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Pavlova M, Noel M, Orr SL, Walker A, Madigan S, McDonald SW, Tough SC, Birnie KA. Early childhood risk factors for later onset of pediatric chronic pain: a multi-method longitudinal study. BMC Pediatr 2024; 24:508. [PMID: 39112922 PMCID: PMC11308333 DOI: 10.1186/s12887-024-04951-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Pediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years. METHODS Available longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child's pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models. RESULTS Gut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11. CONCLUSIONS Some, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.
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Affiliation(s)
- Maria Pavlova
- Department of Psychology, University of Guelph, Guelph, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, Calgary, Canada
- Hotchkiss Brain Institute, Owerko Centre, Calgary, Canada
| | - Serena L Orr
- Alberta Children's Hospital Research Institute, Calgary, Canada
- Hotchkiss Brain Institute, Owerko Centre, Calgary, Canada
- Community Health Sciences, University of Calgary, Calgary, Canada
- Clinical Neurosciences, University of Calgary, Calgary, Canada
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Andrew Walker
- Alberta Health Services, Calgary, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, Department of Community Health Sciences, University of Calgary, 2500 University Drive, Calgary, AB, T2N 1N4, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | | | - Suzanne C Tough
- Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kathryn A Birnie
- Department of Psychology, University of Calgary, Calgary, Canada.
- Alberta Children's Hospital Research Institute, Calgary, Canada.
- Hotchkiss Brain Institute, Owerko Centre, Calgary, Canada.
- Community Health Sciences, University of Calgary, Calgary, Canada.
- Department of Anesthesiology, Perioperative and Pain Medicine, Department of Community Health Sciences, University of Calgary, 2500 University Drive, Calgary, AB, T2N 1N4, Canada.
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Silva TFCE, Nunes ACL, Barreto MCA, Castro SS, Jesus-Moraleida FR. Questionnaires that assess disability in children and adolescents with low back pain adhere to the concepts of the International classification of functioning, disability and health (ICF), but lack validity for this population: a systematic review. Disabil Rehabil 2024; 46:1979-1989. [PMID: 37326065 DOI: 10.1080/09638288.2023.2221901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs. METHODS We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM. RESULTS We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity. CONCLUSION Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs.
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Affiliation(s)
| | - Ana Carla Lima Nunes
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
| | | | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
- Master Program of Public Health, Physical Therapy Department, Federal University of Ceará, Fortaleza, Brazil
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Santos EDS, Bernardes JM, Vianna LS, Ruiz-Frutos C, Gómez-Salgado J, Alonso MS, Noll M, Dias A. The Impact of Low Back Pain on the Quality of Life of Children between 6 and 12 Years of Age. Healthcare (Basel) 2023; 11:healthcare11070948. [PMID: 37046874 PMCID: PMC10094538 DOI: 10.3390/healthcare11070948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
This study aimed to evaluate the impact of low back pain on the perceived health-related quality of life of children between 6 and 12 years of age. This is a cross-sectional study of three hundred seventy-seven students from three schools (two private and one public) located in the city of Botucatu, São Paulo. Data were collected using the Pediatric Quality of Life Inventory (PedsQL, version 4.0), a questionnaire comprising questions on personal background, sociodemographic and socioeconomic information, and a questionnaire about quality of life. Comparisons were made between groups with and without low back pain. The chi-squared test was used for analyzing categorical variables, and the non-parametric Mann–Whitney test was used for continuous variables. According to the findings obtained in this study, it was observed that low back pain in the last month was reported by 27.3% of the total participants. The perceived health-related quality of life was lower among individuals who had low back pain, and the scores of physical and emotional functioning domains were also lower in the presence of low back pain. The prevalence of low back pain among children and adolescents is relatively high. Furthermore, the repercussions of low back pain may lead to a lower overall perception of the health-related quality of life in this population and affect aspects of physical and emotional functioning.
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Affiliation(s)
- Elisiane de Souza Santos
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618687, Brazil (J.M.B.)
| | - João Marcos Bernardes
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618687, Brazil (J.M.B.)
- Department of Public Health, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618687, Brazil
| | - Luana Schneider Vianna
- Medical School, Centro Universitário de Jaguariúna, (UNIFAJ), Jaguariúna 13820000, São Paulo, Brazil
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
- Correspondence: (J.G.-S.); (M.N.); Tel.: +34-959-219-700 (J.G.-S.); +55-(62)-3307-7100 (M.N.)
| | - Melissa Spröesser Alonso
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618687, Brazil (J.M.B.)
| | - Matias Noll
- Health and Physical Examination Laboratory, Instituto Federal Goiano, Ceres 76300000, Goiás, Brazil
- Physical Education Graduate Program, Universidade Federal de Goiás, Goiânia 74690900, Goiás, Brazil
- Correspondence: (J.G.-S.); (M.N.); Tel.: +34-959-219-700 (J.G.-S.); +55-(62)-3307-7100 (M.N.)
| | - Adriano Dias
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618687, Brazil (J.M.B.)
- Department of Public Health, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618687, Brazil
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Pourbordbari N, Jensen MB, Olesen JL, Holden S, Rathleff MS. Bio-psycho-social characteristics and impact of musculoskeletal pain in one hundred children and adolescents consulting general practice. BMC PRIMARY CARE 2022; 23:20. [PMID: 35172756 PMCID: PMC8790922 DOI: 10.1186/s12875-022-01628-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/14/2022] [Indexed: 11/10/2022]
Abstract
Background Eight percent of all child and adolescent general practice consultations are due to musculoskeletal conditions, with pain as the most frequent symptom. Despite the commonality of musculoskeletal pain, limited knowledge exists about care-seeking children and adolescents with musculoskeletal pain. The purpose of this study was to describe characteristics of children and adolescents consulting their general practitioner with musculoskeletal pain. Methods This is a cross-sectional study based on baseline data from the child and adolescent musculoskeletal pain cohort study (ChiBPS), carried out in 17 Danish general practice clinics. Patients aged 8–19 years who had musculoskeletal pain when consulting their general practitioner were recruited. Participants completed a questionnaire on demographics, physical activity, pain impact, psychosocial factors, and expectations of their general practitioner. Descriptive statistics were used to summarize data. Normally distributed continuous data were described using mean and standard deviation while non-normally data were described using median and interquartile range (IQR). Results We included 100 participants (54% female, median age 13 [IQR: 12–16.5 years]). Frequent pain sites limiting activity were knee (56%), back (20%), ankle (19%), and neck (13%). Most participants (63%) consulted their general practitioner due to inability to use their body as usual, due to pain. Median pain duration at consultation was 5 months [IQR: 3 weeks-1 year]. More than a third were often/sometimes nervous (34%), worried or anxious (33%), and took pain medication (33%). Pain impeded ability to participate in sport activities at school (79%) and disturbed spare time activities (88%). Pain also made it difficult to concentrate for 58%, and to fall asleep for 38%. Only 38% expected a pain free long-term future. Conclusion This study demonstrates the bio-psycho-social impact of musculoskeletal pain in care-seeking children and adolescents. Demographics, pain characteristics, psychosocial characteristics, and physical characteristics should be included in addressing children and adolescents with musculoskeletal pain. Trial registration The ChiBPS study was pre-registered before participant recruitment (ClinicalTrials.gov Identifier: NCT03678922) date: 09.20.18. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01628-8.
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Three in Every 10 School-aged Children in Brazil Report Back Pain in Any Given Year: 12-Month Prospective Cohort Study of Prevalence, Incidence, and Prognosis. J Orthop Sports Phys Ther 2022; 52:554-562. [PMID: 35722760 DOI: 10.2519/jospt.2022.10819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate the prevalence, incidence, and prognosis of back pain in children and adolescents. DESIGN Prospective cohort study. METHODS We followed children and adolescents between the ages of 8 and 18 years with and without back pain over 12 months (3, 6, and 12 months) from public and private schools. At baseline, parents (or guardians) answered questionnaires including sociodemographic characteristics and perception of sleep quality of their children and adolescents. Children and adolescents answered questionnaires including sociodemographic characteristics, presence of back pain, pain intensity, quality of life, and psychosomatic symptoms. At follow-up, children and adolescents answered questions about the presence of back pain. RESULTS Six hundred fifteen children and adolescents were included, 163 of whom had back pain and 452 of whom had no back pain at baseline. The mean age of participants was 11.6 years (SD = 2.5), and the majority were female (n = 362; 59%). The 1-month prevalence of back pain was 26% (95% confidence interval: 23%-30%). The incidence rate of back pain was 35% (31%-40%) over 12 months. Of the 163 participants who had back pain at baseline, 83% had recovered by 12 months. Of those who recovered within 6 months, 31% had a recurrence of back pain at the 12-month follow-up. CONCLUSION Two to 3 in every 10 children and adolescents reported back pain in the last month. New cases of back pain were reported by 3-4 in every 10 children and adolescents for a period of 12 months. Nearly all children recover within 12 months, but recurrence seems to be common. J Orthop Sports Phys Ther 2022;52(8):554-562. Epub: 19 June 2022. doi:10.2519/jospt.2022.10819.
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The relationships between physical activity, lumbar multifidus muscle morphology, and low back pain from childhood to early adulthood: a 12-year longitudinal study. Sci Rep 2022; 12:8851. [PMID: 35614086 PMCID: PMC9132932 DOI: 10.1038/s41598-022-12674-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 05/09/2022] [Indexed: 11/08/2022] Open
Abstract
We investigated the longitudinal associations between physical activity (PA), lumbar multifidus morphology, and impactful low back pain (LBP) in young people. Nine-year-old children were recruited from 25 primary schools and followed up at age 13, 16, and 21 years. We measured PA with accelerometers at age 9, 13, and 16; quantified patterns of lumbar multifidus intramuscular adipose tissue (IMAT) change from 13 to 16 years using magnetic resonance imaging; and recorded LBP and its impact with standardised questionnaires and interviews. Associations were examined with crude and adjusted logistic or multinomial models and reported with odds ratios (OR) or relative risk ratios (RRR). We included data from 364 children (mean[SD] age = 9.7[.4] years). PA behaviour was not associated with LBP. Having persistently high IMAT levels at age 13 and 16 was associated with greater odds of LBP (OR[95% CI] = 2.98[1.17 to 7.58]). Increased time in moderate and vigorous intensity PA was associated with a lower risk of higher IMAT patterns (RRR[95% CI] = .67[.46 to .96] to .74[.55 to 1.00]). All associations became non-significant after adjusting for sex and body mass index (BMI). Future studies investigating the relationships between PA behaviour, lumbar multifidus IMAT, and impactful LBP should account for potential confounding by sex and BMI.
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Zhou AZ, Marin JR, Hickey RW, Lam SK, Ramgopal S. Serious diagnoses at revisits in children discharged from the emergency department with back pain. Acad Emerg Med 2021; 28:1299-1307. [PMID: 34245643 DOI: 10.1111/acem.14336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 06/17/2021] [Accepted: 06/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Back pain is often benign but can be a harbinger for serious pathology. Little is known about the outcome in children with back pain but no serious diagnoses detected at the initial visit. We sought to estimate the rate of serious diagnoses at revisits among children initially discharged from the emergency department (ED) with back pain. METHODS We performed a multicenter retrospective cohort study of patients from 45 pediatric hospitals in the Pediatric Health Information System database from October 1, 2015, to March 31, 2019. We included patients discharged from the ED with a principal diagnosis of back pain and excluded patients with trauma and concurrent or previously known serious diagnoses. We identified the rates and types of serious diagnoses made within 30 days of the index visit. We examined the rates of diagnostic tests at the index visit in patients with and without serious diagnoses. RESULTS Of the 25,130 patients with back pain, 88 (0.4%, 95% confidence interval = 0.3% to 0.4%) had serious pathology diagnosed within 30 days. The most common diagnoses were anatomic (40%) and nonneurologic (39%) categories such as vertebral fracture and nephrolithiasis; infectious (19%) and neoplastic etiologies (3%) were less common. Diagnoses requiring acute interventions such as cauda equina syndrome (n = 2) and intraspinal abscess (n = 3) were rare. Patients with serious diagnoses at revisits underwent more blood tests and back ultrasound at the index visit compared to patients without serious diagnoses. CONCLUSIONS In pediatric patients discharged from the ED with a diagnosis of back pain and no serious or trauma diagnoses, there is a low rate of serious pathology on revisits. Of the serious diagnoses identified, high-acuity diseases were rare. For the subset of patients with clinical suspicion for serious pathology but none identified at the index visit, this represents an opportunity for further research to optimize their management.
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Affiliation(s)
- Amy Z. Zhou
- Division of Emergency Medicine Ann & Robert H. Lurie Children's Hospital of ChicagoNorthwestern University Feinberg School of Medicine Chicago Illinois USA
| | - Jennifer R. Marin
- Division of Pediatric Emergency Medicine Department of Pediatrics UPMC Children’s Hospital of PittsburghUniversity of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
- Department of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
| | - Robert W. Hickey
- Division of Pediatric Emergency Medicine Department of Pediatrics UPMC Children’s Hospital of PittsburghUniversity of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
| | - Sandi K. Lam
- Department of Neurosurgery Ann & Robert H. Lurie Children's Hospital of ChicagoNorthwestern University Feinberg School of Medicine Chicago Illinois USA
| | - Sriram Ramgopal
- Division of Emergency Medicine Ann & Robert H. Lurie Children's Hospital of ChicagoNorthwestern University Feinberg School of Medicine Chicago Illinois USA
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Picavet HSJ, Gehring U, van Haselen A, Koppelman GH, van de Putte EM, Vader S, van der Wouden JHC, Schmits RJH, Smit HA, Wijga A. A widening gap between boys and girls in musculoskeletal complaints, while growing up from age 11 to age 20 - the PIAMA birth Cohort study. Eur J Pain 2021; 25:902-912. [PMID: 33405263 PMCID: PMC8048429 DOI: 10.1002/ejp.1719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The adolescent years represent a key period for the development of musculoskeletal complaints (MSC) and the differences between boys and girls. We evaluated the prevalence and course of MSC and factors associated with MSC while growing up from age 11 to age 20. METHODS Questionnaire-based data at age 11 (n = 2,638), age 14 (n = 2,517), age 17 (n = 2,094) and at age 20 (n = 2,206) from the ongoing Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort were analyzed. MSC refers to pain of lower back, upper- and/or lower extremities. A multivariable logistic regression analysis was used to evaluate a number of factors in relation to persistent pain (pain reported at three out of four measurements). RESULTS Prevalence of MSC increased from 14.2% at age 11 to 22.1% at age 20 for boys, and from 17.4% at age 11 to 37.9% at age 20 for girls. Persistent pain was found among 5.1% of the boys and 16.5% of the girls. Being bullied, sleeping problems and tiredness during the day were significantly associated with persistent pain, in both boys and girls, while the latter two were more prevalent among girls. Self-reported (sports-) accidents, and among girls also early onset of puberty, were also significantly associated with persistent pain, but lifestyle factors, such as physical activity and smoking, were not. CONCLUSION The prevalence of MSC increases during adolescence, with a widening gap between boys and girls. The factors associated with MSC are similar in boys and girls, though the prevalence of some of these differ by sex. SIGNIFICANCE Measuring a group of youngsters 4 times between age 11 and 20 shows an increase in the percentage reporting musculoskeletal complaints (MSC) with a widening gap between girls and boys, with more pain among girls. Boys and girls do hardly differ with respect to factors associated with MSC, being mainly psychosocial factors and (sports) accidents.
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Affiliation(s)
- H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Amanda van Haselen
- Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, and GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
| | - Elise M van de Putte
- Division Paediatrics, Wilhelmina Children's Hospital (UMC Utrecht), Utrecht, The Netherlands
| | - Sarah Vader
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - J Hans C van der Wouden
- Department of General Practice and Elderly Care Medicine and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ruben J H Schmits
- Division Preventive Youth Health Care, Public Health Services region Utrecht (GGD Regio Utrecht), Utrecht, The Netherlands
| | - Henriette A Smit
- Division Julius Center, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Alet Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Saraiva BTC, Pinto RZ, Oliveira CB, Zanuto EF, Scarabottolo CC, Delfino LD, Suetake VYB, Gil FCS, Christofaro DGD. Continuity of physical activity practice from childhood to adolescence is associated with lower neck pain in both sexes and lower back pain in girls. J Back Musculoskelet Rehabil 2020; 33:269-275. [PMID: 31403935 DOI: 10.3233/bmr-181136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The literature on physical activity practice through sports as a protective factor for back pain in adolescents is conflicting. However, few studies have aimed to verify if continuity of the practice of physical activity from childhood to adolescence may be related to lower chances of back pain in adolescents. OBJECTIVES The objective of this study was to analyze the association between physical activity practice from childhood to adolescence and back pain in adolescents. METHODS The random sample was composed of 870 adolescents with a mean age of 13.7 ± 2.0 years. The continuity of physical activity practice was assessed through the continuity of sports practice from childhood to adolescence. Pain in the neck and low back were evaluated through a questionnaire. RESULTS The prevalence of neck pain and low back pain in boys was 17.5% and in girls was 20.9% for neck pain and 21.9% for low back pain. Physical activity practice during childhood to adolescence was a protective factor for neck pain (OR = 0.57 [CI = 0.35-0.94]) and low back pain (OR = 0.53 [CI = 0.33-0.86]) in girls and neck pain in boys (OR = 0.52 [CI = 0.30-0.90]), even after adjusting for confounding factors. CONCLUSION Girls with physical activity practice during childhood to adolescence were less likely to develop neck pain and back pain when compared to girls who did not maintain practice of physical activity. Similar results were observed in boys considering neck pain.
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Affiliation(s)
| | - Rafael Z Pinto
- Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Edner Fernando Zanuto
- Postgraduate Program in Physiotherapy, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
| | | | - Leandro Dragueta Delfino
- Postgraduate Program in Motricity Science, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
| | | | | | - Diego Giulliano Destro Christofaro
- Postgraduate Program in Motricity Science, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil.,Postgraduate Program in Physiotherapy, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
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Beynon AM, Hebert JJ, Hodgetts CJ, Boulos LM, Walker BF. Chronic physical illnesses, mental health disorders, and psychological features as potential risk factors for back pain from childhood to young adulthood: a systematic review with meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:480-496. [PMID: 31907659 DOI: 10.1007/s00586-019-06278-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 08/27/2019] [Accepted: 12/29/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To report evidence of chronic physical illnesses, mental health disorders, and psychological features as potential risk factors for back pain in children, adolescents, and young adults. METHODS This systematic review and meta-analysis included cohort and inception cohort studies that investigated potential risk factors for back pain in young people. Potential risk factors of interest were chronic physical illnesses, mental health disorders (e.g. depression, anxiety), and other psychological features (e.g. coping, resistance). Searches were conducted in MEDLINE, Embase, CINAHL, and Scopus from inception to July 2019. RESULTS Nineteen of 2167 screened articles were included in the qualitative synthesis, and data from 12 articles were included in the meta-analysis. Evidence from inception cohort studies demonstrated psychological distress, emotional coping problems, and somatosensory amplification to be likely risk factors for back pain. Evidence from non-inception cohort studies cannot distinguish between risk factors or back pain triggers. However, we identified several additional factors that were associated with back pain. Specifically, asthma, headaches, abdominal pain, depression, anxiety, conduct problems, somatization, and 'feeling tense' are potential risk factors or triggers for back pain. Results from the meta-analyses demonstrated the most likely risk factors for back pain in young people are psychological distress and emotional coping problems. CONCLUSION Psychological features are the most likely risk factors for back pain in young people. Several other factors were associated with back pain, but their potential as risk factors was unclear due to risk of bias. Additional high-quality research is needed to better elucidate these relationships. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Amber M Beynon
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia.
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia.,Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, Fredericton, NB, E3B 5A3, Canada
| | - Christopher J Hodgetts
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
| | - Leah M Boulos
- Maritime SPOR SUPPORT Unit, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
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Kasović M, Štefan L, Zvonar M. Normative values for relative schoolbag weight in primary school children aged 6-14 from Czech Republic: A pilot study. PLoS One 2019; 14:e0225741. [PMID: 31765420 PMCID: PMC6876794 DOI: 10.1371/journal.pone.0225741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 11/11/2019] [Indexed: 12/02/2022] Open
Abstract
Little evidence from observational studies has been provided regarding ‘optimal’ relative schoolbag load during primary education. Also, no study to date has provided reference-based standards for relative schoolbag weight. Therefore, the main purpose of the study was to establish normative values of relative schoolbag weight in a sample of children. In this cross-sectional study, we recruited 584 primary school students aged 6–14 (meanage±SD = 9.6±2.4 yrs, meanheight±SD = 1.4±0.2 m, meanweight±SD = 37.5±13.3 kg, meanbody-mass index±SD = 17.6±3.1 kg/m2, 44.4% girls) chosen from five schools in the city of Brno. Schoolbag weight and child’s body weight were objectively measured by using digital scale. Relative schoolbag weight was calculated by dividing schoolbag weight with child’s body weight and the result was expressed in percentage. Lambda, Mu and Sigma (LMS) method was used to create sex- and age-percentile curves. Boys carried slightly heavier schoolbag, compared with girls (mean difference 0.2 kg, p = 0.020). No significant differences between sexes in relative schoolbag weight were observed (p = 0.240). Median values (P50) for boys and girls were similar and the largest observed between ages 6–9 in boys (15–17%) and 6–8 in girls (16–18%). The percentage of children carrying relative schoolbag weight beyond 10% of their body weight was very high, especially between ages 6–10 in boys (85.1–100%) and 6–11 in girls (86.8–95.4%). This study provides first sex- and age- relative schoolbag weight normative values in primary school children. Future studies should use similar methods for generating comparable data.
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Affiliation(s)
- Mario Kasović
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- * E-mail:
| | - Martin Zvonar
- Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
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Beynon AM, Hebert JJ, Lebouef-Yde C, Walker BF. Potential risk factors and triggers for back pain in children and young adults. A scoping review, part II: unclear or mixed types of back pain. Chiropr Man Therap 2019; 27:61. [PMID: 31827768 PMCID: PMC6862810 DOI: 10.1186/s12998-019-0281-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Back pain is a global problem in terms of disability and financially, with a large burden both to the individual and to society. Back pain was previously believed to be uncommon in children. However, there is a growing body of evidence that this is not the case. Objective Part I of this scoping review studied risk factors of incident and episodic back pain. In this part II we aimed to identify all risk factors and triggers with unclear or mixed type back pain in young people and to identify any gaps in the literature. Methods A scoping review design was selected to summarise the evidence, as there are many studies on "risk factors" for back pain. The scoping review followed the PRISMSA-ScR guidelines. We considered all studies that tested potential risk factors and triggers for thoracic and/or lumbar spine pain, in children, adolescents, and young adults (≤ 24 years). PubMed and Cochrane databases were searched from inception to September 2018, to identify relevant English language articles. The results regarding potential risk factors were separated into temporal precursors and bidirectional risk factors and the studies were classified by study design. Results Our comprehensive search strategy identified 7356 articles, of which 83 articles were considered eligible for this review (part II). There were 53 cross-sectional studies and 30 cohort studies. Potential risk factors for back pain were: female sex, older age, later pubertal status, positive family history of back pain, increased growth, and a history of back pain, most of which are temporal precursor variables. There was limited research for the illness factors, spinal posture, and muscle endurance in the development of back pain. Conclusion Many of the included studies approached risk factors in similar ways and found factors that were associated with back pain but were not obvious risk factors as causality was uncertain. Future research should be more rigorous and innovative in the way that risk factors are considered. This could be through statistical approaches including cumulative exposures, or longitudinal approaches including multi-trajectory methods. Additionally, data on proposed risk factors should be collected before the onset of back pain.
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Affiliation(s)
- Amber M Beynon
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
- Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, Fredericton, New Brunswick E3B 5A3 Canada
| | - Charlotte Lebouef-Yde
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, 6150 Western Australia Australia
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Pourbordbari N, Riis A, Jensen MB, Olesen JL, Rathleff MS. Poor prognosis of child and adolescent musculoskeletal pain: a systematic literature review. BMJ Open 2019; 9:e024921. [PMID: 31324677 PMCID: PMC6661566 DOI: 10.1136/bmjopen-2018-024921] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 04/02/2019] [Accepted: 06/25/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To identify baseline patient characteristics that are (1) associated with a poor outcome on follow-up regardless of which treatment was provided (prognosis) or (2) associated with a successful outcome to a specific treatment (treatment effect modifiers). DESIGN Systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. DATA SOURCES Medline, Embase, Cinahl, Web of Science, Cochrane, SportDiscus, OT Seeker and PsychInfo were searched for prospective cohort studies up to February 2019 without limitation in publication date. ELIGIBILITY CRITERIA Prospective cohort studies reporting either prognostic factors or treatment effect modifiers on persistent musculoskeletal pain in 0-year-old to 19-year-old children and adolescents. Pain caused by tumours, fractures, infections, systemic and neurological conditions were excluded. OUTCOME MEASURES Our primary outcome was musculoskeletal pain at follow-up and identification of any baseline characteristics that were associated with this outcome (prognostic factors). No secondary outcomes were declared. METHOD Two reviewers independently screened abstracts and titles. We included prospective cohort studies investigating the prognosis or treatment effect modifiers of 0-year-old to 19-year-old children and adolescents with self-reported musculoskeletal pain. Risk of bias assessment was conducted with the Quality in Prognostic Studies tool. RESULTS Twenty-six studies yielding a total of 111 unique prognostic factors were included. Female sex and psychological symptoms were the most frequent investigated prognostic factors. Increasing age, generalised pain, longer pain duration and smoking were other identified prognostic factors. No treatment effect modifiers were identified. CONCLUSION Several prognostic factors are associated with a poor prognosis in children and adolescents with musculoskeletal pain. These prognostic factors may help guide clinical practice and shared decision-making. None of the included studies was conducted within a general practice setting which highlights an area in need of research. PROSPERO REGISTRATION NUMBER CRD42016041378.
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Affiliation(s)
| | - Allan Riis
- Center for General Practice at Aalborg University, Aalborg, Denmark
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Abstract
OBJECTIVES To identify factors associated with low back pain (LBP) in children and adolescents. MATERIALS AND METHODS A systematic review was conducted (Prospero CRD42016038186). Observational studies analyzing LBP risk factors among participants aged between 9 and 16 were searched for in 13 electronic databases and 8 specialized journals until March 31, 2016, with no language restrictions. In addition, references in the identified studies were manually tracked. All identified studies that included ≥50 participants aged 9 to 16, were reviewed. Their methodological quality was assessed by 2 reviewers separately, using validated tools, which scored, from worst to best, 0 to 100 for cross-sectional and 0 to 12 for cohort studies. A sensitivity analysis only included studies that had adjusted for confounders, had ≥500 participants, and had a methodological score of ≥50%. RESULTS A total of 5142 citations were screened and 61 studies, including 137,877 participants from 5 continents, were reviewed. Their mean (range) methodological scores were 74.56 (50 to 100) for cross-sectional studies and 7.36 (5 to 9) for cohort studies. The studies had assessed 35 demographic, clinical, biological, family, psychological, ergonomic, and lifestyle risk factors. The mean (range) prevalence of LBP ranged between 15.25% (3.20 to 57.00) for point prevalence and 38.98% (11.60 to 85.56) for lifetime prevalence. Results on the association between LBP and risk factors were inconsistent. In the sensitivity analysis, "older age" and "participation in competitive sports" showed a consistent association with LBP. DISCUSSION Future studies should focus on muscle characteristics, the relationship between body and backpack weights, duration of carrying the backpack, characteristics of sport practice, and which are the factors associated with specifically chronic pain.
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Management of children presenting with low back pain to emergency department. Am J Emerg Med 2019; 37:672-679. [DOI: 10.1016/j.ajem.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 11/22/2022] Open
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Santos MAD, Lunkes LC, Ribeiro ADO, Souza ADC. Low back pain and risk factors during the third infancy. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Low back pain is characterized as a pain in the area between the 12th rib and the low gluteal fold. This pain can affect different ages. During the growth peak, the postural control system is rearranged; therefore, the maintenance and fixation of these structures is crucial for the performance of daily activities. Thus, the prevalence of low back pain and their risk factors must be investigated, so that effective preventive measures against low back pain may be taken. Objective: To investigate the prevalence of low back pain and the risks associated to it during the third infancy, that is, children aged between 6 and 12 years old. Method: A transversal and observational study with 150 children of both genders, students from private institutions of Lavras, Minas Gerais, in 2016. Questionnaires were applied in order to understand the characteristics of the sample (age, gender, school year, ethnic group, parents’ educational level, means of transportation to go to school and situations that caused or aggravated low back pain) and their low back pain (in the last 12 months). Results: The rate of occurrence of low back pain in the senior year of school was 20%. According to the chi-squared, “school year” and “ethnic group” (pardos) were the variables associated to low back pain. Sitting, mainly in front of the computer, was reported to be the main cause of the symptoms. Conclusion: Low back pain presented a prevalence of 20% with no significant difference between genders, but there was an association of low back pain and variables related to the school year and the ethnic group.
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Chiwaridzo M, Chamarime KJ, Dambi JM. The burden of low back pain among undergraduate physiotherapy students at the University of Zimbabwe: a cross-sectional study. BMC Res Notes 2018; 11:697. [PMID: 30286786 PMCID: PMC6172757 DOI: 10.1186/s13104-018-3796-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/27/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Globally, non-specific low back pain (NSLBP) is a common cause of morbidity in all people including physiotherapy students. However, no study has investigated the problem among undergraduate physiotherapy students in Zimbabwe. This study was conducted, therefore, to provide evidence of the prevalence, clinical characteristics and consequences of recurrent NSLBP among undergraduate physiotherapy students at the University of Zimbabwe. RESULTS The final sample had 90 participants, giving a study response rate of 97.8%. The median age of the participants was 22 years. The lifetime prevalence of NSLBP was 56.7% (n = 51) and the mean age of onset for NSLBP was 19.7 years (SD = 1.64 years). The 12-month prevalence of recurrent NSLBP was 38.9% (n = 35). Of the 35, 20 (57.1%) experienced at least three episodes in the last 12 months. Each episode lasted for 1-7 days in most participants (n = 31, 88.6%). The mean intensity of recurrent episodes was 3.37 (SD = 1.43) measured on Visual Analogue Scale. Only 7 (20%) experienced at least one functional limitation due to recurrent NSLBP. Additionally, only 2 (5.7%) sought medical treatment for the pain. However, 6 (17.1%) had to be absent from the university secondary to recurrent NSLBP.
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Affiliation(s)
- M. Chiwaridzo
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, Ground Floor, New Health Sciences Building, Avondale, Harare, Zimbabwe
| | - K. J. Chamarime
- Mutare Provincial Hospital, P.O Box 30, Mutare, Harare, Zimbabwe
| | - J. M. Dambi
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, Ground Floor, New Health Sciences Building, Avondale, Harare, Zimbabwe
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Yamato TP, Maher CG, Traeger AC, Wiliams CM, Kamper SJ. Do schoolbags cause back pain in children and adolescents? A systematic review. Br J Sports Med 2018; 52:1241-1245. [PMID: 29720469 DOI: 10.1136/bjsports-2017-098927] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate whether characteristics of schoolbag use are risk factors for back pain in children and adolescents. DATA SOURCES Electronic searches of MEDLINE, EMBASE and CINAHL databases up to April 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies, cross-sectional and randomised controlled trials conducted with children or adolescents. The primary outcome was an episode of back pain and the secondary outcomes were an episode of care seeking and school absence due to back pain. We weighted evidence from longitudinal studies above that from cross-sectional. The risk of bias of the longitudinal studies was assessed by a modified version of the Quality in Prognosis Studies tool. RESULTS We included 69 studies (n=72 627), of which five were prospective longitudinal and 64 cross-sectional or retrospective. We found evidence from five prospective studies that schoolbag characteristics such as weight, design and carriage method do not increase the risk of developing back pain in children and adolescents. The included studies were at moderate to high risk of bias. Evidence from cross-sectional studies aligned with that from longitudinal studies (ie, there was no consistent pattern of association between schoolbag use or type and back pain). We were unable to pool results due to different variables and inconsistent results. SUMMARY/CONCLUSION There is no convincing evidence that aspects of schoolbag use increase the risk of back pain in children and adolescents.
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Affiliation(s)
- Tiê Parma Yamato
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Australia
| | - Chris G Maher
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian C Traeger
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia
| | - Christopher M Wiliams
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Steve J Kamper
- Institute for Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Pain, Health and Lifestyle, Australia
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Fuglkjær S, Vach W, Hartvigsen J, Wedderkopp N, Junge T, Hestbæk L. Does lower extremity pain precede spinal pain? A longitudinal study. Eur J Pediatr 2018; 177:1803-1810. [PMID: 30232592 PMCID: PMC6244689 DOI: 10.1007/s00431-018-3235-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/26/2022]
Abstract
The main objective was to investigate whether children aged 9-15 years at baseline were more likely to experience an incident event of spinal pain after experiencing lower extremity pain. Children's musculoskeletal pain was monitored by weekly mobile phone text message responses from parents, indicating whether the child had spinal pain, lower extremity pain, or upper extremity pain the preceding week. Data were analyzed using mixed effect logistic regression models and cox regression models. The association between an incident event of spinal pain and LE pain the preceding weeks increased with increasing observation period and was statistically significant for 12 and 20 weeks (OR = 1.34 (95% CI 1.05 to 1.70) and OR = 1.39 (95% CI 1.11 to 1.75), respectively). We found that the likelihood increased in children with more frequent or longer duration of lower extremity pain. The reversed relationship was investigated as well, and we also found a positive association between spinal pain and a subsequent incidence event of lower extremity pain, but less pronounced.Conclusion: Children were more likely to experience an incident event of spinal pain after experiencing lower extremity pain. The likelihood increased in children with more frequent or longer duration of lower extremity pain. What is Known: • Both spinal pain and lower extremity pain often start early in life and is common already in adolescence. What is New: • Children were more likely to experience an incident event of spinal pain after experiencing LE pain. • The likelihood increased in children with more frequent or longer duration of LE pain.
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Affiliation(s)
- Signe Fuglkjær
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Werner Vach
- Department of Orthopaedics and Traumatoloy, University Hospital Basel, Spitalstr 21, CH-4031 Basel, Switzerland
- Institute for Medical Biometry and Statistics, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
| | - Niels Wedderkopp
- Institute of Regional Health Services Research, University of Southern Denmark, Winsloewparken 193, 5000 Odense C, Denmark
- Sports Medicine Clinic, Orthopaedic Department, Hospital Lillebaelt, Østre Hougvej 55, 5500 Middelfart, Denmark
| | - Tina Junge
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Health Sciences Research Centre, University College Lillebaelt, Vestre Engvej 51C, 7100 Vejle, Denmark
| | - Lise Hestbæk
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
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Low Back Pain With Impact at 17 Years of Age Is Predicted by Early Adolescent Risk Factors From Multiple Domains: Analysis of the Western Australian Pregnancy Cohort (Raine) Study. J Orthop Sports Phys Ther 2017; 47:752-762. [PMID: 28915771 DOI: 10.2519/jospt.2017.7464] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Prospective cohort study of the Western Australian Pregnancy Cohort (Raine) Study. Background Low back pain (LBP) commonly develops in adolescence and is a significant risk factor for adult LBP. A broad range of factors have been associated with the development of adolescent LBP, but prior literature has limitations related to characterization of LBP and the scope of risk factors considered. Objective This study aimed to identify potential factors contributing to the development of LBP, with and without impact, at 17 years of age, utilizing a broad range of exposures at 14 years of age. Methods Data from 1088 participants (52.1% female) with "no LBP," "LBP with minimal impact," and "LBP with impact" at 17 years of age and a range of measures from multiple domains, including spinal pain, physical, psychological, social, and lifestyle, at 14 years of age were collected for the study. Multivariable multinomial logistic regression was used to estimate the association of potential mechanistic factors at 14 years of age with LBP at 17 years of age. Results Female sex and back pain at 14 years of age were strongly associated with LBP at 17 years of age. Potential mechanistic factors for LBP outcomes at 17 years of age included exposures from the pain (neck/shoulder pain) and physical domains (standing posture subgroup membership, back muscle endurance, throwing distance), psychological domain (somatic complaints, aggressive behavior), social domain (socioeconomic area), and lifestyle domain (exercise out of school). Conclusion The findings support the multidimensional nature of adolescent LBP and highlight the challenge this presents for epidemiological research, clinical practice, and prevention initiatives in the general population. Level of Evidence Prognosis, level 1b. J Orthop Sports Phys Ther 2017;47(10):752-762. doi:10.2519/jospt.2017.7464.
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Abstract
There are substantial gaps in our understanding of musculoskeletal pain in children and adolescents. While there are challenges to performing research in this space, the prevalence, burden, and lack of available evidence to inform clinical practice mean that overcoming these challenges is important. The editors see the collection of work in this special issue as a step in the right direction. J Orthop Sports Phys Ther 2017;47(10):702-704. doi:10.2519/jospt.2017.0109.
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Fernandes CS, Martins T, Rocha NS, Mendes M. “Jogo da postura”: programa de intervenção de enfermagem em crianças. AQUICHAN 2017. [DOI: 10.5294/aqui.2017.17.2.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: evidenciar el impacto de un juego para impulsar la educación postural de los niños. El enfermero tiene un rol preponderante en la educación para la salud, por el cual buscamos un camino que les agregara alguna innovación a las Escuelas Posturales ya existentes incorporando una estrategia formativa novedosa: “un juego”. Materiales y método: se trata de un estudio casi experimental con delineamiento de tiempo. La muestra se constituye de 215 niños del pre-escolar y el 1º ciclo de la enseñanza básica, de una ciudad del norte de Portugal. La intervención se realiza por medio de la aplicación de un juego titulado “Juego de la postura”; para evaluar su impacto, se administró un cuestionario sobre hábitos posturales antes y después de la intervención. Resultados: los resultados dan cuenta de una elevada prevalencia de quejas músculo-esqueléticas (48,8 %) y un incremento de respuestas correctas tras la intervención. Hubo cambio en el conocimiento de hábitos posturales antes de la participación de los alumnos en un programa de educación postural y luego de ella. Conclusiones: el juego es una estrategia activa útil y eficaz a utilizarse por los formadores en el contexto de la enfermería y debe replicarse a otras áreas temáticas.
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Minghelli B, Oliveira R, Nunes C. Postural habits and weight of backpacks of Portuguese adolescents: Are they associated with scoliosis and low back pain? Work 2017; 54:197-208. [PMID: 27061692 DOI: 10.3233/wor-162284] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The adoption of incorrect postures or carrying overweight backpacks may contribute to the development of musculoskeletal disorders in school children. OBJECTIVE This study evaluated the weight of backpacks and the postural habits adopted in schools by Portuguese adolescents, and their association with scoliosis and low back pain (LBP). METHOD The sample comprised 966 Portuguese students, aged between 10 and 16 years. The instruments included a questionnaire to characterize the presence of LBP and the postural habits adopted by students, the weighing of backpacks and a scoliometer to evaluate scoliosis. RESULTS No association was observed between assuming incorrect postures and carrying overweight backpacks, in students with scoliosis. Students who adopted incorrect sitting postures had 1.77 times the risk (95% CI: 1.32-2.36; p < 0.001) of developing LBP; those positioned incorrectly whilst watching TV and playing games had 1.44 times the risk (95% CI: 1.08-1.90; p = 0.012) of developing LBP; and those standing incorrectly had 2.39 the risk (95% CI: 1.52-3.78; p < 0.001) of developing LBP. CONCLUSIONS The results revealed that students who sat with the spine positioned wrongly, as well as those who were standing incorrectly, were more likely to present with LBP.
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Affiliation(s)
- Beatriz Minghelli
- School of Health Jean Piaget-Algarve, Piaget Institute, Silves, Portugal.,National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Raul Oliveira
- Faculty of Human Kinetics, Technical University of Lisbon, Lisbon, Portugal
| | - Carla Nunes
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Chiwaridzo M, Chikasha TN, Naidoo N, Dambi JM, Tadyanemhandu C, Munambah N, Chizanga PT. Content validity and test-retest reliability of a low back pain questionnaire in Zimbabwean adolescents. Arch Physiother 2017; 7:3. [PMID: 29340198 PMCID: PMC5759913 DOI: 10.1186/s40945-017-0031-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/17/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In Zimbabwe, a recent increase in the volume of research on recurrent non-specific low back pain (NSLBP) has revealed that adolescents are commonly affected. This is alarming to health professionals and parents and calls for serious primary preventative strategies to be developed and implemented forthwith. Early identification initiatives should be prioritised in order to curtail the condition and its progression. In an attempt to be proactive in minimising the prevalence of recurrent NSLBP, this study was conducted to evaluate the content validity and test-retest reliability of a survey questionnaire with the aim of proffering a valid and reliable questionnaire which can be used in non-clinical settings to identify adolescents with recurrent NSLBP in Harare, Zimbabwe and determine the possible factors associated with the condition. METHODS The study was conducted in two parts. The first part assessed content validity of the questionnaire using four experts derived from academia and clinical practice. The second part evaluated the reliability of the questionnaire among 125 high school-children aged between 13 and 19 years in a test-retest study. RESULTS Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. Overall, the Scale Content Validity Index for the questionnaire was 0.97. Item completion for the reliability study was satisfactory. The questionnaire items had kappa values ranging from 0.17 (slight agreement) to 1 (perfect agreement). High levels of reliability were found for the questions on school bag use (k=0.94), sports participation (k=0.97), and lifetime prevalence (k=0.89). CONCLUSION Excellent content validity and slight to perfect test-retest reliability was found for the Low Back Pain (LBP) questionnaire. These results are comparable to findings of other studies evaluating the psychometric properties of LBP questionnaires. Cognisant of the limitations of the study, the results of this study suggest that the LBP questionnaire could be used in local studies investigating LBP among adolescents although questions enquiring on functional limitations and sciatica may need further consideration.
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Affiliation(s)
- Matthew Chiwaridzo
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe
- Division of Physiotherapy, University of Cape Town, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Cape Town, South Africa
| | - Tafadzwa Nicole Chikasha
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe
| | - Nirmala Naidoo
- Division of Physiotherapy, University of Cape Town, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, Cape Town, South Africa
| | - Jermaine Matewu Dambi
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe
| | - Cathrine Tadyanemhandu
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe
| | - Nyaradzai Munambah
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe
| | - Precious Trish Chizanga
- Department of Tourism and Hospitality, Harare Polytechnic College, P.O Box CY 407, Causeway, Harare Zimbabwe
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Coenen P, Smith A, Paananen M, O'Sullivan P, Beales D, Straker L. Trajectories of Low Back Pain From Adolescence to Young Adulthood. Arthritis Care Res (Hoboken) 2017; 69:403-412. [DOI: 10.1002/acr.22949] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 05/05/2016] [Accepted: 05/31/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Pieter Coenen
- School of Physiotherapy and Exercise Science; Curtin University; Perth Australia
| | - Anne Smith
- School of Physiotherapy and Exercise Science; Curtin University; Perth Australia
| | - Markus Paananen
- Centre for Life-Course Epidemiology, and Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Peter O'Sullivan
- School of Physiotherapy and Exercise Science; Curtin University; Perth Australia
| | - Darren Beales
- School of Physiotherapy and Exercise Science; Curtin University; Perth Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science; Curtin University; Perth Australia
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Udom C, Janwantanakul P, Kanlayanaphotporn R. The prevalence of low back pain and its associated factors in Thai rubber farmers. J Occup Health 2016; 58:534-542. [PMID: 27725486 PMCID: PMC5373904 DOI: 10.1539/joh.16-0044-oa] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in the general population, especially among manual laborers. Moreover, it often brings about lost wages and additional medical expenses. However, the potential risk factors for LBP are unknown. This study aimed to estimate the prevalence of LBP and to determine the individual, occupational, and psychosocial factors associated with LBP among rubber farmers. Methods: A cross-sectional survey was conducted among 450 Thai rubber farmers using cluster random sampling. Data were collected using face-to-face interviews and objective examination and were analyzed using multivariate logistic regression. Results: Of the 433 rubber farmers, the point and 12-month prevalence of LBP in rubber farmers was 33% and 55.7%, respectively. BMI, primary school education, exposure to pesticides, and tapping below knee level were statistically associated with LBP after controlling for other variables. Conclusions: Low back pain is common among rubber farmers. Only four factors were identified as being associated with the high prevalence of LBP. However, these factors might be altered if more variables are taken into account. Further research investigating the causal relation between these factors and LBP should be conducted.
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Affiliation(s)
- Chadayu Udom
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University
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Massoud M, Del Bufalo F, Caterina Musolino AM, Schingo PM, Gaspari S, Pisani M, Orazi C, Reale A, Raucci U. Myeloid Sarcoma Presenting as Low Back Pain in the Pediatric Emergency Department. J Emerg Med 2016; 51:308-14. [DOI: 10.1016/j.jemermed.2016.01.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 12/15/2015] [Accepted: 01/21/2016] [Indexed: 10/21/2022]
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Systematic review with meta-analysis of childhood and adolescent risk and prognostic factors for musculoskeletal pain. Pain 2016; 157:2640-2656. [DOI: 10.1097/j.pain.0000000000000685] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Nahle IS, Hamam MS, Masrouha KZ, Afeiche NE, Abdelnoor J. Back pain: A puzzle in children. J Paediatr Child Health 2016; 52:802-8. [PMID: 27535879 DOI: 10.1111/jpc.13291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/27/2022]
Abstract
Back pain in children is underdiagnosed and increases incidence in adolescence. A systematic approach can diagnose the most common causes: trauma, structural deformities, inflammatory diseases, infection and malignancy.
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Affiliation(s)
- Imad S Nahle
- Division of Orthopaedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohamed S Hamam
- Division of Orthopaedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karim Z Masrouha
- Division of Orthopaedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadim E Afeiche
- Division of Orthopaedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Johnny Abdelnoor
- Division of Orthopaedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Orthopaedic Surgery, University Medical Center - Rizk Hospital, Beirut, Lebanon
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Dissing KB, Hartvigsen J, Wedderkopp N, Hestbæk L. Conservative care with or without manipulative therapy in the management of back and neck pain in Danish children aged 9-15. Study protocol for a randomized controlled trial. Chiropr Man Therap 2016; 24:5. [PMID: 26823970 PMCID: PMC4730742 DOI: 10.1186/s12998-016-0086-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/13/2016] [Indexed: 01/06/2023] Open
Abstract
Background Complaints in the musculoskeletal system often start early in life and back and neck pain in children are well-established predictors for similar problems in adulthood. Despite lack of evidence of effectiveness, manipulative therapy is one of the most commonly used treatment modalities for back and neck pain in children. The primary objective of this study is to evaluate the effectiveness of manipulative therapy when added to an approach consisting of manual soft tissue treatment, exercises and advice as needed, in children aged 9–15 complaining of back and neck pain. Method The project is nested in the Childhood Health, Activity and Motor Performance School Study, which includes around 1200 children aged 9–15, who were all invited to participate in this randomized controlled trial in case they experienced back and/or neck pain during the two year inclusion period. Parents received text messages (SMS) on a weekly basis inquiring about the child’s musculoskeletal pain. If pain was reported, the child was evaluated for inclusion into the trial and, if eligible, randomized into one of two intervention groups:Pragmatic advice, manual soft tissue treatment and exercises The above plus manipulative therapy
By the end of data collection 237 children were included in the study. The primary outcome measure is number of recurrences of back and neck pain during the follow-up period (3–27 months). Secondary outcome measures are average duration of complaint time for each episode, total duration of complaint time, global perceived effect after two weeks, and change in pain intensity after 2 weeks. Baseline information includes quality of life, expectations to treatment, expectations to future course, age, gender, social class and physical education at school. Discussion For most common non-traumatic musculoskeletal complaints no standardized and evidence based treatment strategy exists. We want to evaluate the effectiveness of manipulative therapy in addition to an approach consisting of manual soft tissue treatment, exercises and advice as needed, in children aged 9–15 complaining of back and neck pain. To our knowledge this is the first large scale randomized controlled trial investigating the effectiveness of commonly used treatments for back and neck pain in children. Trial registration ClinicalTrials NCT01504698 Electronic supplementary material The online version of this article (doi:10.1186/s12998-016-0086-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristina Boe Dissing
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark ; Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, DK-5230 Odense M, Denmark
| | - Niels Wedderkopp
- Institute of Regional Health Services Research, University of Southern Denmark, Winsloewparken 193, DK-5000 Odense C, Denmark ; Orthopaedic Department Hospital of Lillebaelt, Sports Medicine Clinic, Østre Hougvej 55, DK-5500 Middelfart, Denmark
| | - Lise Hestbæk
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark ; Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, DK-5230 Odense M, Denmark
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Jones GT, Kyabaggu R, Marais D, Macfarlane GJ. Reproducibility of pain manikins: a comparison of paper versus online questionnaires. Br J Pain 2015; 7:130-7. [PMID: 26516514 DOI: 10.1177/2049463713487895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In epidemiological studies, pain location is often collected by paper questionnaire using blank body manikins, onto which participants shade the location of their pain(s). However, it is unknown how reliable these will transfer to online questionnaires. The aim of the current study was to determine agreement between online- and paper-based completion of pain manikins. METHODS A total of 264 children, aged 15-18 years, completed both an online and a paper questionnaire. Participants were asked to identify the location of their pain by highlighting predefined body areas on a manikin (online) or by shading a blank version of the manikin (paper). The difference in the prevalence of 12 regional/widespread pain conditions was determined, and agreement between online and paper questionnaires was assessed using prevalence- and bias-adjusted kappa (PABAK). RESULTS For the majority of pain conditions, prevalence was higher when ascertained by paper questionnaire. However, for the most part, the difference in prevalence was modest (range: -1.1 to 5.7%) the exceptions being hip/thigh pain (difference: 10.6%) and upper back pain (difference: 14.8%). For most pain locations, there was good or very good agreement between paper and online manikins (PABAK range: 0.61 to 0.88). However, identification of pain in the hip/thigh and in the upper back had poorer agreement (PABAK: 0.49 and 0.29, respectively). CONCLUSIONS This is the first study to examine the reproducibility of body manikins on different media, in a population-based survey. We have shown that online manikins can be used to capture data on pain location in a manner satisfactorily comparable to paper questionnaires.
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Affiliation(s)
- Gareth T Jones
- Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Ramona Kyabaggu
- Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Debbi Marais
- Public Health Nutrition Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Gary J Macfarlane
- Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Functional consequences and health-care seeking behaviour for recurrent non-specific low back pain in Zimbabwean adolescents: a cross-sectional study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:643-50. [PMID: 26148568 DOI: 10.1007/s00586-015-4105-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of the study was to investigate the consequences of recurrent non-specific low back pain in Zimbabwean adolescents. Recurrent non-specific low back pain is a common cause of adult disability in low-income countries. However, its impact in adolescents has been a matter of debate in the literature. METHODS A survey was conducted using a cluster sample of 544 school children between the ages of 13 and 19 years. The school children were randomly selected from government-administered secondary schools in Harare, Zimbabwe. RESULTS Parental and students' response rate were 90.3 and 97.8 %, respectively. Almost a third (28.8 %) of school children reported recurrent symptoms (CI 27.8-31.6). However, the majority (84 %) of these cases were unknown to parents. Twenty-seven percent reported having sought medical treatment. On the nine-item Hanover Low Back Pain Disability Questionnaire, 71.2 % of school children had at least one activity of daily living compromised by recurrent NSLBP, especially sports participation. However, severe disability was reported in 28 % of the adolescents. Health-care seeking behaviour was not associated with the level of disability [χ (2)(1) = 0.36, p = 0.55]. CONCLUSION Although most parents are unaware, recurrent NSLBP is common in Zimbabwean school children. However, treatment is rarely sought for the symptoms. A preponderance of adolescents with recurrent NSLBP experiences some degree of functional consequences, although severe disability is rare. There is need to raise awareness of the condition in schools and to parents. Spinal health educational programmes may need to be implemented to avert the functional consequences. Further studies are needed in the future to investigate the coping strategies for pain in adolescents.
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Prevalence and management of back pain in adolescent idiopathic scoliosis patients: A retrospective study. Pain Res Manag 2015; 20:153-7. [PMID: 25831076 PMCID: PMC4447159 DOI: 10.1155/2015/674354] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Back pain (BP) has often been associated with adolescent idiopathic scoliosis (AIS), which is a three-dimensional deviation of the vertebral column. In adolescents, chronic pain appears to be a predictor of health care utilization and has a negative impact on physical, psychological and family well-being. In this population, BP tends to be persistent and may be a predictor of BP in adulthood. OBJECTIVE To document the prevalence and management of BP in AIS patients. METHODS A retrospective chart review of AIS patients who were referred to Sainte-Justine University Teaching Hospital (Montreal, Quebec) from 2006 to 2011 was conducted. RESULTS A total of 310 randomly selected charts were reviewed. Nearly one-half of the patients (47.3%) mentioned that they experienced BP, most commonly in the lumbar (19.7%) and thoracic regions (7.7%). The type of BP was documented in only 36% (n=112) of the charts. Pain intensity was specified in only 21% (n=65) of the charts. In approximately 80% (n=248) of the charts, no pain management treatment plan was documented. CONCLUSIONS The prevalence of BP was moderately high among the present sample of adolescents with AIS. An improved system for documenting BP assessment, type, treatment plan and treatment effectiveness would improve pain management for these patients.
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Wójcik M, Siatkowski I. Assessment of spine pain presence in children and young persons studying in ballet schools. J Phys Ther Sci 2015; 27:1103-6. [PMID: 25995566 PMCID: PMC4433987 DOI: 10.1589/jpts.27.1103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 12/04/2014] [Indexed: 02/07/2023] Open
Abstract
[Purpose] Spine disorders affect various sections of the spine and have a variety of causes. Most pain occurs in the lumbo-sacral and cervical regions. Dance is associated with exercise. High levels of physical activity predispose to back pain occurrence. [Subjects and Methods] The subjects were 237 ballet learners; 80 children (primary school level), mean age 11.24±0.77, mean of years of training ballet 2.14±0.74; 93 students (junior high school level), mean age 14.01±0.84, mean of years of learning ballet 4.64±1.24; 64 students (high school) mean age 17.01±0.77, mean of years of learning ballet 7.47±1.54. Numeric rating scale was used to determine spine pain. [Results] Feelings of pain were analyzed on the basis of "now" and "before" between levels education by using point statistics and statistical tests to compare groups. "Now" exhibited weaker back pain feelings than "before" at all the education levels. There were statistically significant differences in pain feeling for "before" (at any time of learning) and "now" (the day of survey). [Conclusion] All patients reported pain "before" and "now" in cervical, thoracic and lumbar spine. At all levels of education there were statistically significant differences in feelings of pain between "before" and "now".
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Affiliation(s)
- Małgorzata Wójcik
- Department of Physiotherapy, Stanislaw Staszic University
of Applied Science in Pila, Poland
- Corresponding author. Małgorzata Wójcik, Department of Physiotherapy, Stanislaw Staszic University
of Applied Science in Pila: Podchorążych 10, 64-920 Piła, Poland. (E-mail: )
| | - Idzi Siatkowski
- Department of Mathematical and Statistical Methods, Poznan
University of Life Sciences, Poland
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Chiwaridzo M, Naidoo N. Prevalence and associated characteristics of recurrent non-specific low back pain in Zimbabwean adolescents: a cross-sectional study. BMC Musculoskelet Disord 2014; 15:381. [PMID: 25406690 PMCID: PMC4246475 DOI: 10.1186/1471-2474-15-381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/28/2014] [Indexed: 11/10/2022] Open
Abstract
Background Until recently, non-specific low back pain (NSLBP) in adolescents was considered a rare phenomenon unlike in adults. The last two decades has shown an increasing amount of research highlighting the prevalence in this age group. Recent studies estimate lifetime prevalence at 7%-80%, point prevalence at 10%-15%, and prevalence of recurrent NSLBP at 13%-36%. In Zimbabwe, there is dearth of literature on the magnitude of the problem in adolescents. Therefore, the aims of the study were to determine the prevalence (lifetime, point, recurrent) and the nature of recurrent NSLBP reported by adolescents in secondary schools. Methods A cross-sectional study was conducted using a questionnaire. A cluster sample of 544 adolescents (age 13–19 years) randomly derived from government schools participated in the study. Lifetime prevalence, point prevalence and prevalence of recurrent NSLBP were presented as percentages of the total population. Exact 95% confidence intervals were given. Chi-square test was used to evaluate the effect of gender and age on prevalence. Results The students’ response rate was 97.8%. The lifetime prevalence was 42.9% [95% confidence interval = 40.8-44.6] with no significant difference between sexes [χ2 (1) =0.006, p = 0.94]. However, NSLBP peaked earlier in female students (13.9 years) than in male students (15 years) [t (226) = 4.21, p < 0.001]. About 10% of the adolescents reported having an episode of NSLBP on the day of the survey. However, female students (14.2%) were more affected on the day [χ2 (1) = 11.2, p < 0.001]. Twenty-nine percent of the adolescents experienced recurrent NSLBP with 78% experiencing at least three episodes in the last 12 months. On average, recurrent NSLBP reported was mild in intensity (4.8 ± 1.9) on the visual analogue scale (VAS) and short in duration. Recurrent NSLBP was associated with sciatica in 20.9% of adolescents. Conclusions NSLBP is a common occurrence among Zimbabwean adolescents in secondary schools. It increases with chronological age and is recurrent in the minority of adolescents. Although much of the symptomatology may be considered benign, the existence of recurrent NSLBP in adolescents before their work-life begins should be a concern to health professionals, teachers and parents. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-381) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew Chiwaridzo
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.
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Silva MROGCM, Badaró AFV, Dall'Agnol MM. Low back pain in adolescent and associated factors: A cross sectional study with schoolchildren. Braz J Phys Ther 2014; 18:402-9. [PMID: 25372002 PMCID: PMC4228625 DOI: 10.1590/bjpt-rbf.2014.0051] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 02/10/2014] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE To determine the prevalence of low back pain nonspecific and associated factors in schoolchildren. METHOD This cross-sectional study investigated 343 adolescents, aged between 12 and 15 years, of both sexes of public schools. The questionnaire included questions regarding sociodemographic characteristics, type of school transportation, body mass index and low back pain. The outcome was defined as discomfort localized below the costal margin and above the inferior gluteal folds in the last 12 months. RESULTS The prevalence of low back pain in the last year was 57% (n=195) among participants, with no significant difference between the sexes (OR 1.13, 95% CI 0.93 to 1.37). Advancing age and body mass index were associated with the presence of low back pain in the bivariate analysis. The remaining seated at school in usual days was considered one of the main activities that trigger symptoms that lasted up to seven days for the majority (80%) of adolescents. CONCLUSIONS The high prevalence of low back pain presented, indicating that it is a common condition among these adolescents. There was no difference between the sexes, but had influence of age and body mass index. Our results point to the need for the development epidemiological studies of low back pain among children and adolescents.
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Affiliation(s)
- Mônica R O G C M Silva
- Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Ana Fátima V Badaró
- Departamento de Fisioterapia e Reabilitação, CCS, UFSM, Santa Maria, RS, Brazil
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Lemos ATD, Santos FRD, Moreira RB, Machado DT, Braga FCC, Gaya ACA. [Low back pain and associated factors in children and adolescents in a private school in Southern Brazil]. CAD SAUDE PUBLICA 2014; 29:2177-85. [PMID: 24233033 DOI: 10.1590/0102-311x00030113] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 06/05/2013] [Indexed: 11/21/2022] Open
Abstract
Studies have shown that children and adolescents with low back pain are also similarly affected when they reach adulthood, thus highlighting the importance of investigating causes of low back pain in school-age children. The study examined low back pain and associated factors in 770 schoolchildren 7 to 17 years of age in a private school in Porto Alegre, Rio Grande do Sul State, Brazil. Low back pain was defined as pain or discomfort in the lumbar region in the previous month, assessed by a questionnaire. Low back pain was found in 31.6% of the subjects and was more prevalent in girls (41.9%) than boys (21.4%). Factors associated with lumbar pain were female gender, age 9 to 17 years, hyperactivity (borderline and abnormal categories), and emotional symptoms (abnormal category). Mapping the occurrence of low back pain and associated factors is important for identifying children and adolescents at risk and for developing effective programs for primary prevention.
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Kim KY, Sim KC, Kim TG, Bae SH, Lee JC, Kim GD. Effects of Sling Bridge Exercise with Rhythmic Stabilization Technique on Trunk Muscle Endurance and Flexibility in Adolescents with Low Back Pain. INTERNATIONAL JOURNAL OF CONTENTS 2013. [DOI: 10.5392/ijoc.2013.9.4.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lazary A, Szövérfi Z, Szita J, Somhegyi A, Kümin M, Varga PP. Primary prevention of disc degeneration-related symptoms. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 23 Suppl 3:S385-93. [PMID: 24221919 DOI: 10.1007/s00586-013-3069-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 12/18/2022]
Abstract
INTRODUCTION It has been shown previously that a history of low back pain often begins in childhood or adulthood. Indeed, the prevalence of severe back symptoms among schoolchildren is not insignificant. Possibilities for the primary prevention of intervertebral disc degeneration-related conditions are poorly reported in the literature despite the assumed socio-economical impact of the prevention of these conditions. METHODS In this review, the authors have collated published data on the prevalence and risk factors of childhood low back pain as well as the structure and results of published primary prevention programs. RESULTS The prevalence of self-reported low back pain is 7-65% among children and it increases with age. Several lifestyle factors have been reported as significant risk factors for back pain, many of which are related to the schools. Current educational primary prevention programs in schools show no clear or long-term stable effect. CONCLUSION Considering the growing evidence about the importance of normal and bad posture, an exercise-based posture correction program is suggested as a school-based primary prevention of disc degeneration-related symptoms. Further, prospective randomized studies with more than 20 years follow-up, however, are strongly required to confirm it.
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Affiliation(s)
- Aron Lazary
- National Center for Spinal Disorders, Buda Health Center, Kiralyhago u. 1-3., Budapest, 1126, Hungary,
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Abstract
Back pain episodes are traditionally regarded as individual events, but this model is currently being challenged in favour of treating back pain as a long-term or lifelong condition. Back pain can be present throughout life, from childhood to older age, and evidence is mounting that pain experience is maintained over long periods: for example, people with pain continue to have it on and off for years, and people without pain do not suddenly develop long-term pain. A number of factors predict back pain presence in epidemiological studies, and these are often present, and predictive, at different life stages. There are also factors present at particular life stages, such as childhood or adolescence, which predict back pain in adulthood. However, there are little published data on long-term pain patterns or predictors over the life course. Such studies could improve our understanding of the development and fluctuations in back pain, and therefore influence treatment approaches.
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Affiliation(s)
- Kate M Dunn
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire ST5 5BG, UK.
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Dunn KM, Hestbaek L, Cassidy JD. WITHDRAWN: Low back pain across the lifecourse. Best Pract Res Clin Rheumatol 2013. [DOI: 10.1016/j.berh.2013.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dockrell S, Simms C, Blake C. Schoolbag weight limit: can it be defined? THE JOURNAL OF SCHOOL HEALTH 2013; 83:368-377. [PMID: 23517005 DOI: 10.1111/josh.12040] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 04/24/2012] [Accepted: 05/03/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Carrying a schoolbag is a daily activity for most children and much research has been conducted in an effort to identify a safe load limit for children to carry in their schoolbags. Despite this, there is still no consensus about guideline weight and other factors associated with carrying a schoolbag. The objective of this article is to review the literature on schoolbags with particular emphasis on the load limit guidelines and schoolbag-related musculoskeletal pain, and to suggest directions for school health and future research. METHODS Science Direct, PubMed, AMED, CINAHL, OVID, EMBASE, and Scopus were searched for peer-reviewed articles using combinations of the following key words: schoolbag, backpack, rucksack, knapsack, satchel, book bag, book pack and included combinations of children, pain, gait, and posture. Article references were also checked for further citations. All are in English, with the exception of one which is in German but is widely cited. RESULTS There are conflicting findings in the literature. The recommended load limit for schoolchildren to carry varies from 5% to 20% of their body weight, and the evidence linking backpack weight and back pain is inconclusive. CONCLUSIONS The shortcomings in the current literature should be addressed so that evidence-based guidelines can be provided to schoolchildren, parents, and teachers. It is suggested that general guidance may be more appropriate than a single load limit guideline.
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Affiliation(s)
- Sara Dockrell
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin 2, Ireland.
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Calvo-Muñoz I, Gómez-Conesa A, Sánchez-Meca J. Physical therapy treatments for low back pain in children and adolescents: a meta-analysis. BMC Musculoskelet Disord 2013; 14:55. [PMID: 23374375 PMCID: PMC3568715 DOI: 10.1186/1471-2474-14-55] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 01/30/2013] [Indexed: 11/26/2022] Open
Abstract
Background Low back pain (LBP) in adolescents is associated with LBP in later years. In recent years treatments have been administered to adolescents for LBP, but it is not known which physical therapy treatment is the most efficacious. By means of a meta-analysis, the current study investigated the effectiveness of the physical therapy treatments for LBP in children and adolescents. Methods Studies in English, Spanish, French, Italian and Portuguese, and carried out by March 2011, were selected by electronic and manual search. Two independent researchers coded the moderator variables of the studies, and performed the effect size calculations. The mean effect size index used was the standardized mean change between the pretest and posttest, and it was applied separately for each combination of outcome measures, (pain, disability, flexibility, endurance and mental health) and measurement type (self-reports, and clinician assessments). Results Eight articles that met the selection criteria enabled us to define 11 treatment groups and 5 control groups using the group as the unit of analysis. The 16 groups involved a total sample of 334 subjects at the posttest (221 in the treatment groups and 113 in the control groups). For all outcome measures, the average effect size of the treatment groups was statistically and clinically significant, whereas the control groups had negative average effect sizes that were not statistically significant. Conclusions Of all the physical therapy treatments for LBP in children and adolescents, the combination of therapeutic physical conditioning and manual therapy is the most effective. The low number of studies and control groups, and the methodological limitations in this meta-analysis prevent us from drawing definitive conclusions in relation to the efficacy of physical therapy treatments in LBP.
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Affiliation(s)
- Inmaculada Calvo-Muñoz
- Department of Physiotherapy, Faculty of Medicine, Espinardo Campus, University of Murcia, Murcia 30100, Spain.
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Hoftun GB, Romundstad PR, Rygg M. Factors associated with adolescent chronic non-specific pain, chronic multisite pain, and chronic pain with high disability: the Young-HUNT Study 2008. THE JOURNAL OF PAIN 2012; 13:874-83. [PMID: 22832694 DOI: 10.1016/j.jpain.2012.06.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/23/2012] [Accepted: 06/05/2012] [Indexed: 11/28/2022]
Abstract
UNLABELLED The aim of this study was to assess the association of chronic pain with different lifestyle factors and psychological symptoms in a large, unselected adolescent population. Pain was evaluated as chronic non-specific pain, chronic multisite pain, and in additional analyses, chronic pain with high disability. The study was performed during 2006 to 2008 in Nord-Trøndelag County, Norway. Adolescents aged 13 to 18 years were invited to participate. The response rate was 78%. The final study population consisted of 7,373. Sedentary behavior and pain were associated only in girls. In both sexes, overweight and obesity were associated with increased odds of pain. Whereas both smoking and alcohol intoxication showed strong associations with pain, the associations were attenuated after adjustments for psychosocial factors. Symptoms of anxiety and depression showed the strongest associations with pain (odds ratio 4.1 in girls and 3.7 in boys). The odds of pain increased gradually by number of unfavorable lifestyle factors reported. This study revealed consistent associations between lifestyle factors, anxiety and depression, and chronic pain, including multisite pain and pain with high disability. The consistency across the different pain categories suggests common underlying explanatory mechanisms, and despite the cross-sectional design, the study indicates several modifiable targets in the management of adolescent chronic pain. PERSPECTIVE This study showed a clear and consistent relation between different lifestyle factors, anxiety and depression, and the pain categories chronic non-specific pain, multisite pain, and also pain with high disability. Independent of causality, it underlines the importance of a broad perspective when studying, preventing, and treating chronic pain in adolescents.
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Affiliation(s)
- Gry Børmark Hoftun
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Berde CB, Walco GA, Krane EJ, Anand KJS, Aranda JV, Craig KD, Dampier CD, Finkel JC, Grabois M, Johnston C, Lantos J, Lebel A, Maxwell LG, McGrath P, Oberlander TF, Schanberg LE, Stevens B, Taddio A, von Baeyer CL, Yaster M, Zempsky WT. Pediatric analgesic clinical trial designs, measures, and extrapolation: report of an FDA scientific workshop. Pediatrics 2012; 129:354-64. [PMID: 22250028 PMCID: PMC9923552 DOI: 10.1542/peds.2010-3591] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Analgesic trials pose unique scientific, ethical, and practical challenges in pediatrics. Participants in a scientific workshop sponsored by the US Food and Drug Administration developed consensus on aspects of pediatric analgesic clinical trial design. The standard parallel-placebo analgesic trial design commonly used for adults has ethical and practical difficulties in pediatrics, due to the likelihood of subjects experiencing pain for extended periods of time. Immediate-rescue designs using opioid-sparing, rather than pain scores, as a primary outcome measure have been successfully used in pediatric analgesic efficacy trials. These designs maintain some of the scientific benefits of blinding, with some ethical and practical advantages over traditional designs. Preferred outcome measures were recommended for each age group. Acute pain trials are feasible for children undergoing surgery. Pharmacodynamic responses to opioids, local anesthetics, acetaminophen, and nonsteroidal antiinflammatory drugs appear substantially mature by age 2 years. There is currently no clear evidence for analgesic efficacy of acetaminophen or nonsteroidal antiinflammatory drugs in neonates or infants younger than 3 months of age. Small sample designs, including cross-over trials and N of 1 trials, for particular pediatric chronic pain conditions and for studies of pain and irritability in pediatric palliative care should be considered. Pediatric analgesic trials can be improved by using innovative study designs and outcome measures specific for children. Multicenter consortia will help to facilitate adequately powered pediatric analgesic trials.
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Affiliation(s)
- Charles B. Berde
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Children's Hospital, Boston, Boston, Massachusetts;,Harvard Medical School, Boston, Massachusetts;,Address correspondence to Charles Berde, MD, PhD, Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital, Boston, 333 Longwood Ave, 5th floor, Boston, MA 02115. E-mail:
| | - Gary A. Walco
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, Washington;,University of Washington School of Medicine, Seattle, Washington
| | - Elliot J. Krane
- Stanford University School of Medicine, Stanford, California;,Lucile Packard Children's Hospital, Stanford, California
| | - K. J. S. Anand
- Division of Pediatric Critical Care Medicine, Le Bonheur Children's Hospital, Memphis, Tennessee;,University of Tennessee Health Science Center, Memphis, Tennessee
| | - Jacob V. Aranda
- The Children's Hospital of Brooklyn, State University of New York, New York, New York;,Pediatric Pharmacology Research Unit Network, Children's Hospital of Michigan, Detroit, Michigan
| | - Kenneth D. Craig
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carlton D. Dampier
- Emory University School of Medicine, Atlanta, Georgia;,Atlanta Clinical Translational Science Institute, Atlanta, Georgia
| | - Julia C. Finkel
- Department of Anesthesiology George Washington University, Washington, District of Columbia;,Division of Anesthesiology and Pain Medicine, Children's National Medical Center, Washington, District of Columbia
| | - Martin Grabois
- Baylor College of Medicine, Houston, Texas;,University of Texas Health Science Center-Houston, Houston, Texas
| | | | - John Lantos
- Children's Mercy Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri;,University of Missouri–Kansas City, Kansas City, Missouri
| | - Alyssa Lebel
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Children's Hospital, Boston, Boston, Massachusetts;,Harvard Medical School, Boston, Massachusetts
| | - Lynne G. Maxwell
- Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;,Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Patrick McGrath
- IWK Health Centre, Halifax, Nova Scotia, Canada;,Dalhousie University, Halifax, Nova Scotia, Canada
| | - Timothy F. Oberlander
- Division of Developmental Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada;,BC Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Bonnie Stevens
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Anna Taddio
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Carl L. von Baeyer
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Myron Yaster
- Division of Pediatric Anesthesiology, Department of Anesthesiology and Critical Care Medicine, Children's Medical and Surgical Center, The Johns Hopkins Hospital, Baltimore, Maryland; and
| | - William T. Zempsky
- Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, Connecticut
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Kanchanomai S, Janwantanakul P, Pensri P, Jiamjarasrangsi W. A Prospective Study of Incidence and Risk Factors for the Onset and Persistence of Low Back Pain in Thai University Students. Asia Pac J Public Health 2011; 27:NP106-15. [DOI: 10.1177/1010539511427579] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to examine the 12-month incidence and risk factors for the onset and persistence of low back pain (LBP) in undergraduate students. A 1-year prospective study was carried out among 684 healthy students in a large public university in Thailand. Data were collected using a self-administered questionnaire and a physical examination. Follow-up data were collected every 3 months. A total of 524 (77%) students were followed for 1 year. A total of 31% reported a new onset of LBP, of whom 31% reported persistent LBP. Having no low back support during computer work was a significant predictor for the onset and persistence of LBP. The onset of LBP was also associated with quadriceps muscle tightness. LBP is common among undergraduate students, and many of them may have persistent symptoms. Physical risk factor plays a significant role for the onset and persistence of LBP among the study population.
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Jackson C, McLaughlin K, Teti B. Back pain in children: a holistic approach to diagnosis and management. J Pediatr Health Care 2011; 25:284-93. [PMID: 21867856 DOI: 10.1016/j.pedhc.2010.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 03/13/2010] [Accepted: 03/14/2010] [Indexed: 11/17/2022]
Abstract
Back pain is a relatively common complaint presenting to the primary care practitioner and is addressed with increasing frequency in the pediatric literature. Back pain is not uncommon in adolescents and often is symptomatic of a relatively benign musculoskeletal etiology. Back pain in children less than 10 years of age and most especially less than 4 years of age can signal a more alarming underlying condition. Evaluation requires a complete history including psychosocial and cultural considerations. Additionally a thorough clinical examination, strategic lab work and judicious imaging are imperative. Management and appropriate referral is specific to the underlying disease process. A holistic, individualized plan of care with inherent involvement of the child and parent/caregiver is essential to ensure safety and enhance outcomes.
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Hoftun GB, Romundstad PR, Zwart JA, Rygg M. Chronic idiopathic pain in adolescence--high prevalence and disability: the young HUNT Study 2008. Pain 2011; 152:2259-2266. [PMID: 21683528 DOI: 10.1016/j.pain.2011.05.007] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/02/2011] [Accepted: 05/11/2011] [Indexed: 11/20/2022]
Abstract
The aim of this study was to determine the prevalence of self-reported chronic idiopathic pain among adolescents in relation to age and gender, and to explore how pain interferes with daily activities. The study was performed in Nord-Trøndelag County, Norway in 2006-2008. All adolescents were invited to participate; the response rate was 78%. Participants completed a comprehensive questionnaire, including questions about pain and interference with everyday life. Chronic idiopathic pain was defined as pain at least once a week during the last 3 months, not related to any known disease or injury. The final study population, with complete pain questionnaires, consisted of 7373 adolescents aged 13-18 years. Chronic pain was reported by 44.4% of the participants, and 25.5% reported pain in at least 2 locations. Chronic idiopathic musculoskeletal pain was most prevalent (33.4%), and the neck/shoulder was most commonly affected. Musculoskeletal pain in 3 or more locations was reported by 8.5%. Pain almost daily was reported by 10.2%. More girls than boys reported pain. In girls, the prevalence of pain increased with age. A high number of pain-associated disabilities were reported, and 58.5% described difficulties doing daily activities in leisure time. Subjective disabilities were higher in girls, and increased with the frequency of pain and the number of pain locations, as shown by high disability in adolescents with musculoskeletal pain in 3 or more locations. Chronic idiopathic pain, especially multisite pain, is common among adolescents, and those suffering from it report a major impact on several areas of daily living.
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Affiliation(s)
- Gry Børmark Hoftun
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Neurology, Oslo University Hospital, Ullevål and University of Oslo, Norway
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Long-term effectiveness of a back education programme in elementary schoolchildren: an 8-year follow-up study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 20:2134-42. [PMID: 21647724 DOI: 10.1007/s00586-011-1856-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 05/21/2011] [Indexed: 01/23/2023]
Abstract
The purpose of this study was to investigate the long-term effectiveness of a spine care education programme conducted in 9- to 11-year-old schoolchildren. The study sample included 96 intervention subjects and 98 controls (9- to 11-year-olds at baseline). Intervention consisted of a 6-week school-based back education programme (predominantly biomechanically oriented) and was implemented by a physical therapist. Self-reported outcomes on back care knowledge, spinal care behaviour, self-efficacy towards favourable back care behaviour, prevalence of back and neck pain during the week and fear-avoidance beliefs were evaluated by the use of questionnaires. Post-tests were performed within 1 week after programme completion, after 1 year and after 8 years. Whereas the educational back care programme resulted in increased back care knowledge up to adulthood (P < 0.001), intervention did not change spinal care behaviour or self-efficacy. Pain prevalence figures increased less in the experimental group compared to the controls over the 8-year time span, yet statistical significance was not reached. Dropout analysis revealed spinal pain prevalence rates to be different in both groups throughout the study, including at baseline. Back education at young age did not reinforce fear-avoidance beliefs up to adulthood. Predominantly biomechanical oriented back education in elementary schoolchildren is effective in improving the cognitive aspect of back care up to adulthood, yet not in changing actual behaviour or self-efficacy. The current study does not provide evidence that educational back care programmes have any impact on spinal pain in adulthood. The true long-term impact of school-based spinal health interventions on clinically relevant outcome measures merits further attention.
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