ABSTRACT
ObjectiveTo analyze the evidence of risk factors and health and rehabilitation intervention strategies for lower back injuries in adult golfers. MethodsA thematic search method was employed, retrieving literature related to low back pain in adult golfers from PubMed, Web of Science, EBSCO, Scopus, the Cochrane Library, CNKI, VIP and Wanfang Data, with publication dates ranging from inception to April 1st, 2024. Authors, country, publication time, study subjects, risk factors for low back pain and intervention strategies were extracted from the literature for systematic review. ResultsNine English articles from the United States, Australia, South Korea, Portugal and South Africa were included, involving 237 golfers, three survey studies, one prospective cohort study, five randomized controlled trial (RCT) and quasi-RCT articles were enrolled. The study subjects included adult professional and amateur golfers. The primary risk factors were excessive repetition of non-standard golf swinging movements resulting in excessive lumbar torsion and overuse of the lumbar musculature; abnormal activation patterns of the rectus abdominis, erector spinae and latissimus dorsi muscles; and functional limitation of the trunk and hip joints, causing excessive lumbar compensation during the swinging motion. Health and rehabilitation intervention strategies included the comprehensive application of electromyography and ultrasound biofeedback technologies with a focus on screening the lumbar weak muscle groups and swinging actions, optimizing training load, and standardizing swinging technical movements; strengthening functional training of the trunk and hip joints; and enhancing strength training of the abdominal and core muscle groups, as well as the deep muscle groups. ConclusionThe risk factors for low back pain in adult golfers are primarily associated with excessive repetition of improper golf swing techniques, insufficient strength in the abdominal and core muscle groups, and functional limitations of the trunk and hip joints. Key intervention strategies include optimizing training load using electromyography and ultrasound biofeedback techniques, standardizing swing techniques, enhancing trunk and hip joint functional training, and strengthening waist, abdominal, core and deep muscle group strength training. The implementation of these strategies helps to reduce the risk of low back pain in golfers, enhance athletic performance, and promote physical and mental health.
ABSTRACT
Objective:To compare the difference between the combined diagnostic effect of plasma Septin9(SEPT9) and polyligand Syndecan-2(SDC2) methylation with four serum tumor markers in the diagnosis of colorectal cancer.Methods:In this study, 128 patients who were treated in the affiliated Hospital of Xuzhou Medical University from March to December in 2019 were selected for a case-control study.All the subjects were examined by gastroenteroscopy.According to the pathological results, they were divided into three groups: colorectal cancer group( n=74) and colorectal adenoma group( n=7). The patients with no abnormal or inflammatory polyps or proliferative polyps examined by gastroenteroscopy were taken as the control group( n=47). The methylation levels of SEPT9 gene and SDC2 gene were detected by Roche Lightcycler 480 II real-time fluorescence quantitative polymerase chain reaction, and the concentrations of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 were detected by Roche Cobas 8000 electrochemiluminescence instrument.Chi-square test was used to compare the positive rate of each marker in the three groups.Medcalc was used to draw the receiver operating characteristic curve (ROC) curve of the subjects′ working characteristic curve, and the value of each index in the diagnosis of colorectal cancer was analyzed. Results:The positive rates of SEPT9 gene and SDC2 gene methylation were 81.1%(60/74) and 67.6%(50/74) respectively in colorectal cancer group, and increased to 85.1%(63/74) after combined detection.The positive detection rates of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 in colorectal cancer group were 1.4%(1/74), 33.8%(25/74), 6.8%(5/74) and 13.5%(10/74), respectively.When the four tumor markers were detected together, the positive detection rates were only increased to 43.2%(32/74), except for AFP and carbohydrate antigen 125(χ 2=3.847, 2.430, all P>0.05). The differences were statistically significant (χ 2=48.230, 30.487, 43.285, 3.847, 8.788, 6.988, 8.722, all P<0.05). The area under the curve (AUC) of SEPT9 methylation, SDC2 methylation, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 were 0.854 (0.781, 0.910), 0.795 (0.715, 0.861), 0.575 (0.485, 0.662), 0.685 (0.597, 0.764), 0.603 (0.513, 0.689) and 0.631 (0.541, 0.715), respectively.The AUC of combined detection of two DNA methylation markers was better than that of alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199, and the differences were statistically significant (alpha fetoprotein: Z=4.990, P<0.001; carcinoembryonic antigen: Z=3.743, P<0.001; carbohydrate antigen 125: Z=4.951, P<0.001; carbohydrate antigen 199: Z=3.983, P<0.001). The combined detection of two kinds of gene methylation was better than the combined detection of four kinds of serum markers in the diagnosis of colorectal cancer, and the difference was statistically significant ( Z=3.334, P<0.001). Conclusion:The combined detection of SEPT9 gene and SDC2 gene methylation in plasma is more suitable for non-invasive diagnosis of colorectal cancer than the combined detection of 4 serum tumor markers.