When diving in open water with a dry suit the weights amounted to more than 8 kg in most scuba divers Over the preceding 12 months, 5. The one-year prevalence of injuries in general was However, most of the symptomatic scuba divers The most diagnosed structural abnormalities of the LBP were lumbar hyperlordosis 5.
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Primary impairments due to LBP were predominantly pain Among the 91 scuba divers with LBP, The onset of LBP was in Next, LBP was mostly localized in the entire low back Table 5. Comparison between groups for general characteristics. No significant correlations between sport-specific characteristics of scuba diving and overall characteristics of LBP could be revealed. Figure 1. Boxplot for the dive certificate and the amount in kg of weight used during diving in a pool in scuba divers with and without LBP.
Following simple binary stepwise logistic regression the strongest sportspecific predictors for LBP were diving certificate and the weight on the weight belts during outdoor diving with a dry suit Table 7. The weight on the weight belt during indoor diving and during outdoor diving with a wet suit could not be considered as a significant predictor for LBP, as was diving level, diving experience, diving depth during outdoor dives, type of weight used on the weight belt, type of breathing gas used during outdoor dives, amount of indoor training sessions and diving injuries.
Multiple stepwise logistic regression for diving certificate and diving experience and for amount of weight used on the weight belt in different circumstances revealed no predictive models for LBP in scuba divers Table 8. Comparison between grous for sport-specific characteristics. Simple logistic regression for sport-specific predictors of LBP.
The oneyear prevalence of LBP in this study The lifetime prevalence of LBP of Moreover, comparisons with other epidemiological studies are difficult since there is no consensus on the definition or classification of LBP, a lack of methodological uniformity and results are often based upon selfadministered data with no verification from an independent source Van Mechelen et al.
The lifetime prevalence of LBP in recreational scuba divers lies within the range of However, when comparing these data one should again be careful because they are strongly subject to the definition and classification of LBP used, the methodology of the research design, the gender, type and level of sports, training intensity, training frequency or technique. In the current study, a remarkable discrepancy could be found between the one-year prevalence of LBP Although This inclusion is more or less in accordance with other findings in the literature: Baker and Patel and Dunn et al.
Nachemson listed also degenerative disc disease and spondylolysis as the most common abnormalities associated with LBP in athletes Nachemson, Spondylolysis is often regarded as the most serious injury of the lower back in sports involving repetitive hyperextension and axial loading Rossi and Dragoni, ; Nyska et al. These increased loads are transformed into shear forces acting mainly on the pars interarticularis of the vertebra i. L5 Rossi and Dragoni, ; Nyska et al.
Moreover, in swimming and fin swimming, which both have some similarities with scuba diving, clear associations between intensive leg workout and a chronic overload upon the posterior or spinal column were found Goldstein et al. Most LBP in scuba divers was non-specific, characterized by primary impairments as pain, rigidity, disability and strain of the lower back.
This observation corresponds to findings from the general population where LBP is predominantly mechanical or non-specific Kerr et al. Over the preceding 12 months a structural abnormality of the lower back i. In the literature conflicting results are found on which general risk factors contribute to LBP e.
In this study, no such interactions between risk factors were examined. Some significant general risk factors for LBP i. Presumably scuba divers with a higher dive certificate i have a higher responsibility during diving activities i. Next to this, symptomatic scuba divers use a significantly higher amount of weight on their weight belts during indoor training sessions and during outdoor dives with a dry suit.
More weight gives a larger local compression force on the lumbar spine which could also contribute to LBP. Nevertheless, this finding could not be confirmed for the use of weights during outdoor training sessions with a wet suit. The absence of significant correlations between sport-specific characteristics of scuba diving and overall properties of LBP does not mean that scuba diving activities are not associated with LBP since not all sport-specific characteristics have been investigated i.
Further research is necessary 32 Contemporary Sport, Leisure and Ergonomics to elucidate a possible relationship between sport-specific characteristics and overall characteristics of LBP. Simple and multiple logistic regression revealed two significant sport-specific predictors for LBP. A higher diving certificate increases the risk for LBP and more weight on the weight belt during outdoor diving with a dry suit also increases the risk of LBP. Both models are a significant fit of the data of LBP in scuba divers.
First of all, data were only gathered by means of a self-assessment questionnaire in a retrospective way and no verification from an independent source i.
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Secondly, although non-parametric statistics are assumption-free tests i. Moreover, no statistical tests were applied to search for confounding factors or effect modifiers when comparing the two groups so data could be skewed. Next to this, underlying intrinsic as well as extrinsic factors could contribute to LBP in scuba divers.
A challenging potential area of future research would lie in a static and dynamic biomechanical analysis of scuba diving. The self-assessment questionnaire used in this study had sufficient test-retest reliability and content and construct validity for its purpose. Nevertheless if, in future research, the questionnaire would be used to evaluate LBP in other sports, these findings about the properties of the questionnaire should not be generalized. It is recommended to test for validity and reliability once more in a sample of a different population to strengthen the scientific findings of this study.
Moreover, the sport-specific part of the questionnaire has to be adapted each time to the sport involved.
Next to this, an additional question on the presence of current LBP point-prevalence would be appropriate to get a more accurate idea of the prevalence of LBP in different sports and to be able to make comparisons to other findings in the literature Saraux et al. Lifetime and one-year prevalence of LBP among recreational Flemish scuba divers were This study also sheds light on the characteristics of these LBP in recreational scuba divers. Only a few previously-reported general risk factors for LBP could also be found among these recreational scuba divers i.
Sport-specific risk factors for LBP found in this study are the diving certificate and the amount of weight used on the weight belt but further biomechanical research should clarify the underlying mechanisms. Nevertheless, the results of the current study could serve as a guide towards more accurate and specific research methods to study LBP in recreational scuba divers profoundly.
Acknowledgements The authors would like to thank Dr. Van Bogaert hyperbaric physician and company doctor for bringing up the research hypothesis in the first place, Prof. William Duquet for his assistance in the data analysis and all recreational scuba divers who participated in this study. References Aagard, H. Scandinavian Journal of Medicine and Science in Sports, 6, pp. Adams, M. Spine Hagerstown, 24, pp. Akmal, M. Spine Hagerstown, 29, pp. Bahr, R. Baker, R. Primary Care Clinics in Office Practice, 32, pp.
Bono, C. Borenstein, D.https://drilerourfasear.cf
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Current Opinion in Rheumatology, 9 2 , pp. Clenney, T. American Family Physician, 53, pp. Cole, M. Work, 21, pp. De Vet, H. Spine-Hagerstown, 27, pp.
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