Aviva Zeev

Physical Activities and Low Back Pain: A Community-based Study

PURPOSE Very little is known about the relationship between physical activity and low back pain (LBP) in general populations. This study aimed to evaluate the relationship between different dimensions of physical activity and LBP among all adults of a defined community. METHODS A cross-sectional survey addressed all adults aged 22-70 of a single town. Inhabitants were asked to complete a self-administered questionnaire regarding physical activities, LBP, and related characteristics. The Beacke Physical Activity Questionnaire evaluated physical activity, and the Modified Roland and Morris Disability Questionnaire, a pain severity scale, and the Pain Symptoms Frequency and Bothersomeness Indices evaluated LBP. RESULTS High occupational activity demands contributed to increased LBP prevalence, and, conversely, high sporting activity participation contributed to a decline in all LBP measures. Subjects free of LBP and subjects who participate in sporting activities are more likely not to smoke and not to participate in high occupational activity demands. Type of sporting activity was not associated with LBP prevalence or severity. CONCLUSIONS Different dimensions of physical activity yield different relationships to LBP. There are several shared characteristics of those participating in sport on a regular basis and those free of LBP. Both groups present a healthier lifestyle. Although LBP was less frequent among those who participate in sporting activities, participating in sporting activities did not contribute independently to a lower prevalence of LBP. However, once LBP was established, participating in sporting activities contributed indirectly to its severity.

The Medial Longitudinal Arch as a Possible Risk Factor for Ankle Sprains: A Prospective Study in 83 Female Infantry Recruits

Background: Ankle sprains are frequent, especially in athletes, soldiers, or others who perform high levels of physical activity. Although prevention is a primary goal, little is known about the risk factors. We evaluated the association of the structure of the medial arch of the foot to the occurrence of acute and recurrent ankle sprains in 83 female infantry recruits. We found no previous studies on ankle sprains in women in the English literature. Methods: Arch height was quantified using the Chippaux-Smirak index, and each arch was classified as high, normal, or low. Retrospective data were obtained from questionnaires in which the soldiers noted whether or not they had had ankle sprains in the past, the grade of the sprain, and recurrence. Prospective data were accumulated in the 4 months of basic training, during which time every ankle sprain was documented and classified according to its grade and cause. Results: The retrospective data showed more frequent ankle sprains in the low arch group than in the normal arch group, mainly in the right foot (RR of 2.9, p < 0.05). Recurrent sprains studied retrospectively also showed that more sprains occurred in the low arch group than in the normal arch and high arch groups (RR of 10.3, p < 0.05). The prospective data suggested a pattern toward the same outcome (50% in the low arch as opposed to 36% in the normal arch group, RR, 1.3), but with no statistical significance. Conclusions: We concluded that a low arch of the foot might be a risk factor for ankle sprains. However, our study consisted of a relatively small population, and further studies are needed.

A longitudinal, community-based study of low back pain outcomes.

Objectives. To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporting symptoms during an initial cross-sectional survey. Study Design. A longitudinal community-based study. Summary of Background Data. The natural history of LBP is poorly understood. Different studies report various rates of persistent and recurrent symptoms as well as different predictors of outcomes. Methods. Subjects from a single town in Israel reporting low back pain during the previous month were followed up after 2 and 12 months. The primary outcome was experiencing LBP and the secondary outcomes were pain and functional status as measured by the Roland & Morris Disability questionnaire and Pain Symptoms Frequency and Bothersomeness Indexes. Results. More than three fourths reported LBP (different levels of severity) after 2 and 12 months. This group did not show an improvement in pain measures. Baseline pain characteristics and perception of general health were predictors of both primary and secondary outcomes. Work satisfaction and experiencing a negative event during the past months were also predictors of the secondary outcomes. Conclusions. In this community-based study, LBP symptoms after 1 year are common and symptoms of those experiencing LBP at follow up do not improve over time. Predictors of experiencing LBP and of LBP symptoms after 1 year included baseline pain characteristics and psychosocial factors.

Injury patterns in young, non-professional dancers

Abstract The aim of the present study was to assess the prevalence and types of injuries in 1336 young, non-professional female dancers (age 8–16 years) who participated in a descriptive mixed (cross-sectional/ longitudinal) cohort study. Previous and current injuries were diagnosed and later classified into seven major categories. Our results show that 569 (42.6%) of the dancers examined manifested an injury. Advanced age and increased exposure to dance yielded an equivalent increase in the prevalence of injured girls: from 1 of 10 girls in the 8-year-old age cohort (mean = 1.05 per 1000 h) to 1 of 3 girls in the 14-year-old age cohort (mean = 1.25 per 1000 h). Time elapsing between first and second injuries decreased with age. Among the youngest group of dancers (8–9 years) the most common injury was tendonitis (41%), while in adolescent dancers (14–16 years) knee injuries became the leading cause of complaints (33%). We conclude that young, non-professional dancers are at high risk of injury. Dancers who had been injured in the past were at higher risk for re-injury. Tendonitis in the foot or ankle joint was a common injury among the youngest dancers, while knee injuries were common among adolescent dancers. A routine screening of this dancer population by an expert in dance medicine will reduce the risk for an injury.

Effects of walking speed on asymmetry and bilateral coordination of gait

The mechanisms regulating the bilateral coordination of gait in humans are largely unknown. Our objective was to study how bilateral coordination changes as a result of gait speed modifications during over ground walking. 15 young adults wore force sensitive insoles that measured vertical forces used to determine the timing of the gait cycle events under three walking conditions (i.e., usual-walking, fast and slow). Ground reaction force impact (GRFI) associated with heel-strikes was also quantified, representing the potential contribution of sensory feedback to the regulation of gait. Gait asymmetry (GA) was quantified based on the differences between right and left swing times and the bilateral coordination of gait was assessed using the phase coordination index (PCI), a metric that quantifies the consistency and accuracy of the anti-phase stepping pattern. GA was preserved in the three different gait speeds. PCI was higher (reduced coordination) in the slow gait condition, compared to usual-walking (3.51% vs. 2.47%, respectively, p=0.002), but was not significantly affected in the fast condition. GRFI values were lower in the slow walking as compared to usual-walking and higher in the fast walking condition (p<0.001). Stepwise regression revealed that slow gait related changes in PCI were not associated with the slow gait related changes in GRFI. The present findings suggest that left-right anti-phase stepping is similar in normal and fast walking, but altered during slow walking. This behavior might reflect a relative increase in attention resources required to regulate a slow gait speed, consistent with the possibility that cortical function and supraspinal input influences the bilateral coordination of gait.

Loneliness is associated with an increased risk of sedentary life in older Israelis

Objectives: Both loneliness and insufficient physical activity are common in old age. This study investigated the association between loneliness and adherence to recommended guidelines of physical activity in a national sample of Israelis, and examined whether loneliness was a risk factor for insufficient physical activity independent of other variables. Methods: A random sample of 1663 (799 men) older adults aged 65+ reported their physical activity routine, and based on official guidelines were categorized as sufficiently active, insufficiently active, and inactive. In addition, they were divided into lonely or not lonely based on a single question from the Center for Epidemiologic Studies Depression Scale. Results: Chi-square analyses indicated that loneliness, but not living alone, were inversely related to level of physical activity in both genders. Based on multinomial stepwise logistic regressions body mass index, being religious versus secular, self-rated health, and education were associated with engaging in physical activity in men (Cox & Snell R 2 = 0.202). Loneliness contributed significantly to explaining the level of participation in physical activity beyond these variables in women, but not in men (Cox & Snell R 2 = 0.197). Conclusions: Loneliness is associated with an increasing risk of inactivity in advanced age in women. Further research inquiring into whether loneliness is the cause of reduced physical activity or whether physical activity acts as a protective factor against loneliness is needed. Developing and implementing tailored intervention programs that encourage social interaction in combination with a physical activity program are recommended.

Extrinsic and intrinsic risk factors associated with injuries in young dancers aged 8-16 years

Abstract In the present study, we tried to determine the association between joint ranges of motion, anatomical anomalies, body structure, dance discipline, and injuries in young female recreational dancers. A group of 1336 non-professional female dancers (age 8–16 years), were screened. The risk factors considered for injuries were: range of motion, body structure, anatomical anomalies, dance technique, and dance discipline. Sixty-one different types of injuries and symptoms were identified and later classified into four major categories: knee injuries, foot or ankle tendinopathy, back injuries, and non-categorized injuries. We found that 569 (42.6%) out of the 1336 screened dancers, were injured.The following factors were found to be associated with injuries (P < 0.05): (a) range of motion (e.g. dancers with hyper hip abduction are more prone to foot or ankle tendinopathies than dancers with hypo range of motion; (b) anatomical anomalies (scoliotic dancers manifested a higher rate of injuries than non-scoliotic dancers); (c) dance technique (dancers with incorrect technique of rolling-in were found to have more injuries than dancers with correct technique); (d) dance discipline (an association between time of practice en pointe and injury was observed); and (e) early age of onset of menarche decreased risk for an injury. No association between body structure and injury was found. Injuries among recreational dancers should not be overlooked, and therefore precautionary steps should be taken to reduce the risk of injury, such as screening for joint range of motion and anatomical anomalies. Certain dance positions (e.g. en pointe) should be practised only when the dancer has already acquired certain physical skills, and these practices should be time controlled.

Injuries among talented young dancers: findings from the UK Centres for Advanced Training

The aim of the present study was to characterize the injuries of young dancers attending Centres for Advanced Training. 806 dancers, ages 10-18 years responded to surveys regarding their biological profile, dance experience and injury history, and were examined for their anthropometric profile. Of the 806 dancers, 347 reported an injury. Based on 4 age groups, the total hours of practice per week increased significantly with increasing age. Incidence of injuries per 1000 h of dance practice for dancers ages 11-12 were found to be significantly higher compared to the incidence for dancers ages 13-18 (p<0.05). Foot and ankle and other lower extremities were the most common injury location, and muscle injuries were the most common type of injury. Total months in CAT training (OR=1.044, 95% CI=1.014-1.075) and hours per week in creative style practice (OR=1.282, 95% CI=1.068-1.539) were found to be significantly associated with injuries. In conclusion, both young and mature dancers are exposed to extensive risk of injury. The intensity of training (such as number of months and number of hours of training per week) is important factor that should be taken into account in order to decrease future injuries among young dancers.

Reasons attributed to omitting exercising: A population‐based study

Abstract The purpose of the present study was to examine patterns of reasons attributed to not exercising in a population‐based study of 2,298 Australians aged 18–78. A multinomial logistic regression on total number of reasons selected indicated that inactive individuals selected more reasons than active, women more than men, and young people more than old. Factor analysis on the reasons resulted in five categories. A multinomial logistic regression performed for each factor indicated that older individuals selected less External reasons, and less Internal‐State reasons, but more Internal‐Trait and Health reasons than other age groups. Women selected more Internal‐State reasons than males. Sufficiently active individuals selected more External‐Environmental but less Internal‐Trait reasons than insufficiently active individuals. In‐depth psychological techniques should be included in intervention programs geared toward changing thoughts about exercise. Understanding the functions served by beliefs about non‐adherence may aid the attempt to develop appropriate interventions.

Morphological characteristics of the young scoliotic dancer

BACKGROUND The literature lacks important data about the relationship between scoliosis and growth process, scoliosis and intensive exercise, scoliosis and morphological characteristics, and scoliosis and injuries, among young dancers. OBJECTIVE The aims of the present study were to determine the extent to which dance experience, body structure, anatomical anomalies and injuries are associated with scoliosis, and to identify variables able to discriminate between scoliotic and non-scoliotic female dancers at time of screening. DESIGN Cross-sectional cohort study. METHODS One thousand two hundred and eighty-eight non-professional female dancers, aged 8-16 years, were screened for the current study. We determined their morphometrical profile (height, weight, BMI), dance discipline (as hours of practice per week), manifestation of anatomical anomalies, and existing injuries. All dancers were clinically examined for presence of scoliosis. RESULTS Three hundred and seven of the 1288 dancers (23.8%) were diagnosed as having scoliosis. Dance experience and body structure were similar for dancers with or without scoliosis. Scoliotic dancers presented a significantly higher prevalence of anatomical anomalies (such as genu varum, and hallux valgus). Back injuries were more common among scoliotic dancers compared to non-scoliotic dancers. CONCLUSION Screening and identifying the young scoliotic dancers prior to their advancing to higher levels of exercise is recommended. The scoliotic dancers should realize that there might be a connection between the presence of scoliosis and increased incidence of anatomical anomalies and back pain, hence, it should be suggested they seek help with an adequate assessment and exercise rehabilitation program.