Active or passive journeys and low back pain in adolescents

Risk Factors for Low Back Pain in Childhood and Adolescence: A Systematic Review

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.

Low back pain and risk factors during the third infancy

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.

Low back pain in adolescent and associated factors: A cross sectional study with schoolchildren

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.

[Low back pain and associated factors in children and adolescents in a private school in Southern Brazil]

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.

Prevalence of low back pain in children and adolescents: a meta-analysis

BACKGROUND

Low back pain (LBP) is common in children and adolescents, and it is becoming a public health concern. In recent years there has been a considerable increase in research studies that examine the prevalence of LBP in this population, but studies exhibit great variability in the prevalence rates reported. The purpose of this research was to examine, by means of a meta-analytic investigation, the prevalence rates of LBP in children and adolescents.

METHODS

Studies were located from computerized databases (ISI Web of Knowledge, MedLine, PEDro, IME, LILACS, and CINAHL) and other sources. The search period extended to April 2011. To be included in the meta-analysis, studies had to report a prevalence rate (whether point, period or lifetime prevalence) of LBP in children and/or adolescents (≤ 18 years old). Two independent researchers coded the moderator variables of the studies, and extracted the prevalence rates. Separate meta-analyses were carried out for the different types of prevalence in order to avoid dependence problems. In each meta-analysis, a random-effects model was assumed to carry out the statistical analyses.

RESULTS

A total of 59 articles fulfilled the selection criteria. The mean point prevalence obtained from 10 studies was 0.120 (95% CI: 0.09 and 0.159). The mean period prevalence at 12 months obtained from 13 studies was 0.336 (95% CI: 0.269 and 0.410), whereas the mean period prevalence at one week obtained from six studies was 0.177 (95% CI: 0.124 and 0.247). The mean lifetime prevalence obtained from 30 studies was 0.399 (95% CI: 0.342 and 0.459). Lifetime prevalence exhibited a positive, statistically significant relationship with the mean age of the participants in the samples and with the publication year of the studies.

CONCLUSIONS

The most recent studies showed higher prevalence rates than the oldest ones, and studies with a better methodology exhibited higher lifetime prevalence rates than studies that were methodologically poor. Future studies should report more information regarding the definition of LBP and there is a need to improve the methodological quality of studies.

Validity and reliability of a school travel survey

BACKGROUND

Despite the growing interest in active (ie, nonmotorized) travel to and from school, few studies have explored the measurement properties to assess active travel. We evaluated the criterion validity and test-retest reliability of a questionnaire with a sample of young schoolchildren to assess travel to and from school, including mode, travel companion, and destination after school.

METHODS

To assess test-retest reliability, 54 children age 8 to 11 years completed a travel survey on 2 consecutive school days. To assess criterion validity, 28 children age 8 to 10 years and their parents completed a travel survey on 5 consecutive weekdays.

RESULTS

Test-retest reliability of all questions indicated substantial agreement. The questions on mode of transport, where you will go after school, and how you will get there also displayed substantial agreement between parental and child reports.

CONCLUSIONS

For this population, a questionnaire completed by school-age children to assess travel to and from school, including mode, travel companion, and destination after school, was reliably collected and indicated validity for most items when compared with parental reports.

Associations between activities and low back pain in adolescents

The aim of this cross-sectional study was to explore associations between self-reported leisure activities and low back pain (LBP). The material included all adolescents in eighth and ninth grade in two geographical areas in the school year 1996-1997. Eighty-eight adolescents participated (mean age 14.7 years), making the response rate 84%. LBP during the preceding year was reported by 57%. Sixty-six percent reported physical activity 3 times weekly or more. The median time spent on television or computer was 15 h. In multivariate analyses, LBP was inversely associated with time spent on physical activity, in particular with regular walking or bicycling. LBP was associated with the use of television or computer more than 15 h weekly, but not with the time spent reading. The results confirm studies showing inverse associations between walking and LBP. Future research should involve prospective studies of the potential effects of walking or bicycling and other specific activities on LBP.