PROTOCOL: School-based education programmes for improving knowledge of back health, ergonomics and postural behaviour of school children aged 4-18: A systematic review

Assessment of the Effects of Physiotherapy on Back Care and Prevention of Non-Specific Low Back Pain in Children and Adolescents: A Systematic Review and Meta-Analysis

Non-specific low back pain (NSLBP) in children and adolescents has increased in recent years, and the evidence of the physiotherapy interventions in back care needs to be updated. Our main goal was to quantify the effects of preventive physiotherapy interventions on improving behavior and knowledge related to back care and prevention of NSLBP in children and adolescents. Based on two previous meta-analyses, Cochrane Library, MEDLINE, PEDro, Web of Science, LILACS, IBECS, PsycINFO, and IME databases and several journals were searched. Two researchers independently extracted data and assessed the risk of bias in the studies using the RoB2 tool. Data were described according to PRISMA guidelines. A total of 24 studies (28 reports) were included. In the posttest, the behavior variable obtained an overall effect size of d+ = 1.48 (95%CI: 0.40 to 2.56), and the knowledge variable obtained an effect size of d+ = 1.41 (95%CI: 1.05 to 1.76). Physiotherapy has demonstrated beneficial impacts on behavior and knowledge concerning back care and to prevent NSLBP in children and adolescents. Interventions focusing on postural hygiene and exercise should be preferred, especially those that are shorter in number of weeks, more intense, and incorporate as many intervention hours as possible.

The effect of exercise therapy as a tool for preventing and treating musculoskeletal disorders among school-aged children: a randomised controlled trial

BACKGROUND

Children spend a lot of time in school, and there are many ergonomic hazards and postural malalignments that put children at greater risk of developing musculoskeletal disorders (MSDs). This study aimed to investigate the effect of exercise therapy on preventing and treating musculoskeletal disorders among school-aged children.

METHOD

This randomised controlled trial included 212 (121 boys and 91 girls) school-aged children aged 13-15 years assigned to treatment (n = 106) and prevention (n = 106) groups, where the treatment group contained individuals with MSDs and prevention group contained individuals without MSDs. In each group, half of the individuals received exercise therapy (50 min per session, four times per week, for an 8-week), and others continued their daily lives. MSDs and physical activity were assessed by the Teen Nordic Musculoskeletal Screening Questionnaire and the International Physical Activity Questionnaire-Short Form, respectively, at baseline and after the experimental protocol.

RESULTS

There was a statistically significant reduction in the frequency of MSDs in the treatment group and occurring MSDs in the prevention group (P ≤ .05). Also, there was significant improvement in all variables of walking, moderate physical activity, vigorous physical activity, and total in intervention groups spatially in students who received exercise therapy (P ≤ .05).

CONCLUSIONS

This study demonstrated the effectiveness of exercise therapy in reducing and preventing MSDs and improving physical activity levels among school-aged children aged 13-15 years.

TRIAL REGISTRATIONS

Ethical Committee of Shahrekord University (IR.SKU.REC.1401.022) (registration date: 31/05/2022). Clinical Trail Registration (IRCT20220705055375N1), (registration date: 29/07/2022).

Back-Health-Related Physical Activity and Exercise Knowledge in Adolescents: A Cross-Sectional Study

Knowledge is a determining factor for the development of postural habits; it could be considered as the first step in the establishment of changes. The aim of this study was to analyze the level of specific back-health-related physical activity and exercise knowledge in adolescents. A cross-sectional study was conducted on a sample of 1500 high school students between the ages of 13 and 18 (mean age = 15.18 ± 1.44). Students from the Valencian Community (Spain) were recruited with a confidence level of 95% and an accepted standard error of ± 2.53%. Self-report questionnaires were used to record back-health-related physical activity knowledge. The level of specific knowledge of back-health education related to physical activity and exercise in adolescents was low (X = 2.05 ± 2.26). Only 10.9% of the students passed the specific knowledge test, achieving a score equal or superior to 5. The boys’ average score was higher (X = 2.17 ± 2.31) than the girls’ (X = 1.94 ± 2.21) with statistically significant differences (p = 0.048). The level of specific knowledge increased with age (p < 0.001). Secondary school students show a low level of specific knowledge concerning back health. It is recommended that back care education be a part of school curriculum.

The Impact of the COVID-19 Pandemic on Students' Body Posture During Online Learning Should not be Overlooked

Collapse

Teaching Back Health in the School Setting: A Systematic Review of Randomized Controlled Trials

School-based interventions have reported effectiveness on back health; however, there are no specific guidelines for teaching body mechanics and posture in primary and secondary schools. To identify, describe, and analyze the educative features of randomized controlled trials (RCTs) on back health developed to date in the school setting, a systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. RCTs exclusively focused on educational setting electronic databases included PubMed, EMBASE, PEDro, Web of Science, SPORTDiscus, ERIC, and MEDLINE on the Ovid platform. Databases were searched for potentially eligible studies from the earliest date up to 18th March 2020. A total of 584 records were obtained from the database searches. A total of six articles that applied inclusion criteria were assessed for eligibility. All of these studies found improvements in postural habits and the level of knowledge with regard to back health, as well as a reduction in the prevalence of back pain. None of the studies used the student-centered method, and three studies used evaluation instruments with a pilot validation. Research on RCT interventions concerning back health in the school setting is scarce. None of the interventions applied a constructivist or student-centered method. The use of validated and standardized assessment instruments is required.

Cross-Cultural Adaptation and Reliability of the Back Pain and Body Posture Evaluation Instrument (BackPEI) to the Spanish Adolescent Population

The prevalence of back pain (BP) among children and adolescents has increased over recent years. Some authors advocate promoting back-health education in the school setting. It is therefore important to adopt a uniform suite of assessment instruments to measure the various constructs. The present study aimed to perform a cultural adaptation of a validated measurement instrument (BackPEI), beginning with a translation and cultural adaptation phase, followed by a second phase to test reliability using a test-retest design. The translation and cross-cultural adaptation were performed based on the guidelines. Reliability was tested by applying the questionnaire to 224 secondary school students, at two different times with a 7-day interval between the tests. In general, the Spanish version presented adequate agreement for questions 1-20, with only question 9 achieving a low Kappa range of 0.312 (-0.152-0.189). The question about pain intensity did not show differences between the test means (4.72 ± 2.33) and re-test (4.58 ± 2.37) (p = 0.333), and the responses for these two tests obtained a high correlation (ICC = 0.951 (0.928-0.966); p = 0.0001). Psychometric testing indicated that the Spanish version of the BackPEI is well-adapted and reliable, based on the test-retest design, providing similar results to the original Brazilian version.