Department of Physical Therapy, The University of Utah, Salt Lake City, UT 84106, USA.
J Athl Train. 2010 Jan-Feb;45(1):61-6. doi: 10.4085/1062-6050-45.1.61.
Back pain is common in adolescents. Participation in sports has been identified as a risk factor for the development of back pain in adolescents, but the influence of sports participation on treatment outcomes in adolescents has not been adequately examined.
To examine the clinical outcomes of rehabilitation for adolescents with low back pain (LBP) and to evaluate the influence of sports participation on outcomes.
Observational study.
Outpatient physical therapy clinics.
Fifty-eight adolescents (age = 15.40 +/- 1.44 years; 56.90% female) with LBP referred for treatment. Twenty-three patients (39.66%) had developed back pain from sports participation.
INTERVENTION(S): Patients completed the Modified Oswestry Disability Questionnaire and numeric pain rating before and after treatment. Treatment duration and content were at the clinician's discretion. Adolescents were categorized as sports participants if the onset of back pain was linked to organized sports. Additional data collected included diagnostic imaging before referral, clinical characteristics, and medical diagnosis.
MAIN OUTCOME MEASURE(S): Baseline characteristics were compared based on sports participation. The influence of sports participation on outcomes was examined using a repeated-measures analysis of covariance with the Oswestry and pain scores as dependent variables. The number of sessions and duration of care were compared using t tests.
Many adolescents with LBP receiving outpatient physical therapy treatment were involved in sports and cited sports participation as a causative factor for their LBP. Some differences in baseline characteristics and clinical treatment outcomes were noted between sports participants and nonparticipants. Sports participants were more likely to undergo magnetic resonance imaging before referral (P = .013), attended more sessions (mean difference = 1.40, 95% confidence interval [CI] = 0.21, 2.59, P = .022) over a longer duration (mean difference = 12.44 days, 95% CI = 1.28, 23.10, P = .024), and experienced less improvement in disability (mean Oswestry difference = 6.66, 95% CI = 0.53, 12.78, P = .048) than nonparticipants. Overall, the pattern of clinical outcomes in this sample of adolescents with LBP was similar to that of adults with LBP.
Adolescents with LBP due to sports participation received more treatment but experienced less improvement in disability than nonparticipants. This may indicate a worse prognosis for sports participants. Further research is required.
青少年背痛较为常见。参与运动已被确定为青少年背痛发展的一个风险因素，但运动参与对青少年治疗结果的影响尚未得到充分研究。
研究接受康复治疗的青少年腰痛（LBP）的临床结果，并评估运动参与对结果的影响。
观察性研究。
门诊物理治疗诊所。
58 名青少年（年龄=15.40 +/- 1.44 岁；56.90%为女性）因 LBP 接受治疗。23 名患者（39.66%）因运动而出现背痛。
患者在治疗前后完成改良 Oswestry 残疾问卷和数字疼痛评分。治疗时间和内容由临床医生决定。如果背痛的发作与有组织的运动有关，则将青少年归类为运动参与者。收集的其他数据包括转诊前的影像学诊断、临床特征和医学诊断。
根据运动参与情况比较基线特征。使用重复测量协方差分析，以 Oswestry 和疼痛评分作为因变量，评估运动参与对结果的影响。使用 t 检验比较会话次数和护理持续时间。
许多接受门诊物理治疗的青少年腰痛患者都参与了运动，并将运动参与作为其腰痛的致病因素。在运动参与者和非参与者之间，发现了一些基线特征和临床治疗结果的差异。运动参与者在转诊前更有可能接受磁共振成像（P=0.013），接受更多的治疗（平均差异=1.40，95%置信区间[CI]=0.21，2.59，P=0.022），且治疗时间更长（平均差异=12.44 天，95%CI=1.28，23.10，P=0.024），且残疾改善程度较小（平均 Oswestry 差异=6.66，95%CI=0.53，12.78，P=0.048）。总的来说，本研究中青少年腰痛患者的临床结果模式与成人腰痛患者相似。
由于运动导致的 LBP 青少年接受了更多的治疗，但残疾改善程度低于非运动参与者。这可能表明运动参与者的预后更差。需要进一步的研究。
