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Health benefits of participation in selected ‘hard’ martial arts for adults: A systematic review
Abstracts / Journal of Science and Medicine in Sport 20S (2017) e32–e66
endurance exercise is effective in ameliorating glucose control, requires more extensive investigation. http://dx.doi.org/10.1016/j.jsams.2017.01.118 96 Health benefits of participation in selected ‘hard’ martial arts for adults: A systematic review S. Origua Rios 1,∗ , J. Marks 1 , I. Estevan 2 , L. Barnett 1 1
School of Health and Social Development, Deakin University, Australia 2 Department of Teaching of Music, Plastic and Corporal Expression, University of Valencia, Spain Background: Physical inactivity is associated with chronic disease. Participation in organized sports has been promoted as a means of increasing levels of physical activity in adults. Among organized sports, martial arts practice has recently gained popularity amongst adults. This review explores the evidence for health benefits of ‘hard’ martial arts, defined as those relying on strikes, blocks and throws and the confrontation of force by force. It focuses on karate, taekwondo and kung fu to determine whether adults can engage in such activities to improve their health. Methods: An electronic search on selected EBSCOHost databases and Scopus was conducted between March and July 2015. Studies were eligible for inclusion if: in English; peer reviewed; conducted in populations over the age of 18 years; they examined physical and/or psychological effects resulting from ‘hard’ martial arts practice with the potential to reduce risks of poorer health outcomes in the adult population; they included kung fu, karate or taekwondo and were quantitative in design. Studies were excluded if they: aimed at enhancing performance for competition or were conducted in competitions in the selected martial arts; examined ‘soft’ martial arts, such as tai chi; reported solely on injuries and were literature reviews, theses or dissertations. The Effective Public Health Practice Project (EPHPP) tool was used for quality assessment. Results/discussion: Fourteen studies met the inclusion criteria. Studies examined effects on balance, cognitive function, bone mineral density, psychological and other health effects. The majority of studies reported positive effects resulting from the practice of karate, taekwondo and kung fu, showing some improvement or maintenance of balance, cognitive function and psychological health, particularly in middle-aged and older adults. Benefits may be obtained regardless of the age of practice commencement. However, quality of the evidence is affected by methodological weaknesses across the studies. Conclusion: ‘Hard’ martial arts seem to have potential to improve balance and cognitive functions that decline with age and may help prevent poorer health outcomes in adults. Risk of injuries can be seen as a concern with martial arts practice, however, the literature reports lower injury rates compared with other sports. Moreover, the majority of injuries are minor and severe injuries are rare. Injuries could be decreased by reducing or, in some cases, suppressing sparring (fighting) practice. Benefits should be further investigated with Randomized Controlled Trials, representative samples and longer follow-up periods in order to establish associations with morbidity and mortality in the long term. http://dx.doi.org/10.1016/j.jsams.2017.01.119
e43
97 Biological cell therapies for discogenic low back pain B. Mitchell 1,∗ , D. Bates 1 , P. Verrills 1 , D. Vivian 1 , A. Barnard 2 1 2
Metro Pain Group, Australia Monash Clinical Research, Australia
Introduction: Biological therapies use the body’s natural mechanisms to treat disease. For lower back pain, therapies include a range of increasingly purified and targeted biological products from the blood derived platelet-rich plasma to the more specialised adipose tissue derived and expanded mesenchymal stem cells (MSCs). MSCs have been shown to reduce pain and induce repair in osteoarthritis and disc-related lower back pain. A study of 100 patients showed significant pain relief and improvements 24 months after therapy in patients with chronic lower back pain1 whilst a 10-patient study showed improvements in chronic low back pain as early as three months.2 Purpose/aim: To present an initial case series of patients undergoing ethics approved cell therapy for the treatment of discogenic low back pain. Materials and methods: Patients with diagnosed discogenic pain underwent a liposuction procedure to extract adipose tissue. Under strict regulatory and ethical guidelines, MSCs were purified from the adipose tissue and expanded. Expanded MSCs were independently tested for sterility and characterised via flow cytometry prior to be injected into the symptomatic disc. Patients received 10 × 106 MSCs per disc, with a maximum of two discs injected on any one occasion to limit the post procedural pain flare. Patient outcomes are scheduled to be collected at baseline and at 3-, 6-, 9- and 12-months post injection. Outcome measures include pain (NRS), quality of life (EQ-5D), disability (ODI), analgesic use, and psychometrics (DASS21). The study has received ethics approval. Results: To date, three patients have undergone MSC therapy for discogenic pain and are at 3 weeks post injection. All three patients have reported significant pain relief with an average reduction from a baseline NRS of 7.6 ± 2.4 to 3.8 ± 2.1 at 3 weeks follow up. No adverse events have been reported. A full case series will be available at the meeting. Conclusion(s): Biological cell therapies are a proving to be a promising and minimally invasive alternative to traditional surgical options for discogenic back pain. Strict adherence to ethical and regulatory guidelines will enable the further development of this therapy. http://dx.doi.org/10.1016/j.jsams.2017.01.120 98 Movement and muscle activation patterns following medial branch blocks for facet joint pain, and sacroiliac injections for sacroiliac joint pain B. Mitchell 1,∗ , N. DuToit 1 , A. Barnard 2 , B. Laznitski 2 1 2
Metro Pain Group, Australia Monash Clinical Research, Australia
Introduction: Relaxation of the erector spinae often occurs in healthy individuals as full trunk flexion is achieved when bending forward from standing. This phenomenon, referred to as flexion relaxation is often absent or disrupted (EMG activity persists) in individuals reporting low back pain (LBP). While many studies
endurance exercise is effective in ameliorating glucose control, requires more extensive investigation. http://dx.doi.org/10.1016/j.jsams.2017.01.118 96 Health benefits of participation in selected ‘hard’ martial arts for adults: A systematic review S. Origua Rios 1,∗ , J. Marks 1 , I. Estevan 2 , L. Barnett 1 1
School of Health and Social Development, Deakin University, Australia 2 Department of Teaching of Music, Plastic and Corporal Expression, University of Valencia, Spain Background: Physical inactivity is associated with chronic disease. Participation in organized sports has been promoted as a means of increasing levels of physical activity in adults. Among organized sports, martial arts practice has recently gained popularity amongst adults. This review explores the evidence for health benefits of ‘hard’ martial arts, defined as those relying on strikes, blocks and throws and the confrontation of force by force. It focuses on karate, taekwondo and kung fu to determine whether adults can engage in such activities to improve their health. Methods: An electronic search on selected EBSCOHost databases and Scopus was conducted between March and July 2015. Studies were eligible for inclusion if: in English; peer reviewed; conducted in populations over the age of 18 years; they examined physical and/or psychological effects resulting from ‘hard’ martial arts practice with the potential to reduce risks of poorer health outcomes in the adult population; they included kung fu, karate or taekwondo and were quantitative in design. Studies were excluded if they: aimed at enhancing performance for competition or were conducted in competitions in the selected martial arts; examined ‘soft’ martial arts, such as tai chi; reported solely on injuries and were literature reviews, theses or dissertations. The Effective Public Health Practice Project (EPHPP) tool was used for quality assessment. Results/discussion: Fourteen studies met the inclusion criteria. Studies examined effects on balance, cognitive function, bone mineral density, psychological and other health effects. The majority of studies reported positive effects resulting from the practice of karate, taekwondo and kung fu, showing some improvement or maintenance of balance, cognitive function and psychological health, particularly in middle-aged and older adults. Benefits may be obtained regardless of the age of practice commencement. However, quality of the evidence is affected by methodological weaknesses across the studies. Conclusion: ‘Hard’ martial arts seem to have potential to improve balance and cognitive functions that decline with age and may help prevent poorer health outcomes in adults. Risk of injuries can be seen as a concern with martial arts practice, however, the literature reports lower injury rates compared with other sports. Moreover, the majority of injuries are minor and severe injuries are rare. Injuries could be decreased by reducing or, in some cases, suppressing sparring (fighting) practice. Benefits should be further investigated with Randomized Controlled Trials, representative samples and longer follow-up periods in order to establish associations with morbidity and mortality in the long term. http://dx.doi.org/10.1016/j.jsams.2017.01.119
e43
97 Biological cell therapies for discogenic low back pain B. Mitchell 1,∗ , D. Bates 1 , P. Verrills 1 , D. Vivian 1 , A. Barnard 2 1 2
Metro Pain Group, Australia Monash Clinical Research, Australia
Introduction: Biological therapies use the body’s natural mechanisms to treat disease. For lower back pain, therapies include a range of increasingly purified and targeted biological products from the blood derived platelet-rich plasma to the more specialised adipose tissue derived and expanded mesenchymal stem cells (MSCs). MSCs have been shown to reduce pain and induce repair in osteoarthritis and disc-related lower back pain. A study of 100 patients showed significant pain relief and improvements 24 months after therapy in patients with chronic lower back pain1 whilst a 10-patient study showed improvements in chronic low back pain as early as three months.2 Purpose/aim: To present an initial case series of patients undergoing ethics approved cell therapy for the treatment of discogenic low back pain. Materials and methods: Patients with diagnosed discogenic pain underwent a liposuction procedure to extract adipose tissue. Under strict regulatory and ethical guidelines, MSCs were purified from the adipose tissue and expanded. Expanded MSCs were independently tested for sterility and characterised via flow cytometry prior to be injected into the symptomatic disc. Patients received 10 × 106 MSCs per disc, with a maximum of two discs injected on any one occasion to limit the post procedural pain flare. Patient outcomes are scheduled to be collected at baseline and at 3-, 6-, 9- and 12-months post injection. Outcome measures include pain (NRS), quality of life (EQ-5D), disability (ODI), analgesic use, and psychometrics (DASS21). The study has received ethics approval. Results: To date, three patients have undergone MSC therapy for discogenic pain and are at 3 weeks post injection. All three patients have reported significant pain relief with an average reduction from a baseline NRS of 7.6 ± 2.4 to 3.8 ± 2.1 at 3 weeks follow up. No adverse events have been reported. A full case series will be available at the meeting. Conclusion(s): Biological cell therapies are a proving to be a promising and minimally invasive alternative to traditional surgical options for discogenic back pain. Strict adherence to ethical and regulatory guidelines will enable the further development of this therapy. http://dx.doi.org/10.1016/j.jsams.2017.01.120 98 Movement and muscle activation patterns following medial branch blocks for facet joint pain, and sacroiliac injections for sacroiliac joint pain B. Mitchell 1,∗ , N. DuToit 1 , A. Barnard 2 , B. Laznitski 2 1 2
Metro Pain Group, Australia Monash Clinical Research, Australia
Introduction: Relaxation of the erector spinae often occurs in healthy individuals as full trunk flexion is achieved when bending forward from standing. This phenomenon, referred to as flexion relaxation is often absent or disrupted (EMG activity persists) in individuals reporting low back pain (LBP). While many studies