Prediction of ACL-tear by lower limbs muscle strength and flexibility: a prospective cohort study in 95 female soccer players.

The aims of the study were to build models using logistic regression analysis of flexibility and strength tests to prospectively predict risk factors for anterior cruciate ligament tear (ACL-tear) in female soccer (FS) players, and to determine training cut-off for risk factors of the predictive model built. A prospective cohort study of 95 female players (aged 14-33 years) was conducted. Age, anthropometric data, soccer history, lower limb range of motion (ROM) and hip maximal isometric strength (MIS) were measured. At the prospective follow-up after 12 months, 7.4% of the players had developed an ACL-tear. The model showed a significant relationship (χ2(93) = 30.531, p < 0.001) between the ACL-tear and the predictor variables (leg length, HAD-NH [hip adduction] MIS, asymmetric ROM [ankle dorsiflexion with knee extended (AD-KE) and with knee flexed (AD-KF), and HE (hip extension)], hip ROM [HIR (internal rotation) and HAB (abduction)]). The Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC) for model fit were 30.24 and 51.79, respectively. The value R2 showed good model fit, 76.5% for Nagelkerke´s R2, 71.4% for McFadden´s R2 and 67.5% for Tjur´s R2. For the screening test, cut-off for leg length of ≥0.40 m, for HIR ROM of ≤44º and for asymmetry of HE ROM of ≥5° were set, which have an acceptable (AUC ≥ 0.755) discriminatory ability for the development of ACL-tear.

Proyecto REFILAB: Un caso clínico de una hemiplejía secundaria a glioblastoma temporal izquierdo intervenido en Medicina del Trabajo / REFILAB project: a clinical case of hemiplegia secondary to glioblastoma in the left temporal region treated in occupational medicine

REFILAB es un proyecto novedoso aplicado en la medicina laboral para la prevención y readaptación física funcional de los trabajadores de una empresa, que sigue el modelo de intervención de la lesión deportiva. El objetivo del estudio fue analizar los efectos del proyecto REFILAB sobre la aptitud física relacionada con la salud en un trabajador con diagnóstico de hemiplejia derecha secundaria a glioblastoma temporal izquierdo intervenido. El caso clínico fue un hombre de 46 años, operario de limpieza viaria y recogida de residuos de una empresa de servicios urbanos. El trabajador fue intervenido durante 4 meses con REFILAB para combatir las secuelas de su enfermedad. Después de 4 meses de intervención, el trabajador mejoró consideradamente los valores de fuerza, flexibilidad, neuromotor y resistencia. El trabajador con diagnóstico de hemiplejia derecha secundaria a glioblastoma temporal izquierdo intervenido incrementó su autonomía en las actividades de la vida diaria e instrumentales básicas. (AU)

REFILAB is a novel occupational health project for the prevention and functional physical readaptation of workers in a company, following the model of intervention in sports injuries. The aim of the present study was to analyse the effects of the REFILAB project on health-related physical fitness in a subject diagnosed with brain cancer and right hemiplegia. The clinical case involved a 46-year-old man who worked for a municipal service company in street cleaning and refuse collection. The patient was treated with the REFILAB programme for 4 months to combat the sequelae of his disease. After the 4-month intervention, the worker significantly improved his strength, flexibility, neuromotor and endurance values. The worker, who was diagnosed with right hemiplegia as a result of a glioblastoma in the left temporal area, was able to increase his independence in activities of daily living and basic instrumental activities. (AU)

Predicting the Clean Movement Technique in Crossfit® Athletes Using an Optimal Upper-Limb Range of Motion: A Prospective Cohort Study.

BACKGROUND: The aim of this study was to determine the optimal upper-limb range of motion (ROM) profile for the catch phase of the clean movement (CPCM) and to identify the key ROMs for performing the CPCM in CrossFit® athletes. METHODS: A prospective cohort study of twenty CrossFit® athletes aged 20-36 years was conducted. Data were collected regarding age, anthropometrics, CrossFit® training experience and upper-limb ROM. The ROM was measured using the ROM-SPORT method. After 7 months, athletes performed a clean movement with a load of 80% one repetition maximum. A Bayesian Student's t-analysis, binary logistic regression analysis and Receiver Operating Characteristic analysis were performed. RESULTS: The optimal upper-limb ROM profile that predicted correct CPCM performance was 78° in shoulder extension, 173° in shoulder flexion, 107° in shoulder external rotation, 89° in shoulder internal rotation, 153° in elbow flexion, 99° in elbow pronation and 92° in wrist extension (area under the curve ≥ 651; positive predictive value ≥ 80%). Shoulder external rotation, elbow pronation and wrist extension were found to be the most important ROMs for the efficient and safe performance of CPCM (area under the curve ≥ 854; positive predictive value ≥ 85.7%). CONCLUSION: The upper-limb ROM profile is associated with proper clean performance. Further studies are warranted to determine whether improving flexibility on upper-limb ROM may improve proper clean movement performance.

Risk Factors for, and Prediction of, Shoulder Pain in Young Badminton Players: A Prospective Cohort Study.

BACKGROUND: Shoulder pain (SP) caused by hitting the shuttlecock is common in young badminton players. The objectives of the present study were to predict the risk factors for SP in young badminton players, and to determine the optimal risk factor cut-off that best discriminates those players who are at higher risk of suffering from SP. METHODS: A prospective cohort study was conducted with 45 under-17 badminton players who participated in the Spanish Championship. Data were collected on anthropometric age, sports history, sagittal spinal curves, range of motion (ROM) and maximum isometric strength of shoulder. After 12 months, players completed a SP history questionnaire. Bayesian Student's t-analysis, binary logistic regression analysis and ROC analysis were performed. RESULTS: Overall, 18 (47.4%) players reported at least one episode of SP. The shoulder internal rotation (SIR) ROM showed the strongest association (OR = 1.122; p = 0.035) with SP. The SIR ROM has an excellent ability to discriminate players at increased risk for SP (p = 0.001). The optimal cut-off for SIR ROM, which predicts players with an 81% probability of developing SP, was set at 55° (sensitivity = 75.0%, specificity = 83.3%). CONCLUSIONS: The young badminton players who had a shoulder internal rotation ROM of 55° or less have a higher risk of SP one year later.

Description of ROM-SPORT I Battery: Keys to Assess Lower Limb Flexibility.

Limited range of motion (ROM) is considered one of the most important intrinsic and modifiable risk factors for the most common sports-related injuries. In addition, controlling and monitoring an athlete's ROM is a strategy to achieve optimal ROM and improve athletic performance in sports, especially those that require high ROM in the major joints. Therefore, assessing ROM (pre-participation, during a rehabilitation process, on return to play, etc.) is important not only as a method to prevent sports injuries, but also as a quantitative determinant of the potential of athletic performance. However, despite the variety of different ROM assessment methods described in the literature, there is no consensus on which methods are best suited for this goal. Recently, the ROM-SPORT I battery has been shown to have advantages over other ROM assessment methods. This tool has not yet been fully described in detail for researchers, sports professionals, and clinicians to learn. The main objective of this study is to describe the ROM-SPORT I battery tests in detail using the following criteria: test description, simplicity of the test procedure, low need for human and material resources, predictive validity, and reliability.

Incidence, burden, and pattern of injuries in Spanish male youth soccer players: A prospective cohort study.

OBJECTIVES: To explore the incidence, burden, and pattern of injuries in Spanish male youth soccer players during a 9-month competitive season (from September to May-June). DESIGN: Prospective cohort study. PARTICIPANTS: 314 young (10-19 years) soccer players. MAIN OUTCOME MEASURES: Incidence, burden, location, type, severity, mechanism, and circumstance of injuries, as well as potential differences by tactical position, month of the year, age group, and maturity status. RESULTS: A total of 146 time-loss injuries were sustained by 101 different players. This resulted in an overall injury incidence of 3.1 injuries per 1000 h, a training injury incidence of 1.8 injuries per 1000 h, and a match injury incidence of 11.2 injuries per 1000 h. The probability of injury over the season was 34%. Most of the injuries affected the lower extremity and were classified as muscle/tendon injuries, with hamstring muscle injuries representing the most burdensome diagnosis. The incidence of injuries increased with age and maturation, but a heightened risk of overuse injuries during periods around peak height velocity was also identified. CONCLUSIONS: These findings suggest a need for implementing specific injury prevention measures. Due to the high burden shown, these measures should mainly focus on reducing the number and severity of hamstring muscle injuries.

Lower-Limb Range of Motion Predicts Sagittal Spinal Misalignments in Children: A Case-Control Study.

The main objective of this study was to determine lower-limb range of motion (ROM) as a risk factor associated with sagittal spinal misalignments in children. Two hundred and one children (10.9 ± 0.7 years old) from five different primary schools were recruited for this retrospective case-control study. Anthropometric variables, sagittal spinal alignment in habitual everyday postures, and lower-limb ROM, such as ankle dorsiflexion with the knee flexed (ADF-KF), hip extension with the knee relaxed (HE), and hip flexion with the knee extended (HF-KE) were measured. Multivariate and univariate analyses revealed differences between the means of HE and HF-KE ROM, and the thoracic and lumbar curves (p ≤ 0.034; η2 ≥ 0.052). The HE (p ≤ 0.028; OR ≥ 1.066) predicted sagittal thoracic misalignment in the slump sitting (SSP) and relaxed standing (RSP) postures in males and the sagittal lumbar misalignment in the RSP in female children; while HF-KE (p ≤ 0.006; OR ≥ 1.089) predicted sagittal thoracic misalignment in the maximum trunk forward flexion posture (MTFP) and sagittal lumbar misalignment in SSP and MTFP in males. In this study, the reference values for restricted HE and HF-KE were significantly associated with sagittal spinal misalignment in male children but not for the ankle ROM. Physical education teachers should include stretching exercises in the ISQUIOS programme to increase the extensibility of the iliopsoas (HE) and hamstrings (HF-KE) and prevent sagittal spinal misalignments in habitual everyday postures.

Reliability of a Qualitative Instrument to Assess High-Risk Mechanisms during a 90° Change of Direction in Female Football Players.

Sidestep cuts between 60° and 180° and one-leg landings have been identified as the main mechanisms of ACL injuries in several sports. This study sought to determine intra- and inter-rater reliability of a qualitative tool to assess high-risk movements in a 90° change of direction when the test is applied in a real framework of sport practice. Female footballers from two teams (n = 38) participated in this study and were asked to perform 90° cutting trials to each side, which were simultaneously filmed from a frontal and a sagittal view. A total of 61 cases were selected for 2D qualitative observational analysis by three raters. Poor reliability was found among each pair of raters as well as moderate reliability when the Cutting Movement Assessment Score (CMAS) was given by the same rater at different moments, but with too high a minimum detectable change. On the other hand, raters presented a significant, as well as moderate-to-good intra-rater reliability for most items of the CMAS tool. There was, however, non-significant reliability between observers in rating most check-points of the tool. For these reasons, more objective guidelines and clearer definitions for each criterion within the CMAS, as well as a longer, standardised training period for novel observers, would be highly recommended to improve the reliability of this tool in an applied context with female footballers.

Prevalence and Characteristics of Back Pain in Children and Adolescents from the Region of Murcia (Spain): ISQUIOS Programme.

Puberty is a vulnerable period for musculoskeletal disorders due to the existence of a wide inter-individual variation in growth and development. The main objective of the present study was to describe the prevalence of back pain (BP) in the past year and month in school-aged children according to sex, age, maturity status, body mass index (BMI) and pain characteristics. This study involved 513 students aged between 9 and 16 years. Anthropometric measures were recorded to calculate the maturity stage of the students using a regression equation comprising measures for age, body mass, body height, sitting height and leg length. An ad hoc questionnaire composed of eight questions was used to describe BP prevalence in school-aged children. The results showed that the prevalence of BP in school-aged children was observed in 35.1% over the last year (45% boys and 55% girls), and 17.3% (40.4% boys and 59.6% girls, with an association found between female sex and BP) in the last month. The prevalence of back pain in the past year and month was higher the older the students were, or the more pubertal development they had experienced. The prevalence of BP in the last year was also higher in those with overweight or obesity. After adjustment for sex, there was an association between BP and older age and higher BMI in boys and an association between BP and higher pubertal development in girls. In summary, the present study showed that the prevalence of BP was related to the maturity stage and weight of the participants, with different prevalence patterns found according to sex.

Effects of Age and Maturation on Lower Extremity Range of Motion in Male Youth Soccer Players.

ABSTRACT: Robles-Palazón, FJ, Ayala, F, Cejudo, A, De Ste Croix, M, Sainz de Baranda, P, and Santonja, F. Effects of age and maturation on lower extremity range of motion in male youth soccer players. J Strength Cond Res 36(5): 1417-1425, 2022-Restricted joint range of motion (ROM) has been considered as a primary risk factor for some sport-related injuries. Consequently, preparticipation assessment of lower extremity joints ROM could help identify youth soccer players at high risk of injury and to aid in the design of tailored age and maturational specific training interventions. The purpose of this study was to analyze and compare the influence of chronological age and maturational stage on several lower extremity ROM measures, as well as to describe the lower extremity ROM profile using a comprehensive approach in youth soccer players. A total of 286 male youth soccer players' ROM were assessed including passive hip (extension [PHE], adduction with hip flexed 90° [PHADHF90°], flexion with knee flexed [PHFKF] and extended [PHFKE], abduction with hip neutral [PHABD] and flexed 90° [PHABDHF90°], external [PHER] and internal [PHIR] rotation), knee (flexion [PKF]) and ankle (dorsiflexion with knee flexed [ADFKF] and extended [ADFKE]) ROMs. Between-group differences were analyzed using a one-way analysis of variance (ANOVA) and magnitude-based decisions. The results only report statistically significant (p < 0.05; d > 0.5) and clinically relevant differences (>8°) for the PKF ROM between U12 vs. U19, and Pre-PHV vs. Post-PHV groups. Furthermore, approximately 40, 35, and 20% of players displayed restrictions in their PHFKE, PKF, and ADFKF ROM values, respectively. These findings emphasize the necessity of prescribing (across all age groups and periods of growth and maturation) compensatory measures in daily soccer training, and these exercises should be equally applied to both limbs with the aim of improving PHFKE, PKF and ADFKF ROM values.

Lower Extremity Flexibility Profile in Basketball Players: Gender Differences and Injury Risk Identification.

Analysis of the flexibility profile of basketball players (BPs) can reveal differences in range of motion (ROM) by gender and also identify those players who are at higher risk for sports injuries. A descriptive observational study was conducted to determine the lower extremity flexibility profile of sixty-four basketball players and gender differences to identify players at higher risk of injury due to limited and asymmetric ROM in one or more movements. Participants: Sixty-four (33 male and 31 female) competitive athletes from the national leagues of the Spanish basketball league system participated in the present study (power of sample size ≥0.99). The eight passive ROM tests of the hip, knee and ankle were assessed using the ROM-SPORT battery. Each player completed a questionnaire on age, basic anthropometric data, dominant extremities, and training and sport-related variables. The lower extremity flexibility profile was established at 15° and 10° hip extension (HE), 39° and 38° ankle dorsiflexion with knee extended (ADF-KE), 40° and 39° ankle dorsiflexion with knee flexed (ADF-KF), 43° and 43° hip abduction (HAB), 75° and 61° hip abduction with the hip flexed (HAB-HF), 78° and 83° hip flexion with the knee extended (HF-KE), 134° and 120° knee flexion (KF), and 145° and 144° hip flexion (HF) by male and female basketball players, respectively. Sex differences in HE, HAB-HF, and KF were observed in BPs (p ≤ 0.01; Hedges' g ≥ 1.04). Players reported limited ROM in ADF-KF, HE, HAB-HF, HF-KE, and KF; and asymmetric ROM mainly in HE, ADF-KE, KF, ADF-KF, and HF-KE. In conclusion, this study provides gender-specific lower extremity flexibility profile scores in BPs that can help athletic trainers and athletic and conditioning trainers to identify those players who are at higher risk of injury due to abnormal ROM scores.

Sagittal Integral Morphotype of Competitive Amateur Athletes and Its Potential Relation with Recurrent Low Back Pain.

Athletes have higher thoracic and lumbar curvature in standing than the reference values of the non-athletic population. The sagittal integral morphotype method (SIM) assessment has not previously been applied to competitive amateur athletes (CAA). The propose of the present study was to determine the SIM of CAA treated at a sports-medicine center and to identify spinal misalignments associated with recurrent low back pain (LBP). An observational analysis was developed to describe the SIM in 94 CAA. The thoracic and lumbar curvatures of the CAA were measured in standing, sitting, and trunk forward flexion. Association analysis (Pearson's chi-square and Cramér's V tests) was then performed to identify the SIM misalignments associated with LBP. Effect size was analyzed based on Hedges' g. The most common thoracic SIMs in CAA were total hyperkyphosis (male = 59.02%; female = 42.42%) and static hyperkyphosis (male = 11.48%; female = 6.06%). Hyperlordotic attitude (female = 30.30%; male = 4.92%), static-functional hyperkyphosis (male = 16.39%; female = 3.03%), and structured hyperlordosis (female = 21.21%; male = 1.64%) were the most common lumbar SIMs. Hyperlordotic attitude, static functional lumbar hyperkyphosis, and structured hyperlordosis were associated with LBP in male and female athletes.

The Potential Role of Hamstring Extensibility on Sagittal Pelvic Tilt, Sagittal Spinal Curves and Recurrent Low Back Pain in Team Sports Players: A Gender Perspective Analysis.

It is assumed that mechanical restriction of hamstring tightness disrupts sagittal spine-pelvis-leg alignment and alters the lumbar-pelvic rhythm predisposing to low back pain (LBP) in athletes; however, this association is not clear. A prospective cross-sectional cohort study was conducted to determine the influence of hamstring extensibility (HE) on sagittal pelvic tilt, sagittal spinal curves, and LBP in 94 soccer and basketball players (61 man and 33 woman) with (n = 36) and without recurrent LBP (n = 58). Descriptive analysis displayed significant gender differences for HE, sagittal pelvic tilt, and lumbar curve. Differences were found between the low-HE and high-HE groups in lumbosacral angle in for the maximum trunk forward flexion (LH-MTFP). Low-HE was associated with LH-MTFP, lumbar curve and LBP in male players (p ≤ 0.023). In female players, LH-MTFP and lumbar curve were associated with low-HE (p ≤ 0.020). Low-HE predicted LH-MTFP (p = 0.000; OR = 65.6950) and LBP (p = 0.028; OR = 13.915) in male players. The decision tree analysis showed that 50.8% of the players were classified with restricted LH-MTFP, 77.4% with low-HE among male players. The 100% of male players with recurrent LBP had low-HE. The 65% of female players with low-HE had restricted LH-MTFP. Measurement of HE, lumbar curve, and LH-MTFP are important in making training decisions for to reduce the incidence of recurrent LBP in soccer and basketball players.

Comprehensive Lower Extremities Joints Range of Motion Profile in Futsal Players.

The purposes of this study were to describe the lower extremities joints range of motion (ROM) profile using a comprehensive approach in futsal players and to examine potential player position (goalkeepers vs. outfield players), competitive level (first [top] division vs. second division), number of playing years, sex (males vs. females), and bilateral (dominant limb vs. non-dominant limb) differences. A total of 72 male and 67 female elite futsal players from 11 clubs were measured of passive hip (flexion with knee flexed [HF KF ] and extended [HF KE ], extension [HE], abduction [HA], external [HER], and internal [HIR] rotation), knee (flexion [KF]) and ankle (dorsiflexion with knee flexed [ADF KF ] and extended [ADF KE ]) ROMs. Bayesian inferences exploring differences between player position, competitive level, sex and limb were made. A Bayesian correlation analysis was conducted to explore the influence of playing years on joints ROMs. The results showed no significant player position or competitive level related differences in any average ROM score. However, statistically significant sex-related differences were documented whereby female players reported higher hip and knee joints ROM average values than their male counterparts. Especially relevant were the proportions of males (72%) and players from teams engaged in the second division (61%) displaying limited HF KE ROMs. Likewise, around 35% of all players showed restricted ADF KF ROMs. In addition, approximately 21, 18, 22, and 25% of the futsal players were identified as having bilateral asymmetries (≥8°) for HA, HIR, HER, and KF ROMs, respectively. Finally, Bayesian correlation analysis did not report any significant association between years of playing futsal and ROM measures (all r values < 0.34). The implications that these restricted HF KE and ADF KF ROMs and bilateral asymmetries in hip (abduction, internal and external rotation) and knee (flexion) ROMs caused by the practice of futsal may have on physical performance and injury risk warrant future research.

Sagittal Integral Morphotype of Female Classical Ballet Dancers and Predictors of Sciatica and Low Back Pain.

The aims of this study were to describe the sagittal integral morphotype (SIM) of classical ballet (CB) dancers, and to establish predictor factors and their cut off values for high risk of experiencing sciatica or low back pain (LBP). This retrospective cohort study was performed in 33 female professional CB dancers. Data related to anthropometric parameters, CB dance experience, sciatica or LBP history, and sagittal spine curvatures were collected. A binary logistic regression and receiver-operating characteristic analysis were performed. The main spine misalignments observed in the SIM of CB dancers were thoracic functional hyperkyphosis, hypomobile kyphosis, and hypokyphosis, and those for the lumbar curvature were hyperlordotic attitude and functional hyperkyphosis. The lumbar curvature in slump sitting and trunk forward bending positions, together with the stature, were significant predictor factors of sciatica history, while the years of dance experience was a significant predictor factor of LBP history. The cut off values analysis revealed that dancers with a stature of 161 cm or less, and those with 14 years of experience or more, have a greater probability of experiencing sciatica or LBP history, respectively.

Assessment of the Range of Movement of the Lower Limb in Sport: Advantages of the ROM-SPORT I Battery.

Range of movement (ROM) assessment is an important strategy to increase physical-technical performance and minimize the risk of sports-related injuries. Currently, there is no consensus regarding which ROM assessment method is the most appropriate. The main objective of this study was to perform a systematic review of the test batteries available for the assessment of lower limb ROM; additionally, we compare the ROM-SPORT I battery with those previously reported in the literature. The systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The identification of publications was made by using the databases SciELO, Medline, Scopus, PubMed, and Web of Science. Based on the inclusion criteria, sixteen publications were selected and analyzed. The ROM-SPORT I battery is the most valid of the analyzed methods. This battery evaluates the ROM of eleven lower limb movements. The inclinometer with a telescopic arm and a box is a simpler, more comfortable, and faster procedure than others. The Lumbosant support and use of two examiners are essential to avoid compensatory movements to obtain reliable measurements during ROM assessment. The ROM-SPORT I is a field-based battery of tests that may be used by sports professionals, clinics, and researchers in applied settings to accurately assess and monitor lower extremity ROM.

Trunk Lateral Flexor Endurance and Body Fat: Predictive Risk Factors for Low Back Pain in Child Equestrian Athletes.

Low back pain (LBP) is the most common overuse musculoskeletal injury suffered by child equestrian athletes (CEA). Despite this, little is known about the risk factors related to LBP in these athletes, and very limited research has been conducted on this topic. This study was designed to investigate predictive risk factors for LBP in CEA. The purposes of this research were to determine whether anthropometric, range of motion (ROM), core endurance and sagittal spinal morphotype measures are risk factors for LBP and to establish a diagnostic cutoff value for those factors associated with LBP. Nineteen CEA between the ages of 12 and 17 years were voluntarily recruited. Potential risk factors evaluated included corporal composition, lower limb ROM, core endurance and sagittal spinal measures. Associations and predictions were calculated between these risk factors and the LBP during the last 12 months. Almost half of the CEA have suffered at least one episode of LBP. Two risk factors and cutoff values were identified as predictors of LBP in CEA: having a high body fat higher than 23% (p = 0.01) and trunk lateral flexor endurance lower to 65 s (p = 0.021), body fat being the strongest predictor.

Sagittal standing spinal alignment and back pain in 8 to 12-year-old children from the Region of Murcia, Spain: The ISQUIOS Program.

BACKGROUND: The child's spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP). OBJECTIVE: The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children. METHODS: This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children's parents or legal guardians filled in a questionnaire according to the children's responses about the BP suffered in the previous week and the preceding year. RESULTS: The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009-1.160, p= 0.028). CONCLUSIONS: To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.

Validity and Reliability of the New Basic Functional Assessment Protocol (BFA).

The global evaluation of motion patterns can examine the synchrony of neuromuscular control, range of motion, strength, resistance, balance and coordination needed to complete the movement. Visual assessments are commonly used to detect risk factors. However, it is essential to define standardized field-based tests that can evaluate with accuracy. The aims of the study were to design a protocol to evaluate fundamental motor patterns (FMP), and to analyze the validity and reliability of an instrument created to provide information about the quality of movement in FMP. Five tasks were selected: Overhead Squat (OHS); Hurdle Step (HS); Forward Step Down (FSD); Shoulder Mobility (SM); Active Stretching Leg Raise (ASLR). A list of variables was created for the evaluation of each task. Ten qualified judges assessed the validity of the instrument, while six external observers performed inter-intra reliability. The results show that the instrument is valid according to the experts' opinion; however, the reliability shows values below those established. Thus, the instrument was considered unreliable, so it is recommended to repeat the reliability process by performing more training sessions for the external observers. The present study creates the basic functional assessment (BFA), a new protocol which comprises five tasks and an instrument to evaluate FMP.

External and Total Hip Rotation Ranges of Motion Predispose to Low Back Pain in Elite Spanish Inline Hockey Players.

Low back pain (LBP) is a common ailment in competitive athletes. Although the association between limited range of motion (ROM) and prevalence of LBP has been widely investigated in other sports, there is no research about this topic in inline hockey (IH). The main purposes of this study in IH players were (1) to analyze the association between hip ROM and LBP and (2) to establish a diagnostic cutoff for ROM of high risk of LBP. Twenty elite IH players from the two Spanish National Teams (male and female) were assessed for passive maximum hip ROMs; the movement evaluated were the hip external [HER] and internal [HIR] rotation, hip flexion with flexed [HF-KF] and extended [HF-KE] knee, hip adduction with flexed hip [HAD-HF], hip abduction with neutral [HAB] and flexed [HAB-HF] hip, and hip extension [HE]. LBP was retrospectively monitored for the last 12 months before the date of ROM assessment by using a questionnaire. The data were analyzed via a binary logistic regression and receiver operating characteristic curves. The 70% of players had developed LBP during the retrospective study period. Significant differences between LBP group and asymptomatic group for HER (p = 0.013, d [Cohen's effect size] = 1.17) and hip total rotation [HTR] (p = 0.032, d [Cohen's effect size] = 1.05) were observed. The cutoff points with the greatest discriminatory capacity were 56.5° for HER and 93° for HTR ROMs.