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Back pain is a problem in adolescent athletes affecting postural control which is an important requirement for physical and daily activities whether under static or dynamic conditions. One leg stance and star excursion balance postural control tests are effective in measuring static and dynamic postural control respectively. These tests have been used in individuals with back pain, athletes and non-athletes without first establishing their reliabilities. In addition to this, there is no published literature investigating dynamic posture in adolescent athletes with back pain using the star excursion balance test. Therefore, the aim of the thesis was to assess deficit in postural control in adolescent athletes with and without back pain using static (one leg stance test) and dynamic postural (SEBT) control tests.
Adolescent athletes with and without back pain participated in the study. Static and dynamic postural control tests were performed using one leg stance and SEBT respectively. The reproducibility of both tests was established. Afterwards, it was determined whether there was an association between static and dynamic posture using the measure of displacement of the centre pressure and reach distance respectively. Finally, it was investigated whether there was a difference in postural control in adolescent athletes with and without back pain using the one leg stance test and the SEBT.
Fair to excellent reliabilities was recorded for the static (one leg stance) and dynamic (star excursion balance) postural control tests in the subjects of interest. No association was found between variables of the static and dynamic tests for the adolescent athletes with and without back pain. Also, no statistically significant difference was obtained between adolescent athletics with and without back pain using the static and dynamic postural control test.
One leg stance test and SEBT can be used as measures of postural control in adolescent athletes with and without back pain. Although static and dynamic postural control might be related, adolescent athletes with and without back pain might be using different mechanisms in controlling their static and dynamic posture. Consequently, static and dynamic postural control in adolescent athletes with back pain was not different from those without back pain. These outcome measures might not be challenging enough to detect deficit in postural control in our study group of interest.
Achilles (AT) and patellar tendons (PT) are commonly affected by tendinopathy in adult athletes but prevalence of symptoms and morphological changes in adolescents is unclear. The study aimed to determine prevalence of tendinopathy and intratendinous changes in ATs and PTs of adolescent athletes. A total of 760 adolescent athletes (13.0 +/- 1.9 years; 160 +/- 13cm; 50 +/- 14kg) were examined. History, local clinical examination, and longitudinal Doppler ultrasound analysis for both ATs and PTs were performed including identification of intratendinous echoic changes and vascularization. Diagnosis of tendinopathy was complied clinically in case of positive history of tendon pain and tendon pain on palpation. Achilles tendinopathy was diagnosed in 1.8% and patellar tendinopathy in 5.8%. Vascularizations were visible in 3.0% of ATs and 11.4% of PTs, hypoechogenicities in 0.7% and 3.2% as well as hyperechogenicities in 0% and 0.3%, respectively. Vascularizations and hypoechogenicities were statistically significantly more often in males than in females (P0.02). Subjects with patellar tendinopathy had higher prevalence of structural intratendinous changes than those without PT symptoms (P0.001). In adolescent athletes, patellar tendinopathy is three times more frequent compared with Achilles tendinopathy. Longitudinal studies are necessary to investigate physiological or pathological origin of vascularizations and its predictive value in development of tendinopathy.