Date of Award

2010

Degree Type

Thesis

Degree Name

Doctor of Philosophy

School

School of Exercise, Biomedical and Health Sciences

Faculty

Computing, Health and Science

First Advisor

Dr Angus Burnett

Second Advisor

Dr Peter O'Sullivan

Abstract

Rowing is one of the largest participant sports on the Independent Girls‟ Schools Sporting Association (IGSSA) in Western Australia with approximately 400 participants competing every year. Rowing is an extra-curricular sport offered to girls 14 years of age and above, with these girls competing and training in both sweep and scull boats. Whilst the benefits of regular physical activity and exercise are well known, musculoskeletal problems have been documented in rowing. In particular, clinical evidence and previous research suggests that low back pain (LBP) is common in rowers. Adolescents who suffer from LBP are at an increased risk of recurrent and chronic LBP during adulthood therefore, this is a critical period to investigate the development of LBP. Therefore, the aim of this doctoral research was to examine LBP amongst the IGSSA rowing population in Western Australia. As the aetiology of LBP is known to be multi-factorial, the problem was investigated from a bio-psycho-social perspective. This thesis contains three studies with data collected over a two year period. These studies are described below.

In the first study, an investigation of the incidence of LBP and the levels of LBP and LBP-related disability for rowers and non-rowers was undertaken. Scoping data on self-reported factors that “bring on” or exacerbate LBP, training hours completed per week and boats most frequently rowed in was also collected in rowers. From this study, it was identified that there was a significantly higher prevalence of LBP in the group of 356 Schoolgirl rowers when compared with 496 non-rowing controls. Further, there was a significant difference evident for pain incidence between Year 9 and Year 10 rowers. Rowers also showed significantly greater pain and disability scores when compared with non-rowers. A number of self-reported rowing-related and habitual factors were associated with LBP in rowers.

The second study of this thesis investigated a sub-sample of Schoolgirl rowers from the first study. Specifically, rowers with LBP (N=30) and without LBP (N=30) participated in a cross-sectional study to determine the physical and psycho-social variables associated with LBP. In addition to measuring the levels of pain and disability in the rowers, this study examined physical factors such as static lumbo-pelvic postures, spinal proprioception, isometric back and lower limb muscle endurance, joint hypermobility, and the psycho-social factors of beliefs about back pain, fear of movement with back pain, as well as the tendency for anxious and depressed behaviour. A secondary aim of the study was to classify the patterns of motor control impairment evident in those with LBP. The majority of the rowers were clinically classified with deficits in flexion or multi-directional segmental spinal control. Factors associated with LBP were reduced lower limb and back muscle endurance, and a general pattern for less accuracy and greater variability in lumbar spine repositioning sense.

In the final study of this thesis a non-randomised controlled trial was conducted to decrease the prevalence of LBP and associated levels of pain and disability in a group of Schoolgirl rowers. In this novel study an intervention group consisting of 90 schoolgirl rowers from one school and a control group consisting of 131 participants from three other schools were recruited. The multi-dimensional intervention strategy consisted of physiotherapy screening, prescription of individualised “specific exercise”, follow up sessions, a back pain education talk and off-water strength and conditioning sessions. Primary outcome variables were collected for both the intervention and control groups at the commencement of rowing training, midway through the rowing season, at the completion of the rowing season and three months after the season had concluded. Primary outcome variables included the incidence of LBP and related levels of pain and disability whilst secondary outcome variables from the bio-psycho-social domain were measured at the start of the season and the end of the season in the intervention group only. From this study it was concluded that rowers have a high incidence of LBP but a multi-dimensional intervention program can be implemented to decrease the LBP incidence and the associated levels of pain and disability. Several secondary outcome variables considered to be of importance in LBP also significantly improved including physical fitness (aerobic conditioning, lower limb and back muscle endurance and sit and reach flexibility) and seated posture (usual and slump sitting). Further, improvements were seen in scores from the Child Behaviour Checklist.

This doctoral thesis has investigated a real world problem and has subsequently been used to formulate policy amongst the IGSSA schools in Western Australia. Further research is needed to determine the respective long-term results with respect to LBP and further randomised controlled studies are required to further validate the findings.

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