Efficacy of semi-customized exercises in preventing low back pain in high school volleyball players: A randomized controlled trial

Abstract

Background: Low back pain (LBP) is a common injury in high school volleyball players. We hypothesized that a prevention program could decrease the incidence of LBP in high school volleyball players. This study was an in-season cluster-randomized controlled trial.Methods: We block-randomized 8 high school volleyball teams comprising 70 players aged 15 to 17 years into the intervention (4 teams, 34 players) and control (4 teams, 36 players) groups. The intervention program consisted of 9 physical function tests as well as 1 or 2 self-selected preventive exercises, including dynamic thoracic mobility, trunk stabilization exercises, and static stretching, performed during warm-up. Both groups were followed up for 4 weeks, during which the incidence of LBP was recorded. Physical function tests (back endurance; spinal and back flexibility; active or passive shoulder and trunk range of motion; ankle joint mobility; and iliopsoas, quadriceps, and hamstrings flexibility) were conducted before and after the intervention.Results: The intervention group had a significantly lower incidence of LBP (8.8%) than the control group (33.3%) (relative risk, 3.78; 95% confidence interval, 1.17-12.23; P = .017, 1 − β = 0.99). Lumbar extension accounted for nearly 70% of LBP incidences. Most players in the intervention group demonstrated improved physical function associated with the exercises. Conclusion:The semi-customized prevention program decreased the incidence of LBP and enhanced the physical function parameter in high school volleyball players. Abbreviations: BB = backbends in a supine position, ER = external rotation, FFD = finger-floor distance, HAB = horizontal abduction, LBP = low back pain, MTT = modified Thomas test, ROM = range of motion.

A relação entre a lombalgia e os isquiotibias na literatura atual

“…Com impacto não restrito à dor lombar inespecífica, os isquiotibiais tensos são fatores preditivos negativos na união óssea na espondilólise lombar, afetando também as lombalgias que comprometem a extensão (MIZOGUCHI et al, 2022).…”

“…O aumento da tensão lombar devido à tensão nos isquiotibiais foi observada em jogadores de voleibol, em decorrência da necessidade de maior flexão do quadril, levando a uma lombalgia decorrente da flexão (MIZOGUCHI et al, 2022). Essa tensão é um dos principais problemas encontrados em atletas com lombalgia (HUANG et al, 2020).…”

“…A diminuição da rigidez dos isquiotibiais é válida para a prevenção de lumbago (MIZOGUCHI et al, 2022), sendo crucial para redução da sobrecarga lombar durante atividades da vida diária (BAZZAZ-YAMCHI et al, 2021).…”

“…Com objetivo de melhora da flexibilidade, diferentes técnicas são usadas para o alongamento do músculo encurtado, como alongamentos posicional, dinâmico, estático e balístico (SHAMSI et al, 2019). Sendo o alongamento em canivete (Jack knife stretch) eficaz para melhora de isquiotibiais tensos, podendo ajudar a prevenir lombalgia (MIZOGUCHI et al, 2022).…”

Spinal Postures and Mobility in Children with Achondroplasia vs. Age- and Sex-Matched Healthy Individuals: A Preliminary Report

“…A previous clinical trial of adults with chronic low back pain found that interventions designed to improve thoracic flexibility, such as mobilization or manipulation positively influenced lumbar mobility, which resulted in an improvement in disability and mental state in people with low back pain [27]. Another clinical trial involving 70 volleyball players, aged between 15 and 17, from high schools showed that participants assigned to the intervention group where they engaged in preventative exercises designed to improve thoracic dynamic mobility and stabilization had a significantly lower incidence of low back pain in the follow-up period of 4 weeks [28]. Therefore, reduced thoracic flexibility observed in the present study could be a contributing factor to low back pain in individuals with achondroplasia.…”