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Montgomery LRC, Swain M, Dario AB, O'Keeffe M, Yamato TP, Hartvigsen J, French S, Williams C, Kamper S. Does sedentary behaviour cause spinal pain in children and adolescents? A systematic review with meta-analysis. Br J Sports Med 2024:bjsports-2024-108648. [PMID: 39438037 DOI: 10.1136/bjsports-2024-108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2024] [Indexed: 10/25/2024]
Abstract
OBJECTIVE To evaluate whether sedentary behaviour is a risk or prognostic factor for spinal pain in children and adolescents. Specifically, to estimate the (1) direction and strength of the association; (2) risk of spinal pain onset and (3) effect on spinal pain prognosis. DESIGN Systematic review with meta-analysis. DATA SOURCES Electronic searches of MEDLINE, Embase, CINAHL and Web of Science up to 23 March 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Reports estimating the effect of sedentary behaviour on spinal pain in young people (≤19 years). RESULTS We included 129 reports, 14 were longitudinal (n = 8 433) and 115 were cross-sectional (n > 697 590). We incorporated 86 studies into meta-analyses. (1) From cross-sectional data, we found low certainty evidence of a small positive association between sedentary behaviour and spinal pain (adjusted odds ratio 1.25 (95% CI 1.17 to 1.33), k = 44, n > 92 617). (2) From longitudinal data, we found low certainty evidence of no increased risk for the onset of spinal pain due to sedentary behaviour (adjusted risk ratio 1.07 (95% CI 0.84 to 1.35), k = 4, n = 1 292). (3) No studies assessed prognosis. CONCLUSION Cross-sectional data suggest minimally higher odds of spinal pain for children and adolescents who engage in greater sedentary behaviours. However, longitudinal data do not support a causal relationship, indicating that sedentary behaviour does not increase the risk for onset of spinal pain. Due to the low certainty of evidence, these findings must be interpreted with caution. We found no evidence of the effect sedentary behaviour has on spinal pain prognosis in children and adolescents, highlighting a considerable gap in the literature.
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Affiliation(s)
- Laura R C Montgomery
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Swain
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Amabile B Dario
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mary O'Keeffe
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Tie P Yamato
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Sydney, New South Wales, Australia
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
| | - Simon French
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Christopher Williams
- University Centre for Rural Health, Faculty of Medicine and Health, The University of Sydney, Lismore, New South Wales, Australia
- Research and Knowledge Translation Directorate, Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Steve Kamper
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Sydney, New South Wales, Australia
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Resende BBDE, Almeida PS, Silva MA, Santos PS, Ávila MVDE, Guimarães AC, Damázio LCM, Saldanha PC. PREVALENCE OF POSTURAL CHANGES IN SCHOOL CHILDREN AND ADOLESCENTS. ACTA ORTOPEDICA BRASILEIRA 2023; 31:e262255. [PMID: 37323146 PMCID: PMC10263437 DOI: 10.1590/1413-785220233102e262255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/15/2022] [Indexed: 06/17/2023]
Abstract
Objective Investigate the prevalence of postural changes and correlate them with body weight and the weight of schoolchildren's backpacks in a school in the city of São João del-Rei-MG. Material and. Methods The study is an original type, with a cross-sectional design, where 109 schoolchildren of both sexes and mean age of 13 years were evaluated. The New York scale was used for posture analysis, measuring body weight, height, backpack weight, and Body Mass Index (BMI). The ANOVA statistical test and Pearson's correlation test were used, considering a significance level of 0.05. Results According to the results, the general average of the scores of postural problems was 68.7 points, with a predominance in the head, spine, hips, trunk, and abdomen. The regions of shoulder, feet, and neck presented mean scores below seven. The mean height was 1.61 m, body weight 56.03 kg, backpack weight 4.49 kg and BMI was 21.51 kg/m. Conclusion Postural alterations are highly prevalent among the evaluated students. The most affected body segments are the head, spine, hips, trunk, and abdomen. However, this finding was not related to the weight of the backpacks or the students' body weight. However, different parameters must be used to analyze the factors that may be related to such findings, such as ergonomic changes, inadequate habits, growth spurt, among others. Evidence Level III,Cross-sectional Observational Study.
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Affiliation(s)
- Bruno Boari DE Resende
- . Center University Tancredo Almeida Neves-UNIPTAN, Physiotherapy Course, São João del Rei, Minas Gerais, Brazil
| | - Paula Silva Almeida
- . Center University Tancredo Almeida Neves-UNIPTAN, Physiotherapy Course, São João del Rei, Minas Gerais, Brazil
| | - Marcelo Augusto Silva
- . Center University Tancredo Almeida Neves-UNIPTAN, Physiotherapy Course, São João del Rei, Minas Gerais, Brazil
| | - Patrícia Samara Santos
- . Center University Tancredo Almeida Neves-UNIPTAN, Physiotherapy Course, São João del Rei, Minas Gerais, Brazil
| | - Marcos Vinícius DE Ávila
- . Center University Tancredo Almeida Neves-UNIPTAN, Physiotherapy Course, São João del Rei, Minas Gerais, Brazil
| | - Andréa Carmen Guimarães
- . Federal University São João del-Rei - UFSJ, Department of Physical Education and Health Sciences -DCEFS, São João del Rei, Minas Gerais, Brazil
| | - Laila Cristina Moreira Damázio
- . Federal University São João del-Rei - UFSJ and Center University President Tancredo Almeida Neves - UNIPTAN, São João del Rei, Minas Gerais, Brazil
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Cuenca-Martínez F, Varangot-Reille C, Calatayud J, Suso-Martí L, Salar-Andreu C, Gargallo P, Blanco-Díaz M, Casaña J. The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression. Pediatr Phys Ther 2023; 35:212-226. [PMID: 36989048 DOI: 10.1097/pep.0000000000000996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE To evaluate and explore the influence of the weight of a backpack on standing posture and gait in children and adolescents. METHODS We conducted a search of MEDLINE (PubMed), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science, with the last search in July 2021. Standardized mean differences (SMD) and 95% confidence intervals were calculated for relevant outcomes and were pooled in a meta-analysis using the random-effects model. The participants were healthy children or adolescents. The outcomes were postural variables, spatiotemporal gait variables, gait kinematics, and muscle activity. We analyzed the influence of a loaded backpack on posture while standing and spatiotemporal and kinematic variables while walking. We used GRADE, Risk of Bias 2, ROBINS-I, MINORS, and PEDro scales to rate the quality, certainty, and applicability of the evidence. RESULTS Wearing a loaded backpack induces a significant increase of the craniohorizontal angle while standing and a decrease of walking speed and stride length while walking. Only the craniovertebral angle had a significant relationship with the weight of the backpack. CONCLUSIONS Wearing a backpack induces postural changes while standing and affects gait in children and adolescents; however, almost all the changes are not related to the backpack weight.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy (Messrs Cuenca-Martínez, Varangot-Reille, Calatayud, Suso-Martí, and Casaña), University of Valencia, Valencia, Spain; Department of Physiotherapy (Mr Suso-Martí), Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain; Department of Physiotherapy (Ms Salar-Andreu), Universidad CEU Cardenal Herrera, CEU Universities, Elche, Spain; Department of Physiotherapy (Mr Gargallo), Faculty of Medicine and Health Science, Catholic University of Valencia, Valencia, Spain; Department of Surgery and Medical Surgical Specialities (Ms Blanco-Díaz), Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Asturias, Spain
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Górna S, Pazdro-Zastawny K, Basiak-Rasała A, Krajewska J, Kolator M, Łesiuk-Krajewska A, Kozłowska-Panek K, Cichy I, Rokita A, Zatoński T. Assessment of the elementary school students’ schoolbag weight in the urban environment in Poland: A cross-sectional study carried out as a part of the ‘Lightweight Schoolbag’ and ‘Let’s Get the Kids Moving’ projects. Work 2022; 73:121-129. [DOI: 10.3233/wor-210788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Carrying a properly weighted schoolbag is an important factor in preventing the occurrence of muscular skeletal disorder in early school age children. OBJECTIVE: The purpose of this cross- sectional observational study was to examine the schoolbag weight and to determine the percentage of children were carrying overloaded schoolbag. METHODS: The study group included pupils from five primary public schools in Wrocław, Poland. Anthropometrical measurements such body weight (BW) and height were conducted on 650 children (51.1% of boys). Children’s age, gender, Cole’s Index was juxtaposed with schoolbag weight. The mean age of the examined students was 8.7±0.8 years (range 7 to 10 years). RESULTS: The mean schoolbags weight was 3.7±0.92 kg, which represented 13.0±3.8% of pupils’ BW. The percentage of pupils carry the schoolbags weighing more than 10% of their BW was 77.9%. More than a quarter of Polish children carry school backpack above 15% of their BW. The majority (96.8%) had schoolbags which may be carried on both shoulders. A significant negative correlation was observed between relative schoolbag weight and Cole’s Index (rho = –0.44, p < 0.05). CONCLUSIONS: The problem of overloaded schoolbags among elementary school children was frequent. Pupils ought to be educated in the proper packing of their school backpacks. Additionally, parents and teachers should pay attention regarding the contents carried by children in their respective schoolbags.
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Affiliation(s)
- Sara Górna
- Department of Physiology and Biochemistry, Poznań University of Physical Education, Poznań, Poland
| | | | | | - Joanna Krajewska
- Department of Otolaryngology, Head and Neck Surgery, Wrocław Medical University, Wrocław, Poland
| | - Mateusz Kolator
- Department of Otolaryngology, Head and Neck Surgery, Wrocław Medical University, Wrocław, Poland
| | | | | | - Ireneusz Cichy
- University School of Physical Education in Wroclaw, Wrocław, Poland
| | - Andrzej Rokita
- University School of Physical Education in Wroclaw, Wrocław, Poland
| | - Tomasz Zatoński
- Department of Otolaryngology, Head and Neck Surgery, Wrocław Medical University, Wrocław, Poland
- “Biegaj dla Zdrowia” Foundation, Wrocław, Poland
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The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020825. [PMID: 35055646 PMCID: PMC8776076 DOI: 10.3390/ijerph19020825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023]
Abstract
A systematic review was conducted to assess the efficacy and effectiveness of education programs to prevent and treat low back pain (LBP) in the Hispanic cultural setting. Electronic and manual searches identified 1148 unique references. Nine randomized clinical trials (RCTs) were included in this review. Methodological quality assessment and data extraction followed the recommendations from the Cochrane Back Pain Review Group. Education programs which were assessed focused on active management (3 studies), postural hygiene (7), exercise (4) and pain neurophysiology (1). Comparators were no intervention, usual care, exercise, other types of education, and different combinations of these procedures. Five RCTs had a low risk of bias. Results show that: (a) education programs in the school setting can transmit potentially useful knowledge for LBP prevention and (b) education programs for patients with LBP improve the outcomes of usual care, especially in terms of disability. Education on pain neurophysiology improves the results of education on exercise, and education on active management is more effective than “sham” education and education on postural hygiene. Future studies should assess the comparative or summatory effects of education on exercise, education on pain neurophysiology and education on active management, as well as explore their efficiency.
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Reducing the Weight of Spinal Pain in Children and Adolescents. CHILDREN 2021; 8:children8121139. [PMID: 34943335 PMCID: PMC8700484 DOI: 10.3390/children8121139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/10/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-management of the condition.
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Kemta Lekpa F, Enyama D, Noukeu Njinkui D, Ngongang Chiedjio A, Simeni Njonnou SR, Ngongang Ouankou C, Namme Luma H, Choukem SP. Prevalence and factors associated with low back pain in schoolchildren in Cameroon, sub-Saharan Africa. Int J Rheum Dis 2021; 24:1186-1191. [PMID: 34235853 DOI: 10.1111/1756-185x.14172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/06/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data on the prevalence and factors associated with low back pain (LBP) in schoolchildren are scarce in Africa, particularly in sub-Saharan Africa. OBJECTIVES To assess the prevalence and factors associated with LBP in schoolchildren in Cameroon. PATIENTS AND METHODS We performed a cross-sectional study in 10 randomly selected schools (public and private) in Douala, Cameroon. Using a self-administrated questionnaire, sociodemographic, usual physical activity, and clinical data were collected and all the schoolbags were weighted. Informed consent was obtained from the parents. Statistical significance was established at P < .05. Logistic regression was performed to identify factors associated with LBP. RESULTS We included 1075 schoolchildren (543 boys, 50.5%). The prevalence of LBP was 12.3% (132 children: 81 girls and 51 boys). The mean age was 11 ± 1 years (range, 8-14 years). Body mass index was normal in 110 schoolchildren (83.4%). Sixteen schoolchildren had already met a physician for LBP. Among the factors evaluated, those associated with LBP were female gender, doing competitive sport, sitting position, and LBP in at least 1 parent. The mean weight of the schoolbags was 4.9 ± 1.9 kg. We had 99 children with LBP and a schoolbag weight ≥10% of their body weight. No association was found between the weight of schoolbag and LBP. CONCLUSION LBP is common in Cameroonian schoolchildren, where 12.3% suffer from it. The weight of schoolbags was not associated with LBP. However, female gender, competitive sport, sitting position, and parental history of LBP were significantly associated with its occurrence.
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Affiliation(s)
- Fernando Kemta Lekpa
- Faculty of Medicine and Pharmaceutical Sciences, Department of Clinical Sciences, University of Dschang, Dschang, Cameroon.,Internal Medicine Department, Douala General Hospital, Douala, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Dominique Enyama
- Faculty of Medicine and Pharmaceutical Sciences, Department of Clinical Sciences, University of Dschang, Dschang, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon.,Douala Gynaeco-obstetric and Pediatric Hospital, Douala, Cameroon
| | - Diomede Noukeu Njinkui
- Faculty of Medicine and Pharmaceutical Sciences, Department of Clinical Sciences, University of Dschang, Dschang, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon.,Douala Gynaeco-obstetric and Pediatric Hospital, Douala, Cameroon
| | | | - Sylvain Raoul Simeni Njonnou
- Faculty of Medicine and Pharmaceutical Sciences, Department of Clinical Sciences, University of Dschang, Dschang, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Christian Ngongang Ouankou
- Faculty of Medicine and Pharmaceutical Sciences, Department of Clinical Sciences, University of Dschang, Dschang, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon.,Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Henry Namme Luma
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | - Simeon Pierre Choukem
- Faculty of Medicine and Pharmaceutical Sciences, Department of Clinical Sciences, University of Dschang, Dschang, Cameroon.,Internal Medicine Department, Douala General Hospital, Douala, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon
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Kędra A, Plandowska M, Kędra P, Czaprowski D. Non-specific low back pain: cross-sectional study of 11,423 children and youth and the association with the perception of heaviness in carrying of schoolbags. PeerJ 2021; 9:e11220. [PMID: 33986989 PMCID: PMC8103923 DOI: 10.7717/peerj.11220] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Background Carrying a schoolbag is a daily activity for most children and adolescents.The perception of a schoolbag’s weight depends upon the individual and is a relevant theme in schoolchildren. Describing the association between the perception of heaviness in carrying a schoolbag and NLBP can facilitate the planning of preventive programs, quite different from those based on specific weight limits for schoolbags in children and youth. Objective To determine the prevalence of non-specific low back pain (NLBP) and to analyse the association between the perception of heaviness in carrying of schoolbags and NLBP in Polish children and youth aged 10–19. Methods This study included 11,423 children and youth (6,252 girls and 5,171 boys) from Poland. An original questionnaire was used to assess NLBP prevalence. Results Among 11,423 of the respondents, 41.5% of the respondents admitted that they had experienced NLBP in the period of the last 12 months. The percentage of individuals reporting NLBP increased with age of participants, p < 0.001. Girls reported NLBP more often than boys (p < 0.001). Students with NLBP declared that their school backpack was heavy more often than students without LBP. Students who thought that their backpacks weighed too much manifested a 1.44 (95% Cl [1.33–1.55]) times higher probability to experience NLBP. Conclusion In the examined group of schoolchildren a frequent occurrence of NLBP (41.5%) was noted. Its occurrence was related to female sex and age. Students who thought that their backpacks weighed too much manifested higher probability to develop NLBP.
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Affiliation(s)
- Agnieszka Kędra
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Magdalena Plandowska
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Przemysław Kędra
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Dariusz Czaprowski
- Physiotherapy Unit, Department of Health Sciences, Poznan University of Medical Sciences, Poznan, Poland.,Department of Health Sciences, Olsztyn University, Olsztyn, Poland
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Abstract
This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) level and low back pain (LBP) among adolescents while adjusting for potential confounders pertinent to this age group including the weight of school bags, BMI and physical activity. A cross-sectional study was conducted on 760 randomly selected adolescents in middle schools. Data on LBP and the risk factors for LBP were collected from parents by a self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were tested in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem MS. The lifetime prevalence and the 6-month prevalence of LBP were 32·28 (95 % CI 28·97, 35·73) % and 21·26 (95 % CI 18·40, 24·33) %, respectively. There was no difference in the geometric mean of 25(OH)D between those with and without LBP in the past 6 months (28·50 nmol/l and 30·82 nmol/l, respectively; P = 0·122). There was no association between 25(OH)D and LBP in the univariable or multivariable analysis whether 25(OH)D fitted as a continuous or as a categorical variable. We found no association between vitamin D level and LBP in adolescents in an area with high prevalence of vitamin D deficiency. Although it is important to have sufficient vitamin D levels during adolescence for several other health benefits, we concluded that vitamin D is not a major determinant for LBP among adolescents in our setting.
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