Prevalence of musculoskeletal pain and associated factors in footvolley players in Brazil

ABSTRACT

BACKGROUND AND OBJECTIVES  Footvolley is a new sport that is gaining popularity in Brazil. Several factors contribute to the scarce literature about this sport, such as recent popularization, still-growing practice in the international sphere, and low financial incentives. This study aimed to analyze the prevalence of musculoskeletal pain and associated factors in footvolley players in Brazil.

METHODS  This is a cross-sectional observational study carried out with 629 footvolley players using an online form. Sociodemographic and anthropometric data, time spent practicing, psychosocial factors and pain intensity were collected.

RESULTS  Of the 629 individuals, 450 (71%) were male. More than half of the sample, n=368 (58%), reported being injured while playing footvolley matches, with the lumbar region (41%) being the most affected. Most footvolley players reported pain (54%), and low back pain was the main prevalent condition (46%). Multiple logistic regression analysis showed an association between previous injuries while playing footvolley (OR= 1.56; 95% CI: 1.08-2.25; P= 0.017), being a practitioner of the master category (OR= 8.68; 95% CI: 1.01–74.44; P= 0.049) and the prevalence of pain. Also, it was found that the age group between 18 and 22 years (OR= 0.41; 95% CI: 0.19-0.88; P= 0.023) was a protective factor.

CONCLUSION  Low back pain was prevalent in footvolley players. Players with previous injuries and those in the master category were more likely to report pain. Being aged between 18 and 22 was a protective factor against pain compared to being over 43.

KEYWORDS:
Musculoskeletal pain; Epidemiology; Sport; Footvolley; Sports medicine; Trauma in athletes

HIGHLIGHTS

Low back pain is prevalent in footvolley players

Players with previous injuries and in the master category were more likely to report pain

Being aged between 18 and 22 years was a protection factor to pain compared with being over 43 years

RESUMO

JUSTIFICATIVA E OBJETIVOS  O futevôlei é um esporte novo que vem ganhando popularidade no Brasil. Vários fatores contribuem para a escassa literatura sobre o esporte, como a popularização recente, a prática ainda crescente no âmbito internacional e o baixo incentivo financeiro. O objetivo deste estudo foi analisar a prevalência de dores musculoesqueléticas e fatores associados em jogadores de futevôlei no Brasil.

MÉTODOS  Trata-se de um estudo observacional transversal realizado com 629 jogadores de futevôlei por meio de um formulário online. Foram coletados dados sociodemográficos, antropométricos, tempo de prática, fatores psicossociais e intensidade da dor.

RESULTADOS  Dos 629 indivíduos, 450 (71%) eram do sexo masculino. Mais da metade da amostra, n=368 (58%), relatou ter se lesionado durante partidas de futevôlei, sendo a região lombar (41%) a mais afetada. A maioria dos jogadores de futevôlei relatou dor (54%), sendo a dor lombar a principal condição prevalente (46%). A análise de regressão logística múltipla mostrou associação entre lesões prévias ao jogar futevôlei (OR= 1,56; IC 95%: 1,08-2,25; p= 0,017), ser praticante da categoria master (OR= 8,68; IC 95%: 1,01-74,44); p= 0,049) e a prevalência de dor. Além disso, constatou-se que a faixa etária entre 18 e 22 anos (OR= 0,41; IC 95%: 0,19-0,88; p= 0,023) foi um fator de proteção.

CONCLUSÃO  A dor lombar foi prevalente em jogadores de futevôlei. Jogadores com lesões anteriores e da categoria master tiveram maior probabilidade de relatar dor. Ter idade entre 18 e 22 anos foi um fator de proteção contra a dor em comparação com ter mais de 43 anos.

DESCRITORES:
Dor musculoesquelética; Epidemiologia; Esporte; Futevôlei; Medicina esportiva; Traumatismos em atletas

DESTAQUES

A dor lombar é predominante em jogadores de futevôlei

Os jogadores com lesões anteriores e da categoria master tiveram maior probabilidade de relatar dor

Ter entre 18 e 22 anos de idade foi um fator de proteção para a dor em comparação com ter mais de 43 anos

INTRODUCTION

Footvolley is a sport that originated in the 1960s and became popular worldwide. In the last years new rules, professional athletes, and official competitions have emerged¹ . Footvolley has similar rules to beach volleyball. However, contact between the upper limbs and the ball is not allowed² . Benefits have been attributed to footvolley practice, such as socialization, stress management, body flexibility, and muscle strengthening³ . Footvolley is played on the sand, and footvolley players are exposed to lower limb overload⁴,⁵ . Any sports modality presents injury risk. However, factors such as being overweight and mechanical overload are relevant¹ . Another important factor associated with musculoskeletal injuries is the sports training load. The longer the exposure time, the greater the risk⁶ .

Musculoskeletal pain is a health condition that can affect joints, muscles and tendons and is prevalent in many sports, leading to a decrease in performance⁷,⁸ . Severe pain generates critical disabilities in the domains of activities and participation, according to the International Classification of Functioning, Disability and Health, leading to absenteeism from training and sports practice interruption⁹,¹⁰ . Psychosocial factors, such as fear and avoidance and kinesiophobia, have been associated with pain, especially chronic pain, but there is still a need to investigate the association between pain and psychosocial factors¹¹ . Studies involving soccer players have shown that psychosocial factors can increase injury risk, injury recurrence or delay in sports returning¹²-¹⁴ .

Limited literature on footvolley can be explained by recent modality popularization and low financial incentives. Few studies have investigated the prevalence of musculoskeletal pain, and an inadequate sample size was observed. Moreover, these studies did not report the prevalence of pain considering the body segments¹,¹⁵ . This study aimed to investigate the prevalence of musculoskeletal pain and associated psychosocial factors in footvolley players.

METHODS

Study design

This cross-sectional study was approved by the Ethical Board Committee of the Augusto Motta University Center (Centro Universitário Augusto Motta - CAAE: 39430720.7.0000.5235). This study was reported according to the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement¹⁶ .

Participants

Footvolley players (women and men) were recruited via social media and word of mouth. Data was collected from January 2021 to July 2021 by an online survey created on the Google Form platform^®. The following inclusion criteria were adopted: age between 18 and 60 years old and practicing footvolley at any level. Participants were excluded from the study if they were not Brazilians or could not fill out the form due to physical or mental conditions.

Instruments and measures

Participants were invited to answer a survey of demographic, health-related data, and information about their practice using an online form. The questionnaire, prepared in the Google Form platform, was filled out by the participant, and sent via email, cell phone, or social media in organic dissemination through a link made available to professional athletes, training center teachers, and recreational practitioners of footvolley. The survey of the practitioner's gender, age, and level (beginner, amateur, professional, master) made up the introductory part of the self-completion questionnaire. Anthropometric data such as weight and height were also obtained by self-report.

For the prevalence and classification of musculoskeletal pain, participants answered the following question: “Do you feel any pain today?” with two possible answers: “Yes” or “No”. Concerning the affected region, there were eleven answers, and the participant could choose more than one answer (none, foot or ankle, calf, knee, thigh, hip, groin, lumbar spine, cervical spine, shoulder and head). Pain intensity was assessed using the Numerical Rating Scale (NRS). This scale has the advantage of facilitating the subject's understanding and, therefore, the choice of the appropriate response¹⁷ .

The volunteers answered the following question, “How intense was your last pain?”, and responded on a scale from zero to 10, where (0) is no pain, and (10) the worst pain ever felt.

The assessment of pain-related psychosocial factors was performed through 9 questions extracted from two questionnaires¹⁸,¹⁹ , to assess the existence of these components in footvolley players, covering: the presence of anxiety symptoms - “Do you feel anxious?”; social isolation - “Do you feel socially isolated?”; catastrophizing - “When I feel pain, it's terrible and I feel it will never get better.” and “When I feel pain, I feel like I can't take it anymore.”; depression - “In the past month were you frequently bothered by having little interest or pleasure in doing things?”; kinesiophobia - “Physical activity can harm my body.” and “I shouldn't do physical activities that could make my pain worse.”; stress - “Do you feel stressed?”; and sleep quality - “Did you have trouble sleeping in the last month?”. Each question can be assigned a response between 0 and 10. The value 0 (zero) represents “no, not at all/I never do that/I completely disagree,” gradually increasing to 10 (ten), which means “quite a lot/I always do this/I completely agree”. Only the question regarding sleep quality had 4 response options: “None, A little, Some, or Serious”.

Sample size

The sample was designed through sample size calculation using the Epi InfoTM version 7.2 program to calculate the sample size, with a confidence interval of 95%. Due to the lack of epidemiological studies that indicate the approximate number of footvolley practitioners throughout the national territory, there is an estimate of a population of 100,000 practitioners throughout the Brazilian territory, thus requiring a representative sample of 383 participants.

Statistical analysis

The sample characteristics were described through absolute values, proportions, means, and standard deviations. Logistic regression models were used to verify the association between the independent variables and the prevalence of musculoskeletal pain (dependent variable). Potential associated factors (age, gender, height, weight, time of practice, weekly frequency, performance level, depression, sleep quality, social isolation, stress, and if you have been injured playing) with p<0.2 in the univariate analysis were also included in the multiple logistic regression models. The significant level adopted in the study was 95%. All analyses were performed in RStudio version 0.99.486.

RESULTS

The sample consisted of 629 participants, 71% (n=450) male. The age group with the highest number of practitioners, 27% (n=168), was between 28-32 years. Other characteristics presented were the time of sports practice, in which a large part had less than 6 months (36%, n=226), followed by more than 3 years (30%, n=188). About the weekly practice, 31% (n=193) played 3 times a week, and 52% (n=330) considered themselves at the intermediate level. The dominant limb side of most participants was the right side (86%, n=544 - Table 1).

Table 1
Demographic characteristics of the participants.

Variables	Values
Gender, male, n (%)	450 (71.5)
Age, n (%)
18-22 years old	105 (16.69)
23-27 years old	107 (17.02)
28-32 years old	168 (26.71)
33-37 years old	108 (17.17)
38-42 years old	70 (11.12)
>43 years old	71 (11.29)
Height (cm)	173.25 (8.97)
Weight (kg)	75.67 (13.75)
Practice time, n (%)
< 6 months	226 (35.93)
6 months – 1 year	72 (11.45)
1-2 years	86 (13.67)
2-3 years	57 (9.07)
> 3 years	188 (29.88)
Right-handed dominance, n (%)	544 (86.48)
Weekly attendance, n (%)
< 1 day	13 (2.07)
1 day	26 (4.13)
2 days	165 (26.23)
3 days	193 (30.69)
4 days	129 (20.51)
5 days	62 (9.85)
6 days	23 (3.65)
7 days	18 (2.87)
Level, n (%)
Beginner	267 (42.44)
Intermediate	330 (52.46)
Master	15 (2.39)
Professional	17 (2.71)
Other sports participation, n (%)	474 (75.35)

• Continuous variables are presented as mean (standard deviation) and categorical variables in absolute values (percentage); cm = centimeters; kg = kilograms.

Regarding injury prevalence, (58%, n=368) reported having been injured while playing, being the lumbar region (41%, n=150), foot and ankle (32%, n=117), knee (29%, n=108) and groin (28%, n=103) the most affected ones. During form filling, 54% (n=341) of the individuals complained of at least some pain, with the lower back (46%, n=156) being the most prevalent, followed by the foot and ankle (18%, n=61) and the neck (13%, n=46). The mean of pain intensity was 4.37 ± 1.82. The majority of these practitioners with pain sought a health professional (63%, n=215) and stopped playing footvolley for some period (62%, n=213). The mean of anxiety was 4.72 ± 3.21, and of stress was 3.72 ± 2.91. Of the total, 56% (n=353) have reported at least some difficulty with sleep (Table 2).

Table 2
Prevalence of musculoskeletal pain and associated factors.

Variables	Values
Got hurt playing, yes, n (%)*	368 (58.5)
Foot and ankle	117 (31.79)
Calf	26 (7.06)
Knee	108 (29.34)
Thigh	64 (17.39)
Groin	103 (27.98)
Hip	34 (9.23)
Lower back	150 (40.76)
Shoulder	18 (4.89)
Neck	50 (13.58)
Head	12 (3.26)
Pain prevalence, n (%)	341 (54.21)
Pain intensity, mean (standard deviation)**	4.37 (1.82)
Sought healthcare professional, n (%)**	215 (63.04)
Missed practice because of the pain, n (%)**	213 (62.46)
Body locations with pain, n (%)
None	252 (40.07)
1	254 (40.39)
2	89 (14.15)
3	28 (4.46)
4	2 (0.31)
5	3 (0.47)
6	1 (0.15)
Pain location, n (%)**
Foot and ankle	61 (17.88)
Calf	28 (8.21)
Knee	133 (39)
Thigh	30 (8.79)
Groin	35 (10.26)
Hip	36 (10.55)
Lower back	156 (45.74)
Shoulder	19 (5.57)
Neck	46 (13.48)
Head	1 (0.29)
Psychosocial factors, mean (standard deviation)
Anxiety	4.72 (3.21)
Social Isolation	1.49 (2.4)
Catastrophization**	2.67 (2.54)
Depression	2.12 (2.69)
Kinesiophobia**	2.84 (2.55)
Stress (0-10)	3.72 (2.91)
Sleep disorder, n (%)
None	276 (43.88)
Little	256 (40.69)
Some	82 (13.04)
Serious	15 (2.39)

• Continuous variables are presented as mean (standard deviation) and categorical variables in absolute values (percentage); *Data calculated with total n=368 (referred to getting injured while playing); **Data calculated with total n=341 (referred to have pain).

The multiple logistic regression analysis showed an increase in the chance of reporting pain by those who had previous injuries - they had already been injured while playing – (OR= 1.56; CI 95%: 1.08–2.25; p=0.017) as well as practitioners of the master level (OR= 8.68; 95% CI: 1.01–74.44; p=0.049) and a protection factor for the age group between 18 and 22 years (OR= 0.41; CI 95%: 0.19–0.88; p=0.023) when compared to practitioners older than 43 years (Table 3).

Table 3
Association between musculoskeletal pain and associated factors.

	OR adjusted	CI 95%	p-value
Gender (Female)	0.81	0.47-1.38	0.434
Age (years)
18-22	0.42	0.19-0.89	0.023*
23-27	0.97	0.49-1.95	0.942
28-32	0.70	0.37-1.33	0.282
33-37	0.63	0.32-1.25	0.188
38-42	1.33	0.63-2.81	0.460
Height	1.00	0.98-1.03	0.809
Weight	1.01	0.99-1.03	0.115
Practice time
< 6 months	0.90	0.50-1.63	0.736
6 months-1 year	1.03	0.52-2.03	0.938
2-3 years	0.69	0.33-1.44	0.318
> 3 years	0.63	0.35-1.14	0.125
Weekly attendance (days)
1	1.60	0.38-6.63	0.519
2	0.80	0.33-1.96	0.630
3	1.58	0.65-3.81	0.310
4	1.53	0.62-3.79	0.357
5	1.26	0.47-3.38	0.645
6	2.91	0.82-10.28	0.098
7	1.60	0.38-6.63	0.519
Level
Intermediate	1.31	0.83-2.05	0.247
Professional	1.05	0.33-3.32	0.935
Master	8.68	1.01-74.44	0.049*
Psychosocial factors
Social Isolation	1.03	0.95-1.12	0.480
Depression	1.05	0.97-1.13	0.197
Stress	1.07	0.99-1.14	0.076
Trouble sleeping
None	0.82	0.45-1.50	0.517
A little	0.74	0.41-1.32	0.312
Serious	2.91	0.71-11.97	0.138
Got hurt playing	1.56	1.08-2.25	0.017*

• OR = Odds ratio; CI = Confidence interval; *p<0.05.

DISCUSSION

The main findings indicated that most participants had experienced injuries while playing footvolley. The lower back, foot and ankle, knee, and groin were the main anatomical regions affected. A substantial proportion of participants reported experiencing pain, with the lower back being the most affected body region. Furthermore, it was also observed that pain-related issues temporarily led footvolley players to discontinue training routines. Additionally, this research revealed that participants with a history of previous injuries and being in the master category were more likely to report pain. At the same time, younger age was a protective factor.

This study presented the largest sample size among prevalence pain studies in footvolley players. Most studies with smaller sample sizes had different objectives¹,²,¹⁵,²⁰,²¹ . Although online data collection may facilitate access to a larger number of people, it can also limit the process of solving doubts while filling out the questionnaire, which may be a limitation of this study. There was a low number of responses from professional athletes, despite the efforts made to request the leagues for participation of professional athlete groups and active search for the main footvolley players via social media. Pain prevalence could be influenced by participants' sports participation. Most of the participants were enrolled in sports other than footvolley.

Age and player level seem to be relevant among footvolley players. Low age was a protective factor for musculoskeletal pain. Also, footvolley players from the master level were more likely to present musculoskeletal pain. In older adults, somatosensory thresholds for non-noxious stimuli increased, while pressure pain thresholds decreased²² . Furthermore, age differences in exercise-induced hypoalgesia emerged after both isometric and aerobic exercise, with younger adults experiencing greater pain relief compared to older adults, suggesting that the response to exercise-induced pain may also be modulated by age²³ .

Only two studies investigated the prevalence of pain or injuries in footvolley players¹,¹⁵ . One study, which included 26 footvolley players to identify the injuries prevalence, found the knee and the lower back as the two main affected areas, corroborating in parts with the findings of the present study¹⁵ . Another study showed that 39% reported having suffered injury during footvolley practice, as compared to this study, where 58% of participants reported being injured¹ . When the results of the two studies was compared with the results of this research, was observed that the lower back and knees were the most prevalent locations of pain²¹ .

The most prevalent pain region in the individuals who participated in the present study was the lower back (46%), representing a very high percentage of the sample. Secondly, foot and ankle (18%) demonstrated a large discrepancy in the prevalence of pain in the reported regions. However, the onset of pain experienced by this study subject was not necessarily during sports practice. A recent systematic review sought to study the prevalence of low back pain in sports practitioners, demonstrating that this condition is persistent in several sports, but the prevalence can vary greatly depending on the sport practiced, requiring even more studies with the same focus on some specific divisions of each sport²⁴ . In addition, the lower back was the most prevalent body region (41%) in relation to the history of injuries, being an important risk factor for new episodes of low back pain²⁵ .

Other factors that may be related to low back pain are stress and anxiety²⁶ . The sample of this research had moderate anxiety and stress scores, although no association was found between the presence of musculoskeletal pain and these variables. More than half of the participants reported sleep disorder (56%), ranging from mild to severe problems²⁷,²⁸ , however, sleep disorders were not associated with a higher prevalence.

Conducting longitudinal studies to investigate the incidence of musculoskeletal pain and risk factors in footvolley is necessary. A research field emerges from the present study considering the footvolley popularity and lack of information from sports professionals.

Limitations of this study

The main limitation regarding the prevalence of pain in footvolley practice is the fact that this assessment was investigated based on participants' self-reports. Most participants (75%) practiced other sports besides footvolley. Therefore, it is possible that some reported pain, although exacerbated during footvolley, may have originated in other activities. The results of this study should be interpreted with caution, since data collection was based on an instrument that was not fully validated.

CONCLUSION

Low back pain is prevalent in footvolley players. Players with previous injuries and in the master category were more likely to report pain. Being aged between 18 and 22 years was a protection factor to pain compared with being over 43 years.

ACKNOWLEDGEMENTS

The authors would like to think the Regional Council of Physiotherapy and Occupational Therapy (CREFITO - 2) for the collaboration and help in the dissemination of this research for physiotherapists registered in the state of Rio de Janeiro, and the Brazilian Association of Traumato-Orthopedic Physiotherapy (Associação Brasileira de Fisioterapia Traumato-Ortopédica - ABRAFITO) - Orthopedic trauma physical therapy - for the collaboration and help in the dissemination of this research for the associated professionals.

• Sponsoring sources:
  none.

References

• ¹ Alves AT, Oliveira DM, Valença JGS, Macedo OG, Matheus JPC. Lesions in footvolley athletes. Rev Bras Ciênc Esporte. 2015;37(2):185-90. http://doi.org/10.1016/j.rbce.2015.02.003
  » http://doi.org/10.1016/j.rbce.2015.02.003
• ² Grazioli R, Inácio M, Nunes N, Villeroy L. Brazilian Footvolley: a displacement screening study of a professional national match. Int J Sports Sci. 2018;8(2):63-6.
• ³ Reis DF, Souza FS, Jesus JS, Garcia TA, Ozaki GAT, Zanuto EAC, Junqueira A, Castoldi RC, Camargo RCT, Camargo JCS Fo. Atividade física ao ar livre e a influência na qualidade de vida. Colloq Vitae. 2017;9(esp):191-201.
• ⁴ Gaudino P, Gaudino C, Alberti G, Minetti AE. Biomechanics and predicted energetics of sprinting on sand: hints for soccer training. J Sci Med Sport. 2013;16(3):271-5. http://doi.org/10.1016/j.jsams.2012.07.003 PMid:22883597.
  » http://doi.org/10.1016/j.jsams.2012.07.003
• ⁵ Davies SEH, Mackinnon SN. The energetics of walking on sand and grass at various speeds. Ergonomics. 2006;49(7):651-60. http://doi.org/10.1080/00140130600558023 PMid:16720526.
  » http://doi.org/10.1080/00140130600558023
• ⁶ Hootman JM, Macera CA, Ainsworth BE, Martin M, Addy CL, Blair SN. Association among physical activity level, cardiorespiratory fitness, and risk of musculoskeletal injury. Am J Epidemiol. 2001;154(3):251-8. http://doi.org/10.1093/aje/154.3.251 PMid:11479190.
  » http://doi.org/10.1093/aje/154.3.251
• ⁷ Purcell C, Duignan C, Fullen BM, Ryan S, Ward T, Caulfield B. Comprehensive assessment and classification of upper and lower limb pain in athletes: a scoping review. Br J Sports Med. 2023;57(9):535-42. http://doi.org/10.1136/bjsports-2022-106380 PMid:36759138.
  » http://doi.org/10.1136/bjsports-2022-106380
• ⁸ Shraim MA, Sluka KA, Sterling M, Arendt-Nielsen L, Argoff C, Bagraith KS, Baron R, Brisby H, Carr DB, Chimenti RL, Courtney CA, Curatolo M, Darnall BD, Ford JJ, Graven-Nielsen T, Kolski MC, Kosek E, Liebano RE, Merkle SL, Parker R, Reis FJJ, Smart K, Smeets RJEM, Svensson P, Thompson BL, Treede RD, Ushida T, Williamson OD, Hodges PW. Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study. Pain. 2022;163(9):1812-28. http://doi.org/10.1097/j.pain.0000000000002577 PMid:35319501.
  » http://doi.org/10.1097/j.pain.0000000000002577
• ⁹ Wiese-Bjornstal D, Smith AM, Shaffer SM, Morrey MA. An integrated model of response to sport injury: psychological and sociological dynamics. J Appl Sport Psychol. 1998;10(1):46-69. http://doi.org/10.1080/10413209808406377
  » http://doi.org/10.1080/10413209808406377
• ¹⁰ Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510-30. http://doi.org/10.1249/MSS.0b013e3181a0c95c PMid:19516148.
  » http://doi.org/10.1249/MSS.0b013e3181a0c95c
• ¹¹ Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019;53(9):554-9. http://doi.org/10.1136/bjsports-2017-098673 PMid:29666064.
  » http://doi.org/10.1136/bjsports-2017-098673
• ¹² Nédélec M, Halson S, Abaidia AE, Ahmaidi S, Dupont G. Stress, sleep and recovery in elite soccer: a critical review of the literature. Sports Med. 2015;45(10):1387-400. http://doi.org/10.1007/s40279-015-0358-z PMid:26206724.
  » http://doi.org/10.1007/s40279-015-0358-z
• ¹³ Slimani M, Bragazzi NL, Znazen H, Paravlic A, Azaiez F, Tod D. Psychosocial predictors and psychological prevention of soccer injuries: a systematic review and meta-analysis of the literature. Phys Ther Sport. 2018;32:293-300. http://doi.org/10.1016/j.ptsp.2018.05.006 PMid:29776844.
  » http://doi.org/10.1016/j.ptsp.2018.05.006
• ¹⁴ Rollo I, Carter JM, Close GL, Yangüas J, Gomez-Diaz A, Medina Leal D, Duda JL, Holohan D, Erith SJ, Podlog L. Role of sports psychology and sports nutrition in return to play from musculoskeletal injuries in professional soccer: an interdisciplinary approach. Eur J Sport Sci. 2021;21(7):1054-63. http://doi.org/10.1080/17461391.2020.1792558 PMid:32633210.
  » http://doi.org/10.1080/17461391.2020.1792558
• ¹⁵ Bezerra MDP, Kubagawa LA, Peralta CC, Cabrera-Rosa RA. Futevôlei e as lesões em atletas profissionais e amadores. In: Ferrari FC, editor. Fisioterapia e terapia ocupacional: promoção & prevenção e reabilitação. Ponta Grossa: Atena Editora; 2021. p. 11-9. http://doi.org/10.22533/at.ed.0212105012
  » http://doi.org/10.22533/at.ed.0212105012
• ¹⁶ von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-7. http://doi.org/10.7326/0003-4819-147-8-200710160-00010 PMid:17938396.
  » http://doi.org/10.7326/0003-4819-147-8-200710160-00010
• ¹⁷ Sousa FF, Silva JA. A métrica da dor (dormetria): problemas teóricos e metodológicos. Rev Dor Pesq Clin Ter. 2005;6(1):469-513.
• ¹⁸ Eriksen HR, Ihlebæk C, Ursin H. A scoring system for subjective health complaints (SHC). Scand J Public Health. 1999;27(1):63-72. http://doi.org/10.1177/14034948990270010401 PMid:10847674.
  » http://doi.org/10.1177/14034948990270010401
• ¹⁹ Kent P, Mirkhil S, Keating J, Buchbinder R, Manniche C, Albert HB. The concurrent validity of brief screening questions for anxiety, depression, social isolation, catastrophization, and fear of movement in people with low back pain. Clin J Pain. 2014;30(6):479-89. http://doi.org/10.1097/AJP.0000000000000010 PMid:24281277.
  » http://doi.org/10.1097/AJP.0000000000000010
• ²⁰ Moura JAR, Machado GS. Atletas de futevôlei: antropometria, morfologia, posturografia por fotogrametria e índices de flexibilidade muscular. EFDeportes.com. 2011;16(159).
• ²¹ Silva CS, Fiuza TS, Strini PJSA. Análise morfofuncional dos movimentos executados no futevôlei. Extendere. 2017;5(2):37-47.
• ²² Lautenbacher S, Kunz M, Strate P, Nielsen J, Arendt-Nielsen L. Age effects on pain thresholds, temporal summation and spatial summation of heat and pressure pain. Pain. 2005;115(3):410-8. http://doi.org/10.1016/j.pain.2005.03.025 PMid:15876494.
  » http://doi.org/10.1016/j.pain.2005.03.025
• ²³ Naugle KM, Naugle KE, Riley JL 3rd. Reduced modulation of pain in older adults after isometric and aerobic exercise. J Pain. 2016;17(6):719-28. http://doi.org/10.1016/j.jpain.2016.02.013 PMid:26993959.
  » http://doi.org/10.1016/j.jpain.2016.02.013
• ²⁴ Trompeter K, Fett D, Platen P. Prevalence of back pain in sports: a systematic review of the literature. Sports Med. 2017;47(6):1183-207. http://doi.org/10.1007/s40279-016-0645-3 PMid:28035587.
  » http://doi.org/10.1007/s40279-016-0645-3
• ²⁵ Wilson F, Ardern CL, Hartvigsen J, Dane K, Trompeter K, Trease L, Vinther A, Gissane C, McDonnell SJ, Caneiro JP, Newlands C, Wilkie K, Mockler D, Thornton JS. Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis. Br J Sports Med. 2020;55(11):601-7. http://doi.org/10.1136/bjsports-2020-102537 PMid:33077481.
  » http://doi.org/10.1136/bjsports-2020-102537
• ²⁶ Gonzalez GZ, Silva T, Avanzi MA, Macedo GT, Alves SS, Indini LS, Egea LMP, Marques AP, Pastre CM, Costa LCM, Costa LOP. Low back pain prevalence in Sao Paulo, Brazil: a cross-sectional study. Braz J Phys Ther. 2021;25(6):837-45. http://doi.org/10.1016/j.bjpt.2021.07.004 PMid:34561187.
  » http://doi.org/10.1016/j.bjpt.2021.07.004
• ²⁷ van Looveren E, Bilterys T, Munneke W, Cagnie B, Ickmans K, Mairesse O, Malfliet A, De Baets L, Nijs J, Goubert D, Danneels L, Moens M, Meeus M. The association between sleep and chronic spinal pain: a systematic review from the last decade. J Clin Med. 2021;10(17):3836. http://doi.org/10.3390/jcm10173836 PMid:34501283.
  » http://doi.org/10.3390/jcm10173836
• ²⁸ Seiger AN, Penzel T, Fietze I. Chronic pain management and sleep disorders. Cell Rep Med. 2024;5(10):101761. http://doi.org/10.1016/j.xcrm.2024.101761 PMid:39413729.
  » http://doi.org/10.1016/j.xcrm.2024.101761

Edited by

• Associate editor in charge:
  Deyse Borges Machado https://orcid.org/0000-0002-4305-4952

Publication Dates

• Publication in this collection
  24 Mar 2025
• Date of issue
  2025

History

• Received
  16 July 2024
• Accepted
  05 Dec 2024