Potential neurophysiological and biomechanical risk factors for sport-related back problems:A scoping review

This scoping review aims(1)to map the literature dealing with neurophysiological and biomechanical aspects of back problems in athletes in order to identify valid risk-factors for their prevention,plus(2)to identify gaps in the existing research and propose suggestions for future studies.A literature search conducted with Scopus,Web of Science,MEDLINE and Cochrane Library was completed by Elsevier,SpringerLink and Google Scholar.The main neurophysiological risk factors identified leading to back problems in athletes are neuromuscular imbalance,increased muscle fatigability,muscle dysfunction and impaired motor control,whilst biomechanical risk factors include maladaptive spinal,spinopelvic and lower limb kinematics,side-to-side imbalances in axial strength and hip rotation range of motion,spinal overloading and deficits in movement pattern.However,most studies focused on back pain in the lumbar region,whereas less attention has been paid to thoracic and cervical spine problems.The range of sports where this topic has been studied is relatively small.There is a lack of research in sports in which the core muscles are highly involved in specific movements such as lifting weights or trunk rotations.A limited number of studies include female athletes and master athletes of both genders.In addition to chronic back pain patients,it is equally important to conduct research on healthy athletes with a predisposition to spine problems.Investigators should focus their empirical work on identifying modifiable risk factors,predict which athletes are at risk for back problems,and develop personalized sport-specific assessment tools and targeted prevention strategies for them.

Finite Element Analysis of Porous Titanium Alloy Hip Stem to Evaluate the Biomechanical Performance During Walking and Stair Climbing

Despite the success of cementless hip stem,stress shielding still presents a serious problem leading to bone resorption.Stems incorporating porous cellular structures represent a promising solution.Therefore,this study validates the finite element models of titanium(Ti)alloy(Ti-6Al-4V)porous stem and effective porous stems.Several effective porous stems with strut thicknesses 0.33 mm-1.25 mm(18%-90%porosity)under different loading conditions were analyzed.The results of finite element models revealed that changing the load type and porosity affect stress shielding.Climbing loads yield the maximum stress levels while walking loads result in the lowest stresses in the stems.Furthermore,the point load results in the maximum stress shielding and micromotions(-19% to 18%,40μm to 703μm),as compared to walking(-17.5% to 3%,35μm to 242μm)and climbing loads(-7% to 1.6%,30μm to 221 μm).Finally,effective porous stems of strut thickness 0.87 mm exhibit the lowest stress shielding signals(<5%)under all loading conditions.