Document Type : Research Article

Authors

1 Department of Corrective Exercise & Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran

2 Department of Sports Injuries, and Corrective Exercises, Faculty of Sports Sciences, University of Mazandaran, Mazandaran, Iran

Abstract

Background: Low back pain (LBP) is one of the prevalent injuries among athletes. This study aimed to compare the mechanical energy transfer of gait in female athletes with and without non-specific chronic low back pain.
Methods: In this cross-sectional study, based on convenience sampling method, we selected a total of 14 females with NSCLBP and 14 females without a history of LBP who referred to Tehran physiotherapy clinics . To capture marker trajectories and ground reaction forces, we used a Vicon 6 camera motion capture system (Vicon MX, Oxford Metrics, UK), which was synchronized with two ground embedded force plates (Kistler, Winterthur, Switzerland). We performed gait analysis in the biomechanics laboratory of the University of Social Welfare and Rehabilitation Sciences. The independent t-test analyzed the data. All analyses were performed at a confidence level of 95% (p <0.05).
Results: The mechanical energy transfer in female athletes with LBP differed from athletes without LBP (P=0.037). There were no significant statistical differences between the ankle and knee joints regarding mechanical energy transfer (P>0.05).
Conclusion: Our study showed that female athletes with LBP had higher eccentric mechanical energy compensation coefficient in the hip joint, which is possibly a compensatory mechanism for lumbosacral region disorders.

Keywords

1. Trompeter K, Fett D, Platen P. Prevalence of Back Pain in Sports: A Systematic Review of the Literature. Sports medicine. 2017;47(6):1183-207. Epub 2016/12/31. doi: 10.1007/s40279-016-0645-3. PubMed PMID: 28035587; PubMed Central PMCID: PMCPMC5432558. ## 2. Lemmers GPG, van Lankveld W, Westert GP, van der Wees PJ, Staal JB. Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work. European Spine Journal. 2019;28(5):937-50. doi: 10.1007/s00586-019-05918-1. ## 3. da Silva T, Mills K, Brown BT, Pocovi N, de Campos T, Maher C, et al. Recurrence of low back pain is common: a prospective inception cohort study. Journal of Physiotherapy. 2019;65(3):159-65. doi: https://doi.org/10.1016/j.jphys.2019.04.010. ## 4. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. The Lancet. 2017;389(10070):736-47. doi: https://doi.org/10.1016/S0140-6736(16)30970-9. ## 5. Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, et al. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Current pain and headache reports. 2019;23(3):23. doi: 10.1007/s11916-019-0757-1. ## 6. O’Sullivan K, O’Keeffe M, Forster BB, Qamar SR, van der Westhuizen A, O’Sullivan PB. Managing low back pain in active adolescents. Best Practice & Research Clinical Rheumatology. 2019;33(1):102-21. doi: https://doi.org/10.1016/j.berh.2019.02.005. ## 7. Sheikhhoseini R, O’Sullivan K, Alizadeh MH, Sadeghisani M. Altered Motor Control in Athletes with Low Back Pain: a Literature Review. Ann Appl Sport Sci. 2016;4(4):43-50. ## 8. Hodges PW, Smeets RJ. Interaction Between Pain, Movement and Physical Activity: Short-term Benefits, Long-term Consequences, and Targets for Treatment. Clin J Pain. 2015;31(2):97-107. doi: 10.1097/AJP.0000000000000098. PubMed PMID: 24709625. ## 9. Sahrmann S. THE HOW AND WHY OF THE MOVEMENT SYSTEM AS THE IDENTITY OF PHYSICAL THERAPY. International journal of sports physical therapy. 2017;12(6):862-9. PubMed PMID: 29158948. ## 10. Movahed M, Salavati M, Sheikhhoseini R, Arab AM, O’Sullivan K. Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain. Journal of bodywork and movement therapies. 2019;23(4):924-9. doi: 10.1016/j.jbmt.2019.01.012. ## 11. Sheikhhoseini R, Alizadeh M-H, Salavati M, O’Sullivan K, Shirzad E, Movahed M. Altered Lower Limb Kinematics during Jumping among Athletes with Persistent Low Back Pain. Ann-Appl-Sport-Sci. 2018;6(2):23-30. doi: 10.29252/aassjournal.6.2.23. ## 12. Van Hoof W, Volkaerts K, O’Sullivan K, Verschueren S, Dankaerts W. Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls--field study using a wireless posture monitoring system. Manual therapy. 2012;17(4):312-7. Epub 2012/03/23. doi: 10.1016/j.math.2012.02.012S1356-689X(12)00042-2 [pii]. PubMed PMID: 22436688. ## 13. Sadeghisani M, Sobhani V, Azimi H, Karimi MT. Analysis of Symmetry of Weight-Bearing in Athletes With and Without Low Back Pain during Gait. Annals of Applied Sport Science. 2018;6(2):31-6. doi: 10.29252/aassjournal.6.2.31. ## 14. Sadeghisani M, Sobhani V, Kabir MM, Asnaashari A, Rahmani P, Azimi H. Investigation of Weight-Bearing Symmetry in a Group of Athletes with Low Back Pain and Healthy People During Gait. Journal of Mechanics in Medicine and Biology. 2017;17(05):1750086. doi: https://doi.org/10.1142/S0219519417500865. ## 15. Weinert-Aplin RA, Howard D, Twiste M, Jarvis HL, Bennett AN, Baker RJ. Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off. Medical engineering & physics. 2017;39:73-82. Epub 2016/11/12. doi: 10.1016/j.medengphy.2016.10.005. PubMed PMID: 27836575. ## 16. Chen H-B, Chang L-W, Cheng C-H. Aging effects on the mechanical energy transfer through the lower extremity joints during the swing phase of level walking. Sci Rep. 2019;9(1):9555-. doi: 10.1038/s41598-019-45267-z. PubMed PMID: 31266963. ## 17. Hosseininejad E, Eslami M. Mechanical energy analysis of barefoot and minimalist running. Journal of Applied Exercise Physiology. 2019;14(28):265-72. doi: 10.22080/jaep.2019.14724.1797. ## 18. Verhagen AP, Downie A, Popal N, Maher C, Koes BW. Red flags presented in current low back pain guidelines: a review. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2016;25(9):2788-802. doi: 10.1007/s00586-016-4684-0. PubMed PMID: 27376890. ## 19. Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review. The journal of pain : official journal of the American Pain Society. 2019;20(3):245-63. Epub 2018/08/14. doi: 10.1016/j.jpain.2018.07.009. PubMed PMID: 30099210. ## 20. McGibbon CA, Krebs DE, Puniello MS. Mechanical energy analysis identifies compensatory strategies in disabled elders’ gait. Journal of biomechanics. 2001;34(4):481-90. Epub 2001/03/27. doi: 10.1016/s0021-9290(00)00220-7. PubMed PMID: 11266671. ## 21. Streisfeld GM, Bartoszek C, Creran E, Inge B, McShane MD, Johnston T. Relationship Between Body Positioning, Muscle Activity, and Spinal Kinematics in Cyclists With and Without Low Back Pain: A Systematic Review. Sports health. 2017;9(1):75-9. Epub 10/27. doi: 10.1177/1941738116676260. PubMed PMID: 27784817. ## 22. Swain CTV, Whyte DG, Ekegren CL, Taylor P, McMaster K, Lee Dow C, et al. Multi-segment spine kinematics: Relationship with dance training and low back pain. Gait & posture. 2019;68:274-9. Epub 2018/12/15. doi: 10.1016/j.gaitpost.2018.12.001. PubMed PMID: 30551053. ## 23. Koyama Y, Tateuchi H, Araki K, Fujita K, Umehara J, Kobayashi M, et al. Mechanical energy efficiency for stepping up and down in persons with medial knee osteoarthritis. Gait & posture. 2019;69:143-9. Epub 2019/02/05. doi: 10.1016/j.gaitpost.2019.01.009. PubMed PMID: 30716670. ## 24. Harris-Hayes M, Sahrmann SA, Van Dillen LR. Relationship between the hip and low back pain in athletes who participate in rotation-related sports. J Sport Rehabil. 2009;18(1):60-75. Epub 2009/03/27. doi: 10.1123/jsr.18.1.60. PubMed PMID: 19321907; PubMed Central PMCID: PMCPMC2699456. ## 25. Sadeghisani M, Manshadi FD, Kalantari KK, Rahimi A, Namnik N, Karimi MT, et al. Correlation between Hip Rotation Range-of-Motion Impairment and Low Back Pain. A Literature Review. Ortopedia, traumatologia, rehabilitacja. 2015;17(5):455-62. Epub 2016/01/12. doi: 10.5604/15093492.1186813. PubMed PMID: 26751745. ## 26. Kisner C, Colby LA. Therapeutic exercise : foundations and techniques. 6th ed. Philadelphia: F.A. Davis; 2012. 960 p. ##