制定针对力量举运动员腰臀部疼痛的综合临床评估方案:一项可行性研究。

Development of a comprehensive clinical assessment protocol for low back and hip pain in powerlifters: a feasibility study.

作者信息

Olofsson Patrik, Aasa Ulrika, Berglund Lars

机构信息

Laponia Health Care Center, Norrbottens County Council, Gällivare, Sweden.

Care Sciences and Society, Physiotherapy, Karolinska Institutet, and Karolinska University Hospital, Medical Unit Allied Health Professionals, Stockholm, Sweden.

出版信息

Pilot Feasibility Stud. 2024 Dec 12;10(1):150. doi: 10.1186/s40814-024-01579-0.

Abstract

BACKGROUND

Low back and hip pain problems are frequent in powerlifting. There is a lack of information on the specific pain phenotypes and specific impairments in body function associated with these pain problems, as well as how to reach a clinical diagnosis relevant for powerlifters' pain problems. Therefore, the aim was to develop a comprehensive clinical assessment protocol for pain and function in powerlifters with low back and/or hip pain and evaluate its feasibility for use in further epidemiological or clinical studies of powerlifters.

METHODS

The study was conducted in two phases. In phase one, the protocol was developed according to literature regarding musculoskeletal assessment and sports injuries, and in phase two, feasibility was evaluated. Eight powerlifters with low back/hip pain were included in phase two. Four of them were examined independently by two physical therapists, and the other four were examined by one of the physical therapists. The time spent on the examination, whether the physical therapists could reach a clinical diagnosis without adding items to the protocol, and whether the two physical therapists were consistent in terms of the clinical diagnosis, were evaluated.

RESULTS

The protocol was developed including subjective examination, physical examination, and a clinical diagnosis based mainly on signs and symptoms of associated neurophysiological pain mechanisms and the specific impairments in body functions associated with the powerlifter's pain problem. The protocol met the feasibility criteria. The examination lasted approximately 1 h, no items needed to be added, and both physical therapists were able to make a consistent clinical diagnosis. Visual observation and alteration of movement strategy of the squat/deadlift were thought to be crucial for assessing the powerlifters' pain problem.

CONCLUSIONS

This is the first comprehensive clinical assessment protocol developed to describe powerlifters' pain problems/injuries with a clinical diagnosis based on the dominating neurophysiological pain mechanism and impairments in body functions. However, before use in larger studies, it is recommended that the protocol be further evaluated by a larger number of physical therapists and powerlifters to evaluate its reliability and whether the content of the protocol should be further expanded.

摘要

背景

在力量举运动中,下背部和臀部疼痛问题很常见。目前缺乏关于这些疼痛问题所对应的特定疼痛表型、身体功能的特定损伤,以及如何做出与力量举运动员疼痛问题相关的临床诊断的信息。因此,本研究旨在为患有下背部和/或臀部疼痛的力量举运动员制定一个全面的疼痛和功能临床评估方案,并评估其在力量举运动员进一步的流行病学或临床研究中的应用可行性。

方法

本研究分两个阶段进行。第一阶段,根据有关肌肉骨骼评估和运动损伤的文献制定方案;第二阶段,评估可行性。8名下背部/臀部疼痛的力量举运动员纳入第二阶段研究。其中4名由两名物理治疗师独立检查,另外4名由一名物理治疗师检查。评估了检查所花费的时间、物理治疗师是否能在不增加方案项目的情况下做出临床诊断,以及两名物理治疗师在临床诊断方面是否一致。

结果

制定的方案包括主观检查、体格检查以及主要基于相关神经生理疼痛机制的体征和症状以及与力量举运动员疼痛问题相关的身体功能特定损伤的临床诊断。该方案符合可行性标准。检查持续约1小时,无需添加项目,两名物理治疗师均能做出一致的临床诊断。深蹲/硬拉动作的视觉观察和运动策略改变被认为对评估力量举运动员的疼痛问题至关重要。

结论

这是首个全面的临床评估方案,旨在通过基于主导神经生理疼痛机制和身体功能损伤的临床诊断来描述力量举运动员的疼痛问题/损伤。然而,在用于更大规模研究之前,建议由更多的物理治疗师和力量举运动员对该方案进行进一步评估,以评估其可靠性以及方案内容是否应进一步扩展。

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