Low back pain prevention's effects in schoolchildren. What is the evidence?

Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Gent, Belgium.
European Spine Journal (Impact Factor: 2.47). 01/2005; 13(8):663-79. DOI: 10.1007/s00586-004-0749-6
Source: PubMed

ABSTRACT Given the high prevalence rates of back pain, as early as in childhood, there has been a call for early preventive interventions. To determine which interventions are used to prevent back problems in schoolchildren, as well as what the evidence is for their utility, the literature was searched to locate all investigations that used subjects under the age of 18 and not seeking treatment. Included investigations were specifically designed as an intervention for low back pain (LBP) prevention. Additionally, a literature search was performed for modifiable risk factors for LBP in schoolchildren. The literature-update search was performed within the scope of the "COST Action B13" of the European Commission, approved for the development of European guidelines for the management of LBP. It was concluded that intervention studies in schoolchildren focusing on back-pain prevention are promising but too limited to formulate evidence-based guidelines. On the other hand, since the literature shows that back-pain reports about schoolchildren are mainly associated with psychosocial factors, the scope for LBP prevention in schoolchildren may be limited. However, schoolchildren are receptive to back-care-related knowledge and postural habits, which may play a preventive role for back pain in adulthood. Further studies with a follow-up into adulthood are needed to evaluate the long-term effect of early interventions and the possible detrimental effect of spinal loading at young age.

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    ABSTRACT: Objetivo. Evaluar el nivel de conocimiento sobre la salud y cuidado de la espalda relacionado con la práctica de ejercicio físico en chicas y chicos de ESO y Bachillerato de la Comunidad Valenciana. Antecedentes. Actualmente, se estima que la prevalencia del dolor lumbar inespecífico en niños y adolescentes es elevada. Este índice incrementa constantemente con la edad, apareciendo más pronto y de forma más común en las chicas que en los chicos [ ]. Programas de intervención en escolares que incluyeron la evaluación de los conocimientos sobre el cuidado de la espalda [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20], ratifican que la educación de la espalda a través del currículum de primaria resulta ser una estrategia eficaz para mejorar el aspecto cognitivo del cuidado de la espalda hasta la adolescencia. A pesar de ello, no existen guías o pautas específicas para enseñar la mecánica del cuerpo y la postura en la escuela primaria [2, 3] y la literatura existente es escasa [10]. Métodos. Una muestra de 440 alumnos de ESO y Bachiller cumplimentó el cuestionario de conocimientos sobre la salud y el cuidado de la espalda relacionado con la práctica de ejercicio físico (CoSaCuEs-EF). Resultados. Las chicas obtuvieron una media de resultados de 3.15 (DT= 2.35), mientras que los chicos obtuvieron una media de resultados de 3.20 (DT= 2.51). Los alumnos con peores resultados fueron los de 13 años (1.90; DT= 2.66) y los que mejores resultados consiguieron fueron los alumnos de 17 años (3.67; DT= 2.47). Conclusión. Los alumnos de ESO y Bachiller poseen un nivel de conocimientos específicos sobre la salud y el cuidado de la espalda relacionados con la práctica de ejercicio físico bajos. Palabras calve. Adolescentes, conocimientos, salud de la espalda, ejercicio físico.
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    ABSTRACT: A group-randomized controlled trial was carried out to investigate the effects of a postural education program on daily life habits related to low back pain in children. The study sample included 137 children aged 10.7 years. 6 classes from 2 primary schools were randomly allocated into an experimental group (EG) (N=63) or a control group (CG) (N=74). The EG received a postural education program over 6 weeks consisting of 6 sessions, while the CG followed the usual school curriculum. A questionnaire was completed by the participants at pretest, post-test and 3 months after the intervention finished. The outcomes collected were: correct use of sofa, stooping correctly, take care to sit correctly at home/school and frequent posture change on chair at home/school. A sum score was computed from the 6 items. To examine the effect of the intervention, we used repeated measures analysis of co-variance (ANCOVA); with baseline, post-test and follow-up outcome values as dependent variables, study group as fixed factor, and sex and age as covariates. Single healthy items mostly improved after the intervention and remained improved after 3 month follow-up in EG, while no substantial changes were observed in the CG. Healthy habits score was significantly increased at post-test compared to baseline in the EG (P<0.001), and remained significantly increased after 3-months, compared to baseline (P<0.001). No significant changes were observed in the CG (P>0.6). The results suggest that children are able to learn healthy daily life habits which might contribute to future prevention of low back pain.
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    ABSTRACT: Introduction : For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim : To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods : A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5-24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results : LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion : LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP.
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