Cognitive functional approach to manage low back pain in male adolescent rowers: A randomised controlled trial
Abstract
Background Low back pain (LBP) is prevalent among adolescent rowers. This study evaluated the efficacy of a cognitive functional approach to reduce LBP in this population.
Methods Thirty-six adolescent male rowers reporting LBP participated. Nineteen were randomly allocated to the intervention group to receive a cognitive functional approach targeting cognitions, movement patterns, conditioning and lifestyle factors relevant to each rower for 8 weeks. The active control group (n=17) received usual care from their coaches (rowing skills and conditioning exercises). The primary outcome of the study was pain intensity as measured by the Numeric Pain Rating Scale during a 15 min ergometer trial preintervention and postintervention. Disability (Patient Specific Functional Scale and Roland Morris Disability Questionnaire) was measured preintervention/postintervention and at 12 weeks follow-up. Isometric muscle endurance of the back extensors and lower limb muscles, usual sitting posture and regional lumbar kinematic data during a 15 min ergometer row were measured preintervention/postintervention.
Results Compared with the control group, the intervention group reported significantly less pain during ergometer rowing (Numeric Pain Rating Scale −2.4, p=0.008) and reduced disability (Patient Specific Functional Scale (4.1, p=0.01); Roland Morris Disability Questionnaire (−1.7, p=0.003)) following the intervention, and at 12 weeks follow-up. They also demonstrated greater lower limb muscle endurance (20.9 s, p=0.03) and postured their lower lumbar spine in greater extension during static sitting (−9.6°, p=0.007). No significant differences were reported in back muscle endurance and regional lumbar kinematics during ergometer rowing.
Conclusion Cognitive functional approach was more effective than usual care in reducing pain and disability in adolescent male rowers.
Clinical Trial Registry Number Australian and New Zealand Clinical Trial Registry Number 12609000565246.
Supplementary resource (1)
Data
May 2015
... We screened 8461 citations and 307 full-text articles, and included 11 studies (Fig. 1). Of these 11 studies, the effectiveness of rehabilitation interventions were investigated in 10 quantitative studies including eight RCTs (518 participants) [22,[32][33][34][35][36][37][38][39] and two non-randomized clinical trials (40 participants) [40,41] (Table 5), and one qualitative study investigated patients' experience of physiotherapy (14 Participants) [42] (Table 6). We did not identify studies on cost-effectiveness of rehabilitation interventions. ...
... All studies included participants with nonspecific LBP, with no studies focusing on TSP. Participants received various rehabilitation interventions including exercise (4 studies) [34-36, 39, 40], spinal manipulation (2 studies) [22,33], cognitive therapy (1 study) [38], whole-body vibration (1 study) [37], and multimodal care (2 studies) [32,41]. The duration of rehabilitation interventions varied: 1) four weeks (1 study) [22]; 2) eight weeks (4 studies) [34-36, 38, 40]; and 3) 12 weeks (4 studies) [32,33,37,39]; and 4) variable duration (1 study) [41]. ...
... The duration of rehabilitation interventions varied: 1) four weeks (1 study) [22]; 2) eight weeks (4 studies) [34-36, 38, 40]; and 3) 12 weeks (4 studies) [32,33,37,39]; and 4) variable duration (1 study) [41]. These 10 studies investigated rehabilitation interventions: 1) as an addition to active comparison interventions where the attributable effect of the comparison interventions can be isolated (4 studies) [32,33,37,39]; 2) compared to no treatment (3 studies) [34][35][36]38]; 3) compared to sham (1 study) [22]; and 4) compared to other active interventions (2 studies) [40,41], respectively. Outcomes included LBP intensity (9 studies) [22,[32][33][34][35][36][37][38][39][40], function (5 studies) [22,32,33,38,41], quality of life (2 studies) [32,33], improvement (2 studies) [22,33], satisfaction (1 study) [33], wellbeing (1 study) [34], feelings about school and life (1 study) [34], absence from school or physical activity (1 study) [35], and health resource utilization (1 study) [22]. ...
Background
A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking.
Objectives
To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population.
Methods
Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach.
Results
We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1–2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified.
Conclusions
Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed.
Trial registration
CRD42019135009 (PROSPERO)
... In addition, the CFT group also showed significantly greater reductions in HSC and FABQ-Work scores. Ng et al. (2015) evaluate the effectiveness of CFT in managing LBP in male adolescent rowers. The randomized controlled trial included 36 adolescent male rowers, with 19 receiving CFT and 17 receiving usual care. ...
... Although disability and pain are related, the results in pain intensity were mixed. Most of the included trials presented significant changes in the pain intensity after the intervention (Fersum et al., 2013;Ng et al., 2015 ;O'Keeffe et al., 2020;O'Neill et al., 2020;Javdaneh et al., 2020) while some showed no statistical improvement (Fersum et al., 2019;Conway et al., 2019;O'Sullivan et al., 2015). This difference Trevlaki et al. 94 may be due to the time of the evaluation. ...
... The studies that presented no improvement in pain intensity conducted a 6month, 12-month (Conway et al., 2019;O'Sullivan et al., 2015), and 3-year (Fersum et al., 2019) follow-up. As far as the comparing treatments, most studies (n=3) used the usual care (Ng et al., 2015;Conway et al., 2019;Ussing et al., 2020), (n=2) MT combined with exercises (Fersum et al., 2013;Fersum et al., 2019), (n=2) exercises and education (Javdaneh et al., 2020;O'Sullivan et al., 2015), (n=1) the LST and (n=2) no comparison group. Additionally, some studies investigated the effectiveness of CFT in different patient populations. ...
... Different protocols, such as kinesio taping [32], cognitive functional approach, movement patterns, conditioning, and lifestyle factors [18,20] movement patterns, conditioning and lifestyle factors relevant to each rower for 8 weeks. The active control group (n=17, motor control [19,20,28] quadratus lumborum, and psoas muscles and the change in CSA of the trunk in response to an abdominal drawing-in task. ...
... Tactile sensory perception using 10-g Semmes-Weinstein monofilament, thermic perception using TIP THERM device, graphesthesia assessed by a touch monitor pencil, 2-point discrimination assessed by a digital caliper, and vibration perception assessed by a 128-Hz tuning fork measured in mid-thoracic spine 5 times.Results:No significant group differences in pain and sensory perception were identified at baseline. Over the 2-month study interval, repeated-measures analysis of variance revealed that the experimental group improved significantly relative to the control group on pain intensity (P=0.005 for cervical, P=0.004 for thoracic, and P=0.014 for lumbar, functional movement system Different protocols, such as kinesio taping (32), cognitive functional approach, movement patterns, conditioning, and lifestyle factors (18,20), motor control (19,20,28), segmental motion in the midthoracic spine (21), functional movement system (FMS) training (30), isokinetic and core stabilization (22,23), virtual reality training (26), dynamic and static stretching (24) Mézières method (25,29,31), semicustomized exercises (4), had been working on elite and semi-elite athletes. Figure 2 shows the average of the sports that have been worked on in the present studies. ...
... Except for three articles that did not have a control group and only compared training methods [19,24,28], the rest had a control group. In four studies, RMDQ was used to evaluate performance or functional disability [18,25,29,31]. To evaluate the pain level, VAS, NPR, and McGill pain questionnaires (short form) were also used [18,22,25,26,[29][30][31][32][33]. ...
Purpose: Low back pain (LBP) is the most common musculoskeletal disorder reported in the community, leading to chronic pain and disability. This review aims to determine the effectiveness of prevention and management protocols on LBP in athletes. Methods: Searches were conducted from 2010 to 2022 from international databases, including Google Scholar, Science Direct, and PubMed using keywords related to back pain in athletes. Randomized controlled trials (RCTs) presenting the prevention and management protocol for back pain of athletes were included in this review. The physiotherapy evidence database (PEDro) scale was used to check the quality of articles. Results: Finally, 16 articles with 1,317 subjects met the inclusion criteria. These studies have mainly focused on the effect of taping, cognitive functional approach, movement patterns, conditioning, lifestyle, motor control, segmental motion, isokinetic, core stabilization, virtual reality training, dynamic and static stretching, Mézières method, functional movement screen, and semi-customized exercises in athletes at risk of LBP. The positive effect of stability and cognitive exercises were documented. Conclusion: The deep and superficial muscle integration exercises by correcting the body posture and correct muscle calling had the greatest effect on the balance of the muscles.
... After screening by title and abstract, 117 remained and were assessed by full text, after which 7 RCTs (reported in 8 manuscripts) were included in our review. 6,7,13,14,[20][21][22][23] The reasons for exclusion are detailed in Figure 1 and the full search strategy is included in Supplementary Appendix 1. For the 3-arm RESTORE Trial, 13 we chose to compare 2 of the 3 trial arms-usual care and CFT only-as the third arm (CFT plus wearable sensor biofeedback) was a combination treatment. ...
... Two trials trials delivered 7 or more sessions.7,13,22 Three studies had an intervention period of 8 weeks,14,21,22 and 3 studies had an intervention period of at least 12 weeks. 7,13,20 One study had a pragmatic duration of 4 to 12 weeks.23 ...
Objective
The objective was to investigate the effectiveness of cognitive functional therapy (CFT) in the management of people with chronic nonspecific low back pain (LBP) and explore the variability in available trials to understand the factors which may affect the effectiveness of the intervention.
Methods
A systematic review with meta-analyses was conducted. Four databases were searched from inception to October 12th 2023. Randomized controlled trials investigating CFT compared to any control group in patients with nonspecific LBP were included. Mean difference and 95% CIs were calculated for pain, disability, and pain self-efficacy. Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Results
Seven trials were included. Low to moderate certainty of evidence was found that CFT was effective for disability at short, medium, and long term time points compared to alternate treatments, including usual care. Low to moderate certainty of evidence was found that CFT is effective for pain in the short and medium terms and probably in the long term. There was high certainty evidence CFT was effective in increasing pain self-efficacy in the medium and long terms. A single study found CFT was cost-effective compared to usual care. Variability was found in the training and implementation of CFT across the included trials, which may contribute to some heterogeneity in the results.
Conclusion
The results show promise in the use of CFT as an intervention likely to effectively manage disability, pain, and self-efficacy in people with chronic nonspecific LBP. The number of clinicians trained, their experience, and quality of training (including competency assessment) may be important in achieving optimal effectiveness.
Impact Statement
This is the most comprehensive review of CFT to date and included investigation of between-trial differences. CFT is a promising intervention for chronic LBP and high-quality synthesis of evidence of its effectiveness is important for its clinical application.
... Table 3 shows the effect of four different treatment modalities on pain, physical function, and disability of LBP in adolescent athletes. Effects Improve pain intensity Improve physical Improve disability function (Ahlqwist et al., 2008) √ √ √ (Ng et al., 2015) √ √ √ (Arampatzis et al., 2021) √ (Selhorst & Selhorst, 2015) Uncertain Uncertain Uncertain ...
... These children still need specialized physical therapy. Ng et al., (2015) was the first RCT to evaluate the effectiveness of an intervention in rowers with low back pain. When compared to the control group, rowers who received the cognitive functional approach experienced less severe pain and reduced degrees of impairment when using the ergometer and showed increased lower limb muscle endurance and greater lower lumbar extension during regular sitting. ...
Background Nowadays there is an increased prevalence of adolescent athletes suffer from LBP. Early effective treatment can improve athletes' performance and delay their careers. Obiectives To identify the effective treatment for adolescent athletes with LBP. Methods Electronic searching on database from inception to January 2024 was used to retrieve articles. The assessment for quality used McMaster Critical Review Form for Quantitative Studies. Findings Only 4 articles met the inclusion criteria. Implications This study provides different treatments form LBP in adolescent athletes. However, which type of treatment is more effective needs further research.
... In general, data collection took place in a school environment [27,32,35,37,40,42,47,48] or in clinical settings (e.g., laboratory, clinical research centers, primary care center) [28][29][30][33][34][35][36]38,44,45]. Four studies targeted young athletes [31,41,43,46]. Most studies were conducted in high-income countries. ...
... However, the content validity was not assessed in the included PROMs. Of 23 studies included, 15 used PROMs with measured properties tested only in adults [26][27][28][29][30][31]33,34,36,[39][40][41][43][44][45], four used PROMs tested in adults and in children/adolescents [35,38,42,46], and only four used PROMs with properties tested in children/adolescents exclusively [32,37,47,48]. ...
Purpose:
We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs.
Methods:
We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM.
Results:
We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity.
Conclusion:
Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs.
... 3 This condition not only puts immense strain on health-4 care infrastructures but also is a principal cause of dis- relief [10]. CFT has adopted a complementary strategy 25 by acknowledging the interplay of the physical, psycho- 26 logical, and social elements that contribute to a person's 27 perception of pain and impairment. CFT seeks to em- 28 power patients by addressing these many components, 29 assisting patients in regaining control over their lives 30 and enhancing their capacity to function [11,12]. ...
BACKGROUND: Cognitive functional therapy (CFT) aims to address low back pain (LBP) comprehensively by considering physical, psychological, and social factors. OBJECTIVE: The objective was to evaluate the effectiveness of CFT in reducing pain and disability in individuals with LBP over various time intervals. METHOD: A comprehensive literature search was conducted to identify relevant randomized controlled trials (RCTs) assessing the effects of CFT on LBP. RESULTS: In this study, 1510 records were initially identified, and 7 studies were included in the analysis. Disability scores were significantly reduced after CFT had been applied for 6 to 8 weeks (SMD =-0.46, 95% CI [-0.74, -0.19]), 12 weeks to 3 months (SMD =-0.54, 95% CI [-0.72, -0.36]), 6 months (MD =-5.82, 95% CI [-9.82, -1.82]), and 12 months (SMD =-0.4, 95% CI [-0.55, -0.26]). There were also significant reductions in pain scores observed after 12 weeks to 3 months (SMD =-0.49, 95% CI [-0.68, -0.3]), 6 months (MD =-0.75, 95% CI [-1.5, -0.0001]), and 12 months (SMD =-0.27, 95% CI [-0.42, -0.12]). CONCLUSION: CFT showed potential for improving disability scores for individuals with LBP across various time intervals. However, its impacts on pain scores varied.
... Of the 60 articles, most were surveyed in athletes in Germany [14,18,49,[52][53][54][55][56][57][58][59][60][61][62], in Sweden [3,[63][64][65][66], and in Iran [36, 37, [67][68][69]. Moreover, also in Norway [11, 70,71], Poland [72][73][74], United States [50,51,75], the Netherlands [76,77], Belgium [78], Switzerland [12,79], Finland [80,81], Australia [82,83], Spain [84,85], Saudi Arabia [86,87], Estonia [88], Serbia [89], New Zealand [90], Ukraine [91], China [92], Austria [93], Brazil [94], and India [95]. Three articles [48,96,97] failed to report the study site, and one study was conducted in several countries [98]. ...
Back pain in athletes varies with sport, age, and sex, which can impair athletic performance, thereby contributing to retirement. Studies on back pain in this population use questionnaires to assess components, such as pain intensity and location and factors associated with pain, among others. This study aimed to review validated questionnaires that have assessed back pain in athletes. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) by searching the databases Embase, MEDLINE, SPORTDiscus, CINAHL, and Scopus. The articles were selected regardless of language and date of publication. Titles and abstracts were independently selected by two reviewers; disagreements were resolved by a third reviewer. All the steps were conducted using the software Rayyan. The methodological quality of the questionnaire validation articles was assessed using a critical appraisal tool checklist proposed by Brink and Louw. The search returned 4748 articles, of which 60 were selected for this review, including 5 questionnaire validation studies. These articles were published between 2004 and 2022, which were performed in more than 20 countries, particularly Germany (14) and Sweden (5). Thirteen different instruments were identified, of which 46.1% were developed in Europe. The most commonly used questionnaires were the Oswestry Disability Index and Nordic Standardized Questionnaire. In addition, five questionnaire validation studies were selected for methodological quality assessment, with only two studies demonstrating high methodological quality. The following three instruments were identified for assessing back pain specifically in athletes: Micheli Functional Scale, Persian Functional Rating Index, and Athlete Disability Index. This review confirmed that all three instruments were specifically designed to assess this condition.
Objective
To assess the effectiveness of cognitive functional therapy (CFT) in reducing disability and pain compared to other interventions in chronic spinal pain patients.
Methods
Five databases were queried to October 2023 for retrieving randomized controlled trials (RCTs), including patients with chronic spinal pain and administering CFT. Primary outcomes were disability and pain. Secondary outcomes included psychological factors, quality-of-life, patient satisfaction and adverse events. Two independent reviewers performed study selection, data extraction, risk of bias assessment (Cochrane RoB 2.0), and evidence certainty (GRADE approach). Random-effect models were used for meta-analyses. Clinical relevance was assessed with the Smallest Worthwhile Effect.
Results
Eight RCTs (N = 1228) for chronic low back pain (CLBP), one (N = 72) for chronic neck pain (CNP) were included. Compared to other conservative interventions, CFT may reduce disability (MD: -9.41; 95%CI: -12.56, -6.27) and pain (MD: -1.59; 95%CI: -2.33, -0.85 for CLBP) at short-term follow-up with probable to possible clinical relevance in CLBP and with low and very low evidence certainty, respectively. Similar results, with larger effect sizes, were observed for CFT compared to any unstructured or unsupervised minimal care treatments. Efficacy persisted in longer-term follow-ups, except for comparison with other conservative interventions. The CNP study showed positive results for CFT. Evidence certainty was low to very low. Sparse evidence was found for secondary outcomes.
Conclusion
CFT may offer clinically relevant benefits for CLBP, although the evidence remains mainly of low to very low certainty. Well-conducted studies, particularly in CNP and other spinal pain conditions are needed to strengthen these findings.
Registration
PROSPERO CRD42023482667
The most commonly reported injury site in rowers is the lower back. Research in recent years has focused on epidemiology and biomechanical analyses to try and understand mechanisms that contribute to this injury's onset. Injury surveillance mainly comprises retrospective questionnaires and reviews of medical records with a lack of prospective data. Of studies that reported 12-month data, the incidence of low back pain ranged from 31.8 to 51% of the cohort. Of the limited studies that specifically examined low back pain in rowers, (1) history of lumbar spine injury and (2) volume of ergometer training were the most significant risk factors for injury onset. Studies of technique on the rowing ergometer have indicated the importance of lumbopelvic rotation during rowing. Greater pelvic rotation at either end of the stroke is ideal-as opposed to lumbar flexion and extension; this tends to be poorly demonstrated in novice rowers on ergometers. Furthermore, technique can deteriorate with the demands of rowing intensity and duration, which puts the rower returning from injury at additional risk.
Lumbar spine injury in rowers is common and ergometer rowing has been cited as a risk factor for this injury. The purpose of this study is to compare lumbar kinematics between ergometer and single scull rowing and to examine the effect of fatigue on kinematics. The sagittal lumbar spine motion of 19 elite male rowers (lumbar spine injury free in the previous six months) was measured with an electrogoniometer during a 'step test' on an ergometer and in a single sculling boat. Maximum range of lumbar flexion was recorded in standing for reference. Power output and heart rate were recorded during the ergometer tests. Heart rate was used as a surrogate for power output in the sculling test. Maximum lumbar flexion increased during the step test and was significantly greater on the ergometer (4.4 degrees +/- 0.9 degrees change), compared with the boat (+1.3 degrees +/- 1.1 degrees change), (3.1 degrees difference, p = 0.035). Compared to the voluntary range of motion, there is an increase of 11.3% (ergometer) and 4.1% (boat). Lumbar spine flexion increases significantly during the course of an ergometer trial while changes in a sculling boat were minimal. Such differences may contribute to the recent findings linking ergometer use to lower-back injury.
Since its founding in Montreal, Canada in 1974, the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) has been providing orthopaedic and manual therapists from around the world with the highest-quality learning opportunities through a conference held every 4 years. In 2012, IFOMPT is partnering with The International Private Practitioners Association (IPPA) to host this prestigious event in Quebec City, Canada. As more than 51% of the Canadian Physiotherapy Association membership is working in private practice, this adds even greater value to this quadrennial event. This conference emulates best-evidence practice in the marriage of research and clinical excellence by pulling together some of the best and brightest hands and minds in orthopaedic physiotherapy. Through a call for proposals that equally emphasized research, clinical excellence, and the knowledge translation link between the two, the IFOMPT mandate of clinical and academic excellence has been kept at the forefront of this year's conference. Included in this supplement are the IFOMPT 2012 keynote addresses, schedule, and abstracts.
J Orthop Sports Phys Ther 2012;42(10):A1–A83. doi:10.2519/jospt.2012.0302
The purpose of this study was to assess a patient specific measure for eliciting and recording patients' problems. While the notion was to develop a measure that would be applicable to a number of conditions or disabilities, this study assessed the measure's performance on 63 out-patients with mechanical low back pain. Patients were asked to identify up to five important activities they were having difficulty with as a result of their back pain. Patients rated difficulty on an 11-point numerical scale. At subsequent reassessments patients were informed of the activities and corresponding difficulty scores identified at the previous assessment and asked to provide a current difficulty score. Concurrent validity of the patient-specific measure was assessed using the Roland-Morris Questionnaire. Sensitivity to valid change over time was determined by comparing the measure's score to the average patient/clinician global rating of change. Moderate to excellent reliability, validity, and sensitivity to change c...
Rowing should become the favourite sport of our young people as no other exercise can provide them with the physical and moral qualities that they need: energy, initiative and health —Pierre de Coubertin The FISA Sports Medicine Commission advises the FISA Council and member federations on rowing-related sports medicine issues. Rowing has been part of the Olympic programme since 1896; women’s rowing was introduced as an Olympic sport in 1976 and the lightweight category was included in 1996. The first World Championships for ‘Adaptive’ (persons with a disability) rowers was in 2002. Rowing was introduced into the programme of the Paralympic Games of 2008. Clinical issues in rowing Most rowing biomechanical and physiological research has been performed on rowing machines (‘ergometers’) on which rowers can closely mimic the movement of the rowing stroke. There has been less research on boats in water. Most rowing injuries are due to overuse/overload or poor mechanics. Lower back pain, wrist tendon disorders and rib stress fractures are the most common injuries reported. There has been a well-documented increase in the incidence of these injuries since the 1991 introduction of the hatchet ‘big’ blades. Lightweight rowing, where athletes compete within defined weight limits, shares many of the problems associated with other weight-controlled sports. The Sports …
The primary objective of this study was to determine the lifetime and point prevalence of low back pain, the related pain intensity and the rowing-related aggravating factors for low back pain in adolescent rowers who participated in school-level competitions. The secondary objective was to determine whether between-gender differences existed in these data.
Retrospective cross-sectional survey METHOD: 130 adolescent male and 235 adolescent female rowers aged between 14 and 16 years were recruited in this study. Participants completed a questionnaire to determine their lifetime and point prevalence of low back pain, their pain intensity and rowing-related factors that aggravated their low back pain.
A high lifetime and point prevalence of low back pain were found in both adolescent male (93.8% and 64.6%, respectively) and female (77.9% and 52.8%, respectively) rowers. A significant between-gender difference was reported for both statistics (p<0.001). A significantly lower (p=0.003) level of pain intensity via a visual analog scale was found for males (4.1/10) when compared to females (5.0/10). Similar rowing-related aggravating factors were reported by males and females although fewer males reported that lifting the rowing shell aggravated their low back pain.
A high lifetime and point prevalence of low back pain was reported by the adolescent rowers recruited in this study. While a greater proportion of adolescent male rowers reported low back pain, they reported a lower intensity of pain when compared to their female counterparts. Coaches, clinicians and rowers should be made aware of these findings such that future research and development can focus on promoting pain management strategies in this sport.