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Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up
Halmstad University, School of Business, Innovation and Sustainability. Spenshult Research and Development Centre, Halmstad, Sweden.ORCID iD: 0000-0001-9918-461X
Halmstad University, School of Business, Innovation and Sustainability. Spenshult Research and Development Center, Halmstad, Sweden; University of Southern Denmark, Odense, Denmark; University Hospital of Southern Denmark, Sønderborg, Denmark; Lund University, Lund, Sweden.ORCID iD: 0000-0002-8081-579X
Spenshult Research and Development Center, Halmstad, Sweden; Lund University, Lund, Sweden; The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID iD: 0000-0002-6294-538X
Halmstad University, School of Business, Innovation and Sustainability. Spenshult Research and Development Center, Halmstad, Sweden; Lund University, Lund, Sweden.ORCID iD: 0000-0002-1445-5247
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2022 (English)In: BMC Sports Science, Medicine and Rehabilitation, E-ISSN 2052-1847 , Vol. 14, no 1, article id 43Article in journal (Refereed) Published
Abstract [en]

Background: Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance.

Methods: Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never–monthly) or frequent (weekly–almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex.

Results: A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146–13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001–11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033–12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026–12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011–34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength.

Conclusions: Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent. © 2022, The Author(s).

Place, publisher, year, edition, pages
London: BioMed Central (BMC), 2022. Vol. 14, no 1, article id 43
Keywords [en]
Epidemiology, Exercise physiology, Health status, Maturity, Sports performance
National Category
Public Health, Global Health, Social Medicine and Epidemiology Other Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-43031DOI: 10.1186/s13102-022-00437-xISI: 000771455100001PubMedID: 35313966Scopus ID: 2-s2.0-85126734264OAI: oai:DiVA.org:hh-43031DiVA, id: diva2:1463491
Funder
Region Halland, HALLAND-639101Region Halland, HALLAND-469111Halmstad University
Note

Funding: Open access funding provided by Halmstad University. The study was supported financially by Halmstad University; Spenshult Research and Development Center, Halmstad; Region Halland (Grant Numbers HALLAND-469111, HALLAND-639101, and HALLAND-749041); and the Mayflower Charity Foundation, Sweden. The sources of funding had no involvement in the study design, data collection, analysis of data, interpretation of data, writing of the manuscript, or submission for publication.

Available from: 2020-09-02 Created: 2020-09-02 Last updated: 2023-01-02Bibliographically approved
In thesis
1. Pain and health in adolescents and young adults – pieces of a puzzle
Open this publication in new window or tab >>Pain and health in adolescents and young adults – pieces of a puzzle
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Musculoskeletal pain is a burden for the individual and for society, and it has a negative impact on overall health. The biological, psychological, and social factors that govern pain and health form a complex puzzle to put together. Musculoskeletal pain conditions may be alleviated by physical activity, but a too high level of physical activity may also increase the risk of pain. Youth athletes may be especially vulnerable to developing pain due to factors related to training load and physical maturity. Being physically active and maintaining a healthy diet is associated with better health, but if carried out to excess these health behaviours may become unhealthy. Our understanding of musculoskeletal pain and health in adolescents and young adults needs to be developed, both in individuals involved in sports and exercise and in the general population.

Aim: The overall aim was to study musculoskeletal pain and its relationship to various health-related factors in adolescents and young adults enrolled in sport or general education programmes.

Methods: Study I was a cross-sectional study on university students (aged 19–29) from an exercise science programme (n = 118) and a business programme (n = 89), assessing health status, physical activity, and orthorexia nervosa (an exaggerated fixation on healthy food). Study II was a cross-sectional study (n = 178), and Study III a 2-year longitudinal (n = 131) study on sport school students (aged 14 at baseline), assessing musculoskeletal pain, health status, physical maturity, and sports performance. Study IV was a 3-year longitudinal study on students from a general upper secondary school (n = 256, aged 16 at baseline), assessing chronic musculoskeletal pain, health status, physical activity, sleep, stress, anxiety, and depression.

Results: In Study I, compared to business students, exercise science students reported more pain, but better general health. A high level of physical activity in combination with orthorexia nervosa was most prevalent in men from the exercise science programme. In Studies II and III, pain was common in sport school students. At baseline, boys with constant pain were not as physically mature as boys with infrequent pain. Students with constant pain reported a worse health status than students with infrequent pain. At follow-up, frequent pain, frequent pain in two or more body regions, and a worse health status at baseline were identified as risk factors for having frequent pain at follow-up in girls. For boys, late physical maturation at baseline was a risk factor. Involvement in non-contact sports was also an identified risk factor over time in both sexes. Pain was associated with a worse sports performance in boys at both baseline and follow-up. In Study IV, chronic musculoskeletal pain was common in students from a general upper secondary school. A worse health status, severe sleeping problems, anxiety, and chronic musculoskeletal pain at baseline were associated with reporting chronic musculoskeletal pain at follow-up.

Conclusions: Pain was prevalent, and also persistent, in adolescents and young adults, irrespective of attending sport or general education programmes. Pain is a biopsychosocial phenomenon and must be treated as such. Pain should be frequently monitored, and treatment should be introduced early on to prevent pain from becoming persistent.

Place, publisher, year, edition, pages
Halmstad: Halmstad University Press, 2020. p. 113
Series
Halmstad University Dissertations ; 73
Keywords
musculoskeletal pain, health status, physical activity, orthorexia nervosa, sports, sleep, stress, anxiety, depression, physical maturity, students, school, biopsychosocial
National Category
Health Sciences
Identifiers
urn:nbn:se:hh:diva-43044 (URN)978-91-88749-54-3 (ISBN)978-91-88749-55-0 (ISBN)
Public defence
2020-10-09, Baertlingsalen, Visionen (hus J), Kristian IV:s väg 3, Halmstad, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2020-09-08 Created: 2020-09-04 Last updated: 2021-03-26Bibliographically approved

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Malmborg, Julia S.Bremander, AnnBergman, StefanHaglund, EmmaOlsson, M. Charlotte

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