Lesões desportivas na ginástica artística: estudo a partir de morbidade referida

INTRODUÇÃO: Os níveis de exigência biomecânica devidos ao alto grau de dificuldade na realização de gestos fazem da ginástica artística (GA) uma modalidade com elevado risco de lesões. Assim, é necessário que os aspectos a elas relacionados sejam controlados. OBJETIVO: Analisar a ocorrência de lesões na Ginástica Artística, associando-as a fatores de risco específicos da modalidade e do atleta, a partir de inquérito de morbidade referida. MÉTODOS: Foram entrevistados 54 ginastas, recrutados ao acaso, classificados segundo o nível competitivo em duas categorias: regional e nacional. Utilizou-se o inquérito de morbidade referida (IMR) com a finalidade de reunir dados sobre a natureza da lesão, região corporal e aparelho ginástico. Os dados foram organizados e apresentados sob a forma de distribuição de freqüências e as variáveis, analisadas segundo nível de associação a partir do teste de Goodman para contrastes entre populações multinomiais, considerando significante o valor P INTRODUCTION: The levels of biomechanical demands due to the high level of difficulty in the gestures accomplishment make Artistic Gymnastics (AG) a modality with high risk of injuries. Thus, it is necessary that the aspects concerned with them are controlled. OBJECTIVE: To analyze the occurrence of injuries in artistic gymnastics, associating them with specific risk factors of the modality and of the athlete from reported morbidity survey. METHODS: 54 gymnasts randomly recruited have been interviewed and classified according to their competitive level into two categories: regional and national. The reported morbidity questionnaire (RMQ) was used with the purpose to collect data on the injury's nature, body region and gymnastic apparatus. Data were organized and presented under frequency distribution and analyzed variables. The variables were analyzed according to their level of association from the Goodmann's test for contrasts between multinomials populations considering significant value p<0.05. RESULTS: 39 (71.70%) athletes have reported injury during the season, being 22 of them (56.41) women and 17 (43.59%) men. In the regional male and female categories and in the national female, the largest reported occurrence of injuries was articular, corresponding to 55.56%, 50% and 45.45% of the total, respectively. For the national female category, the lower limbs were the most affected (68.18%). In female, the most frequent injuries occurred in the jumps (79.41%), while in national male the highest number of complaints has been reported in the support and suspension moves (72%). CONCLUSIONS: There is high frequency of injuries, especially in the joints and lower limbs, being the jump events the most mentioned concerning occurrence. It has also been observed that the higher the level of demand, the higher the occurrence of injuries

Swedish teamgym : injury incidence, mechanism, diagnosis and postural control [Elektronisk resurs]

Teamgym is a fairly new and popular form of gymnastics originating in Scandinavia. Among the gymnastics disciplines teamgym attracts the highest number of gymnasts in Sweden. The discipline differs in several ways from the most known form of gymnastics, artistic gymnastics. It is therefore important to study injury incidence, mechanism and diagnosis in teamgym to be able to develop relevant injury prevention programs. Aim: The main aim of the present thesis was to study injury incidence, injury mechanism, injury site and diagnosis in Swedish teamgym. A second aim was to evaluate if specific exercises for segmental muscle control of the lumbar spine can prevent or reduce low back pain in young female gymnasts. A third aim was to study if, and in that case how, low back pain or lower extremity injuries influence postural control, and also to evaluate the reliability of postural control measurements. Material and method: This thesis included gymnasts during practice and competition. One hundred and eighty-eight gymnasts answered a questionnaire during a National Championship for male and female juniors as well as seniors (study I). Forty-two top level senior male and female gymnasts were followed during one season of training and competition and injuries were registered with respect to diagnosis and mechanism (study II). Fifty-one young top level female gymnasts reported low back pain during a period of 12 weeks. At inclusion they were divided in one intervention group and one control group. After four weeks of baseline an eight-week training program including specific exercises for segmental muscle control of the lumbar spine was introduced and evaluated (study III). Finally, fifty-seven female gymnasts were measured in upright standing on an AMTI force platform (study IV). They were measured standing on hard and foam surface with eyes open and eyes closed during 120 seconds, respectively. A test-retest was conducted to determine the reliability of these measurements. Results: Teamgym gymnasts practice and compete in spite of symptoms from injuries. The injury incidence in top level teamgym was 2.2 / 1000 gymnastics hours, and there was no difference between male and female gymnasts. Most injuries were found in the lower extremity, with the ankle joint being most often injured. The second most injured site was the lower back, where muscle and ligament injuries were represented. The most frequent injury mechanisms were joint compression, joint rotation and hyperextension, and the landing phase of the gymnastics skill was most critical. Half of the injuries were reported at the end of the training session and often while the gymnasts were in a negative state of mood such as stressed or afraid. Gymnasts with low back pain did not experience pain every day. During a period of one month 24 out of 51 gymnasts reported low back pain between one and 28 days. After an eight-week training period with specific exercises for segmental muscle control of the lumbar spine, the intervention group was significantly improved with respect to less number of days with low back pain. A tendency towards the opposite was revealed in the control group. Gymnasts with low back pain showed a larger area of center of pressure, standing on foam surface with eyes closed, than gymnasts with lower extremity injuries. Only gymnasts with low back pain reported pain at the test occasions. Tests with eyes closed were more reliable than tests with eyes open and tests during 120 seconds were in most cases more reliable than tests during 60 seconds. Conclusions: Top level teamgym gymnasts practice and compete in spite of symptoms from injuries. The ankle joint and the lower back are the most common sites for injuries. Gymnasts with low back pain show altered postural control compared to gymnasts with lower extremity injury. This may be due to pain. A specific muscle training program of the local lumbar muscles reduced the number of days with low back pain in young female gymnasts

Características das lesões desportivas e fatores associados com lesão em iniciantes de ginástica artística do sexo feminino

The artistic gymnastics is a modality that associates arts with biomechanical gestures, and it has been prominent among children and adolescents. Its practice can lead to sports injuries; therefore, it is important to know the factors inherent to trauma for the formulation of preventive models. Thus, the objective of this study was to characterize sports injuries and to verify factors associated with injury in people practicing artistic gymnastics with different levels of competitiveness. Forty-six gymnasts were interviewed with mean age of 10.1±2.0 years for female participants, who were classified in two competitive levels, i.e, initiation and training. We used the morbidity questionnaire adapted to sports characteristics to collect personal, training, and injury data. It was observed that injury risk was 0.3 injuries per athlete and 1.4 injuries per injured athlete, in which the gymnasts of the training category showed a higher frequency of the injury (83.3%; n=10) compared with the ones in the initiation category (10.5%; n=4). For both levels of competitiveness, training moment and light severity were the most reported variables. In the mechanism, contactless was more prevalent in the training category (90%; n=9) and the direct contact was more common at initiation category (75%; n=3). Anthropometric and training variables were considered as factors associated with injury to the gymnasts. It is concluded that gymnasts of the training category have higher injury frequency. Anthropometric and training variables were factors associated with injury. Characteristics of the injuries depend on the competitiveness level of the ­gymnasts.A ginástica artística é uma modalidade que combina arte a gestos biomecânicos e tem se destacado entre crianças e adolescentes. Sua prática pode conduzir a lesões desportivas, por isso é importante conhecer os fatores inerentes ao traumatismo para formulação de modelos preventivos. Desse modo, objetivou-se caracterizar as lesões desportivas e verificar os fatores associados com lesão em praticantes de ginástica artística de diferentes níveis de competitividade. Foram entrevistadas 46 ginastas, com média de idade de 10,1±2,0 anos do sexo feminino, classificadas em dois níveis competitivos: iniciação e treinamento. Utilizou-se o inquérito de morbidade referida adaptado com as características da modalidade para reunir dados pessoais, de treinamento e da lesão. Foram observadas 0,3 lesões por atleta e 1,4 lesões por atleta lesionado, em que ginastas da categoria de treinamento apresentaram maior frequência de lesão (83,3%; n=10) do que as de iniciação (10,5%; n=4). Para ambos os níveis, o momento treinamento e a gravidade leve foram os mais relatados. No mecanismo, o sem contato foi mais prevalente na categoria de treinamento (90%; n=9) e o contato direto foi o mais frequente na iniciação (75%; n=3). As variáveis antropométricas e de treinamento foram consideradas fatores associados com lesão para as ginastas. Conclui-se que ginastas da categoria de treinamento possuem maior frequência de lesão. As variáveis antropométricas e de treinamento foram fatores associados com lesão. As características das lesões dependem do nível de competitividade das ginastas.La gimnasia artística es una modalidad que combina arte y gestos biomecánicos, y es destacada entre niños y adolescentes. Su práctica puede conducir a lesiones deportivas, por eso es importante conocer los factores inherentes al traumatismo para la formulación de modelos preventivos. De ese modo, el objetivo de este estudio es caracterizar las lesiones deportivas y verificar los factores asociados con lesión en practicantes de gimnasia artística de diferentes niveles de competitividad. Fueron entrevistadas 46 gimnastas, con edad media de 10,1±2,0 años de sexo femenino, clasificadas en dos niveles competitivos: iniciación y entrenamiento. Se utilizó la encuesta de morbilidad adaptada a las características de este deporte para recabar datos personales, de entrenamiento y de lesión. Fueron observadas 0,3 lesiones por atleta y 1,4 lesiones por atleta lesionado, en que gimnastas de la categoría de entrenamiento presentaron mayor frecuencia de lesión (83,3%; n=10) comparadas con las de iniciación (10,5%, n=4). Para ambos niveles, el momento de entrenamiento y la gravedad leve fueron los más relatados. En cuanto al mecanismo, el sin contacto fue el más prevalente en la categoría de entrenamiento (90%; n=9) y de contacto directo fue el más frecuente en la iniciación (75%; n=3). Las variables antropométricas y de entrenamiento fueron consideradas factores asociados con lesión para las gimnastas. Se concluye que las gimnastas de la categoría de entrenamiento poseen mayor frecuencia de lesión. Las variables antropométricas y de entrenamiento fueron factores asociados con lesión. Las características de las lesiones dependen del nivel de competitividad de las gimnastas

Spine Day 2012: spinal pain in Swiss school children- epidemiology and risk factors

BACKGROUND: The key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents. Based on the data of Spine Day 2012 (an annual action day where Swiss school children were examined by chiropractors on a voluntary basis for back problems), the aim of the present study was to gain systematic epidemiologic data on adolescent spinal pain in Switzerland and to explore risk factors per gender and per spinal area. METHOD: Data (questionnaires and physical examinations) of 836 school children were descriptively analyzed for prevalence, recurrence and severity of spinal pain. Of those, 434 data sets were included in risk factor analysis. Using logistic regression analysis, psycho-social parameters (presence of parental back pain, parental smoking, media consumption, type of school bag) and physical parameters (trunk symmetry, posture, mobility, coordination, BMI) were analyzed per gender and per spinal area. RESULTS: Prevalence of spinal pain was higher for female gender in all areas apart from the neck. With age, a steep increase in prevalence was observed for low back pain (LBP) and for multiple pain sites. The increasing impact of spinal pain on quality of life with age was reflected in an increase in recurrence, but not in severity of spinal pain. Besides age and gender, parental back pain (Odds ratio (OR)=3.26, p=0.011) and trunk asymmetry (OR=3.36, p=0.027) emerged as risk factors for spinal pain in girls. Parental smoking seemed to increase the risk for both genders (boys: OR=2.39, p=0.020; girls: OR=2.19, p=0.051). Risk factor analysis per spinal area resulted in trunk asymmetry as risk factor for LBP (OR=3.15, p=0.015), while parental smoking increased the risk for thoracic spinal pain (TSP) (OR=2.83, p=0.036) and neck pain (OR=2.23, p=0.038). The risk for TSP was further enhanced by a higher BMI (OR=1.15, p=0.027). CONCLUSION: This study supports the view of adolescent spinal pain as a bio-psycho-social problem that should be investigated per spinal area, age and gender. The role of trunk asymmetry and passive smoking as risk factors as well as the association between BMI and TSP should be further investigated, preferably in prospective studies