Lumbar Spine on MRI and Low Back Pain in Elite Cross-country Skiers

The investigators will examine the prevalence of low-back pain and disc degeneration among Finnish elite skiers between 16 and 35 years of age and compare these findings with the data collected among healthy volunteers studied between 1994-2021.

Study Overview

• Status: Completed
• Conditions: Disc Degeneration

Detailed Description

The study population will consist of Finnish elite cross-country skiers between 18 and 35 years of age. Invitation letters will be sent to all skiers who are selected to national teams at season 2022-2023. The study population for the current study will be approximately 100 individuals. Study protocol for the current study will consist of a semi-structured interview, clinical examination, lumbar spine MRI and patient reported outcome measures. All participants will sign an informed consent before commencement of the study. If a participant is younger than 18 years, also his/her caregiver will be asked for a signed consent.

The interview comprised of questions about the athletes training volume and possible LBP without associated trauma. (suspension from training or competition due to LBP, possible contacts to health-care providers).

Body height and weight were self-reported. Leg length inequality was assessed comparing the height of the left and right iliac crests in standing position with straight knees. Wooden blocks of different thickness (with 0.5 cm increment) were used for correction of possible leg length inequality. Symmetry of the back was measured in forward bending using a scoliometer.

From MRI (high field 1.5 T) the signal intensity of the nucleus pulposus will be assessed both qualitatively and quantitatively. The midline T2-weighted images will be independently evaluated visually by three evaluators using a Pfirrmann classification. The quantitative nucleus signal intensities will be assessed by two evaluators using a relative measure comparing the signal intensity of the nucleus pulposus to that of the adjacent cerebrospinal fluid on T2-weighted images.

• Study Type: Observational
• Enrollment (Actual): 63

Contacts and Locations

Study Locations

• Finland
  • In The USA Or Canada, Please Select...
    • Helsinki, In The USA Or Canada, Please Select..., Finland, 02800
      • Research Institute Orton

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 35 years (Child, Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All skiers who are selected to the national teams at season 2022-2023.

Description

Inclusion Criteria:

• Finnish elite cross-country skiers (national teams from the age of 16)

Exclusion Criteria:

• none

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Low back pain and disc degeneration among elite cross-country skiers; No intervention Interview, clinical examination and MRI
Low back pain and disc degeneration among healthy volunteers; No intervention Interview, clinical examination and MRI

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pfirrmann summary score	Summary score of individual Pfirrmann grades of lumbar discs (L1-L5). Grade is 5 to 25, where 5 is the best value and 25 the worst value.	Baseline
Low back pain (LBP)	Low back pain NRS (numeric rating scale) 0 to 10, where 0 is the best value and 100 is the worst value.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Oswestry Disability Index (ODI)	Oswestry Disability Index, 0 to 100, where 0 is the best value and 100 the worst value.	Baseline
EQ-5D-5L	The health-related quality of life, 0 to 100, where 0 is the worst value and 100 the best value.	Baseline

Collaborators and Investigators

• Sponsor: Orton Orthopaedic Hospital
• Collaborators: Helsinki University Central Hospital; University of Helsinki; Päijät Häme Central Hospital
• Investigators: Study Director: Teija Lund, Helsinki University Hospital and Helsinki University; Principal Investigator: Anni Aavikko, PHHYKY

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2022
• Primary Completion (Actual): June 30, 2023
• Study Completion (Actual): June 30, 2023

Study Registration Dates

• First Submitted: November 29, 2022
• First Submitted That Met QC Criteria: November 29, 2022
• First Posted (Actual): December 8, 2022

Study Record Updates

• Last Update Posted (Actual): November 2, 2023
• Last Update Submitted That Met QC Criteria: October 31, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Keywords: low back pain; disc degeneration; athlete; matched case control
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Spinal Diseases; Bone Diseases; Back Pain; Low Back Pain; Intervertebral Disc Degeneration
• Other Study ID Numbers: 465 (BMT CTN)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No