prior to interviewing. MAIN OUTCOME MEASURES Interview transcripts, Modified Oswestry Disability Index, and International Physical Activity Questionnaire. RESULTS Three main themes were developed 1) The culture of normalising LBP in sport negates safeguarding efforts aimed at protecting adolescent athletes against injury and pain 2) LBP changes how athletes are perceived and perceive themselves 3) LBP has broad effects on the well-being of adolescent athletes. CONCLUSIONS The lived experience of LBP for adolescent athletes is impacted by the culture of tolerance of pain and injury in sport. Further steps should be taken to implement safeguarding measures in a way that adequately protects adolescent athletes who experience pain.
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Affiliation(s)
- Julia Wall
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Emer McGowan
- School of Medicine, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - William Meehan
- The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Ireland
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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20
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Ekizos A, Santuz A. "Biofeedback-based return to sport": individualization through objective assessments. Front Physiol 2023; 14:1185556. [PMID: 37378078 PMCID: PMC10291093 DOI: 10.3389/fphys.2023.1185556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Elite athletes are regularly exposed to high and repetitive mechanical stresses and impacts, resulting in high injury rates. The consequences of injury can range from time lost from training and competition to chronic physical and psychological burden, with no guarantee that the athlete will return to preinjury levels of sport activity and performance. Prominent predictors include load management and previous injury, highlighting the importance of the postinjury period for effective return to sport (RTS). Currently, there is conflicting information on how to choose and assess the best reentry strategy. Treating RTS as a continuum, with controlled progression of training load and complexity, seems to provide benefits in this process. Furthermore, objectivity has been identified as a critical factor in improving the effectiveness of RTS. We propose that assessments derived from biomechanical measurements in functional settings can provide the objectivity needed for regular biofeedback cycles. These cycles should aim to identify weaknesses, customize the load, and inform on the status of RTS progress. This approach emphasizes individualization as the primary determinant of RTS and provides a solid foundation for achieving it.
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Affiliation(s)
| | - Alessandro Santuz
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
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21
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Huschtscha Z, Fyfe JJ, Feros SA, Betik AC, Shaw CS, Main LC, Abbott G, Tan SY, Refalo MC, Gerhardy M, Grunwald E, May A, Silver J, Smith CM, White M, Hamilton DL. A randomised controlled trial assessing the potential of palmitoylethanolamide (PEA) to act as an adjuvant to resistance training in healthy adults: a study protocol. Trials 2023; 24:245. [PMID: 37004121 PMCID: PMC10064518 DOI: 10.1186/s13063-023-07199-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/22/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics are used frequently by athletes either prophylactically for the prevention of pain, or to accelerate recovery following an injury. However, these types of pain management strategies have been shown to inhibit signalling pathways (e.g., cyclooxygenase-2) that may hinder muscular adaptations such as hypertrophy and strength. Nutraceuticals such as palmitoylethanolamide (PEA) have analgesic properties that act via different mechanisms to NSAIDS/analgesics. Furthermore, PEA has been shown to have a positive effect on sleep and may contribute positively to muscle hypertrophy via PKB activation. Although PEA has not been widely studied in the athletic or recreationally active population, it may provide an alternative solution for pain management if it is found not to interfere with, or enhance training adaptations. Therefore, the study aim is to investigate the effects of daily PEA supplementation (Levagen + ®) with resistance training on lean body mass, strength, power and physical performance and outcomes of recovery (e.g., sleep) compared to placebo. METHODS This double-blind, randomised controlled study will take place over an 11-week period (including 8-weeks of progressive resistance training). Participants for this study will be 18-35 years old, healthy active adults that are not resistance trained. Participants will attend a familiarisation (week 0), pre-testing (week 1) and final-testing (week 11). At the pre-testing and final-testing weeks, total lean body mass (dual-energy X-ray absorptiometry; DXA), total mid-thigh cross sectional area (pQCT), maximal muscular strength (1 repetition maximum bench press, isometric mid-thigh pull) and power (countermovement jump and bench throw) will be assessed. Additionally, circulating inflammatory cytokines and anabolic hormones, sleep quality and quantity (ActiGraph), pain and subjective wellbeing (questionnaires) will also be examined. DISCUSSION This study is designed to investigate the effects that PEA may have on pre-to post intervention changes in total body and regional lean muscle mass, strength, power, sleep, subjective wellbeing, and pain associated with resistance training and menstruation compared with the placebo condition. Unlike other NSAIDs and analgesics, which may inhibit muscle protein synthesis and training adaptations, PEA which provides analgesia via alternative mechanisms may provide an alternative pain management solution. It is therefore important to determine if this analgesic compound interferes with or enhances training adaptations so that athletes and active individuals can make an informed decision on their pain management strategies. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR: ACTRN12621001726842p).
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Affiliation(s)
- Zoya Huschtscha
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Jackson J Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Simon A Feros
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Andrew C Betik
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Christopher S Shaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Luana C Main
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Sze-Yen Tan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Martin C Refalo
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Michael Gerhardy
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Emma Grunwald
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Anthony May
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Jessica Silver
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - Craig M Smith
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, 3216, Australia
| | - Matthew White
- Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia
| | - D Lee Hamilton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia.
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22
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Pain Acceptance Among Retired National Football League Athletes: Implications for Clinical Intervention. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2023; 17:27-40. [PMID: 36919031 PMCID: PMC10010661 DOI: 10.1123/jcsp.2020-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Over 80% of National Football League (NFL) retirees experience daily pain. Pain acceptance is an important psychological construct implicated in the intensity of chronic pain, though these findings have not been extended to NFL retirees. Therefore, the current study examined the association between pain acceptance and pain intensity among former NFL athletes. NFL retirees (N = 90) recruited from 2018 to 2019 completed questionnaires that assessed pain, substance use, and NFL career information. Multiple linear regression examined the association between current pain acceptance and pain intensity while adjusting for other risk factors of pain. NFL retirees reported average scores of 33.31 (SD = 10.00), and 2.18 (SD = 2.40) on measures of pain acceptance and pain intensity, respectively. After covariate adjustment, greater pain acceptance (β = -0.538, p < .001) was associated with lower pain intensity. These findings can further inform the behavioral and mental health care of retired NFL athletes.
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23
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Tito N, Porter E, Castonguay T, Dover G. Longitudinal Validation of a Specific Measure of Fear Avoidance in Athletes: Predicting Time from Injury to Return to Sports Competition. J Pain Res 2023; 16:1103-1114. [PMID: 37020665 PMCID: PMC10069429 DOI: 10.2147/jpr.s396054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/18/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose We developed the Athlete Fear Avoidance Questionnaire (AFAQ) to measure fear avoidance in athletes. Previous fear avoidance scales were developed for the general population and have demonstrated significant predictive capabilities regarding rehabilitation. No research to date has examined the association between athlete fear avoidance as measured by the AFAQ and the rehabilitation time in athletes. Patients and Methods Fifty-nine athletes who were injured during sport season participated in the study (40 males and 19 females). At injury onset, all participants completed self-report functional questionnaires. In addition, we measured multiple aspects of fear avoidance including athlete fear avoidance (AFAQ), kinesiophobia (TSK), and pain catastrophizing (PCS). Finally, we assessed pain severity and interference, as well as depression. Once the athletes were able to return to competition all participants answered the questionnaires again. Pearson correlations and a regression analysis were used to identify relationships between function, psychological variables, pain, and return to competition time. Results The AFAQ yielded the strongest correlation with return to competition time (r=0.544, p<0.001). In addition, function at initial injury time and pain interference were also significantly correlated with return to competition time (r=0.442, p<0.001 and r=0.356, p=0.006 respectively). Athlete fear-avoidance combined with function at the time of injury explained 34% of the variance of return to competition time in the multivariate regression model (p<0.001). Conclusion Athlete fear-avoidance as measured by the AFAQ is associated with rehabilitation time and returning to competition in injured athletes. Psychosocial factors including athlete fear avoidance may explain why some athletes take longer to rehabilitate than others and should be evaluated in athletes who are taking longer than anticipated to complete their rehabilitation. Reducing athlete fear avoidance may facilitate rehabilitation in future studies.
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Affiliation(s)
- Noémie Tito
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Erica Porter
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Tristan Castonguay
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Geoffrey Dover
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Correspondence: Geoffrey Dover, Department of Health, Kinesiology, and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, Canada, Tel +1 514 848 2424 Ext 3304, Fax +1 514 848 8681, Email
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24
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Purcell C, Duignan C, Fullen BM, Ryan S, Ward T, Caulfield B. Comprehensive assessment and classification of upper and lower limb pain in athletes: a scoping review. Br J Sports Med 2023; 57:535-542. [PMID: 36759138 DOI: 10.1136/bjsports-2022-106380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Upper and lower limb (peripheral) pain is prevalent in athletes. Contemporary research prioritises multidimensional pain assessment and classification. This study aims to review comprehensive athlete pain assessment practices against the reference standard (International Olympic Committee, IOC Athlete Pain framework), identifying trends and highlighting gaps. METHODS AND ANALYSIS Six databases were searched using a comprehensive search strategy. This review followed the Joanna Briggs Institute standardised methodology for scoping reviews and is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Title and abstract, full-text screening and data charting were completed by two independent reviewers. INCLUSION CRITERIA Original research, systematic reviews and clinical practice guidelines reporting assessment or classification of pain in athletes of any age with chronic or acute peripheral pain in English on human participants from database inception. RESULTS 470 studies with 175 different pain assessment tools were mapped against the IOC Athlete Pain Framework. Papers included tools from neurophysiological (470/100%), biomechanical (425/90%), affective (103/22%), cognitive (59/13%) and socioenvironmental (182/39%) domains. Pain classification was included in 108 studies (23%). 4 studies (0.85%) defined pain. Athletes with physical disability were included in 13 (3%) studies and no studies included athletes with intellectual disabilities. Socioeconomic factors were addressed in 29 (6%) studies. DISCUSSION Neurophysiological and biomechanical domains are frequently addressed. Affective, socioenvironmental and cognitive tools are under-represented. Potential tools for use by researchers and clinicians are highlighted. Defining and classifying pain and determining predominant pain mechanisms is needed in both research and clinical practice. More work on underrepresented populations is needed. CONCLUSION This review informs researchers and clinicians working with athletes in pain how pain assessment and classification is currently conducted and highlights future priorities.
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Affiliation(s)
- Ciarán Purcell
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland .,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Ciara Duignan
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brona M Fullen
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland
| | - Shiofra Ryan
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Tomas Ward
- Insight Centre for Data Analytics, School of Computing, Dublin City University, Dublin, Ireland
| | - Brian Caulfield
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland.,Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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25
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Athy V, Hach S, Anderson H, Mason J. Examining the Peer-Reviewed Published Literature Regarding Low Back Pain in Rowing: A Scoping Review. Int J Sports Phys Ther 2023; 18:55-69. [PMID: 36793564 PMCID: PMC9897042 DOI: 10.26603/001c.67836] [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: 05/24/2022] [Accepted: 11/30/2022] [Indexed: 02/04/2023] Open
Abstract
Background Low back pain (LBP) is highly prevalent in the rowing population. The body of existing research variously investigates risk factors, prevention, and treatment methods. Purpose The purpose of this scoping review was to explore the breadth and depth of the LBP literature in rowing and to identify areas for future research. Study Design Scoping review. Methods PubMed, Ebsco and ScienceDirect were searched from inception to November 1, 2020. Only published, peer-reviewed, primary, and secondary data pertaining to LBP in rowing were included for this study. Arksey and O'Malley's framework for guided data synthesis was used. Reporting quality of a subsection of the data was assessed using the STROBE tool. Results Following the removal of duplicates and abstract screening, a set of 78 studies were included and divided into the following categories: epidemiology, biomechanics, biopsychosocial, and miscellaneous. The incidence and prevalence of LBP in rowers were well mapped. The biomechanical literature covered a wide range of investigations with limited cohesion. Significant risk factors for LBP in rowers included back pain history and prolonged ergometer use. Conclusion A lack of consistent definitions within the studies caused fragmentation of the literature. There was good evidence for prolonged ergometer use and history of LBP to constitute risk factors and this may assist future LBP preventative action. Methodological issues such as small sample size and barriers to injury reporting increased heterogeneity and decreased data quality. Further exploration is required to determine the mechanism of LBP in rowers through research with larger samples.
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26
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Verdini E, Maestroni L, Clark M, Turner A, Huber J. Do people with musculoskeletal pain differ from healthy cohorts in terms of global measures of strength? A systematic review and meta-analysis. Clin Rehabil 2023; 37:244-260. [PMID: 36154313 PMCID: PMC9772898 DOI: 10.1177/02692155221128724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/02/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE It is currently unknown if people with musculoskeletal pain display different multi-joint strength capacities than healthy cohorts. The aim was to investigate whether people with musculoskeletal pain show differences in global measures of strength in comparison to healthy cohorts. DATA SOURCES A systematic review was conducted using three databases (Medline, CINAHL and SPORTDiscus) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. REVIEW METHODS Studies involving participants with painful musculoskeletal conditions and multi-joint strength assessment measured at baseline were included. A meta-analysis was also performed to compute standardized mean differences (± 95% confidence intervals), using Hedge's g, and examined the differences in multi-joint strength at baseline between participants with painful musculoskeletal conditions and healthy participants. RESULTS In total, 5043 articles were identified, of which 20 articles met the inclusion criteria and were included in the qualitative analysis. The available evidence revealed that multi-joint strength values were limited to knee osteoarthritis, fibromyalgia, chronic low back pain, and rheumatoid arthritis. Only four studies were included in the quantitative synthesis and revealed that only small differences in both chest press (g = -0.34, 95% CI [-0.64, -0.03]) and leg press (g = -0.25, 95% CI [-0.49, -0.02]) existed between adult women with fibromyalgia and active community women. CONCLUSION There is a paucity of multi-joint strength values in participants with musculoskeletal pain. Quantitative comparison with healthy cohorts was limited, except for those with fibromyalgia. Adult women with fibromyalgia displayed reduced multi-joint strength values in comparison to active community women.
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Affiliation(s)
- Enrico Verdini
- School of Health Sciences, University of Brighton, Brighton, UK
- Studio Medico Jacini, Rome, Italy
| | - Luca Maestroni
- London Sport Institute, School of Science and Technology, Middlesex University, London, UK
| | | | - Anthony Turner
- London Sport Institute, School of Science and Technology, Middlesex University, London, UK
| | - Jörg Huber
- School of Health Sciences, University of Brighton, Brighton, UK
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De Sousa-De Sousa L, Espinosa HG, Maté-Muñoz JL, Lozano-Estevan MDC, Cerrolaza-Tudanca S, Rozalén-Bustín M, Fernández-Carnero S, García-Fernández P. Effects of Capacitive-Resistive Electric Transfer on Sports Performance in Paralympic Swimmers: A Stopped Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14620. [PMID: 36361500 PMCID: PMC9656992 DOI: 10.3390/ijerph192114620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
Throughout history a variety of therapeutic tools have been studied as possible enhancers of sports activities. This study proposes the use of Capacitive-Resistive Electric Transfer (CRET) as a performance booster to paralympic athletes, specifically those belonging to the Spanish Paralympic swimming committee. The study was a randomized, single-blind, and observer-blind, crossover clinical trial. Six athletes were randomly assigned to three groups: one treated with CRET (A); a placebo group (B) and a control group (C). The CRET group attended a twenty-minute session before being subjected to pool trials at distances of 50 and 100 m at maximum performance. Measurements were in two dimensions: time in seconds and the Borg scale for perceived exertion. Comparisons between groups were made with respect to distance and the main variables. In the case of perceived exertion, no significant changes were observed in any of the distances; however, in the case of the time variable, a significant difference was observed between Group A vs. Personal Record at 100 m distance (76.3 ± 6.8 vs. 68.4 ± 3.3). The proposed protocol and level of hyperthermia applied suggest refusal of CRET use for the 100-m distance a few minutes before sports practice. Our analysis suggests the need to modify the presented protocol. ClinicalTrials.gov identifier under NCT number: NCT04336007.
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Affiliation(s)
- Luis De Sousa-De Sousa
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Hugo G. Espinosa
- School of Engineering and Built Environment, Griffith University, Brisbane, QLD 4111, Australia
| | - Jose Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | | | - Sara Cerrolaza-Tudanca
- Faculty of Health Sciences, Alfonso X University, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Manuel Rozalén-Bustín
- Faculty of Health Sciences, Alfonso X University, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Samuel Fernández-Carnero
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain
| | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
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Neurodynamic Exercises in College Athletes With Musculoskeletal Pain: A Critically Appraised Topic. J Sport Rehabil 2022; 31:1105-1110. [PMID: 36049744 DOI: 10.1123/jsr.2021-0268] [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: 12/17/2021] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022]
Abstract
CLINICAL SCENARIO Pain is a common complaint following an orthopedic injury; however, the exact cause of nociception can be complex. Multiple tissues can generate a patient's complaint of pain, such as the skin, muscle, ligaments, tendon, nerves, and bones. Regarding the somatosensory system, inflammation around the nerve can create pain and alter movement coordination; this information has resulted in increased awareness of neurodynamic assessments and exercises. Neurodynamic assessments and exercises provide a unique paradigm to effectively assess and treat neural tissue, which may not commonly be considered within the traditional orthopedic examination. CLINICAL QUESTION In college athletes with musculoskeletal pain and activity impairments, does the use of neurodynamic exercises improve pain or function? SUMMARY OF KEY FINDINGS Of the 5 studies, all consisted of chronic injuries with 3 involving upper-extremity pathologies and 2 focusing on lower-extremity pathologies. All 5 studies noted short- and long-term improvement following the incorporation of neurodynamic sliders or tensioners into the treatment plan. Four of the studies had follow-up periods greater than 30 days with sustained improvement on patient outcomes. Only 2 studies described a progression of neurodynamic exercises through sliders and tensioners. Three studies utilized a set/repetition format for exercise prescription, whereas a fourth used a time-based format, and a fifth article utilized both. Finally, 4 studies utilized neurodynamic assessments to identify whether there was a neural component to the patient's presentation (eg, peripheral nerve mechanosensitivity). CLINICAL BOTTOM LINE In individuals with musculoskeletal impairments, evidence exists to support the use of neurodynamic exercises, such as sliders and tensioners, to improve pain and pain-related disability when neural sensitivity exists. STRENGTH OF RECOMMENDATION Grade C evidence exists to support the use of neurodynamic exercises in college athletes with a musculoskeletal impairment.
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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.
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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
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30
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Movement quantity and quality: How do they relate to pain and disability in dancers? PLoS One 2022; 17:e0268444. [PMID: 35587918 PMCID: PMC9119517 DOI: 10.1371/journal.pone.0268444] [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: 09/09/2021] [Accepted: 04/30/2022] [Indexed: 11/29/2022] Open
Abstract
Objective This field-based study aimed to determine the association between pre-professional student dancers’ movement quantity and quality with (i) pain severity and (ii) pain related disability. Methods Pre-professional female ballet and contemporary dance students (n = 52) participated in 4 time points of data collection over a 12-week university semester. At each time point dancers provided self-reported pain outcomes (Numerical Rating Scale as a measure of pain severity and Patient Specific Functional Scale as a measure of pain related disability) and wore a wearable sensor system. This system combined wearable sensors with previously developed machine learning models capable of capturing movement quantity and quality outcomes. A series of linear mixed models were applied to determine if there was an association between dancers’ movement quantity and quality over the 4 time points with pain severity and pain related disability. Results Almost all dancers (n = 50) experienced pain, and half of the dancers experienced disabling pain (n = 26). Significant associations were evident for pain related disability and movement quantity and quality variables. Specifically, greater pain related disability was associated with more light activity, fewer leg lifts to the front, a shorter average duration of leg lifts to the front and fewer total leg lifts. Greater pain related disability was also associated with higher thigh elevation angles to the side. There was no evidence for associations between movement quantity and quality variables and pain severity. Discussion Despite a high prevalence of musculoskeletal pain, dancers’ levels of pain severity and disability were generally low. Between-person level associations were identified between dancers’ movement quantity and quality, and pain related disability. These findings may reflect dancers’ adaptations to pain related disability, while they continue to dance. This proof-of-concept research provides a compelling model for future work exploring dancers’ pain using field-based, serial data collection.
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Biological Breakdown of Sports in Athletics Based on Multimedia Image Acquisition Techniques. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3497942. [PMID: 35392036 PMCID: PMC8983211 DOI: 10.1155/2022/3497942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/19/2022]
Abstract
This paper provides an in-depth analysis and study of the decomposition of sports biology of athletics events through multimedia image acquisition techniques. The proposed design uses SOPC hardware-software collaboration technology, which makes full use of the parallelism of hardware as well as the flexibility of software to essentially improve the speed of image processing and greatly improve the efficiency of image processing. The high speed and parallelism of hardware are used to realize the image acquisition part with high timing requirements and the preprocessing algorithm with a large number of operations and strong repetition, in addition to the difficulties of many initialization configuration parameters of each peripheral. Additionally, the need for frequent adjustment of peripheral working parameters is solved by making full use of the scalability and flexibility of software, and the control signals output by software can coordinate the work of each hardware module to ensure that each module of the system cooperates. It is also possible to coordinate the work of each hardware module through the control signal output from the software to ensure that each module of the system cooperates and operates in an orderly and efficient manner and provides the possibility of realizing a higher level of the image processing algorithm. The system includes four main factors: swinging action, supporting action, vacating action, and speed rhythm. Based on this system, 14 key kinematic indicators were selected to reflect the technical status of the youth walkers. The landing angle decreased with the increase of speed, and the landing technique was insufficient; it had better control of the large and small arm angle, and their stride width was open, while the other four athletes showed increased tension in the hip joint and upper limb with the increase of walking speed, as well as the wrong action of forward and internal rotation of the large and small arms.
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Malmborg JS, Bremander A, Bergman S, Haglund E, Olsson MC. Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up. BMC Sports Sci Med Rehabil 2022; 14:43. [PMID: 35313966 PMCID: PMC8939173 DOI: 10.1186/s13102-022-00437-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance.
Methods Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never–monthly) or frequent (weekly–almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex. Results A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146–13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001–11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033–12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026–12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011–34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength. Conclusions Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent.
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Affiliation(s)
- Julia S Malmborg
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden. .,Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.
| | - Ann Bremander
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden.,Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.,Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19.3, 5000, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Engelshøjgade 9A, 6400, Sønderborg, Denmark.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, 221 00, Lund, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, 221 00, Lund, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, 405 30, Gothenburg, Sweden
| | - Emma Haglund
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden.,Spenshult Research and Development Center, FoU Spenshult, Bäckagårdsvägen 47, 302 74, Halmstad, Sweden.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, 221 00, Lund, Sweden
| | - M Charlotte Olsson
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, Box 823, 301 18, Halmstad, Sweden
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Low Occurrence of Musculoskeletal Symptoms in Swimming? Musculoskeletal Symptoms and Sports Participation in Adolescents: Cross Sectional Study (ABCD—Growth Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063694. [PMID: 35329389 PMCID: PMC8952247 DOI: 10.3390/ijerph19063694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this paper was to identify the association between the occurrence of musculoskeletal symptoms (MS) and sports participation in adolescents. The sample included 193 adolescents (11 to 17 years of age; 131 boys and 62 girls). For this cross-sectional study, participants were categorized into four groups: “no-sports”, “repetitive non-impact sports”, “high-impact sports”, and “odd-impact sports”. A questionnaire was used, which defined MS as pain or any musculoskeletal complaint that led to restriction of current normal activities. In the entire sample, 112 adolescents reported at least one episode of MS during the recording, representing 58% of the sample. Our findings highlight that adolescents regularly engaged in odd-impact sports, such as martial arts, report a higher occurrence of MS than swimmers and adolescents who do not participate in any physical activity.
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Galsworthy WJH, Carr JAJ, Hearn R. Common health issues and advised treatments reported in an ultraendurance ocean rowing race. BMJ Open Sport Exerc Med 2022; 8:e001120. [PMID: 35136655 PMCID: PMC8804690 DOI: 10.1136/bmjsem-2021-001120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Ocean rowing is an extreme ultraendurance sport where individuals row unsupported across an ocean. This can mean months at sea in unpredictable and inhospitable conditions. The extreme physical and mental demands associated mean medical issues are common yet under researched, impacting the medical assistance provided. Methods The Talisker Whisky Atlantic Challenge provides a framework with safety protocols to create safer environments for athletes to attempt transatlantic crossings. Race logs, which record communication between rowers and safety teams, were anonymised and examined to create cumulative totals of medical issues requiring help and an incident timeline. Results Duty officers were notified of 65 medical complaints, 32% (n=21) requiring race doctors. Dermatological conditions were most common, accounting for 32% of complaints (n=21) and affecting 24% of rowers. Pressure sores and infections represented 43% and 38% of dermatological complaints respectively. Musculoskeletal injuries equalled 18% (n=12) of complaints, affecting 20% of rowers. Most cases were reported in weeks one and three, with 37% (n=24) of issues and 90% (n=10) of seasickness cases in week one. Hygiene and antibiotics were frequently advised management options. Conclusion Conditions requiring race doctor input represent the most severe cases with the potential to deteriorate. Managing dermatological and musculoskeletal issues is vital throughout the race, while seasickness prophylaxis and education is essential in initial race stages. Infections are cause for concern, with gluteal pressure sores a potential route for secondary infections. Further research is required before evidence-based guidelines for management of health issues in ocean rowers can be introduced.
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Affiliation(s)
| | - James A J Carr
- GKT School of Medical Education, King's College London, London, UK
| | - Russell Hearn
- School of Life Course and Population Science, King's College London, London, UK
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Heerey J, Kemp J, Agricola R, Srinivasan R, Smith A, Pizzari T, King M, Lawrenson P, Scholes M, Link T, Souza R, Majumdar S, Crossley K. Cam morphology is associated with MRI-defined cartilage defects and labral tears: a case-control study of 237 young adult football players with and without hip and groin pain. BMJ Open Sport Exerc Med 2022; 7:e001199. [PMID: 34987861 PMCID: PMC8679114 DOI: 10.1136/bmjsem-2021-001199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 12/29/2022] Open
Abstract
Objective Football players are at risk of developing hip osteoarthritis (OA). Cam morphology (present in almost two of every three football players) may explain this heightened risk, but there is limited research on its role in hip OA development in younger athletes. Knowledge of this relationship will advance our understanding of the aetiology of hip OA in football players. We aimed to study the relationship between cam morphology size and MRI-defined cartilage defects and labral tears, and if this relationship differs by symptomatic state in young adult football players. Methods For this case–control study, 182 (288 hips) symptomatic (hip and/or groin pain >6 months and positive flexion-adduction-internal-rotation (FADIR) test) and 55 (110 hips) pain-free football players (soccer or Australian football) underwent anteroposterior and Dunn 45° radiographs, and 3-Tesla MRI. Cam morphology size was defined using alpha angle, and cartilage defects and labral tears were scored semiquantitatively. Presence, location and score (severity) of cartilage defects and labral tears were determined. Each participant completed the International Hip Outcome Tool 33 and Copenhagen Hip and Groin Outcome Score. Results Greater alpha angle was associated with cartilage defects (OR 1.03, 95% CI 1.01 to 1.04) and labral tears (OR 1.02, 95% CI 1.01 to 1.04). Greater alpha angle was associated with superolateral cartilage defects (OR 1.03, 95% CI 1.02 to 1.05) and superior labral tears (OR 1.03, 95% CI 1.02 to 1.05). The association of alpha angle with MRI-defined cartilage defects and labral tears was no greater in football players with symptoms than in those without (p=0.189–0.937) Conclusion Cam morphology size was associated with cartilage defects and labral tears in young adult football players with and without pain. This study provides evidence that cam morphology may contribute to the high prevalence of hip OA in football players. Prospective studies of football players are now needed to establish if cam morphology causes progression of cartilage defects and labral tears and development of hip OA.
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Affiliation(s)
- Joshua Heerey
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Joanne Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Rintje Agricola
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ramya Srinivasan
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Matthew King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Peter Lawrenson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Mark Scholes
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Thomas Link
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA
| | - Richard Souza
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA.,Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA
| | - Kay Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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Murofushi K, Yamaguchi D, Katagiri H, Hirohata K, Furuya H, Mitomo S, Oshikawa T, Kaneoka K, Koga H. The relationship between movement self-screening scores and pain intensity during daily training. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:204-216. [PMID: 36244771 DOI: 10.2152/jmi.69.204] [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] [Indexed: 06/16/2023]
Abstract
Background : Various musculoskeletal screening and functional performance tests are used to evaluate physical condition. However, validated analysis tools that can identify gaps in pain knowledge during athletes' daily training are lacking. This study aimed to investigate the relationship between pain intensity in athletes during their daily training and the KOJI AWARENESS™ test in order to determine whether body dysfunction is related to pain among athletes. Methods : This cross-sectional study was conducted in a fitness center at the authors' affiliated institution. Thirty-five athletes (17 women and 18 men) aged 20-40 years were selected for study participation. KOJI AWARENESS™ self-evaluated test scores and pain intensity during daily training, as assessed on the numerical rating scale (NRS), were recorded. Results : The KOJI AWARENESS™ score showed a strong negative correlation with the NRS score for pain intensity during daily training (r = -0.640, P < 0.001). There was a significant negative correlation between KOJI AWARENESS™ and NRS scores, even when body mass index, sex, and age were entered as control variables. Conclusions : KOJI AWARENESS™ was highly accurate in detecting pain in athletes during their training. J. Med. Invest. 69 : 204-216, August, 2022.
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Affiliation(s)
- Koji Murofushi
- Sports Science Center, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Japan Sports Agency, Tokyo, Japan
| | - Daisuke Yamaguchi
- Sports Science Center, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Orthopedics, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kenji Hirohata
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hidetaka Furuya
- Department of Rehabilitation, Sonoda Third Hospital/Tokyo Medical Institute Tokyo Spine Center, Tokyo, Japan
| | - Sho Mitomo
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | - Koji Kaneoka
- Faculty of Sport Science, Waseda University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Purcell C, Duignan C, Fullen B, Caulfield B. Assessment and classification of peripheral pain in athletes: a scoping review protocol. BMJ Open Sport Exerc Med 2021; 7:e001215. [PMID: 35028159 PMCID: PMC8719172 DOI: 10.1136/bmjsem-2021-001215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/04/2022] Open
Abstract
Pain is often presumed to be part of the sport injury experience. The time-loss definition of injury leads to under-reported athletic pain impacting performance and quality of life. Whilst research regarding the assessment and classification of back pain in athletes is emerging, little has been reported regarding how peripheral pain is assessed and classified in research and practice. Six databases will be searched for relevant articles. Title and abstract screening followed by full-text screening will be completed by two independent reviewers. Data charting will be carried out using a modified standardised form. Descriptive results and frequencies will be reported. Pain measures identified in the studies will be mapped against the IOC Athlete Pain Framework alongside a narrative summary. Published peer-reviewed primary research studies alongside systematic reviews and clinical practice guidelines reporting the assessment or classification of pain in athletes of any age with chronic or acute peripheral pain across all study contexts in the English language on human participants from inception of the databases will be included. The results of this study are part of a body of research which will be used to inform the development of a pain assessment framework. The scoping review will be submitted for peer-reviewed journal publication and presented at sports medicine conferences. This review will inform researchers and clinicians working with athletes in pain how pain assessment and classification is currently conducted and positioned against the IOC Athlete Pain Framework.
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Affiliation(s)
- Ciarán Purcell
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Ciara Duignan
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brona Fullen
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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Effect of Compensatory Mechanisms on Postural Disturbances and Musculoskeletal Pain in Elite Sitting Volleyball Players: Preparation of a Compensatory Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910105. [PMID: 34639407 PMCID: PMC8508345 DOI: 10.3390/ijerph181910105] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
The aim of the study was to identify the effect of compensatory mechanisms on the prevalence of sagittal spinal curvature deformity and musculoskeletal pain and to assess the interrelationships between those components in sitting volleyball players. Twenty-one elite Polish sitting volleyball players (age = 34.1 ± 7.5, BM = 77.9 ± 16.0) participated in the study in which direct participatory systematic observation and a non-invasive method were used. Both objective (anthropometric, spinal curvature-Idiag M360) and subjective (musculoskeletal ailments-NMQ = 7) measurements were performed. The Statistica 13.3 software package was used for statistical analyses. The neck, lower back (43%), and upper back (38%) were the most frequently reported painful areas. Of all participants, 76% reported sagittal spinal deformities. In the habitual position, the results indicated moderate correlations (r = 0.5, p < 0.05) between the lumbar concavity of the back and low back pain (LBP) and between thoracic convexity and LBP (r = 0.4, p < 0.05). Internal and external compensation have an effect on the prevalence of spinal curvature deformities in the sagittal plane, with thoracic hyperkyphosis (38%) and lumbar hyperlordosis (33%) being the most common. More severe lower and upper back pain were correlated with greater angles of thoracic kyphosis and lumbar lordosis in the habitual position.
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Burton I. Autoregulation in Resistance Training for Lower Limb Tendinopathy: A Potential Method for Addressing Individual Factors, Intervention Issues, and Inadequate Outcomes. Front Physiol 2021; 12:704306. [PMID: 34421641 PMCID: PMC8375597 DOI: 10.3389/fphys.2021.704306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023] Open
Abstract
Musculoskeletal disorders, such as tendinopathy, are placing an increasing burden on society and health systems. Tendinopathy accounts for up to 30% of musculoskeletal disorders, with a high incidence in athletes and the general population. Although resistance training has shown short-term effectiveness in the treatment of lower limb tendinopathy, more comprehensive exercise protocols and progression methods are required due to poor long-term outcomes. The most common resistance training protocols are predetermined and standardized, which presents significant limitations. Current standardized protocols do not adhere to scientific resistance training principles, consider individual factors, or take the importance of individualized training into account. Resistance training programs in case of tendinopathy are currently not achieving the required intensity and dosage, leading to high recurrence rates. Therefore, better methods for individualizing and progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress training at their own rate, taking individual factors into account. Despite the finding of their effectiveness in increasing the strength of healthy athletes, autoregulation methods have not been investigated in case of tendinopathy. The purpose of this narrative review was 3-fold: firstly, to give an overview and a critical analysis of the individual factors involved in tendinopathy and current resistance training protocols and their limitations. Secondly, to give an overview of the history, methods, and application of autoregulation strategies both in sports performance and physiotherapy. Finally, a theoretical adaptation of a current tendinopathy resistance training protocol using autoregulation methods is presented, providing an example of how the method could be implemented in clinical practice or future research.
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Affiliation(s)
- Ian Burton
- National Health Service (NHS) Grampian, Aberdeen, United Kingdom
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Molenaar B, Willems C, Verbunt J, Goossens M. Achievement Goals, Fear of Failure and Self-Handicapping in Young Elite Athletes with and without Chronic Pain. CHILDREN-BASEL 2021; 8:children8070591. [PMID: 34356570 PMCID: PMC8305616 DOI: 10.3390/children8070591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/05/2022]
Abstract
Background: Pain is a common problem in elite athletes. This exploratory study compares goal orientations towards sport, fear of failure, self-handicapping and pain catastrophizing between active young elite athletes with and without chronic pain (CP) complaints (longer than three months). It examines the associations between chronic pain, fear of failure, goal orientations, self-handicapping and pain catastrophizing in young elite athletes. We explore how far goal orientation can be explained by these factors. Methods: Young elite athletes completed an online questionnaire. Data analysis: Independent samples t-test, correlational analyses and multivariate regression analyses. Results: Participants were 132 young elite athletes (mean 16 years); data for 126 were analyzed. A total of 47% reported current pain, of which 60% had CP. Adolescents with CP showed significantly more pain intensity, fear of failure, self-handicapping and mastery–avoidance goals than those without. Pain intensity was significantly related to fear of failure, self-handicapping, pain catastrophizing and mastery–avoidance. Self-handicapping and fear of failure contributed significantly to mastery–avoidance variance. Performance–avoidance and –approach goals were explained by fear of failure. Conclusion: CP was common, with sufferers showing more fear of failure and self-handicapping strategies, and being motivated to avoid performing worse (mastery–avoidance). Self-handicapping and fear of failure influenced mastery–avoidance orientation, and fear of failure explained part of performance–avoidance and –approach orientations. Longitudinal studies should explore the role of these factors in the trajectory of CP in these athletes.
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Affiliation(s)
- Bodile Molenaar
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
| | - Charlotte Willems
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
- Adelante Center of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands
| | - Jeanine Verbunt
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
- Adelante Center of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands
| | - Mariëlle Goossens
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
- Department of Clinical Psychological Sciences, Experimental Psychology, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-43-388-2160
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Bascour-Sandoval C, Norambuena-Noches Y, Monrroy-Uarac M, Flández-Valderrama J, Gálvez-García G, Gajardo-Burgos R. ASSOCIATION BETWEEN SLEEP QUALITY AND PAIN IN YOUNG AMATEUR ATHLETES. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127022019_0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: It has been shown that there is a close association between sleep quality and pain. In young athletes, sleep disorders and pain have a particularly high prevalence; however, the relationship between them has not been widely studied. Objective: To study the association between sleep quality and pain in young athletes. Methods: A cross-sectional study was conducted in which 71 young amateur athletes (39 males) were included. The mean age was 16.9 ± 1.2 years, with 6.5 ± 3.2 years of sports practice and 5.2 ± 1.2 hours of training per week. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The participants were classified according to sleep quality, as PSQI-I = without sleep disorders, PSQI-II = requiring medical assistance and PSQI-III = requiring medical assistance and treatment. Also, pain intensity was assessed on the Numerical Rating Scale, both at rest (NRSr) and during sports activity (NRSs), along with pain duration. Results: The individuals classified as PSQI-III presented higher NRSr (Mdn = 2.0; IQR = 4.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.04) and higher NRSs (Mdn = 4.0; IQR = 5.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.03) than the individuals classified as PSQI-I. No differences were observed in relation to pain duration. The PSQI score was positively but weakly associated with NRSr (rs = 0.24, p=0.046) and NRSs (rs = 0.27, p = 0.03) but not with pain duration. Conclusion: Young athletes with lower levels of sleep quality show higher levels of pain at rest and during sports practice. Therefore, sleep quality and pain should be considered in the routine assessment of young athletes, by technical and health teams. Level of evidence III; type of study: Cross-sectional .
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Vail RE, Harridge SDR, Hodkinson PD, Green NDC, Pavlou M. A Novel Biopsychosocial Approach to Neck Pain in Military Helicopter Aircrew. Aerosp Med Hum Perform 2021; 92:333-341. [PMID: 33875066 DOI: 10.3357/amhp.5449.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: Flight-related neck pain (FRNP) is a frequently reported musculoskeletal complaint among military helicopter aircrew. However, despite its prevalence and suspected causes, little is known of the underpinning pain mechanisms or the impact of neck pain on aircrews in-flight task performance. The biopsychosocial (BPS) approach to health, combined with the contemporary conceptualization of musculoskeletal pain, in which injury and pain are not necessarily synonymous, provides a relatively new holistic framework within which to consider the problem of FRNP in military helicopter aircrew. Combining these concepts, a new conceptual model is proposed to illustrate how biopsychosocial factors may influence pain perception, potentially affecting aircrews capacity to process information and, therefore, threatening in-flight task performance. Recommendations are made for considering the underlying pain mechanisms of FRNP to aid prognoses and guide the development of holistic evidence-based countermeasures for FRNP in military helicopter aircrew. Development of instruments able to measure psychosocial factors, such as self-efficacy and functional ability, validated in the military helicopter aircrew population, would assist this task.Vail RE, Harridge SDR, Hodkinson PD, Green NDC, Pavlou M. A novel biopsychosocial approach to neck pain in military helicopter aircrew. Aerosp Med Hum Perform. 2021; 92(5):333341.
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Wilson F, Thornton JS, Wilkie K, Hartvigsen J, Vinther A, Ackerman KE, Caneiro JP, Trease L, Nugent F, Gissane C, McDonnell SJ, McGregor A, Newlands C, Ardern CL. 2021 consensus statement for preventing and managing low back pain in elite and subelite adult rowers. Br J Sports Med 2021; 55:893-899. [PMID: 33685861 DOI: 10.1136/bjsports-2020-103385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice. METHODS There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice. RESULTS The scope of the consensus statement included epidemiology; biomechanics; management; the athlete's voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged. CONCLUSION Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
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Affiliation(s)
- Fiona Wilson
- Discipline of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, Ireland
| | - Jane S Thornton
- Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.,Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Syddanmark, Denmark
| | | | - Kathryn E Ackerman
- Division of Sports Medicine- Boston Children's Hospital, Neuroendocrine Unit- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - J P Caneiro
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Larissa Trease
- University of Tasmania School of Medicine, Hobart, Tasmania, Australia
| | - Frank Nugent
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Conor Gissane
- Discipline of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, Ireland
| | | | - Alison McGregor
- Surgery and Cancer/Human Performance Group, Faculty of Medicine, Imperial College London, London, London, UK
| | - Craig Newlands
- High Performance Sport New Zealand, Auckland, New Zealand
| | - Clare L Ardern
- Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.,Division of Physiotherapy, Karolinska Institute, Huddinge, Sweden
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44
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Liddle DG, Changstrom B, Senter C, Meirick P, Stern N, Putukian M, Shah S, Powell A, Dixit S, Eerkes K, Moran B, Barnes KP, Dal Molin C, Myers R, Waterbrook AL. Recommended Musculoskeletal and Sports Medicine Curriculum for Internal Medicine Residency Training. Curr Sports Med Rep 2021; 20:113-123. [PMID: 33560036 DOI: 10.1249/jsr.0000000000000811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
ABSTRACT Patients present to primary care physicians with musculoskeletal complaints more often than they do for upper respiratory infections, hypertension, or diabetes. Despite this, instruction in musculoskeletal medicine for internal medicine residents represents less than 1% of their total didactic and clinical education time. We recognize the immense breadth of knowledge and skill required to train residents in the practice of internal medicine. This curriculum guideline defines a recommended training strategy, and supplies relevant resources, to improve musculoskeletal education among internal medicine residents to optimize patient care. This curriculum guideline was created by internists who are sports medicine specialists. Sports medicine physicians promote overall health and well-being while providing expertise in acute and chronic musculoskeletal conditions, as well as how disease affects exercise and using exercise as medicine for people with chronic disease.
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Affiliation(s)
- David G Liddle
- Intermountain Sports Medicine, Intermountain Healthcare, Logan Regional Orthopedics and Sports Medicine, Logan, UT
| | - Bradley Changstrom
- Department of Medicine, Division of Internal Medicine, University of Colorado, Denver, CO
| | - Carlin Senter
- Department of Orthopaedic Surgery, Division of Sports Medicine, University of California San Francisco, San Francisco, CA
| | | | | | - Margot Putukian
- Princeton University, McCosh Health Center, University Health Services, Preinceton, NJ
| | - Selina Shah
- Center for Sports Medicine, Walnut Creek, CA
| | - Amy Powell
- Department of Orthopaedic Surgery and Department of Internal Medicine, Division of General Internal Medicine, University of Utah, Salt Lake City, UT
| | - Sameer Dixit
- Department of Primary Care Sports Medicine, Hospital for Special Surgery, New York, NY
| | - Kevin Eerkes
- NYU Langone Health, Department of Internal Medicine, New York University, New York, NY
| | - Byron Moran
- Department of Orthopaedic Surgery, Division of Sports Medicine, College of Medicine, University of South Florida, Tampa, FL
| | - Kenneth P Barnes
- Department of Orthopaedic Surgery, Division of Sports Medicine, Moses H. Cone Memorial Hospital, Greensboro, NC
| | - Claudia Dal Molin
- Department of Internal Medicine and Department of Orthopaedic Surgery, Division of Sports Medicine, University of Maryland, Baltimore, MD
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McCabe T, Peirce N, Gorczynski P, Heron N. Narrative review of mental illness in cricket with recommendations for mental health support. BMJ Open Sport Exerc Med 2021; 7:e000910. [PMID: 33537152 PMCID: PMC7849879 DOI: 10.1136/bmjsem-2020-000910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/17/2023] Open
Abstract
Introduction Epidemiology reporting within the cricketing medical literature has emerged over the past 2 years, with a focus on physical injuries. Despite mental health in elite sport gaining increasing recognition, few studies have addressed mental health symptoms and disorders within cricket. Recently, cricketers have been prominent in the mainstream media describing their lived experiences of mental illness. As a result, some have withdrawn from competition and suggested there is an unmet need for mental health services within the sport. Objectives (i) To appraise the existing evidence on mental health symptoms and disorders amongst cricketers. (ii) To provide guidance on shaping mental health research and services within cricket. Design A narrative review of the literature from inception of available databases until 26 July 2019, with analysis and recommendations. Results Five studies were included in this narrative review. Studies covered a range of mental health symptoms and disorders, including distress, anxiety, depression, sleep disturbance, suicide, adverse alcohol use, illicit drug use, eating disorders and bipolar disorder. Results indicated that cricketers are at high risk for distress, anxiety, depression and adverse alcohol use. When compared with the general population, cricketers are more likely to experience anxiety and depressive symptoms. Rates of suicide were proposed to be high for test cricketers. Overall, studies to date have been of low quality, demonstrating non-rigorous research methods. Some studies have relied on non-validated questionnaires to collect self-reported data on mental health symptoms and disorders, while others have presented biographical data obtained through searches of the media. Conclusions The results of this narrative review highlight the lack of evidence underpinning mental health services for athletes within cricket. We suggest the following recommendations for future research and practice: (i) normalising mental health symptoms and disorders; (ii) working with and helping vulnerable demographic segments within the target population; (iii) designing and implementing early recognition systems of mental health symptoms and disorders; (iv) addressing the mental health needs of cricketers on a population basis.
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Affiliation(s)
- Thomas McCabe
- NHS Ayrshire and Arran, Kilmarnock, UK.,School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - Nicholas Peirce
- Centre For Sports Medicine, Nottingham University Hospitals Trust, Nottingham, UK.,National Cricket Performance Centre, England and Wales Cricket Board, Loughborough, UK
| | - Paul Gorczynski
- Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Neil Heron
- Centre of Public Health, Queen's University, Belfast, UK.,Department of Primary Care, Keele University, Staffordhsire, UK
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46
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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.
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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
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47
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Wippert PM, Niederer D, Drießlein D, Beck H, Banzer W, Schneider C, Schiltenwolf M, Mayer F. Psychosocial Moderators and Mediators of Sensorimotor Exercise in Low Back Pain: A Randomized Multicenter Controlled Trial. Front Psychiatry 2021; 12:629474. [PMID: 34393840 PMCID: PMC8358182 DOI: 10.3389/fpsyt.2021.629474] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/31/2021] [Indexed: 12/24/2022] Open
Abstract
The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this study assessed psychosocial characteristics, which moderate and mediate the effects of sensorimotor exercise on LBP. A single-blind 3-arm multicenter randomized controlled trial was conducted for 12-weeks. Three exercise groups, sensorimotor exercise (SMT), sensorimotor and behavioral training (SMT-BT), and regular routines (CG) were randomly assigned to 662 volunteers. Primary outcomes (pain intensity and disability) and psychosocial characteristics were assessed at baseline (M1) and follow-up (3/6/12/24 weeks, M2-M5). Multiple regression models were used to analyze whether psychosocial characteristics are moderators of the relationship between exercise and pain, meaning that psychosocial factors and exercise interact. Causal mediation analysis were conducted to analyze, whether psychosocial characteristics mediate the exercise effect on pain. A total of 453 participants with intermittent pain (mean age = 39.5 ± 12.2 years, f = 62%) completed the training. It was shown, that depressive symptomatology (at M4, M5), vital exhaustion (at M4), and perceived social support (at M5) are significant moderators of the relationship between exercise and the reduction of pain intensity. Further depressive mood (at M4), social-satisfaction (at M4), and anxiety (at M5 SMT) significantly moderate the exercise effect on pain disability. The amount of moderation was of clinical relevance. In contrast, there were no psychosocial variables which mediated exercise effects on pain. In conclusion it was shown, that psychosocial variables can be moderators in the relationship between sensorimotor exercise induced adaptation on CLBP which may explain conflicting results in the past regarding the merit of exercise interventions in CLBP. Results suggest further an early identification of psychosocial risk factors by diagnostic tools, which may essential support the planning of personalized exercise therapy. Level of Evidence: Level I. Clinical Trial Registration: DRKS00004977, LOE: I, MiSpEx: grant-number: 080102A/11-14. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004977.
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Affiliation(s)
- Pia-Maria Wippert
- Sociology of Medicine and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus, Senftenberg, Germany
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - David Drießlein
- Statistical Consulting Unit StaBLab, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Heidrun Beck
- University Hospital Carl Gustav Carus at Technical University Dresden, Dresden, Germany
| | - Winfried Banzer
- Department of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Marcus Schiltenwolf
- Pain Management, Centre of Orthopaedics and Trauma Surgery, Conservative Orthopaedics and Pain Management, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Mayer
- Faculty of Health Sciences Brandenburg, University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus, Senftenberg, Germany.,Centre of Sports Medicine, University Outpatient Clinic, University of Potsdam, Potsdam, Germany
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48
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Thornton JS, Caneiro JP, Hartvigsen J, Ardern CL, Vinther A, Wilkie K, Trease L, Ackerman KE, Dane K, McDonnell SJ, Mockler D, Gissane C, Wilson F. Treating low back pain in athletes: a systematic review with meta-analysis. Br J Sports Med 2020; 55:656-662. [PMID: 33355180 DOI: 10.1136/bjsports-2020-102723] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement. DATA SOURCES Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS). RESULTS Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments. CONCLUSIONS While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes.
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Affiliation(s)
- Jane S Thornton
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - J P Caneiro
- Physiotherapy, Curtin University, Perth, Western Australia, Australia
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Clare L Ardern
- Division of Physiotherapy, Karolinska Institute, Huddinge, Sweden
- Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Anders Vinther
- Physiotherapy and Occupational Therapy and QD research-unit, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
| | - Kellie Wilkie
- Tasmania Institute of Sport, Hobart, Tasmania, Australia
| | - Larissa Trease
- Heathcare in remote and extreme environments, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Orthopedics ACT, Canberra, New South Wales, Australia
| | - Kathryn E Ackerman
- Sports Medicine Division, Boston Children's Hospital, Boston, Massachusetts, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn Dane
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - David Mockler
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Conor Gissane
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Fiona Wilson
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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49
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Wilson F, Ardern CL, Hartvigsen J, Dane K, Trompeter K, Trease L, Vinther A, Gissane C, McDonnell SJ, Caneiro JP, Newlands C, Wilkie K, Mockler D, Thornton JS. Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis. Br J Sports Med 2020; 55:bjsports-2020-102537. [PMID: 33077481 DOI: 10.1136/bjsports-2020-102537] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes. DESIGN Systematic review with meta-analysis. DATA SOURCES Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching. ELIGIBILITY CRITERIA Studies evaluating prevalence of LBP in adult athletes across all sports. RESULTS Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport. CONCLUSION LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.
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Affiliation(s)
- Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - Clare L Ardern
- Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
- Sport & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Kathryn Dane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - Katharina Trompeter
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Larissa Trease
- Healthcare in Remote and Extreme Environments program, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy and QD-Research Unit, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
| | - Conor Gissane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | | | - J P Caneiro
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | | | - Kellie Wilkie
- Bodysystem Physiotherapy, Hobart, Tasmania, Australia
| | - David Mockler
- John Stearne Library, Trinity College Dublin, Dublin, Ireland
| | - Jane S Thornton
- Fowler Kennedy Sports Medicine Clinic, Western University, London, Ontario, Canada
- Western Centre for Public Health and Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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50
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Caneiro JP, Alaiti RK, Fukusawa L, Hespanhol L, Brukner P, O'Sullivan PP. There is more to pain than tissue damage: eight principles to guide care of acute non-traumatic pain in sport. Br J Sports Med 2020; 55:75-77. [PMID: 32907798 DOI: 10.1136/bjsports-2019-101705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 11/04/2022]
Affiliation(s)
- J P Caneiro
- Curtin University, School of Physiotherapy and Exercise Science, Perth, Western Australia, Australia .,Body Logic Physiotherapy, Perth, Western Australia, Australia
| | - Rafael Krasic Alaiti
- Universidade de São Paulo, Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience, São Paulo, Brazil.,Projeto Superador, Research and Data Science Unit, São Paulo, Brazil
| | - Leandro Fukusawa
- Projeto Superador, Research and Data Science Unit, São Paulo, Brazil.,Faculdade de Ciências Médicas Santa Casa de São Paulo, Masters and Doctoral Programs in Medical Science, São Paulo, Brazil
| | - Luiz Hespanhol
- Universidade Cidade de São Paulo (UNICID), Masters and Doctoral Programs in Physical Therapy, São Paulo, Brazil.,VU University Medical Center Amsterdam (VUmc), Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam Movement Sciences, Amsterdam Universities Medical Centers, Amsterdam, Netherlands
| | - Peter Brukner
- La Trobe Sport & Exercise Medicine Research Centre at La Trobe University, Melbourne, Victoria, Australia
| | - Peter Pb O'Sullivan
- Curtin University, School of Physiotherapy and Exercise Science, Perth, Western Australia, Australia.,Body Logic Physiotherapy, Perth, Western Australia, Australia
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