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一种针对下背痛高尔夫运动员的评估方法:一份住院医师病例报告。

A Targeted Approach to Evaluating the Golfing Athlete with Low Back Pain: A Resident's Case Report.

作者信息

Deckard Luke

机构信息

ProRehab Physical Therapy.

出版信息

Int J Sports Phys Ther. 2021 Jun 1;16(3):636-650. doi: 10.26603/001c.23470.


DOI:10.26603/001c.23470
PMID:34123516
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8169011/
Abstract

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.

摘要

背景与目的:腰痛是高尔夫球爱好者中最常见的病症之一。多年来,人们采用了多种方法来治疗这种病症,包括区域相互依存的概念。本病例报告的目的是描述一名腰痛高尔夫球手的评估过程和治疗方法,采用区域相互依存的原则。 病例描述:一名30岁的男性,右侧腰痛,采用综合方法进行评估,包括高尔夫特定运动筛查和挥杆评估。患者胸椎和髋关节活动受限,这似乎导致了下腰椎的过度活动。根据评估,他被归类为基于治疗的稳定分类(TBC),但也将从松动/手法技术中受益。 结果:在四周内进行了七次就诊后,患者的活动能力和核心稳定性均有所改善,他能够无痛地打高尔夫球和锻炼。他的结果指标也有所改善,包括修订后的奥斯威斯利残疾指数从26%残疾降至10%,恐惧回避行为问卷(FABQ)工作项从10/42降至3/42,FABQ身体活动项从19/24降至6/24。 讨论:评估和制定治疗计划以解决狂热高尔夫球手的腰痛可能具有挑战性,因为在运动过程中脊柱会受到各种需求的影响。本病例报告描述了评估过程和治疗方法,以专门针对高尔夫挥杆过程中所需的需求。采用包括高尔夫特定运动筛查和挥杆评估的针对性方法可以帮助指导治疗师进行治疗,并改善患者的治疗效果。 证据水平:4级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/8f3afbd97d51/ijspt_2021_16_3_23470_59050.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/464c701076cd/ijspt_2021_16_3_23470_59042.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/2d0b9925e6b3/ijspt_2021_16_3_23470_59045.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/1b7c9d6e91c6/ijspt_2021_16_3_23470_59046.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/eca7f3cd8be0/ijspt_2021_16_3_23470_59049.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/8f3afbd97d51/ijspt_2021_16_3_23470_59050.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/464c701076cd/ijspt_2021_16_3_23470_59042.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/2d0b9925e6b3/ijspt_2021_16_3_23470_59045.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/1b7c9d6e91c6/ijspt_2021_16_3_23470_59046.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/eca7f3cd8be0/ijspt_2021_16_3_23470_59049.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d664/8169011/8f3afbd97d51/ijspt_2021_16_3_23470_59050.jpg

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引用本文的文献

[1]
Establishing normative flexibility values for the thoracic spine of competitive male South African golfers.

S Afr J Sports Med. 2025-7-15

本文引用的文献

[1]
USING THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT AND REGIONAL INTERDEPENDENCE THEORY TO GUIDE TREATMENT OF AN ATHLETE WITH BACK PAIN: A CASE REPORT.

Int J Sports Phys Ther. 2016-8

[2]
Regional interdependence of the hip and lumbo-pelvic region in divison ii collegiate level baseball pitchers: a preliminary study.

Int J Sports Phys Ther. 2015-2

[3]
Lumbopelvic kinematic characteristics of golfers with limited hip rotation.

Am J Sports Med. 2015-1

[4]
Rehabilitation of low back pain in golfers: from diagnosis to return to sport.

Sports Health. 2013-7

[5]
Elimination of intermittent chronic low back pain in a recreational golfer following improvement of hip range of motion impairments.

J Bodyw Mov Ther. 2013-10

[6]
Weight-bearing hip rotation range of motion in female golfers.

N Am J Sports Phys Ther. 2010-6

[7]
The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: an observational study.

Phys Ther Sport. 2009-10-9

[8]
Golf-related lower back injuries: an epidemiological survey.

J Chiropr Med. 2007-3

[9]
Trunk muscle onset and cessation in golfers with and without low back pain.

J Biomech. 2008-9-18

[10]
Fear-avoidance beliefs as measured by the fear-avoidance beliefs questionnaire: change in fear-avoidance beliefs questionnaire is predictive of change in self-report of disability and pain intensity for patients with acute low back pain.

Clin J Pain. 2006-2

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