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Abstract

Objectives: Low back pain (LBP) is a common and disabling problem amongst golfers. Despite this, the risk factors for LBP in golfers have not been clearly established and therefore, optimal prevention strategies are not developed. This study was designed as a preliminary investigation of predictors for LBP in trainee professional golfers. Design: Longitudinal prospective study. Setting: Golf courses. Participants: Trainee professional golfers (N=1 4). Main outcome measures: Potential risk factors included anthropometric variables, flexibility, muscle strength, and muscle endurance. Associations were evaluated between these risk factors and reported episodes of LBP obtained from participants after every trainee match during one competition season. Results: Golfers with a body mass index (BMI) <25.7 kg/m2 and those with a right side deficit of >12.5 s on the side bridge endurance test reported more frequent episodes of moderate-severe LBP. Golfers with reduced hip flexor length more often reported that LBP affected their golf. Conclusions: BMI, the side bridge endurance test, and hip flexor length were found to be significantly related to LBP amongst trainee professional golfers. Having optimal values on these variables may potentially prevent LBP arising from the repetitive biomechanical demands of the golf swing.

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... A high injury incidence is well established in young elite golfers. Evans et al. (2005) reported an 85.71% of incidence of lower back pain in young elite golfers over a 10-month monitoring period. The present study incidence may have been reduced compared to Evans et al. (2005) due to the shortened monitoring period. ...
... Evans et al. (2005) reported an 85.71% of incidence of lower back pain in young elite golfers over a 10-month monitoring period. The present study incidence may have been reduced compared to Evans et al. (2005) due to the shortened monitoring period. This large incidence in lower back pain over a six-month period highlights the need for targeted lower back pain prevention strategies for this group of golfers. ...
... A systematic review by Smith et al. (2018) showed that pooled analysis demonstrated golfers with lower back pain were heavier than golfers without lower back pain. In contrast a longitudinal study by Evans et al. (2005) on trainee professional golfers showed that golfers with a BMI below 25.7 kg/m 2 were at greater risk of developing lower back pain. Whilst we acknowledge the possible impact that BMI had on the results, we would like to argue that it is not possible to account for all confounding variables and that it is not yet clear how BMI affects injury risk in golfers. ...
Article
Background This is the first study that presents electromyographic measurements prior to the development of lower back pain in young elite golfers. Study design: Prospective longitudinal cohort study. Methods Thirty-three injury free elite golfers were included. Muscle activity from latissimus dorsi, rectus abdominis, external oblique and erector spinae muscles were recorded during 10 drive golf swings. Lower back pain, training and performance were monitored over a six-month period. Muscle activation comparisons were made between the baseline results of those who went on to develop lower back pain versus those who did not go on to develop lower back pain. Results After the six-month monitoring period 17 participants developed lower back pain. The group that developed lower back pain had increased dominant rectus abdominis and dominant latissimus activation at various time points throughout the swing. Discussion The increased dominant rectus abdominis and dominant latissimus during the golf swing is linked with developing lower back pain. Training strategies aimed at reducing these muscles activation during the swing may reduce the incidence of lower back pain in young elite male golfers.
... The highest predictor for LBP is having a BMI < 25.7 kg/m. 2,5 This suggests that the tall, slender golfer is actually at a higher risk than someone with greater mass relative to their height. The second known predictor is having a right-side deficit (in right-handed golfers) of >12.5 seconds on the side-plank endurance test compared to the left. ...
... The second known predictor is having a right-side deficit (in right-handed golfers) of >12.5 seconds on the side-plank endurance test compared to the left. 5 Several authors have examined the relationship between lead and non-lead hip rotation in golfers with low back pain. A decrease in lead hip internal rotation (IR) compared to the non-lead hip has been correlated with the presence of low back pain in both amateur and professional golfers. ...
... al, this patient was at a higher risk for experiencing low back pain as his BMI was 23 kg/m. 2,5 Although his side plank deficits were not largely different side to side, his overall hold times in all positions were poor. Anderson et al. found the average side-plank hold in healthy males with an average age of 28 in their study to be 68.2 sec on the right and 69.5 sec on the left. ...
Article
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Background and purpose: Low back pain is one of the most common conditions occurring in the golfing population. Many approaches have been utilized throughout the years to address this condition including the concept of regional interdependence. The purpose of this case report is to describe the evaluation process and treatment approach of a golfer with low back pain using the principles of regional interdependence. Case description: A thirty-year-old male with right-sided low back pain was evaluated using a comprehensive approach including golf specific movement screening and a swing evaluation. The patient had mobility restrictions in his thoracic spine and hips that appeared to be contributing to a hypermobility in the lower lumbar spine. Based on the evaluation, he was placed into the treatment-based classification (TBC) of stabilization but would also benefit from mobilization/manipulation techniques. Outcomes: After seven visits over a four-week span, the patient's mobility and core stability both improved and he was able to play golf and workout pain free. His outcome measures also improved, including the revised Oswestry Disability index from 26% disabled to 10%, the Fear Avoidance Behavior Questionnaire (FABQ) Work from 10/42 to 3/42, and the FABQ Physical Activity from 19/24 to 6/24. Discussion: Evaluating and developing a plan of care to address low back pain in an avid golfer can be challenging as a variety of demands are placed on the spine during the movement. This case report describes the evaluation process and treatment approach to specifically target the demands that are required during the golf swing. Utilizing a targeted approach that includes golf specific movement screening and a swing evaluation can help guide the therapist in their treatment and improve the patient's outcome. Level of evidence: Level 4.
... Our results are consistent with Kraft et al. [9], Kujala et al. [46], Kujala et al. [48], and Burdorf, Van Der Steenhoven and Tromp-Klaren [49], who did not find a significant association between other anthropometric traits such as stature and body mass index with LBP. Evans, Refshauge, Adams and Aliprandi [50] found surprisingly higher body mass index values in golfers without LBP that golfers with LBP. ...
... Several studies reported poor endurance test scores (trunk extensor endurance, trunk flexor endurance, and trunk lateral flexor endurance) related to LBP in athletes [48,50]. In this study, ISBE was 27.7 s shorter in CEA-LBP than in CEA-A. ...
... The cutoff score with the greatest discriminatory power for prognostic screening were those obtained from ISBE (≤65 s). These results are in accordance with those reported by Evans et al. [50] in young golfers. Specifically, Evans, Refshauge, Adam and Aliprandi [50] observed that golfers with a right-side deficit of >12.5 s on ISBE reported more frequent episodes of LBP. ...
Article
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Low back pain (LBP) is the most common overuse musculoskeletal injury suffered by child equestrian athletes (CEA). Despite this, little is known about the risk factors related to LBP in these athletes, and very limited research has been conducted on this topic. This study was designed to investigate predictive risk factors for LBP in CEA. The purposes of this research were to determine whether anthropometric, range of motion (ROM), core endurance and sagittal spinal morphotype measures are risk factors for LBP and to establish a diagnostic cutoff value for those factors associated with LBP. Nineteen CEA between the ages of 12 and 17 years were voluntarily recruited. Potential risk factors evaluated included corporal composition, lower limb ROM, core endurance and sagittal spinal measures. Associations and predictions were calculated between these risk factors and the LBP during the last 12 months. Almost half of the CEA have suffered at least one episode of LBP. Two risk factors and cutoff values were identified as predictors of LBP in CEA: having a high body fat higher than 23% (p = 0.01) and trunk lateral flexor endurance lower to 65 s (p = 0.021), body fat being the strongest predictor.
... 15,16 The lower back, wrist, and elbow are commonly effected by overuse injuries, and for both male professional and amateur golfers, the lower back is the most frequently injured area. 3,12,[17][18][19] Injuries to the lower back, often denoted by low back pain (LBP), have a wide etiology. ...
... Some golfers may be predisposed to developing LBP irrespective of golf swing technique. Interestingly, body mass index (BMI) has been negatively correlated with LBP development in young golfers, 18 while body mass was positively related to LBP. 59,60 Golfers with BMI > 25 experienced more instances of LBP from mechanisms outside of golf. 37 Body composition may impact the distribution of force through the body, and taller golfers or golfers with longer swing arcs need to have adequate musculature to support the lumbar spine. ...
... 37 Body composition may impact the distribution of force through the body, and taller golfers or golfers with longer swing arcs need to have adequate musculature to support the lumbar spine. 18 Increasing age has also been linked to LBP risk. 61 LBP is a multifaceted injury that requires a holistic approach to treatment. ...
Article
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Golf is an international sport played by a variety of age groups and fitness levels, and although golf has a low to moderate aerobic intensity level, injuries are common among professional and amateur golfers. High amounts of force experienced during the golf swing can lead to injury when golfers lack appropriate strength or technique with the lower back most commonly injured. Research has indicated that trunk muscle activation, hip strength and mobility, and pelvis and trunk rotation are associated with low back pain (LBP). Based on anecdotal evidence, golf practitioners specifically address issues in weight shift, lumbar positioning, and pelvis sequencing for golfers with LBP. This review aims to elucidate the effects of proper and improper golf swing technique on LBP and to help golf practitioners understand how to approach the alleviation of LBP in their clientele.
... 21,39,40 The prevalence of lower back injuries has been estimated to be between 15% and 35% in amateurs and up to 55% in professionals 10 and is associated with significant time lost from golf play and practice. 16,21 Multiple factors have been identified as potential causes of LBP in golfers. These include movement characteristics of the golf swing, individual demographic and physical characteristics, and volume of play/practice. ...
... Of these, 3 specified a minimum duration of golf experience or frequency of play for inclusion, 11,15,44 and 2 required a handicap below 20. 30,52 Three studies included both professional and elite recreational golfers, 21,27,35 and 4 investigated professional golfers exclusively 16,22,34,53 (Table A1 in the Appendix, available in the online version of this article). ...
... One longitudinal study showed that, in trainee professional golfers, body mass index (BMI) was significantly negatively correlated with frequency (% time) of LBP symptoms over a 10-month period (r = −0.7). 16 There was no evidence that hand dominance is associated with LBP. 43 ...
Article
Context: Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing. Objective: The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers. Data sources: A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017. Study selection: Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related low back pain. Study design: Systematic review and meta-analysis. Level of evidence: Level 3. Data extraction: Studies were independently reviewed for inclusion by 2 authors, and the following data were extracted: characterization of low back pain, participant demographics, anthropometrics, biomechanics, strength/flexibility, and practice characteristics. The methodological quality of studies was appraised by 3 authors using a previously published checklist. Where possible, individual and pooled effect sizes of select variables of interest were calculated for differences between golfers with and without pain. Results: The search retrieved 73 articles, 19 of which met the inclusion criteria (12 case-control studies, 5 cross-sectional studies, and 2 prospective longitudinal studies). Methodological quality scores ranged from 12.5% to 100.0%. Pooled analyses demonstrated a significant association between increased age and body mass and golf-related low back pain in cross-sectional/case-control studies. Prospective data indicated that previous history of back pain predicts future episodes of pain. Conclusion: Individual demographic and anthropometric characteristics may be associated with low back pain, but this does not support a relationship between swing characteristics and the development of golf-related pain. Additional high-quality prospective studies are needed to clarify risk factors for back pain in golfers.
... On the other hand some of the published data for such risk factors is controversial. For example, Evans et al. showed that body mass index (BMI) could be a risk factor of 2 Rehabilitation Research and Practice athletes' LBP but Kujala et al. could not support their finding [21,22]. Thus in this study, we conducted a comprehensive review based on prospective studies that evaluated risk factors of LBP in athletes. ...
... One high quality and one low quality studies reported that flexor tightness was significantly and negatively associated with LBP [21,22]. Also, flexor tightness was not associated with low back pain in one low quality study [27]. ...
... Also, flexor tightness was not associated with low back pain in one low quality study [27]. Decreased lumbar flexion and extension were significant risk factors for LBP in two high quality studies [21,28] but were not associated with low back pain in one low quality study [22]. These studies assessed lumbar sagittal flexibility using a modified version of the flexicurve technique introduced by Tillotson and Burton [29]. ...
Article
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We aimed to examine systematically the available evidence on risk factors of low back pain (LBP) in athletes. We performed search without language restriction in PubMed, Ovid, Google Scholar, Scopus, and CINAHL. Longitudinal studies that examined possible risk factors of LBP in athletes were included in this systematic review. Based on methodological quality of studies, a best-evidence synthesis was conducted. Seven longitudinal studies were included, four of which had high methodological quality. Results showed that previous LBP, decreased lumbar flexion, and decreased lumbar extension are positively associated with LBP. There was moderate evidence for hip flexor tightness and high body weight as a risk factor. We found insufficient evidence for association between forward bending, previous injury, and amount of training per week, active years, age, and sex with LBP. In conclusion this study would provide a list of risk factors for LBP in athletes, though it showed a strong evidence for only a few including decrease lumbar flexion or extension, previous LBP, and high body weight. This review indicated a high heterogeneity of study characteristics including assessed risk factors and statistical techniques might limit the quality of evidence.
... Impaired paraspinal muscle endurance is proposed as a contributor to persistent back pain in the general population and in athletes. [5][6][7][8] During the types of sub-maximal activities that are encountered during daily life, paraspinal fatigue results in taskspecific alterations in the timing of feedforward and feedback postural responses. [9][10][11][12] Therefore, impaired paraspinal endurance may result in altered postural control and maladaptive spinal loading, and may cause new or persistent pain. ...
... Insufficient trunk and hip muscle endurance has also been suggested to contribute to LBP in athletes due to the high demands placed upon the spinal musculature and the high prevalence of back pain in sporting disciplines such as rowing and golf. 8,13,14 The Biering-Sørensen test is commonly used in the general population and in athletes to assess endurance of the paraspinal and hip extensor musculature. 15 The test requires the participant to maintain the load of their head, arms, and trunk in a horizontal position against gravity for as long as possible. ...
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Impaired paraspinal muscle endurance may be a contributor to persistent low back pain (LBP) and is frequently assessed using a single repetition of the Biering-Sorensen test. The aim of this study was to investigate how Sorensen test duration, and muscle fatigability, are affected by multiple repetitions of the test, and to determine predictors of Sorensen test duration in young, active adults with and without a history of LBP. Sixty-four individuals participated; 41 had a greater than one-year history of LBP symptoms. Participants performed 3 repetitions of the Sorensen test while electromyography (EMG) data were collected from the lumbar and thoracic paraspinals and the hamstrings. Muscle fatigability was quantified as the slope of the change in median frequency of the EMG signal over time. Duration of the test decreased across repetitions for both groups and was significantly less for the 2nd and 3rd repetitions in individuals with LBP. For all three muscles, fatigability increased across repetitions, but did not differ between groups. In individuals without LBP, fatigability of the lumbar paraspinals was the best predictor of test duration. In individuals with LBP, Sorensen test duration was predicted by fatigability of the thoracic paraspinals and hamstrings. Our findings demonstrate that it is necessary to amplify the difficulty of the Sorensen test to fully elucidate impairments in young adults with LBP. Training or rehabilitation programs aiming to improve lumbar paraspinal endurance in individuals with LBP should account for the endurance of other synergist muscle groups during endurance exercise.
... Core strength is important for athletes in many different sports [1][2][3][4]. The core consists of the back muscles, abdominal muscles and muscles around the pelvis [2]. ...
... The aim of the core is to stabilize the pelvis and spine during rest and movement [3,5]. Research has shown that improving core strength can lead to better performance and less injuries [3,4]. Weak core strength, on the other hand, might be associated with a number of different injuries, such as problems with the groin or back [5][6][7][8]. ...
Article
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Background: Core strength is an important aspect of physical fitness. A dynamometer was developed to measure isokinetic core muscle strength in multiple planes of motion. Establishing the reliability is needed before it can be used in practice. Objective: Examine the intra-observer reliability of a trunk isokinetic dynamometer. Methods: 31 participants were recruited. Tests were performed twice with an interval of 5-9 days by the same observer. Testing included rotation, flexion/extension and lateral flexion at speeds of 90∘/s and 60∘/s. The main outcome measure was peak torque (PT). The secondary outcomes included peak torque angle (PTA), time to peak torque (TTPT) and compensatory torques (CompTQ). The intra-observer reliability was investigated using intraclass correlation coefficients (ICC). Results: Peak torque reliability was good to excellent (ICC = 0.70-0.91), whereas the reliability of the PTA (ICC =-0.04-0.56) and TTPT (ICC = 0.01-0.68) were poor to moderate. CompTQ reliability was moderate to good (ICC = 0.20-0.88). Conclusions: The intra-observer reliability of the isokinetic measurement of core strength peak torque was good. The secondary outcomes peak torque angle and time to peak torque were less reliable and the compensatory torques showed moderate to good reliability. This isokinetic dynamometer could have useful applications in the field of sports medicine and rehabilitation.
... The closed-chain SB task has been widely used as an assessment of trunk muscle isometric endurance capacity, [1][2][3][4][5]8,17,[26][27][28][29][30] and some studies have linked sideto-side asymmetry in holding times to the development of LBP. 29,31 Motivation for the current study was based on the suggestion that an open-chain SB may be a suitable alternative for those who report shoulder pain or fatigue as the reason for terminating the closed-chain SB endurance test. ...
... The closed-chain SB task has been widely used as an assessment of trunk muscle isometric endurance capacity, [1][2][3][4][5]8,17,[26][27][28][29][30] and some studies have linked sideto-side asymmetry in holding times to the development of LBP. 29,31 Motivation for the current study was based on the suggestion that an open-chain SB may be a suitable alternative for those who report shoulder pain or fatigue as the reason for terminating the closed-chain SB endurance test. 7 Theoretically, to use the open-chain SB as an alternative for the closedchain SB would require matching of the biomechanical demand imposed on the trunk muscles between these two variations as a logical precursor. ...
Article
Background: The side-bridge (SB) is a commonly used closed-chain task to assess trunk muscle endurance and side-to-side endurance asymmetry. An open-chain variation of the SB, that positions the participant in an inclined side-lying posture, may be useful for those who report shoulder pain or fatigue as the reason for terminating the closed-chain SB. Low back loading demands of the open- and closed-chain variations should be matched to facilitate comparison of SB endurance measures. Purpose: To quantify the low back reaction moments during the open- and closed-chain SB and determine the appropriate open-chain angle of inclination that matches the lateral bend moment magnitude of the closed-chain SB. Study Design: Observational cohort Methods: Upper body and trunk postural data were obtained during the closed-chain SB and during the open-chain SB at each of four inclination angles from a group of eight healthy male adults. Ground reaction force (GRF) data were also collected during the closed-chain SB. Low back reaction moments were calculated using a static ‘top-down’ linked segment model in both SB variations. Latent growth modeling was used to determine the angle of inclination in the open-chain SB that produced a low back lateral bend moment that matched the closed-chain SB. Sensitivity of the matching open-chain inclination angle was evaluated by rotating the measured GRF vector from the closed-chain SB by five degrees clockwise and counter-clockwise in the frontal plane. Results: The open-chain inclination angle that best matched the loading demands of the closed-chain SB was 38 ± 12 degrees. Clockwise rotation of the measured GRF in the closed-chain SB increased the matching inclination angle to 56 ± 17 degrees. Counter-clockwise rotation reduced the matching inclination angle to 17 ± 11 degrees. Secondary descriptive analysis of spine posture and off-axis low back moments revealed biomechanically relevant differences between SB positions. Conclusion: The average open-chain SB angle of inclination that matched the closed-chain SB approximated the 45-degree recommendation offered in the literature. Differences in spine posture and off-axis low back reaction moments, and the potential impact on holding times, should be considered if using the open-chain SB. Level of Evidence: 2b
... Up to now, there is a lack 12 of understanding of the risk factors. As possible rea-13 sons for low back pain, some authors have reported 14 decreased muscle flexibility and trunk strength [25, 15 26,41], poor hamstring flexibility [13,23,31,40], trunk 16 muscle strength [36] and endurance [4]. The correla-17 tion between tight hamstrings and LBP has been es-18 tablished in cross-sectional studies [7,27,30,32]. ...
... We found no statistically significant difference 252 among groups in Relative peak torque of the right knee 253 extensors, Relative peak torque of the left knee exten-254 sors and Functional asymmetry in the dominant limb 255 according to LBP. Several studies showed that this 256 variable was not significantly different between ath-257 letes with and without LBP [14,33,37]. Renkawitz et 258 al. [37] found that there is no significant difference for 259 hip extensor strength among athletes with and without 260 LBP. ...
Article
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Correspondence: [*] Corresponding author: Dragan Marinkovic, Faculty of Sport and Physical Education, University of Novi Sad, Lovćenska 16 21000 Novi Sad, Serbia. Tel.:+381 21 450 188; Fax: +381 21 450 199; E-mail: marinkovic@uns.ac.rs. Abstract: BACKGROUND: Soccer as a sport has a very high injury rate and low back pain (LBP) is considered to be the most common overuse injury typically occurring in the back and spine in elite soccer players. OBJECTIVE:This study aimed to investigate differences in knee muscle strength and muscle imbalances in soccer players according to lower back pain. METHODS: One hundred and thirty-six male professional soccer players (20.49 ± 3.73 years, 76.57 ± 8.24 kg, 182.63 ± 6.73 cm) volunteered for the study. The isokinetic dynamometer PrimaDOC (EASYTECH, Italy) was used to assess the hamstring and quadriceps strength at the selected speeds of 60∘/s, whereas the Roland-Morris Disability Questionnaire (RDQ) was used as a health status measure to assess physical disability caused by low back pain. RESULTS: A univariate analysis of variance has shown that there is a statistically significant difference among the groups divided into Absolut peak torque right knee flexors, Absolut peak torque left knee flexors, Ratio between hamstrings and quadriceps strength right leg, Ratio between hamstrings and quadriceps strength left leg based on the RDQ scores. On the other hand, no other significant differences among the groups were found in other parameters CONCLUSION: The current study indicates that knee muscle strength variables, resulting from an isokinetic testing, have the potential to discriminate between soccer players with and without a history of low back pain. However, low back pain is a multidimensional phenomenon and knee muscle strength or imbalance alone cannot be expected to explain low back pain. Keywords: Soccer, assessment, differences, muscle imbalances
... Amateur golfers are believed to be at risk of lower back pain because they often train hard to become professional players (Evans et al. 2005). Major risk factors that contribute to their back pain are the poor endurance and strength of the trunk muscles (Evans et al. 2005). ...
... Amateur golfers are believed to be at risk of lower back pain because they often train hard to become professional players (Evans et al. 2005). Major risk factors that contribute to their back pain are the poor endurance and strength of the trunk muscles (Evans et al. 2005). In a study conducted by Gosheger et al. (2003), out of 637 reported golf injuries, 92.3% were found to have back problems where excessive play was blamed. ...
Article
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Background: Mechanical lower back pain (MLBP) and sacroiliac joint dysfunction (SIJD) are common problems among golfers. There are currently few studies on golfers regarding the relationship between MLBP and SIJD. Objective: The objective of this study was to determine the prevalence of MLBP and SIJD and their association in golfers at two golf clubs in Durban, South Africa. Method: A correlation design included convenience sampling. The Standardised Nordic Questionnaire for the analysis of musculoskeletal symptoms determined the prevalence of MLBP. Sacroiliac joint pain provocative tests determined the prevalence of SIJD. Institutional ethical clearance was granted and consent from participants was obtained. Data were collected over 3 weeks and SPSS was used to calculate descriptive and inferential statistics. Results: There were 271 participants dominated by males (86.7%) aged between 39 and 47 years (33.2%). A total of 123 (45%) of the participants presented with MLBP and 62 (23%) with SIJD. The MLBP prevalence was moderately associated with age (χ2 = 71.22, p = 0.004) and years of experience (χ2 = 69.93, p = 0.001). The SIJD prevalence was moderately associated with age (χ2 = 55.49, p = 0.003) and poorly associated with years of experience (χ2 = 44.93, p = 0.005). Twenty-two per cent (60) had both MLBP and SIJD and 54% (146) had neither. A strong association (χ2 = 88.234, p = 0.000) between MLBP and SIJD was observed. Conclusion: There was a high prevalence of MLBP and SIJD and a strong association between them. A comprehensive management approach is recommended for golfers with MLBP and SIJD. Clinical Implications: This study will provide valuable knowledge that will assist clinicians, especially physiotherapists, in their clinical management of golfers with MLBP and SIJD. Intervention studies are needed to address lower back and sacroiliac joint problems reported in this study.
... Our study found higher BMI (>25 kg/m 2 ) as a risk factor for CLBP. Evans et al. [55] showed that BMI could be a risk factor for athletes' LBP. Only a moderate evidence for BMI as a risk factor for LBP in athletes has been reported by Moradi et al. [34]. ...
Article
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.
... Conversely, adjustment to the main background variables uncovered significantly less extensor endurance in the LBP group only in models that featured the lateral flexors endurance as a dependent variable. Swain (54) and Evans (102) reported higher endurance of the lateral flexors on the dominant side in ballerinas and elite golfers. In gymnasts, trunk flexor endurance is higher compared to extensor endurance (103). ...
Article
Background: Musculoskeletal dysfunction is one of the most important occupational health issues. Prolonged sitting may be a risk factor for low back pain (LBP) associated with reduced muscle endurance, although many people with a sedentary lifestyle and sitting-type job report no pain and discomfort in the lumbar region. In the present study, endurance of the core muscles in individuals with sedentary jobs with nonspecific chronic LBP were compared with those without LBP. Objective: The present study compared core muscle endurance in individuals with sedentary jobs with and without nonspecific chronic low back pain. Methods: A total of 50 sedentary staffs were selected and divided into LBP and control group. Trunk muscle endurance was measured in seconds using the McGill’s trunk flexor endurance test, the Sorenson’s trunk extensor endurance test, and the right and left trunk flexor endurance test (Side-bridge test). Differences between the two groups were analyzed using multivariate general linear models in 2 ways ANOVA. Results: There were no significant between-group differences in the raw endurance of the extensor, flexor, right/ left flexor muscles (P≥0.05). However, there were significant between group differences in some self-reported physical fitness subscales (P<0.05), duration of sitting at home (P=0.035), frequency of assuming a slump sitting position (P=0.049), and sitting with leaning back to the backrest (P=0.02) at work. We developed uni- and multivariate general linear models, which showed adjustments to these parameters and unmasked fundamental between-group differences in extensor muscle endurance. Conclusions: Our finding does not support the popular opinion that daily sitting-while-at-work for long durations is necessarily associated with LBP. Instead, sitting posture, lower physical fitness levels, and shorter duration of sitting activities at home may be associated with reduced extensor muscle endurance in nonspecific chronic low back pain. KEY WORDS: Core muscle; Endurance; McGill tests; Nonspecific Chronic Low Back Pain; Sedentary Occupation.
... Adolescent athletes might therefore be more influenced by hamstring tightness during physical development than adult athletes, resulting in high-risk LBP occurrences [21]. With regard to young populations, one prospective study evaluating 14 young trainee professional golfers indicated that body mass index (BMI), the side bridge endurance test, and hip flexor length were significantly related to LBP, but hamstring tightness was not [22]. Similarly, no association was seen between hamstring tightness and LBP occurrence in prospective cohort studies of 86 adolescent athletes (soccer, ice hockey, gymnastics, figure skating, and ballet) and 396 adolescent basketball and floorball players [10,11]. ...
Article
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Background Limited flexibility of the lower extremities, such as hamstring tightness, has long been suggested as a physical risk factor for low back pain among adolescent athletes. However, few prospective cohort studies have examined the direction of causality for this relationship. This prospective cohort study investigated the relationship between limited flexibility of the lower extremities and the occurrence of low back pain among high school baseball players. Methods Participants comprised 335 high school baseball players from 43 high school baseball teams who had undergone baseline medical evaluations (a self-completed questionnaire and physical examination). Occurrence of low back pain during a 1-year follow up, and associations with measurements of flexibility of the lower extremities such as straight-leg-raising angle (hamstring tightness), Thomas test (iliopsoas tightness), heel-buttock-distance (quadriceps tightness), and passive range of motion of the hip were investigated. Results In total, 296 players (88.4%) participated in the 1-year follow-up survey, with 147 of the 296 players (49.7%) reporting the occurrence of low back pain during follow-up. The number of players with low back pain during follow-up peaked in November, then decreased and was lowest in June. After adjusting for factors associated with low back pain using logistic regression modeling, a significant association between hamstring tightness on the non-throwing arm side and low back pain (odds ratio 2.86, 95% confidence interval 1.17–6.94; P = 0.018) was found. Conclusions Hamstring tightness on the non-throwing arm side was identified as a potential risk factor for low back pain in high school baseball players. These results may provide guidance in the development of future prevention programs.
... This result suggests an imbalance between the lateral muscle chains of the torso in the LBP group, since the lateral flexor endurance test demonstrates activation of the gluteus medius, a hip stabilizer [33]. A study of golfers found that those with a difference of more than 12.5 seconds between the right and left sides in lateral trunk muscle endurance testing were more likely to experience pain episodes in the next ten months [34]. ...
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Introduction: Low back pain is one of the most common injuries in sailors. Findings in the literature indicate that poor trunk endurance, flexibility and muscle strength are common in individuals with low back pain (LBP). Objective: Analyze trunk muscle endurance, lumbar spine mobility and hip flexibility in windsurfers with and without low back pain. Method: Sailors of both sexes with at least three years’ experience in the sport answered the Nordic Musculoskeletal Questionnaire and were submitted to Schober’s test, the passive straight leg raise (PSLR), the modified Thomas test, and isometric endurance assessment of the flexor, extensor and lateral flexor muscles of the torso. The sailors were divided into two groups (with and without LBP) and compared using the Student’s t-test or Mann Whitney U test. Results: Participants were 22 national-level sailors, 11 with low back pain (LBP) and 11 without (NLBP). The LBP group obtained longer holding times for the trunk extensors (p=0.028) and a greater difference in endurance between the right and left sides for lateral trunk muscles (p=0.030). Both groups obtained results below normative values in most of the tests performed. Conclusion: Sailors with low back pain exhibited greater trunk extensor endurance and a larger imbalance between lateral trunk muscles when compared to those with no LBP. Spinal mobility and hip flexibility were similar between groups.
... He sustained a prone plank for 48 seconds, a bridge for 1 minute, a right lateral plank for 35 seconds, and a left lateral plank for 15 seconds. Asymmetry in side plank endurance was considered important since it has been associated with LBP in certain populations [31] and may lead to asymmetrical holding postures, such as a lateral shift. Therefore, side and front planks were added to improve his ability to hold his spine in a neutral position. ...
Article
Background A lumbar lateral shift (LLS) is a common clinical observation in patients with low back pain (LBP), and a shift contralateral to the side of pain is the most common presentation. An LLS that can rapidly alternate sides presents several treatment difficulties and has rarely been described. The purpose of the current case report was to describe the presentation and management of a patient with an alternating LLS. Case Description A 39-year-old male with a 7-week history of LBP and previous lower extremity radicular pain was referred to physical therapy. An alternating LLS was present. Outcomes The patient was treated for six visits over 37 days. Treatment included modified self-correction of the LLS, motor control and trunk muscle endurance training, and development of an activity management program. The patient’s LLS resolved, his worst pain improved from 3/10 to 0/10, and the Oswestry Disability Index improved from 26% to 4% disability. The patient reported maintenance of improvement at 6-month follow-up. Discussion The current approach produced a positive outcome in a patient with an alternating LLS. The current understanding of mechanisms and optimal treatment of an alternating LLS is limited. Level of Evidence 4
... The test is performed bilaterally, and muscle balance is compared by assessing contraction time. This procedure contributes to the analysis of laterality imbalance, reported in the literature as an important indicator of the causes of low back pain 7 . ...
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Aim: To compare the effects of different physical activities on laterality and asymmetry values through the side bridge test. Methods: the assessments were carried out in 45 subjects between 18 and 30 years old, 15 Crossfit-trained individuals, 15 weight trained and 15 sedentary. The subjects performed the side bridge test on both sides. After checking the normality and homogeneity of the data, we selected the appropriate statistical analysis for the comparison of the variables, adopting a significance level of α <0.05. Results: there was no statistical difference in the balance ratio; however, significant difference was found in the side bridge test endurance time, in which the Crossfit group obtained longer times on both sides than the other two groups. The side bridge test is a test of simple execution and that in this study the Crossfit group presented better results in the endurance time in the side bridge test. Conclusion: the results of the ratio asymmetry and endurance time are not sufficient to evaluate the resistance of the core muscles but could be an evaluation tool, the side bridge test can be introduced in postural training programs.
... There is limited research that has sought to investigate the prevalence of asymmetries within golfers and the relationships these asymmetries have with performance. Of the existing literature, research within golf has quantified asymmetries for torso rotation (1), hip morphology between the right and left leg (11), and isometric side bridge endurance (13). Although these studies have highlighted that asymmetries are prevalent within golfers, these studies failed to quantify the relationships these asymmetries had with performance measures such as CHV. ...
Article
Wells, JET, Mitchell, ACS, Charalambous, LH, and Fletcher, IM. Relationships between highly skilled golfers' clubhead velocity and vertical ground reaction force asymmetry during vertical jumps and an isometric midthigh pull. J Strength Cond Res XX(X): 000-000, 2019-Clubhead velocity (CHV) is a commonly measured variable within golf due to strong associations with increased drive distance. Previous research has revealed significant relationships between CHV and vertical ground reaction force (vGRF) variables during bilateral tasks including a countermovement jump (CMJ), squat jump (SJ), drop jump (DJ), and isometric midthigh pull (IMTP). Asymmetries have been linked to performance outcomes in a number of sports; however, few studies have assessed asymmetries within golf. The current study, therefore, examined the relationships between CHV and vGRF asymmetries for CMJ positive impulse, SJ positive impulse, DJ positive impulse, and IMTP peak force (PF). Furthermore, the level of agreement for asymmetries between protocols was assessed by using Kappa coefficients. Fifty highly skilled (handicap #5) male golfers attended laboratory and range-based testing sessions. Positive impulse and PF were measured using a dual force platform system, with CHV measured using a TrackMan 3e launch monitor. There was no significant relationship (r 5 20.14 to 0.22) between CHV and each of the vGRF asymmetry measures. Of the golfers tested, 26 had a "real" asymmetry in the CMJ, 18 had a "real" asymmetry in the SJ, 25 had a "real" asymmetry in the DJ, and 27 had a "real" asymmetry in the IMTP. Kappa coefficients indicated that asymmetries rarely favored the same limb (k 5 0.06 to 0.39) with asymmetries varying for individual golfers between protocols. As such, asymmetries are neither beneficial nor detrimental to CHV but are inherently individual and dependent on the task.
... 7,8,13 Likewise, an increasing number of young professional golfers are experiencing low-back pain and degenerative disc disease at ages much younger than those of the general adult population. 5 To understand why this is occurring, one needs to take a closer look at how the modern golf swing has changed in recent decades. ...
... Normal HE mobility is important for a normal mechanical load distribution when standing (Roach et al., 2015). Previous studies indicated that subjects with NSCLBP had significantly shortened hip flexors, with an average difference of 10°in HE ROM between subjects with NSCLBP and controls (Paatelma et al., 2009;Evans et al., 2005;Mellin, 1988). Furthermore, subjects who stand for long periods tend to show an excessive PATA during gait to compensate for the lack of HE ROM (Thambyah et al., 2003). ...
Article
Background: Because patients with nonspecific chronic low back pain (NSCLBP) are heterogeneous, subgrouping patients with NSCLBP might clarify the research findings. NSCLBP in the direction of extension movement, namely active extension pattern (AEP), is common during prolonged standing. Objective: Predictors of pain intensity and dysfunction were determined in prolonged standing service workers (PSSWs) with NSCLBP subclassified as AEP in the motor impairment subgroup. Methods: Variables were measured using questionnaires including a visual analog scale (VAS), the Oswestry Disability Index (ODI), Borg Rating of Perceived Exertion (RPE) Scale, and Korean Occupational Stress Scale (KOSS). Postural assessment was performed by measuring pelvic anterior tilting angle (PATA). The smart KEMA measurement system was used to evaluate hip flexion, hip extension (HE), and knee flexion range of motion (ROM), as well as hip extensor strength, hip abductor strength (HArS), hip external rotator strength (HERrS), hip internal rotator strength, knee extensor strength, and knee flexor strength, and lumbopelvic stability (LS) in 78 PSSWs with NSCLBP subclassified as AEP. Results: In prediction models, HArS, LS, PATA, KOSS and HE ROM accounted for 40.1% of the variance in the VAS (p < 0.05); predictors of dysfunction included the HERrS and age, which accounted for 11.9% of the variance in the ODI (p < 0.05) in multiple regression models when using a stepwise selection procedure. Conclusions: The present results indicate that HArS and HERrS, LS, PATA, KOSS, HE ROM and age should be considered for evaluating and predicting NSCLBP subclassified as AEP in PSSWs, and when designing interventions.
... Previous studies have also failed to identify a role of many of the variables not shown here to predict chronic LBP outcomes, including age, gender, LPB duration (Denison et al., 2004), spinal stiffness (Ferreira et al., 2009) or muscular endurance test scores (Mannion et al., 2001;Hicks et al., 2005), though not in all cases for trunk muscle endurance in relation to LBP disability (Enthoven et al., 2003;Evans et al., 2005). On the other hand, psychological factors such as fear of pain and movement, catastrophising, distress and depression, and fear avoidance beliefs, though not identified as predictors here, have been found to play a strong role in the development and maintenance or amelioration of LBP-related disability (Burton et al., 2004;Leeuw et al., 2007;Main et al., 2010;Picavet et al., 2002;Mannion et al., 2001). ...
Article
Background Several studies have investigated subgroups of patients with low back pain (LBP) most likely to benefit from Pilates or movement control exercises, but none have determined prognostic factors specifically for chronic LBP. This prospective cohort study aimed to determine predictors of change in disability in people with chronic LBP following a Pilates-based exercise programme and reports summarised integrated prediction statistics to aid clinical utility for determination of subgroups likely to benefit or not benefit from treatment. Methods Healthy adults (n = 55) with non-specific chronic LBP undertook a graded 6-week programme involving two 1-hour Pilates sessions/week (1 mat and 1 equipment-based) led in small groups by a trained Pilates instructor. Predictors of change in Patient-Specific Functional Scale (PSFS) were identified through regression analysis and used to develop clinical prediction statistics. Results Clinically important improvement (n = 14 of 48 analysed) was predicted by four variables: gradual rather than sudden onset of LBP, PSFS <3.7 points, absence of aberrant motions on forward bending, and body mass index >24.5 kg/m². Presence of ≥3 improved probability of success from 29% to 73%. Failure to improve (n = 18) was predicted by three variables: sudden onset of low back pain, patient-specific functional score ≥3.7, and difference between left and right active straight leg raise >7°. Presence of all three increased probability of failure from 38% to 80%. Conclusions A combination of five, easily measured variables were able to predict disability outcome following a graded programme of Pilates-based exercises in people with chronic LBP. Two common movement deficits were inversely related to positive changes in function which may call into question the structural mechanism of improvements observed. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12616001588482
... 29 Flexor endurance results of LBP subjects showed similar values to those of the healthy general population. 14 Mean flexor endurance is comparable to values found in golfers 15 and lower than those found in an athletic population. 20 Asymptomatic players produced a higher right side bridge endurance time. ...
Article
Background: Neural mobilization (NM) is widely used to assess and treat several neuromuscular disorders. However, information regarding the NM effects targeting the lower body quadrant is scarce. Objectives: To determine the effects of NM techniques targeting the lower body quadrant in healthy and low back pain (LBP) populations. Design: Systematic review with meta-analysis. Method: Randomized controlled trials were included if any form of NM was applied to the lower body quadrant. Pain, disability, and lower limb flexibility were the main outcomes. PEDro scale was used to assess methodological quality. Results: Forty-five studies were selected for full-text analysis, and ten were included in the metaanalysis, involving 502 participants. Overall, studies presented fair to good quality, with a mean PEDro score of 6.3 (from 4 to 8). Five studies used healthy participants, and five targeted people with LBP. A moderate effect size (g ¼ 0.73, 95% CI: 0.48e0.98) was determined, favoring the use of NM to increase flexibility in healthy adults. Larger effect sizes were found for the effect of NM in pain reduction (g ¼ 0.82, 95% CI 0.56e1.08) and disability improvement (g ¼ 1.59, 95% CI: 1.14e2.03), in people with LBP. Conclusion: Evidence suggests that there are positive effects from the application of NM to the lower body quadrant. Specifically, NM shows moderate effects on flexibility in healthy participants, and large effects on pain and disability in people with LBP. Nevertheless, more studies with high methodological quality are necessary to support these conclusions.
... The elbow joint of the support arm flexed at 90°, with the opposite arm placed across their chest and legs extended. Participants then elevated their hips and kept a straight line with their whole body for maximum time, as assessed by a stopwatch[32,33].Front plankChallenges the muscles of the anterior abdominal muscles.Participants were prone, placing their hands and elbows in front of them on the ground. Participants had to elevate their bodies to start the test, using their hands and toes as pivots whilst maintaining a straight, neutral body position where time taken was in seconds and participants were encouraged to maintain this for as long as possible.Combined Global measure of the flexibility of the Participants were prone on the floor, arms extended out in front of them with and thoracic spine pointing forward, palms facing down and thumbs touching. ...
Article
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As most golf exercise studies have shown improved golf performance as a result of two or three sessions per week, the present study investigated the effects of a supervised exercise session performed once a week for seven weeks on golf swing variables and musculoskeletal screening measures. Professional Golfers Association of Australia International Golf Institute student golfers (n = 43) with a mean ± standard deviation handicap of 8.6 ± 8.3 participated in the study. Each golfer performed 10 musculoskeletal tests and a standardised 60-shot golf performance test (TrackMan, Vedbaek, Denmark) on separate days before and after the seven-week program. Significant improvements in a number of musculoskeletal tests (i.e. left leg bridging (6.6%), thoracic extension (62.5%), right thoracic rotation (23.3%), and right (20.8%) and left single leg squat (29.1%)) were observed (all p ≤ 0.024); however, no significant differences were observed for any golf swing variables. Future research investigating different training protocols may help to determine whether the type or frequency of training has the greatest influence on golf swing performance.
... Lumbar spine pathologies are often associated with time-loss injuries in golf and reducing trunk rotation during the backswing is thought to reduce torsional stress to the vertebral spine (Evans et al., 2005;Gluck et al., 2008;Gosheger et al., 2003). To our knowledge, only one other paper has previously examined the effects of the shortened backswing upon golf performance (Bulbulian et al., 2001). ...
Article
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The purpose of this study was to compare kinetic, kinematic, and performance variables associated with full and shortened modern backswings in a skilled group of modern swing (one-plane) golfers. Shortening the modern golf backswing is proposed to reduce vertebral spine stress, but supporting evidence is lacking and performance implications are unknown. Thirteen male golfers performed ten swings of each swing type using their own 7-iron club. Biomechanical-dependent variables included the X-Factor kinematic data and spine kinetics. Performance-related dependent variables included club head velocity (CHV), shot distance, and accuracy (distance from the target line). Data were analysed with repeated measures ANOVA with an a priori alpha of 0.05 (SPSS 22.0, IBM, Armonk, NY, USA). We found significant reductions for the X-Factor (p < 0.05) between the full and shortened swings. The shortened swing condition ameliorated vertebral compression force from 7.6 ± 1.4 to 7.0 ± 1.7 N (normalised to body weight, p = 0.01) and significantly reduced CHV (p < 0.05) by ~2 m/s with concomitant shot distance diminution by ~10 m (p < 0.05). Further research is necessary to examine the applicability of a shortened swing for golfers with low back pain.
... Measurements were taken at the end of a practice day. Prior to the measuring procedure, each participant performed 2 supervised hip rotation stretches (a standing stork stretch and standing sit-squat stretch), chosen to enhance the surrounding soft tissue for hip flexibility (Tamai et al., 1989;Evans et al., 2005;Kurihashi et al., 2006). Seated measurement positions, were done as described in a later section. ...
Article
The aim of this pilot study was to determine the association between the passive range of motion versus golf dynamic rotation range of both the lead hip and trail hip of healthy adult male golf players. Seven skilled male golfers between the ages of 18 and 40 years were selected randomly. Passive hip rotation range of movement (ROM) measurements were collected with a hand-held inclinometer. Dynamic kinematic hip rotation data were captured with a high-speed opto-electric 3-D motion capture system during a golf swing. There was a positive correlation (r= 0.42) between the passive hip ROM and dynamic hip range of movement during the golf swing of the lead hip, but the correlation was not significant (p= 0.34). There was a weak negative correlation (r=-0.05) that was not significant (p= 0.9) between the passive hip range of movement and dynamic hip range during the golf swing of the trail hip. Clinicians and coaches should thus note that improving passive hip ROM might not be associated with an increased hip rotation utilised during the golf swing.
... Any athlete in a sport involving single-side repetitive loading of the trunk (e.g., pitchers, quarterbacks, golfers, hockey forwards, soccer forwards, and bowlers) is at risk for development of LBP. 15 Because these athletic positions require repetitive, single-side mechanical loading, adaptive changes occur on the dominant side that ultimate result in bilateral asymmetry. 16 Postsurgical microdiscectomy patients also exhibit a high incidence of paraspinal muscle asymmetry. ...
... more than 50 times during a round or up to 300 times during a typical practice session [13,18], it is not surprising that the repeated performance of the golf swing is considered one of the primary causes of low back injuries in golfers (Table 1) [13,15,[19][20][21]. Research has consistently reported that the lower back is the most common site of injury for male golfers [22][23][24][25] and the second most common site for female players [26][27][28]. Furthermore, low back injuries account for up to 55 and 35 % of the golfrelated injuries developed by professional and amateur golfers, respectively [22,26,[29][30][31][32][33][34][35]. ...
Article
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The modern golf swing is a complex and asymmetrical movement that places an emphasis on restricting pelvic turn while increasing thorax rotation during the backswing to generate higher clubhead speeds at impact. Increasing thorax rotation relative to pelvic rotation preloads the trunk muscles by accentuating their length and allowing them to use the energy stored in their elastic elements to produce more power. As the thorax and pelvis turn back towards the ball during the downswing, more skilled golfers are known to laterally slide their pelvis toward the target, which further contributes to final clubhead speed. However, despite the apparent performance benefits associated with these sequences, it has been argued that the lumbar spine is incapable of safely accommodating the forces they produce. This notion supports a link between the repeated performance of the golf swing and the development of golf-related low back injuries. Of the complaints reported by golfers, low back injuries continue to be the most prevalent, but the mechanism of these injuries is still poorly understood. This review highlights that there is a paucity of research directly evaluating the apparent link between the modern golf swing and golf-related low back pain. Furthermore, there has been a general lack of consensus within the literature with respect to the methods used to objectively assess the golf swing and the methods used to derived common outcome measures. Future research would benefit from a clear set of guidelines to help reduce the variability between studies.
... Specifically in terms of side bridge, according to Leetun et al. (36), performance in the side bridge test was not a risk factor for low back and LL injuries during a season in basketball and track and field athletes. Evans et al. (37), in their study of golfers, reported that athletes with a difference of over 12.5 s between sides presented more episodes of low back pain than more balanced athletes. Other factors may have influenced the results of this study, such as shorter and less frequent trainings, a study population of young people in the development phase, and the fact that this is a retrospective study (31). ...
Article
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Introduction Central instability is associated with insufficient endurance and strength of the stabilizer muscles, and it can lead to muscle imbalance and injuries. Objective Relate side bridge performance with the presence of injuries in amateur soccer athletes. Materials and methods A cross-sectional study with a sample of 188 male athletes, aged between 11 and 17 years. To identify the injuries, a questionnaire developed by researchers was applied and the players’ clinical records were reviewed. The time of the side bridge test was used to identify muscle imbalance. For statistical analysis, the following tests were used: chi-square test; Pearson’s chi-square test; Fisher’s exact test; Yates’s correction for continuity; two-way ANOVA; one-way ANOVA; and t-test. The significance level (α) of 5% was adopted. Results Injuries were reported by 59.6% of the athletes: sprain (31.3%); muscle strain (28.6%) and fracture; luxation and subluxation (19.6%) were the most frequently reported injuries. Athletes that reported any injury corresponded to 73.2% of the sample. The presence of injuries was not associated with muscle imbalance (p = 0.565), as it prevailed in athletes with both balance (64%) and imbalance (58%). Injury type and prevalence were not significant when compared with the presence of imbalance (p > 0.05). Final considerations No significant relation between muscle imbalance and injury was observed in the studied sample.
Article
Objective: To investigate the maternal, neonatal outcomes of the patients with short interdelivery interval (IDI) considering initial pregnancy outcomes. Materials and methods: Women with two consecutive deliveries between 2016 and 2020 were included in the study. The maternal and neonatal outcomes of both pregnancies were reviewed. The time interval between consecutive deliveries was calculated. The patients were divided into two groups in terms of IDI either less or more than 24 months. Results: The number of patients with short IDI (≤24 months), and normal IDI was 1.915 and 1.370, respectively. About 15% of the women in both groups had at least one obstetric morbidity. The rates of uterine rupture, placenta previa, and peripartum hysterectomy were higher in women with short IDI. The number of patients with low birth weight, very low birth weight, and stillbirth was higher in the short IDI group. Conclusion: Patients with short interpregnancy intervals should be considered high-risk pregnancy. Adequate contraceptive methods should be used to prevent unintended pregnancies.
Article
Context: Elite golfers have a high incidence of low back pain. Recent reviews have emphasized the need for investigation into how to prevent low back pain in golfers, prompting the current study. Design: Prospective longitudinal cohort study. Methods: Forty-one injury-free golfers were included in this study. At baseline, lower quadrant joint angles and club and ball performance were measured while each golfer performed 10 drives. The golfers were then monitored for 6 months and were allocated into 2 groups depending on whether or not they developed low back pain. The initial, baseline kinematic variables of the low back pain group and the uninjured group were then compared. Results: Over the 6-month monitoring period, 17 (41%) of the golfers developed low back pain. At baseline assessment, the low back pain group had 4° less lead ankle dorsiflexion at setup (P = .01; effect size = 0.82), 6° less lead knee flexion at the top of the backswing (P = .05; effect size = 0.64), 6° less lead ankle dorsiflexion at the top of the backswing (P = .01; effect size = 0.82), 6° more trail hip adduction at the top of the backswing (P = .02; effect size = 0.79), 9° more trail knee flexion at impact (P = .05; effect size = -0.64), and 6° more trail hip adduction at the end of follow through (P < .00; effect size = 1.00). Conclusion: Golfers who developed low back pain during the 6-month monitoring period displayed distinct differences in biomechanics at baseline when all golfers were injury free. These biomechanical differences may be considered a precursor to injury. Three-dimensional motion analysis may indicate whether elite golfers are at risk of developing low back pain. Research is needed to assess whether targeted exercise and sports drills aimed at addressing the biomechanical risk factors identified may prevent low back pain in elite golfers.
Article
Introduction:Research results have shown that Back School instruction is an effective method to change the level of knowledge of the workers. The aim of this study was to survey the Effect of Back School program education and decrease of low back pain and alteration in spine curves. Materials and Methods: Participants in this study were workers of Iran-Khodro Company in three different workplace posts with mean age 31 ± 6.6 years old. First, lumbar lordosis, thoracic kyphosis and back pain evaluated. Then participants divided into two groups and Back School program administered for experimental group. One sample t-test and Paired t-test used for statistical analysis. Results: The Paired t-test results showed that lumbar lordosis (p=0.672), thoracic kyphosis (p=0.517) and back pain (p=0.399) in Back-School group didn’t have significant changes and were approximately the same as another group with respect to the initial amounts. Conclusion: We concluded that the work situation is an influential factor in occurrence of lumbar lordosis, thoracic kyphosis and back pain amounts and Back School programs is one of the best programs in optimal posture maintenance program in workplace.
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Is er een verband tussen een relatief geringe kracht van de heupspieren en een grotere kans op het krijgen van lage rugklachten door sporters? En welke andere factoren spelen daarbij een rol? En kunnen deze oorzaken door training worden aangepakt?
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Sportler leiden häufig unter lumbalen Rückenschmerzen. Die Ursachen dafür bleiben oft unklar und auch der Umgang mit den Beschwerden ist nicht einfach – erst recht nicht, wenn aufgrund der Schmerzen die sportliche Laufbahn auf der Kippe steht. Da ist guter Rat teuer.
Article
Résumé Introduction Le golf, sport multigénérationnel, se pratique de 4 à 106 ans en France et, comme tout sport, il induit des blessures qui lui sont spécifiques. Les localisations les plus fréquemment atteintes sont le rachis lombaire et les membres supérieurs. L’objectif principal de l’étude était d’évaluer la prévalence des blessures du rachis chez les professionnels-enseignants de golf français. Méthodes Le recrutement s’est fait avec l’envoi d’un questionnaire par e-mails par la Fédération française de golf (FFG) à l’ensemble des professionnels-enseignants de golf déclarés à la FFG. Résultats Deux cent deux patients inclus. La prévalence des blessures du rachis était de 39 %. Deux facteurs de risque des blessures ont été identifiés : les antécédents de maladie de la colonne vertébrale (p = 0,025) et les problèmes de dos et/ou de hanche dans l’enfance (p = 0,038). Au total, 61,1 % des enseignants blessés s’étaient rendus chez l’ostéopathe, 48,6 % chez leur médecin généraliste, 41,7 % chez le kinésithérapeute. Conclusion Cette population considère la colonne vertébrale comme une zone de fragilité anatomique importante pour leur profession (37,7 %). Selon cette étude, la prévalence des blessures du rachis chez ces enseignants était de 39 %, ce qui corrobore les précédentes études réalisées chez les professionnels joueurs et chez les amateurs. Nous avons pu remarquer que, dans plus de la moitié des cas (55,6 %), la blessure était récurrente. Il semble donc important d’insister sur la prévention primaire.
Article
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.
Article
Background: The low back is the most common injury location in pole vaulters, and low back pain (LBP) can easily become chronic. Therefore, knowing the physical characteristics of athletes experiencing repeated LBP may be beneficial for recovery and injury prevention. Purpose: The purpose of this study was to describe and analyze the physical characteristics of pole vaulters with chronic LBP. Study design: A cross-sectional study. Methods: Twenty male pole vaulters participated in this study. A questionnaire was used to garner descriptive and personal data, including personal best performance in the pole vault. Additionally, the following physical characteristics were measured: 1) isokinetic muscle strength of hip and knee flexors and extensors, 2) active/passive range of motion and muscle flexibility in multiple joints and regions, 3) performance on the Functional Movement Screen™ (FMS™) and 4) spinal column alignment. Subjects were categorized using the questionnaire and divided into two groups, one with and one without chronic LBP. Results: The personal best performance and angle on the active straight leg raise test (SLR) were significantly lower and smaller, respectively, in the chronic LBP group than in the non-chronic LBP group. Additionally, the difference between the passive SLR angle and active SLR angle (ΔSLR) was significantly larger in the chronic LBP group than in the non-chronic LBP group. Those with chronic LBP had were more likely to have a FMS™ composite score ≤14. Conclusion: The active SLR angle and ΔSLR were significantly smaller and larger, respectively, in the chronic LBP group than in the non-chronic LBP group. This may be because of the poor stability of trunk or incompetence of the kinetic chain required for raising the lower limbs. The chronic LBP group had a significantly higher probability of having an FMS™ composite score of ≤14. it may be important to examine the active straight leg raise (vs. passive only), and fundamental movements as screened by the FMS ™ in pole vaulters. Level of evidence: 2b.
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Introduction: Golf is a popular sport played worldwide for which there are no sex and age limit and also no extreme strength or flexibility requirements. The incidence of golf injuries has received little attention in the literature. The diversity of the ages and abilities of golf players leads to a wide spectrum of injuries. However, there is a paucity of data regarding golf injuries. Therefore, the aim of this study was to review the epidemiology of spine injuries in golf players. Materials and Methods: Searching in specific scientific citations was carried out for relevant articles with the subject coverage of golf injuries, spine injuries and golf spine injuries from 1982 to 2011. Results: Results showed that the prevalence of the total body injuries in golf was 42.3%. The most common site of injuries was lower back (18.3% to 31.5%) with an average of 26.2%. The incidence of spinal cord injury was 39.4% that indicates the high prevalence of spinal injuries in this sport. The average percent of lower back injuries in golf is 33%. The most commonly reported site of injury was lower back in men and forearm and elbow in women. Moreover, the low back pain was somewhat more common in men than in women. Comparing professional and amateur athletes, low back pain was more common in professionals. Conclusion: Lower back is the most common site of injuries in golf. The main causing mechanism of such injuries may be the overuse of incorrect swings. To prevent lower back injuries, it is recommended that amateur golf players attempt to learn correct swing movements. Coaches of professional golf players may also focus on the core stability exercises in order to …
Article
Introduction: The aim of this study is to compare the level of awareness & attitude of AJA nurses from the prevention & treatment methods of low back pain before & after of Back School workshops – Tehran2013. Methods: 200 nursing staff of Aja hospitals in Tehran (505 ,502 ,501, Khanevadeh, Golestan) Participated in a back school work shop. The level of awareness & attitude before & after of the workshop was evaluated & the results from the study were analyzed by the software SPSS v (18), pair t-test. Results: The findings showed the primary level of nurse’s awareness of low back pain is 15.5 as weak, 68.2 as moderate and 16.3 as good. After participating in back school work shop, nurse’s awareness of back pain was 3.8 as weak, 48.9 as moderate, and 47.3 as good. The difference of awareness level before and after attending back school, significantly increased (P<0.001). Also the results showed 20.6 of nurses before attending the back school had positive attitude, 65.7 had neutral attitude and 13.7 had negative attitude to low back pain. After attending back school 45.6 of them had positive attitude, 49.9 had neutral attitude and 4.5 had negative attitude. The difference of attitude before and after of attending back school is statistically significant (P<0.001). Conclusion: Participation in training courses on prevention and treatment of low back pain increase nurse’s awareness of back pain. Also increase positive attitude and decrease negative and neutral attitude. The use of training methods will be effective in increasing of back pain prevention behavior. Key words: low back pain ' nurse ' knowledge ' attitudes
Article
The purpose of the study was to investigate the differences of physical fitness between elite and non-elite golfers in the National Golf Academy, UUM. The two groups were compared based on their physical fitness (leg power, muscular endurance, muscular strength, cardiovascular endurance, balance and abdominal muscle performances) and golf performances (handicap, 5-iron ball speed, 5-iron clubhead speed, 5-iron carry distance, average score, greens in regulations, and putts per round). Significant differences were found on handicap and predicted Vo2max variables (p < 0.05). Significant differences were also found on non-dominant leg vertical jump (20.6 ± 4.5 vs. 14.7 ± 5, p < 0.05) and push up performances (27.9 ± 10.1 vs. 16.4 ± 11.2, p < 0.05) between the elite and non-elite groups. Elite golfers have better performances in static balance (both dominant and non-dominant leg) and abdominal muscle performance where the significant level was found to be less than 0.05. While for golf performances, the difference between those two groups were found on the 5-iron clubhead speed, 5-iron ball speed, 5-iron carrying distance and average score (p < 0.05). These results can be used for developing training programmemes, as well as for the development of talent identification programmemes. Keywords: golf, fitness, performance, comparison, elite, university
Article
BACKGROUND: Although low back pain (LBP) is known to be multi-factorial, certain studies have suggested that a deficit in hip extension and rotation range of motion (ROM) may be associated with LBP in athletes. OBJETIVE: The purpose of this study was to compare hip extension and rotation ROMs in elite tennis players with and without a history of LBP. METHODS: Forty-two male young and 22 female young elite tennis players completed this study. Participants were divided into two groups: (1) 32 with history of LBP and (2) 32 without history of LBP. Descriptive measures of passive hip extension and rotation ROMs of the dominant and non-dominant limbs were taken. Active hip rotation ROMs were also assessed. Magnitud based inferences on differences between groups and legs were made by standardizing differences. RESULTS: The inter-group statistical analysis reported no significant differences (p > 0.05; trivial effect with a probability higher than 95%; d 6 0.4) in any ROM measure analyzed. Further, neither LBP group nor control group reported significant bilateral or side-to-side differences (p > 0.05; trivial effect with a probability higher than 99%; d < 0.3). .between legs regarding hip extension and rotation ROM measures. CONCLUSION: No relationship between hip extension and rotation ROM and history of LBP was found.
Article
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Objective The distribution of injuries affecting professional golfers is yet to be fully understood. We performed a systematic review of the clinical literature to establish the epidemiology of musculoskeletal injuries affecting professional golfers. Design Systematic review. Data sources Searched databases in July 2018 were PubMed, SPORTDiscus and Embase. Eligibility criteria Published observational research articles relating to the incidence or prevalence of musculoskeletal injuries in professional golfers, which were written in the English language and not restricted by age or gender. Results Of the 1863 studies identified on the initial search, 5 studies were found to satisfy the inclusion criteria for analysis. The mean age of the golfers in these studies was 34.8 (±3.6) years. The gender of patients in included studies compromised 72% males and 28% females. Four studies reported that lumbar spine injuries were the most common (range 22%–34%). Excluding injuries to the spine (lumbar, thoracic and cervical), the hand/wrist was the next most common region of injury (range 6%–37%). The quality of the studies was relatively poor with no study satisfying >50% of the quality assessment tool questions and only one study giving a clear definition of how they defined injury. Conclusion There is a paucity of well-designed epidemiological studies evaluating musculoskeletal injuries affecting professional golfers. Injuries to the spine are the most frequently affected region, followed by the hand/wrist. This study has identified targeted areas of future research that aims to improve the management of injuries among professional golfers.
Article
While most trunk endurance field protocols are performed in the sagittal or frontal planes, the flexion-rotation trunk (FRT) test combines trunk flexion with rotation, which may be relevant to rotation-related sports. The aim of this study was to describe the trunk and hip muscle activation and fatigue and the range of hip flexion of this test. Twenty-seven physically active males and females performed the FRT test after a period of practice. Electromyographic (EMG) signals were bilaterally collected from the rectus abdominis (RA), internal oblique (IO), and rectus femoris (RF), and hip flexion amplitude was measured using a biaxial electrogoniometer. Since the fast Fourier transform algorithm requires stationary EMG signals, participants performed a 6-s isometric trunk flexion-rotation repetition just before and just after the test execution (pre- and post-execution repetitions, respectively). RA showed the highest mean activation levels (about 30% maximal voluntary isometric contractions [MVC]) in the pre-execution repetition, followed by IO (about 20% MVC). Also, the mean power frequency (MPF) significantly decreased from the pre- to the post-execution repetition for RA and IO, which shows abdominal muscle fatigue. Although each trunk flexion rotation repetition involved an average 8-14° hip flexion, the RF activation was lower than 10% MVC, and no significant MPF reduction (i.e. no muscle fatigue) was observed for this muscle. Additionally, significant negative correlations were found between the FRT test scores and the normalised EMG amplitudes of RF. Based on these results, the FRT test seems a valid field protocol to assess abdominal muscle endurance in trunk flexion-rotation exertions.
Article
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Purpose: The purpose of this study was to examine the reliability and the learning effect of an isokinetic trunk flexion-extension protocol designed to simultaneously assess trunk muscle strength and endurance. In addition, the effect of the participants' sex on the reliability data was examined. Methods: Fifty-seven healthy and physically active young men (n = 28) and women (n = 29) performed the isokinetic protocol 5 times, separated by a week between each of the first 4 sessions and by a month between the last 2 sessions. The protocol consisted of performing 4 trials of 15 maximum flexion-extension concentric exertions at 120°/s (range of trunk motion = 50°). The absolute and relative peak torque and total work were calculated to assess trunk flexion and extension strength. In addition, endurance ratio, modified endurance ratio, fatigue final ratio, recovery ratio, and modified recovery ratio variables were used for the assessment of trunk muscle endurance in both directions. Results: Regarding the absolute reliability, no relevant changes were found between paired-comparison sessions for most strength and endurance variables, except for total work and relative total work variables in the flexion movement in both sexes. In addition, the typical error of the isokinetic variables was lower than 10% in both males and females, and minimum detectable changes ranged from 7% to 20%, with a tendency to be higher in females and in endurance variables. The strength variables showed high-to-excellent intraclass correlation coefficients (ICCs; >0.74); however, for the endurance variables only the endurance ratio and the modified endurance ratio obtained moderate-to-high ICC values (0.57 < ICC < 0.82). In addition, the analysis of the variance reported no significant differences between consecutive pairs of sessions for most variables in both sexes. Conclusion: Overall, these findings provide clinicians, trainers, and researchers with a 10-min single-session protocol to perform a reliable muscle strength and endurance evaluation of trunk flexor and extensor muscles, all within the same protocol.
Thesis
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Chronische lage rugklachten vormen een enorm socio-economisch probleem in onze samenleving. Internationale richtlijnen adviseren gesuperviseerde oefentherapie. Het blijft echter onduidelijk of bepaalde soorten oefentherapie superieure resultaten leveren. Momenteel zijn in België, maar ook internationaal, twee grote tendenzen waar te nemen in de actieve aanpak. Enerzijds wordt getracht om na grondig klinisch onderzoek zo specifiek mogelijk in te spelen op de klachten van de patiënt door hands-on en sterk individueel begeleide oefentherapie gericht op de dagelijkse activiteiten en werksituatie van de patiënt. Binnen deze individueel begeleide aanpak wordt vaak specifieke stabilisatietraining toegepast. Anderzijds wordt geïnvesteerd in specifiek ontworpen lumbale trainingstoestellen zodat patiënten zelfstandig kunnen trainen volgens individueel geprogrammeerde oefenschema’s. Met deze thesis werd getracht een waardevolle bijdrage te leveren aan de klinische kinesitherapeutische praktijk door een beter inzicht in vaak gebruikte oefeningen te verschaffen, evenals door de effectiviteit van de twee meest toegepaste actieve therapievormen te vergelijken in een specifieke chronische lage rugpopulatie.
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The paper presents various researches of functionalization of cellulosic textile materials with plasma, as well as the basis of cellulosic textile fibers and cotton as the representative of the purest form of cellulose in nature. Due to its favorable characteristics, cotton is still highly valued in the textile industry. The existing chemical technologies for the modification of cotton textiles are time-consuming, and economically and ecologically problematic. Therefore, the search for new technologies and ways of functionalizing textile materials is in progress. This paper offers an insight into new plasma technologies and possibilities for their use to achieve and change cotton properties. Plasma technologies can be used for changing hydrophilic and hydrophobic characteristics of cotton, cleaning and bleaching cotton, achieving different physical properties and for the adhesion enhancement of nanoparticles.
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This research looks at health issues and injuries affecting the motion apparatus of professional and amateur golfers. Significant differences have been observed between the groups in terms of both the mechanics and localization of injuries. Golfers suffer most frequently from lumbar spine issues, and other problems include the areas of the shoulder girdle, the elbow, wrist and hand, vertebral compression fractures and rib stress fractures. The most important preventive measure to avoid risk of injury is the drill practice of the right swing and sufficient warmup before the practice session and the game.
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Low back pain is a common musculoskeletal disorder affecting golfers, yet little is known of the specific mechanisms responsible for this injury. The aim of this study was to compare golf swing spinal motion in three movement planes between six male professional golfers with low back pain (age 29.2+/-6.4 years; height 1.79+/-0.04 m; body mass 78.2+/-12.2 kg; mean +/- s) and six without low back pain (age 32.7+/-4.8 years; height 1.75+/-0.03 m; body mass 85.8+/-10.9 kg) using a lightweight triaxial electrogoniometer. We found that golfers with low back pain tended to flex their spines more when addressing the ball and used significantly greater left side bending on the backswing. Golfers with low back pain also had less trunk rotation(obtained from a neutral posture), which resulted in a relative 'supramaximal' rotation of their spines when swinging. Pain-free golfers demonstrated over twice as much trunk flexion velocity on the downswing, which could relate to increased abdominal muscle activity in this group. This study is the first to show distinct differences in the swing mechanics between golfers with and without low back pain and provides valuable guidance for clinicians and teachers to improve technique to facilitate recovery from golf-related low back pain.
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A survey of 461 amateur golfers was undertaken to assess golf injuries. There were 193 respondents of whom 57% reported injuries. Wrist, back, muscle, elbow and knee problems were the most likely ailments to compromise a player's game. Overuse and poor technique were the main aetiological factors. Attention to those factors in addition to maintenance of physique would reduce the incidence of these problems.
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This retrospective study was undertaken to determine the test-retest reliability of hand-held dynamometer strength testing for 18 extremity muscle groups. To assess reliability, I compared three dynamometer strength scores recorded for each muscle group on the strength score forms of 30 neurologically involved patients, using the Pearson product-moment correlation and a one-way analysis of variance (ANOVA) for repeated measures. All correlations were significant (p less than .01); the median and modal correlations were all .97 or .98. The ANOVA revealed significant differences in repeated dynamometer test scores only for hip and shoulder abduction. The results suggest that hand-held dynamometry can be a reliable assessment technique when practiced by a single experienced tester.
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The primary purpose of this study was to determine the reliability of lumbar flexion and extension range-of-motion measurements obtained with the modified-modified Schöber and the double inclinometer methods on subjects with low back pain. Fifteen patients (8 women, 7 men), aged 25 to 53 years (mean = 35.7, SD = 9.9), with chronic low back pain were measured by three physical therapists with 3 to 12 years (mean = 8.3, SD = 4.7) of clinical experience. The therapists used the modified-modified Schöber and double inclinometer techniques to measure, in random order and on two occasions, the subjects' lumbar flexion and extension. Pearson Product-Moment Correlation Coefficients for test-retest reliability for the modified-modified Schöber technique varied from .78 to .89 for lumbar flexion and from .69 to .91 for extension; for the double inclinometer method, Pearson correlation coefficients varied from .13 to .87 for lumbar flexion and from .28 to .66 for extension. Analysis of variance-derived intraclass correlation coefficients for interrater reliability for the modified-modified Schöber technique were .72 for flexion and .76 for extension; for the double inclinometer technique, they were .60 for flexion and .48 for extension. The modified-modified Schöber method thus appears to be a reliable method for measuring lumbar flexion and extension for patients with low back pain, whereas the double inclinometer technique needs improvement.
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This study investigated the magnitude and rate of age-associated strength reductions in Australian independent urban-dwelling women and the relationship to muscle groups, limb dominance, and physical activity level. Independent urban-dwelling women aged 20 to 89 years performed maximal voluntary contractions with the dominant and nondominant knee extensors, plantar flexors, and handgrip. Anthropometric measurements were made and questionnaire responses used to obtain current physical activity levels. Trend analysis within analysis of variance and regression analysis on strength was performed. Limb muscle strength was found to be associated with increased age, muscle group, limb dominance, and activity. Self-reported physical activity levels declined with age but women who were more physically active for their age group were stronger in all muscle groups and had more lean body mass and lean thigh and leg cross-sectional area than relatively inactive women. Slopes of the linear reductions of maximal voluntary strength of the knee extensors, plantar flexors, and handgrip with age were significantly different ( p < .05) at 9.3%, 7.4%, and 6.2% per decade, respectively. The limb muscle strength of healthy Australian independent and urban-dwelling women aged 20 to 89 years was found to be associated with age and three aspects of disuse: muscle group, relative levels of physical activity, and limb dominance.
Chapter
This chapter discusses the concepts involved in power analysis. It presents the methods for accomplishing the two major kinds of power analysis, which can be applied to the null hypothesis tests. There are four major parameters involved in power analysis, such as the significance criterion, the sample size, the population effect size, and power. These four parameters are mathematically related in such a way that any one of them is an exact function of the other three. The chapter discusses how power analysis of significance tests of the Pearson r of a sample proceeds quite simply. The test of the difference between the means of two independently drawn random samples is probably the most frequently performed test in the behavioral sciences. The chapter also presents the techniques for determining power that make possible the planning of efficient experiments designed to yield more conclusive statements if HO is not rejected.
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Recreational athletes tend to prefer to spend their workout time on their sport of choice rather than on exercises designed to prevent injury. In order to prevent injuries (and to make the game more enjoyable), however, it is wise to distribute one’s workout time between warming up, stretching, muscular strengthening, and endurance and cardiovascular conditioning. This article discusses the components of an exercise program designed to prevent injuries and improve an individual’s golf game.
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To determine the types and frequency of injuries among amateurs, open-ended questionnaires were sent to 4,036 golfers; 1,144 responded (942 men and 202 women; average age, 52 years). The respondents played an average of two rounds per week; 708 (62%) had sustained one or more injuries. Among men, the most common injury site was the lower back; among women it was the elbow. Excessive practice and poor swing mechanics were the most common causes. Golf injuries perhaps could be prevented or reduced by proper technique, controlled practice routines, and physical conditioning.
Article
Professional golfers' injuries are usually related to their swings. A wide variety of acute and chronic injuries have been reported, including carpal fractures, ulnar and median nerve neuropathies, tendinitis, skin rashes, and eye injuries. There have been two deaths. In this study questionnaires were mailed to 500 professional golfers, and 226 were returned. During their careers 103 men and 87 women were injured, an average of two injuries per player. The left wrist, lower back, and left hand were most commonly injured. Repetitive practice swings caused the most injuries in both men and women.
Article
Study Design. Prospective study with follow-up by a postal questionnaire to 6626 men nearly 40 years of age who had been examined for the first time at the age of 18. Objectives. To study the predictability of frequent musculoskeletal problems, health, lifestyle, and work situation from the examination 20 years earlier. Background. Those who enlisted for military duty during 6 months in 1979–1980 answered a questionnaire focusing on back pain, smoking, and physical work exposure. As these men enter the biologic age when back pain is most frequent, a follow-up was of interest. Methods. A new questionnaire was sent to those from the enlistment group who could be identified in the population register, and the answers were compared with those given at enlistment. Results. The prevalence of low back pain increased from 38% to 74% during the 20-year period. Neck or shoulder problems were nearly as common as back problems. The number of those with a body mass index more than 25 had increased from 9% to 50%, and smoking had decreased from 29% to 14%. The odds ratio for frequent back/neck/shoulder problems at follow-up evaluation was 8.7 (95% CI: 3.78–20.10) if the person had experienced back pain that greatly affected everyday life at enlistment, 3.0 (95% CI: 2.33–3.93) if he had been off work or school because of that pain, and 2.2 (95% CI 1.57–3.24) if he had been doing heavy work already at the time of enlistment. Conclusion. Early back pain causing absence from work, reduced activity levels because of the pain, and heavy work loads showed a significantly increased risk for frequent pain problems at follow-up examination.
Article
Background Low back pain is fairly prevalent among golfers; however, its precise biomechanical mechanism is often debated. Hypothesis There is a positive correlation between decreased lead hip rotation and lumbar range of motion with a prior history of low back pain in professional golfers. Study Design A cross-sectional study. Methods Forty-two consecutive professional male golfers were categorized as group 1 (history of low back pain greater than 2 weeks affecting quality of play within past 1 year) and group 2 (no previous such history). All underwent measurements of hip and lumbar range of motion, FABERE's distance, and finger-to-floor distance. Differences in measurements were analyzed using the Wilcoxon signed rank test. Results 33% of golfers had previously experienced low back pain. A statistically significant correlation (P < .05) was observed between a history of low back pain with decreased lead hip internal rotation, FABERE's distance, and lumbar extension. No statistically significant difference was noted in nonlead hip range of motion or finger-to-floor distance with history of low back pain. Conclusions Range-of-motion deficits in the lead hip rotation and lumbar spine extension correlated with a history of low back pain in golfers.
Article
Objectives: Pre-season or pre-participation screening is commonly used to identify intrinsic risk factors for sports injury. Tests chosen are generally based on clinical experience due to the paucity of quality injury risk factor studies for sport and, often, the reliability of these clinical tests has not been established. The purpose of this study was to establish the reliability of eight, musculoskeletal screening tests, commonly used in the screening protocols of elite-level Australian football clubs.Methods: Fifteen participants (n=9 female, n=6 male) were tested by two raters on two occasions, 1 week apart to establish the inter-rater and test–retest reliability of the chosen measurement tools. The tests of interest were Sit and Reach, Active Knee Extension, Passive Straight Leg Raise, slump, active hip internal rotation range of movement (ROM), active hip external rotation ROM, lumbar spine extension ROM and the Modified Thomas Test.Results: All tests demonstrated very good to excellent (Intraclass correlation coefficient, ICC 0.88–0.97) inter-rater reliability. Test–retest reliability was also shown to be good for these tests (ICC 0.63–0.99).Conclusion: The findings suggest that these simple, clinical measures of flexibility and ROM are reliable and support their use as pre-participation screening tools for sports participants.
Article
The aim of this study was to test the hypothesis that male workers exposed to heavy work and with no lifetime history of a low back disorder (group A) have better trunk muscle strength and back muscle endurance compared to male workers with the same work exposure but with a probable (group B) or definite low back disorder (group C). Group A (n = 42) was clinically negative on physical examination. Group B (n = 75) was clinically negative or uncertain and group C (n = 86) was clinically positive, with current or previous low back disorders occurring in both groups. Group A had a significantly higher mean intraindividual extension/flexion ratio, namely 1.29 versus 1.19, in group C. The mean values for maximum isometric trunk extension and flexion strength did not differ between the groups. The isometric trunk extensor endurance was significantly lower in group C than in both group A and group B.
Article
Correlations of age, height, weight, lordosis, and kyphosis with noninvasive spinal mobility measurements were studied in 301 men and 175 women, aged 35-55 years, who suffered from chronic or recurrent low back pain (LBP). Correlations of the different spinal movements with the degree of LBP were analyzed, with corrections for these relationships. Age had significant indirect correlations with most of the mobility measurements, but the effect of height was minor. Weight had considerable negative correlations with the mobility measurements, except lateral flexion. Lordosis and kyphosis had significant relationships with mobility in the sagittal and frontal planes. Correction for the factors analyzed only slightly reduced the correlations between spinal mobility and LPB. Thoracolumbar mobility had higher correlations with LBP than mobility of the lumbar spine. Thoracal spinal mobility alone also correlated with LBP. Lateral flexion and rotation, except for rotation in women, had stronger relationships than forward flexion and extension with LBP.
Article
Of all 30-, 40-, 50-, and 60-year-old inhabitants of Glostrup, a suburb of Copenhagen, 82% (449 men and 479 women) participated in a general health survey, which included a thorough physical examination relating to the lower back. The examination was constituted of anthropometric measurements, flexibility/elasticity measurements of the back and hamstrings, as well as tests for trunk muscle strength and endurance. The reproducibility of the tests was found to be satisfactory. Twelve months after the physical examination 99% of the participants completed a questionnaire sent by mail concerning low back trouble (LBT) in the intervening period. The prognostic value of the physical measurements was evaluated for first-time experience and for recurrence or persistence of LBT by analyses of the separate measurements and discriminant analyses. The main findings were that good isometric endurance of the back muscles may prevent first-time occurrence of LBT in men and that men with hypermobile backs are more liable to contract LBT. Recurrence or persistence of LBT was correlated primarily to the interval since last LBT-episode: the more LBT, the shorter the intervals had been. Weak trunk muscles and reduced flexibility/elasticity of the back and hamstrings were found as residual signs, in particular, among those with recurrence or persistence of LBT in the follow-up year.
Article
Golf is a popular sport for both men and women. The trunk is the most common area of injury during the golf swing. The purpose of this study was to describe and compare the muscle firing patterns in the trunk during the golf swing. Twenty-three golfers with handicaps of five or below volunteered for this study. Surface electromyographic electrodes were placed on the abdominal oblique and erector spinae muscles bilaterally. High-speed cinematography was used in conjunction with the electromyographic electrodes. The results demonstrated relatively low activity in all muscles during takeaway (below 30% of maximal muscle test), and relatively high and constant activity throughout the rest of the swing (above 30% maximal muscle test, with the exception of the contralateral erector spinae during late follow-through, which was 28% maximal muscle test). This high and constant activity demonstrated the importance of the trunk muscles during a golf swing. These results indicate the need for an effective preventive and rehabilitative exercise program for the golfer.
Article
Using dynamic surface electrode electromyography, we evaluated muscle activity in 13 male professional golfers during the golf swing. Surface electrodes were used to record the level of muscle activity in the right abdominal oblique, left abdominal oblique, right gluteus maximus, left gluteus maximus, right erector spinae, left erector spinae, upper rectus abdominis, and lower rectus abdominis muscles during the golfer's swing. These signals were synchronized electronically with photographic images of the various phases of the golf swing; the images were recorded in slow motion through motion picture photography. The golf swing was divided into five phases: take away, forward swing, acceleration, early follow-through, and late follow-through. Despite individual differences among the subjects' swings, we observed reproducible patterns of trunk muscle activity throughout all phases of the golf swing. Our findings demonstrate the importance of the trunk muscles in stabilizing and controlling the loading response for maximal power and accuracy in the golfer's swing. This study provides a basis for developing a rehabilitation program for golfers that stresses strengthening of the trunk muscles and coordination exercises.
Article
We conducted a 1-year follow-up study on back pain among 196 men taking up golf. A questionnaire on individual characteristics, occupation, sports, and back pain was distributed at the start of the study and was followed by another questionnaire after 12 months. Eleven percent of the original subjects (25 of 211) were lost to followup, but withdrawal from the survey was not associated with health status. In the baseline survey (N = 221), the self-reported lifetime cumulative incidence of back pain was 63%; 28% reported back pain during the month before answering the questionnaire, and 13% reported current back pain. Athletes had an increased odds ratio of 2.1 (95% confidence interval, 1.1 to 4.0) for previous back pain. During the 12 months between the surveys, the incidence of first-time back pain was 8% and the incidence of recurrent back pain was about 45%. Men involved in golf and another sport demonstrated a risk of 1.4 for recurrence of back pain, compared with men playing golf only. Six subjects attributed the recurrent back pain to playing golf. Given the high proportion of athletes in this study (68%), the risk factor of playing golf failed to demonstrate an additional significant effect on the general relationship between sport and back pain.
Article
In summary, a sport-specific exercise program for golfers includes warming up, stretching, strengthening, and cardiovascular conditioning. The goals of such a program incorporated with playing the game of golf are to optimize performance and prevent injuries. The integration of each of these components represents a well-balanced fitness approach to sport and enhances the enjoyment of the game.
Article
Although golfing is generally considered a begin activity, lower back pain is endemic among golfers. The golf swing subjects the lumbar spine to rapid, intense loads, more frequently in amateurs than in professionals. These loads predispose the golfing population to muscle strains, lumbar disc disease, spondylolysis, and facet joint arthropathy. It is imperative for all golfers to warm up properly, develop good swing mechanics, and participate in a lower back conditioning program off the golf course.
Article
Although golf has not been recognized as a sport associated with injuries, epidemiologic studies document that back and elbow injuries are most common in male amateur golfers. Lower back and wrist injuries occur in the male golf professional while female professional golfers are more likely to suffer injuries to the wrist and lower back, respectively. The elbow, followed by the lower back, is the most likely area of injury associated with female amateur golfers. These injuries are related to overuse, poor conditioning, and improper swing mechanics. It is the hope of this author that more studies regarding the mechanics, prevention, and treatment of these injuries will be stimulated by this journal and others.
Article
Abdominal exercises are prescribed for both the prevention and treatment of low back injury. However, these exercises sometimes appear to have hazardous effects on the lumbar spine. The purpose of this study was to identify quantitatively abdominal exercises that optimize the challenge to the abdominal muscles (rectus abdominis, external oblique, internal oblique) but impose minimal load penalty to the lumbar spine. Nine volunteers performed 12 different abdominal exercises. For a given task the maximum abdominal muscle EMG value was divided by the maximum compression value, resulting in an abdominal challenge versus spinal compression cost index. In general, the partial curl-ups generated the highest muscle challenge-to-spine cost indices. However, those exercises that generated the best challenge-to-cost indices did not necessarily record the lowest compression levels along with the highest EMG activations. No single exercise was found that optimally trained all of the abdominal muscles while at the same time incurring minimal intervertebral joint loads. It was concluded that a variety of selected abdominal exercises are required to sufficiently challenge all of the abdominal muscles and that these exercises will-differ to best meet the different training objectives of individuals.
Article
To analyse the modified Thomas test and obtain measures of flexibility for the iliopsoas, quadriceps and tensor fascia lata/iliotibial band. The modified Thomas test was used to determine the range of flexibility of 117 elite athletes in tennis, basketball, rowing, and running. The study has provided objective data for a clinical test measuring flexibility of the iliopsoas, quadriceps, and tensor fascia lata/iliotibial band. It is recommended that sufficient flexibility is obtained to perform a specific sport and that asymmetries between limbs are addressed.
Article
The purpose of this study was to evaluate the effects of an 8-wk. conditioning program on selected measures of physical fitness and golf performance for 12 male and 5 female recreational golfers (M age = 52.4 yr., SD = 6.7 yr.). Measurements were made at baseline and following the intervention. The twice-per-week program consisted of strength training, flexibility, and plyometric exercises. Analysis of the pre- and posttest scores showed that conditioning was associated with significant increases in muscular strength, flexibility, and club head speed. Without a control group, the data suggest conditioning may be a worthwhile activity for mature golfers.
Article
Despite the wide variety of exercises that are prescribed for the low back, the scientific foundation to justify their choice is not as complete as one may think, or expect. Thus, the clinician must often call upon "clinical opinion" when selecting exercise. Given that low back tissues may need stressing to enhance their health but too much loading can be detrimental, choosing the optimal exercise requires judgment based on clinical experience and scientific evidence. To assist in developing better exercise programs, this review documents some recent biomechanical evidence from my laboratory and from laboratories of other researchers that has been reported in various publications in an attempt to update clinicians on issues of low back exercise. Among the issues examined are mechanisms of injury; the relative importance of "strength" (ie, maximum force a muscle can produce during a single exertion to create joint torque), "flexibility," and "endurance"; and training to enhance stability. Finally, some specific exercises are described that have been shown to challenge muscle and enhance performance but that are performed in such a way as to minimize loading of the spine to reduce the risk of injury exacerbation. These exercises form a basic program for rehabilitation and maintenance of low back health.
Article
Over the years, golf has become an increasingly popular sport, attracting new players of almost all ages and socioeconomic groups. Golf is practised by up to 10 to 20% of the overall adult population in many countries. Beyond the enjoyment of the sport itself, the health-related benefits of the exercise involved in walking up to 10 km and of relaxing in a pleasant natural environment are often reported to be the main motives for adhering to this activity by recreational golfers. Golf is considered to be a moderate risk activity for sports injury; however, excessive time spent golfing and technical deficiencies lead to overuse injuries. These are the 2 main causes of injuries among golfers, and each has specific differences in the pattern in which they occur in professional and amateur golfers. Golf injuries originate either from overuse or from a traumatic origin and primarily affect the elbow, wrist, shoulder and the dorsolumbar sites. Professional and weekend golfers, although showing a similar overall anatomical distribution of injuries by body segment, tend to present differences in the ranking of injury occurrence by anatomical site; these differences can be explained by their playing habits and the biomechanical characteristics of their golf swing. Many of these injuries can be prevented by a preseason, and year-round, sport-specific conditioning programme including: (i) muscular strengthening, flexibility and aerobic exercise components; (ii) a short, practical, pre-game warm-up routine; and (iii) the adjustment of an individual's golf swing to meet their physical capacities and limitations through properly supervised golf lessons. Finally, the correct selection of golf equipment and an awareness of the environmental conditions and etiquette of golf can also contribute to making golf a safe and enjoyable lifetime activity.
Article
A cross-sectional postal survey of 29,424 twin subjects aged 12-41 years obtained from a population-generated panel. To determine whether obesity is associated with low back pain. Despite a large number of epidemiologic studies in this area, it is unclear whether obesity and low back pain are positively associated, and if so, whether there is a causal association. The association and dose-response connection between body mass index and nonspecific low back pain experienced by subjects in the preceding year were studied. Possible modifying effects of age, gender, type of work, and smoking were investigated. The prevalence of nonspecific low back pain was also studied in monozygotic twin pairs who were dissimilar in body mass index. There was a modest positive association between body mass index and low back pain that increased with the duration of low back pain. The underweight subjects consistently reported lower prevalence of low back pain (odds ratios < 1) than did those higher in weight. The dose-response curve was usually A-shaped. A positive monotonic dose response was apparent mainly in those with long-lasting or recurrent low back pain. The positive association between body mass index and low back pain disappeared when monozygotic twins who were dissimilar in body weight classification were studied. Obesity is modestly positively associated with low back pain, in particular with chronic or recurrent low back pain. However, because the association is weak, because there is no consistent positive monotonic dose response, and because the link disappears in monozygotic twins who are dissimilar in body mass index, it is unlikely that this association is causal. It is possible, however, that obesity plays a part in the chronicity of simple low back pain. Therefore, those with recurring or long-term low back pain deserve further attention.
Article
To establish isometric endurance holding times, as well as ratios between torso extensors, flexors, and lateral flexors (stabilizers), for clinical assessment and rehabilitation targets. Simple measurement of endurance times in four tests performed in random order by a healthy cohort. To measure reliability, a subsample also performed the tests again 8 weeks later. University laboratory. Seventy-five young healthy subjects (31 men, 44 women). Women had longer endurance times than men for torso extension, but not for torso flexion or for the "side bridge" exercise, which challenges the lateral flexors (stabilizers). Men could sustain the "side bridge" for 65% of their extensor time and 99% of their flexion time, whereas women could sustain the "side bridge" for only 39% of their extensor time and 79% of their flexion time. The tests proved reliable, with reliability coefficients of >.97 for the repeated tests on 5 consecutive days and again 8 weeks later. Healthy young men and women possess different endurance profiles for the spine stabilizing musculature. Given the growing support for quantification of endurance, these data of endurance times and their ratios between extensor, flexor, and lateral flexor groups in healthy normal subjects are useful for patient evaluation and for providing clinical training targets.
Article
This study was conducted to determine if anthropometric and fitness testing scores can be used to discriminate between players that were selected or not selected in an elite Under 18 Australian Rules Football side. A training squad of 40 Australian Rules Football players was assessed on a battery of standard anthropometric and fitness tests just prior to the selection of the 30 man player roster for the upcoming season. Results showed that the selected players were significantly (P<0.05) taller and had greater upper body strength than non-selected players. A discriminant analysis was performed which predicted with an accuracy of 80% whether each player was successful or unsuccessful in gaining selection. This suggested that physical conditioning and anthropometric measurements do play an important part in determining selection in elite junior Australian Rules Football teams. However the discriminant function predicted non-selected players (90.9%) better than it predicted selected players (75.9%). Selected Under 18 players were found to be similar to the values reported for elite to sub-elite senior players on height, sit and reach, CMJ and perhaps aerobic fitness, but considerably less than the senior players on 3RM bench press and body mass.
Article
A reliability study and case-control study were conducted. To determine the reliability and discriminative validity of the Biering-Sorensen test. A low Biering-Sorensen score has been found to predict who will have nonspecific low back pain. However, the reliability of the test remains controversial, implying that some studies may have produced results that underestimated the magnitude of the predictive validity of this test. Two raters measured the time holding a specific position (holding time) of 63 subjects (23 currently experiencing nonspecific low back pain, 20 who had had an episode, and 20 who were asymptomatic) while they performed the Biering-Sorensen test twice, 15 minutes apart. A standardized protocol was followed. Test-retest reliability was evaluated by calculating intra-class correlation coefficients (ICC 1,1), 95% confidence intervals (CI), and standard errors of the measurement (SEM) for the total group and for the subgroups. A three-way analysis of variance was used to determine whether test order, subject gender, or symptom status affected holding time. High reliability indices were obtained for the Biering-Sorensen test in subjects with current nonspecific low back pain (ICC [1,1], 0.88; 95% CI, 0.73-0.95; SEM, 11.6 seconds), in subjects who had had nonspecific low back pain (ICC [1,1], 0.77; 95% CI, 0.52-0.90; SEM, 17.5 seconds), and in asymptomatic subjects (ICC [1,1], 0.83; 95% CI, 0.62-0.93; SEM, 17.4 seconds). Results of an analysis of variance showed that subjects asymptomatic for low back pain had a significantly longer holding time than the other two groups (P < 0.05). The Biering-Sorensen test provides reliable measures of position-holding time and can discriminate between subjects with and without nonspecific low back pain.
Article
The diagnostic abilities of two or more diagnostic tests are traditionally compared by their respective sensitivities and specificities, either separately or using a summary of them such as Youden's index. Several authors have argued that the likelihood ratios provide a more appropriate, if in practice a less intuitive, comparison. We present a simple graphic which incorporates all these measures and admits easily interpreted comparison of two or more diagnostic tests. We show, using likelihood ratios and this graphic, that a test can be superior to a competitor in terms of predictive values while having either sensitivity or specificity smaller. A decision theoretic basis for the interpretation of the graph is given by relating it to the tent graph of Hilden and Glasziou (Statistics in Medicine, 1996). Finally, a brief example comparing two serodiagnostic tests for Lyme disease is presented. Published in 2000 by John Wiley & Sons, Ltd.
Article
Although injuries to golfers are not common, both survey studies and hospital emergency department records have provided objective evidence that golfers are sometimes at risk of injury. While many golf injury studies describe the associated mechanisms and types of injuries, less attention has been given to research relating to the various injury prevention measures for this sport. This paper provides a critical review of the range of countermeasures to prevent golf injuries and highlights areas to be considered for future research, development, and implementation. In particular, it focuses on the strength of the evidence for the effectiveness of these measures. This review concludes that there needs to be more formal evaluation of the suggested countermeasures to prevent golf injuries. Particular attention should be given to evaluations of the golf swing and its relationship to particular injuries such as low-back, wrist, and shoulder problems. These countermeasures and associated strategies are recommended to reduce the incidence of injury in this popular and accessible sport.
Article
Although golf is perceived as a sport with low risk for injury, majority of golf players complain about problems along the spine. One possible reason could be poor physical condition. To see if golf players in general show deficits in spine-stabilizing muscles, twenty-three male golfers without back pain were examined with regard to their maximal isometric strength of trunk muscles. They were compared with persons of same age and constitution that do no sports. The Golf players have highly significant stronger lumbar extensors and show muscular dysbalance in lateral flexors and rotators of the spine. Specific training for well-balanced strengthening of spine-stabilizing muscles seem to be advisable, because muscular dysbalance can contribute to the development of back pain.
Article
Previous research agrees that the majority of injuries that affect male golfers are located in the lower back and that they are related to improper swing mechanics and/or the repetitive nature of the swing. This study describes the trunk motion and paraspinal muscle activity during the swing of a golfer with related low back pain (LBP) and assesses the effect of a 3-month period of muscle conditioning and coaching on these variables. Motion of the trunk was measured using three-dimensional video analysis and electromyograms (EMGs) were recorded from the same six sites of the erector spinae at the start and end of the 3-month period. At the end of the period, the golfer was able to play and practice without LBP. Coaching resulted in an increase in the range of hip turn and a decrease in the amount of shoulder turn, which occurred during the swing. In addition, a reduction in the amount of trunk flexion/lateral flexion during the downswing occurred in conjunction with less activity in the left erector spinae. These changes may serve to reduce the torsional and compressive loads acting on the thoracic and lumbar spine, which in turn may have contributed to the cessation of the LBP and would reduce the risk of reoccurrence in the future. In conclusion, further research with more subjects would now be warranted in order to test the findings of this program for the prevention of low back in golfers as piloted in this case report.
Article
Prospective study with follow-up by a postal questionnaire to 6626 men nearly 40 years of age who had been examined for the first time at the age of 18. To study the predictability of frequent musculoskeletal problems, health, lifestyle, and work situation from the examination 20 years earlier. Those who enlisted for military duty during 6 months in 1979-1980 answered a questionnaire focusing on back pain, smoking, and physical work exposure. As these men enter the biologic age when back pain is most frequent, a follow-up was of interest. A new questionnaire was sent to those from the enlistment group who could be identified in the population register, and the answers were compared with those given at enlistment. The prevalence of low back pain increased from 38% to 74% during the 20-year period. Neck or shoulder problems were nearly as common as back problems. The number of those with a body mass index more than 25 had increased from 9% to 50%, and smoking had decreased from 29% to 14%. The odds ratio for frequent back/neck/shoulder problems at follow-up evaluation was 8.7 (95% CI: 3.78-20.10) if the person had experienced back pain that greatly affected everyday life at enlistment, 3.0 (95% CI: 2.33-3.93) if he had been off work or school because of that pain, and 2.2 (95% CI 1.57-3.24) if he had been doing heavy work already at the time of enlistment. Early back pain causing absence from work, reduced activity levels because of the pain, and heavy work loads showed a significantly increased risk for frequent pain problems at follow-up examination.
Article
Spinal physical capacity and in particular static back endurance were studied for their prediction of first-time experience of low-back pain. Of a total of 126 persons who were free from back complaints at entry, 33 developed low-back pain during a follow-up of 1 year. The static back endurance test was found to be the only physical capacity measurement that indicated an increased risk of low-back pain. Adjusted for age, sex, and occupation, the odds ratio of a new low-back pain in those with poor performance was 3.4 (95% confidence interval, 1.2-10.0) compared to those with medium or good performance. RELEVANCE--:The simple static back endurance test might have value in health examinations because of its strong predictive value of future low-back pain.
Article
Cross-sectional study of 25 male golfers with chronic low back pain and 16 healthy controls of similar age. To assess the association between functional capacity of the back extensors and the quadriceps muscles. Chronic low back pain has been shown to lead to changes in muscle activation patterns of the abdominals and the gluteus maximus. The effect of chronic low back pain on lower limb function has not been investigated. Back extensor endurance was assessed by a Biering-Sørensen test; surface EMG was measured bilaterally on the erector spinae at T12 and L4--L5. Muscle inhibition in the quadriceps was assessed by applying an electrical twitch to the maximally contracted muscle. The associations between holding time, decrease in EMG median frequency (i.e., the slope of the regression line on median frequency vs. time), and muscle inhibition were compared for study participants with chronic low back pain and controls. Mean back extensor holding times were 88 +/- 30 seconds for study participants with chronic low back pain and 92 +/- 17 seconds for controls. Both groups showed bilaterally similar decreases in EMG median frequency at L4--L5 and T12; however, the slopes were significantly steeper at L4--L5 than T12. Study participants with chronic low back pain with poor back endurance had significantly higher muscle inhibition compared with study participants with chronic low back pain with good back endurance, whereas such an association was not evident in healthy controls. In golfers with chronic low back pain reduced back endurance was associated with significant inhibition of the knee extensors, indicating that this muscle group c