{"title":"Assessing the risk of lumbar degenerative disc disease associated with swimming: A systematic review.","authors":"Connie Hsu, Timothy Genovese, Kelly C McInnis","doi":"10.1002/pmrj.13138","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the current study is to synthesize the outcomes of investigations reporting the odds of lumbar degenerative disc disease (DDD) in competitive swimmers compared to controls.</p><p><strong>Literature survey: </strong>PubMed, Embase, and Web of Science databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from inception until March 2023 to identify relevant studies evaluating the risk for lumbar DDD associated with swimming.</p><p><strong>Methods: </strong>Data in the current literature were synthesized for positive imaging findings of DDD at one or more lumbar level in swimmers compared to nonswimmers. Additionally, data regarding prevalence of lumbar disc degeneration and back pain in competitive swimmers were synthesized.</p><p><strong>Synthesis: </strong>Four studies were included in the final analysis. Study quality and risk of bias were deemed adequate. There was significant heterogeneity among studies (I<sup>2</sup> = 0.74) regarding data collected, population of swimmers, sample size, and methods. Therefore, a meta-analysis was not conducted. Three of the four studies included in this review reported that swimmers have increased odds of developing lumbar DDD. Additionally, secondary outcome analysis indicated that swimmers have a higher probability of developing moderate-to-severe back pain.</p><p><strong>Conclusion: </strong>Competitive swimming appears to be associated with the presence of DDD on advanced imaging and moderate-to-severe back pain. These findings are limited by significant differences in study methodology in the included studies. Although swimming is conventionally considered a low-impact sport, elite swimmers risk developing lower back pain and disc pathology, possibly because training involves unique biomechanics with repetitive rotational and hyperextension/flexion of the spine. Further research investigating risk factors involving biomechanics of swimming on the spine may have important implications for stroke technique, injury prevention, and rehabilitation for swimmers.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1012-1022"},"PeriodicalIF":2.2000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PM&R","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/pmrj.13138","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The purpose of the current study is to synthesize the outcomes of investigations reporting the odds of lumbar degenerative disc disease (DDD) in competitive swimmers compared to controls.
Literature survey: PubMed, Embase, and Web of Science databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from inception until March 2023 to identify relevant studies evaluating the risk for lumbar DDD associated with swimming.
Methods: Data in the current literature were synthesized for positive imaging findings of DDD at one or more lumbar level in swimmers compared to nonswimmers. Additionally, data regarding prevalence of lumbar disc degeneration and back pain in competitive swimmers were synthesized.
Synthesis: Four studies were included in the final analysis. Study quality and risk of bias were deemed adequate. There was significant heterogeneity among studies (I2 = 0.74) regarding data collected, population of swimmers, sample size, and methods. Therefore, a meta-analysis was not conducted. Three of the four studies included in this review reported that swimmers have increased odds of developing lumbar DDD. Additionally, secondary outcome analysis indicated that swimmers have a higher probability of developing moderate-to-severe back pain.
Conclusion: Competitive swimming appears to be associated with the presence of DDD on advanced imaging and moderate-to-severe back pain. These findings are limited by significant differences in study methodology in the included studies. Although swimming is conventionally considered a low-impact sport, elite swimmers risk developing lower back pain and disc pathology, possibly because training involves unique biomechanics with repetitive rotational and hyperextension/flexion of the spine. Further research investigating risk factors involving biomechanics of swimming on the spine may have important implications for stroke technique, injury prevention, and rehabilitation for swimmers.
目的：本研究的目的是综合报告竞技游泳运动员与对照组相比患腰椎间盘退行性病变（DDD）几率的调查结果：根据《系统综述和元分析首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses）指南，检索了从开始到2023年3月的PubMed、Embase和Web of Science数据库，以确定评估与游泳相关的腰椎间盘退行性病变风险的相关研究：方法：综合现有文献中关于游泳者与非游泳者一个或多个腰椎水平 DDD 的阳性成像结果的数据。此外，还综合了有关竞技游泳运动员腰椎间盘变性和背痛患病率的数据：最终分析包括四项研究。研究质量和偏倚风险被认为是适当的。在收集的数据、游泳运动员人群、样本大小和方法方面，各研究之间存在明显的异质性（I2 = 0.74）。因此，没有进行荟萃分析。本研究纳入的大多数研究（四项研究中的三项）都报告称，游泳者患腰椎间盘突出症的几率增加。此外，次要结果分析表明，游泳运动员患中度至重度背痛的几率更高：结论：竞技游泳似乎与高级成像显示的腰椎间盘突出症和中重度背痛有关。由于所纳入研究的研究方法存在显著差异，这些发现受到了限制。虽然游泳在传统上被认为是一项低冲击运动，但精英游泳运动员仍有可能患上下背痛和椎间盘病变，这可能是因为训练涉及独特的生物力学，脊柱会反复旋转和过度伸展/屈曲。进一步研究游泳生物力学对脊柱影响的风险因素，可能会对游泳运动员的划水技术、损伤预防和康复产生重要影响。
期刊介绍：
Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.
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