Sarah Morton1, Christian J Barton, Simon Rice, Dylan Morrissey. 1. Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, , London, UK.
Abstract
BACKGROUND: Low back pain (LBP) is highly prevalent in cricketers, particularly in adolescent fast bowlers. Numerous modifiable risk factors for and interventions to address LBP in cricketers have been proposed in the literature. AIM: Summarise and critique studies evaluating LBP risk factors in cricketers, and evaluate the effectiveness of interventions designed to prevent or treat such LBP. STUDY DESIGN: Systematic literature review. METHODS: MEDLINE, ISI Web of Knowledge, CINAHL, SportDiscus and the Cochrane Library were searched from inception using key terms relating to risk factors and interventions in LBP in cricketers. Quality of included studies was assessed using the Downs and Black Quality Index, data were extracted to complete the effect size and OR calculations and evidence levels were established using van Tulder's criteria. RESULTS: 12 studies (6 of high quality) investigating the factors associated with LBP in cricketers and 5 low-quality studies evaluating the interventions for the treatment/prevention of LBP in cricketers were identified. Moderate evidence indicates the presence of acute MRI bone stress as a risk factor for developing lumbar stress fractures. Additionally, moderate evidence indicates increased shoulder counter rotation (associated with mixed bowling actions) and decreased anterior abdominal fascial slide may be associated with LBP in cricketers. CONCLUSIONS: Screening for bone stress on MRI should be considered by clinicians managing developing cricketers to identify the risk of lumbar stress fracture development. Numerous associative factors were outlined, although causality needs establishing to further guide interventions in cricketers with LBP. Intervention studies were of insufficient quality to generate concrete conclusions and these research failings require rapid attention.
BACKGROUND:Low back pain (LBP) is highly prevalent in cricketers, particularly in adolescent fast bowlers. Numerous modifiable risk factors for and interventions to address LBP in cricketers have been proposed in the literature. AIM: Summarise and critique studies evaluating LBP risk factors in cricketers, and evaluate the effectiveness of interventions designed to prevent or treat such LBP. STUDY DESIGN: Systematic literature review. METHODS: MEDLINE, ISI Web of Knowledge, CINAHL, SportDiscus and the Cochrane Library were searched from inception using key terms relating to risk factors and interventions in LBP in cricketers. Quality of included studies was assessed using the Downs and Black Quality Index, data were extracted to complete the effect size and OR calculations and evidence levels were established using van Tulder's criteria. RESULTS: 12 studies (6 of high quality) investigating the factors associated with LBP in cricketers and 5 low-quality studies evaluating the interventions for the treatment/prevention of LBP in cricketers were identified. Moderate evidence indicates the presence of acute MRI bone stress as a risk factor for developing lumbar stress fractures. Additionally, moderate evidence indicates increased shoulder counter rotation (associated with mixed bowling actions) and decreased anterior abdominal fascial slide may be associated with LBP in cricketers. CONCLUSIONS: Screening for bone stress on MRI should be considered by clinicians managing developing cricketers to identify the risk of lumbar stress fracture development. Numerous associative factors were outlined, although causality needs establishing to further guide interventions in cricketers with LBP. Intervention studies were of insufficient quality to generate concrete conclusions and these research failings require rapid attention.
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