Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use

Adolescents' electronic devices use during the COVID-19 pandemic and its relationship to anxiety and depression levels: a cross-sectional study

BACKGROUND

The aim of this study is to assess the prevalence of anxiety and depression symptoms among adolescent students in the West Bank region of Palestine, with a particular focus on the impact of electronic device usage on their mental well-being.

METHODS

This cross-sectional study included a representative sample of 1,140 adolescents enrolled in governmental secondary schools. We targeted schools located in Nablus, Ramallah, and Hebron districts, which, respectively, represent the northern, central, and southern regions of the West Bank. We collected data on their sociodemographic characteristics, patterns of electronic device usage, scores from the Beck Depression Inventory-II, and the 7-item Generalized Anxiety Disorder scale, all gathered through a self-administered online questionnaire. To explore the independent relationship between anxiety, depression, and various factors, we calculated odds ratios and their corresponding 95% CI using a binary logistic regression model.

RESULTS

The study revealed a prevalence of moderate to severe anxiety at 35.4% [95% CI: 32.7-38.3%] and moderate to severe depression at 23.9% [95% CI: 21.4-26.4%]. Notably, anxiety scores were significantly higher among females [OR = 3.8, 95% CI: 2.5-5.9], individuals with lower academic performance [OR = 3.4, 95% CI: 2.1-5.4], and smokers [OR = 1.9, 95% CI: 1.1-3.0]. Similarly, significantly elevated depressive scores were observed among females [OR = 2.0, 95% CI: 1.3-3.1], those with lower academic performance [OR = 3.4, 95% CI: 2.1-5.4], and smokers [OR = 1.9, 95% CI: 1.3-2.8]. Conversely, students who used electronic devices for shorter durations were less likely to experience depression [OR = 0.49, 95% CI: 0.32-0.76] or anxiety [OR = 0.47, 95% CI: 0.32-0.69].

CONCLUSION

Considering the alarming rates of anxiety and depression in adolescents, along with their connection to the time spent using electronic devices, we strongly recommend the creation of initiatives and support networks to alleviate this issue's impact. Encouraging healthier lifestyles, such as reducing screen time and increasing physical activity, could potentially enhance the mental well-being of adolescents.

Prevalence of disabling musculoskeletal pain in children and adolescents in Brazil: A cross-sectional study

BACKGROUND

Estimates of prevalence of musculoskeletal pain in children and adolescents vary considerably and the impact of pain on children's life is often not considered.

OBJECTIVE

To determine the one-month prevalence of disabling musculoskeletal pain in children and adolescents. The secondary aims are to: 1) determine the body region with the highest prevalence; 2) understand the characteristics of the children with disabling musculoskeletal pain; and 3) describe the parents' perception of the prevalence.

METHODS

This cross-sectional study was conducted in public and private schools in the states of São Paulo and Ceará, Brazil. Children self-reported presence and impact of pain, pain intensity, psychosomatic symptoms, and quality of life. Parents completed parent-proxy versions and perception of the child's sleep quality. Descriptive statistics were used to summarise the data.

RESULTS

A total of 2,688 children and adolescents were included in this study. The prevalence of disabling musculoskeletal pain in the previous month was 27.1%. The back was the region most often affected (51.8%). Children with disabling musculoskeletal pain were older, heavier, had worse relationships with their family, perceived their backpacks as heavy, carried their backpacks more with one shoulder, had more negative psychosomatic symptoms, had poorer quality of life, and had higher pain intensity. Parents tended to underestimate the presence of pain in their children.

CONCLUSION

The one-month prevalence of activity limiting musculoskeletal pain in children and adolescents was 27.1% with the back being the most often affected body region. Parents tended to underestimate the presence of pain in their children.

Prevalence and Awareness of Musculoskeletal Injuries Associated With Competitive Video Gaming in Saudi Arabia

Background In recent years, the use of electronic devices has become an important part of the lives of adolescents who regularly use computers for academic activities and leisure. The excessive use of these devices has been associated with several health problems, such as obesity, headaches, anxiety, stress, sleep disorders, and musculoskeletal pain. This study aimed to assess the prevalence and awareness of musculoskeletal injuries associated with competitive video gaming in Saudi Arabia. Methodology This descriptive, cross-sectional study targeted all individuals involved in competitive video gaming aged 18 years or older in Saudi Arabia. The data were collected using a researcher-initiated online questionnaire. The final electronic questionnaire contained questions on participants' data, frequency and pattern of playing competitive video gaming, the associated musculoskeletal injuries, the most reported sites, and the associated consequences. The final questionnaire was sent to the participants via social media platforms and no more answers were obtained. Results A total of 116 competitive video gaming participants were included. Participants' ages ranged from 18 to 48 years, with a mean age of 22.5. The majority of the participants were males (86.2%; 100). A total of 100 (86.2%) participants had at least one site-associated musculoskeletal injury, while only 16 (13.8%) had none. Regarding sites, the most reported sites included the lower back (63.8%), neck (50%), hand/wrist (44.8%), and shoulder (35.3%). A total of 58 (50.4%) thought that competing in electronic game tournaments negatively affects the musculoskeletal system, and 43 (37.1%) had an idea that competing in electronic gaming tournaments is linked to conditions such as tendinopathy, carpal tunnel syndrome, and repetitive stress injuries. Conclusions This study showed that the majority of competitive video gamers had musculoskeletal injuries mainly at the lower back, neck, hand/ wrist, and shoulder. A higher pain rate was reported among females and new gamers.

Screen time and low back pain in children and adolescents: a systematic review of Brazilian studies

OBJECTIVE

To identify and summarize the possible associations between screen time and low back pain in children and adolescents.

DATA SOURCE

Systematic searches were performed in five electronic databases (Lilacs, Scielo, Scopus, PubMed and Web of Science) on 01/25/2021, complemented by manual searches in reference lists and on Google Scholar, looking for original scientific articles that included Brazilian observational studies; whose samples had children and/or adolescents aged between 6 and 19 years, without specific clinical conditions, and that presented analyses of associations between indicators of screen time and nonspecific low back pain, based on regression models.

DATA SYNTHESIS

Nine cross-sectional studies whose samples had adolescents were included. Of the 18 analyses identified, nine reported risk relationships between the variables of interest. More specifically, risk associations were found in two studies that evaluated adolescents exposed to at least three hours using cell phone or tablet, and watching television per day. Also, instruments, cut-off points adopted, and screen equipment evaluated were diverse.

CONCLUSIONS

Even though most of the risk associations were borderline from the statistical point of view, we found a higher frequency of risk associations between screen time and non-specific low back pain in adolescents exposed to screen time for at least three hours a day. In addition, further longitudinal studies with samples composed of children should be conducted across the country.

Sedentary behavior and neck pain in children and adolescents; a systematic review and meta-analysis

Background: Sedentary behavior (SB) is considered a risk factor for musculoskeletal pain. We aimed to explore the association of sedentary behavior indicators with neck pain among children and adolescents. Methods: A comprehensive review was performed in different databases until the end of January 2022. Odds ratios (ORs) with 95% confidence intervals were used as desired effect sizes to evaluate the association between prolonged screen time or mobile phone (MP) usage and neck pain risk. Results: Among 1651 records, 15 cross-sectional studies were included in the systematic review, and 7 reports were included in the meta-analysis. Our results suggested a significant relationship between prolonged MP use and neck pain (OR=1.36, 95% CI=1.001-1.85, I²=40.8%, P value for heterogeneity test=0.119). Furthermore, a marginally insignificant association was found between prolonged screen time and neck pain (OR=1.13, 95% CI=0.98-1.30, I²=60.3%, P value=0.01); however, after sensitivity analysis and removing one study, this association became significant (OR=1.30, 95% CI=1.03-1.64). Moreover, a significant association between prolonged sitting time and neck pain was reported in two studies. Conclusion: Available good-quality evidence reveals a significant mild association between sedentary behavior and the risk of neck pain among children and adolescents. However, longitudinal studies with objective measurement tools are warranted. In particular, potential preventive educational programs are suggested for pediatrics to reduce sedentary behavior and neck pain.

Musculoskeletal complaints and associated factors in school children aged between 6 and 13 years in Istanbul during the COVID-19 pandemic: A cross-sectional study

BACKGROUND: Following the first COVID-19 cases in Turkey, face-to-face education was ceased after March 16, 2020 until the end of the educational year (i.e. June 19, 2020) and education was substituted remotely due to confinement. OBJECTIVE: This study aims to investigate the frequency of musculoskeletal complaints in school-age children and associated risk factors including reduced physical activity, increased screen time and poor ergonomics conditions in school-age children during the pandemic. METHODS: This cross-sectional study included parents or guardians of 960 students aged between 6–13 years old with a non-randomized sampling. A survey was administered consisting of 66 items related with sociodemographic characteristics of the children and family, online education hours, technological device(s) used, screen time, type of physical activity, presence of musculoskeletal problems and poor ergonomics conditions such as incorrect sitting posture. RESULTS: Logistic regression results demonstrated that age, excess weight gain, total daily screen time, smartphone use, incorrect sitting posture were associated with musculoskeletal complaints. CONCLUSION: The long-term closure of schools due to the pandemic may have led to an increase in musculoskeletal complaints in 6–13 years old children, based on the factors identified in this study, which were excess weight gain, increased screen time and incorrect sitting posture. These findings might help education and health authorities to develop strategies to improve musculoskeletal health of children especially in emergencies such as the pandemic.

Narrative review of the prevalence and distribution of acute pain in children in the self-care setting

Acute pain among children is common, yet it may be underestimated and undertreated if the pain is not recognized. Assessing and managing pediatric pain can be complicated, and as such, measuring the prevalence of acute pain in children can be challenging. We sought to provide a consolidated review of the available data on the prevalence of commonly occurring acute pain in children in the self-care setting. An extensive literature search was performed to determine the prevalence of acute pain at multiple bodily locations in children aged between 3 months and 18 years. We considered the influence of age, sex, and sociodemographic factors on prevalence estimates. We also sought to identify some of the challenges involved in assessing and managing pediatric pain, thus shedding light on areas where there may be clinical and medical unmet needs. In general, a high prevalence of acute pain in children was detected, particularly headache, menstruation-related pain, and dental and back pain. Older age, female sex, and lower socioeconomic status were associated with increased pain prevalence. Risk factors were identified for all pain types and included psychological issues, stress, and unhealthy lifestyle habits. Owing to the heterogeneity in study populations, the prevalence estimates varied widely; there was also heterogeneity in the pain assessment tools utilized. The paucity of information regarding pain prevalence appears to be out of proportion with the burden of acute pain in children. This could indicate that clinicians may not be equipped with an optimal pain management strategy to guide their practice, especially regarding the use of developmentally appropriate pain assessment tools, without which prevalence data may not be captured. If acute pain is not accurately identified, it cannot be optimally treated. Further investigation is required to determine how the information from prevalence studies translates to the real-world setting.

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

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.

Musculoskeletal disorders in video gamers - a systematic review

Background

Video gaming is a recreational activity with yearly increasing popularity. It is mostly a sedentary behavior combined with repetitive movements of the upper limbs. If performed excessively, these movements may promote strain injuries and a sedentary lifestyle is one of the contributing factors to musculoskeletal disorders. Therefore, a systematic review was conducted to evaluate if video gaming negatively affects the musculoskeletal system of video gamers.

Methods

PubMed, Web of Science and The Cochrane Library were systematically searched in order to identify relevant peer reviewed original articles in English published between 2000 and 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used for the analysis. Studies were included when they contained investigations of changes of the musculoskeletal system due to video gaming in healthy individuals. Studies with participants older than 60 years or solely psychological, social or cardiovascular outcomes were excluded. An adapted version of the Newcastle–Ottawa Scale was used for the risk of bias analysis.

Results

Sixteen observational studies involving a total of 62,987 participants met the inclusion criteria. A majority (11) of the studies reported statistical negative musculoskeletal changes due to video game playtime. Four studies did not report changes and one study found no effect of video game playtime on the musculoskeletal system. Out of the eleven studies, which demonstrated a negative impact of video game playtime on the musculoskeletal system, the most reported painful body parts were the neck (n = 4), shoulder (n = 4) and back (n = 3). Ten studies reported odds ratios (OR) for the dependence of the appearance of musculoskeletal disorders on video game playtime. In eight studies OR were significantly increased (1.3—5.2).

Conclusion

Eleven out of twelve studies demonstrated a negative impact of video game playtime on the musculoskeletal system. In particular, excessive video game playtimes (> 3 h/day) seemed to be a predictor for the appearance of musculoskeletal disorders. Due to their great popularity across multiple generations, specific and tailored prevention and health promotion programs for video gamers need to be developed to counteract this important public health issue.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-022-05614-0.

Onset Timing of Hyoid Muscles Activation during Cervical Flexion Is Position-Dependent: An EMG Study

Due to the high prevalence of neck pain, considerable attention is paid to the function of cervical flexor muscles. Although the deep and superficial cervical flexor muscles have been evaluated, the impact of hyoid muscles on cervical flexion is still not well known. We, therefore, aimed to investigate the activation of hyoid muscles during physiological cervical flexion, and to determine the impact of different starting positions on cervical flexion muscle activation. The activities of bilateral sternocleidomastoid, scalene, suprahyoid, and infrahyoid muscles were evaluated by surface electromyography (EMG) in twenty young healthy volunteers. They performed a repetitive cervical flexion-extension movement, from neutral position of the head to the maximum flexion with the same speed set at eight seconds in a cycle, in three various positions (sitting, standing, and supine). In sitting and standing positions, the group of suprahyoid muscles was activated in advance of other cervical flexor muscles despite only significant differences were found in scalene muscles, and the activation of the group of infrahyoid muscles was time-synchronous with sternocleidomastoid muscles. On the other hand, in supine position, the activation of all measured cervical flexor muscles was significantly earlier and longer than in the other two positions. This study confirmed the empirical suggestion that hyoid muscles contributed to cervical flexion, and it confirmed that muscle activation was position dependent, even if the given movement is nearly identical.

Idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma

OBJECTIVE

To evaluate idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma and healthy controls.

METHODS

Cross-sectional study was conducted on 150 asthmatic adolescents and 300 controls. Adolescents completed a self-administered questionnaire regarding painful symptoms, use of electronic devices, and physical activity. Seven musculoskeletal pain syndromes were evaluated, and Asthma Control Test (ACT) was assessed.

RESULTS

Musculoskeletal pain (42% vs. 61%, p = 0.0002) and musculoskeletal pain syndromes (2.7% vs. 15.7%, p = 0.0006) were significantly lower in asthmatic adolescents than in controls. The frequency of pain in the hands and wrists was reduced in asthmatic than in controls (12.6% vs. 31.1%, p = 0.004), in addition to cell phone use (80% vs. 93%, p < 0.0001), simultaneous use of at least two electronic media (47% vs. 91%, p < 0.0001), myofascial syndrome (0% vs. 7.1%, p = 0.043), and tendinitis (0% vs. 9.2%, p = 0.008). Logistic regression analysis, including asthma with musculoskeletal pain as the dependent variable, and female sex, ACT > 20, simultaneous use of at least two electronic devices, cell phone use, and weekends and weekdays of cell phone use, as independent variables, showed that female sex (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.929-6.316; p = 0.0009) and ACT ≥ 20 (OR, 0.194; 95% CI, 0.039-0.967; p = 0.045) were associated with asthma and musculoskeletal pain (Nagelkerke R² = 0.206).

CONCLUSIONS

Musculoskeletal pain and musculoskeletal pain syndromes were lower in adolescents with asthma. Female sex was associated with musculoskeletal pain in asthmatic, whereas patients with asthma symptoms and well-controlled disease reported a lower prevalence of musculoskeletal pain.

Gender Mediation in Adolescents’ Back Pain and Physical Fitness: A Cross-Sectional Study

There is a lack of studies that analyze the interaction between risk variables as predictors of back pain (BP) in adolescents. The objectives of this study were to examine the relationship between BP and several risk variables, and to analyze the effect of the mediation of gender in this association. This cross-sectional study included n = 617 adolescents (mean age: 14.10 ± 1.18 years old) who completed the BP Adolescent Survey and who performed the bench trunk curl (BTC) and Sorensen (SOR) tests. Males showed a significantly lower prevalence (OR: 0.67) and frequency (contingency coefficient: 1.73) of BP than females, less participation in leisure-time sedentary behaviors (LRSBs) per day of more than 2 h (Cramer’s V: 0.110), a higher sufficient Physical Activity (PA) (Cramer’s V: 0.323) and a higher score in the BTC test (Contingency coefficient: 0.346). A high BTC score indicated significantly lower risk of BP than mid (OR: 1.74; p = 0.025) or low (OR: 1.62; p = 0.022) BTC. The mediation analysis showed a significant indirect effect with a significant value for the Sobel test (z = 7.45 ± 0.111). When the BTC test value was included in the equations, the connection between gender and BP was no longer significant. There was a difference in the prevalence between gender in BP and LRSB and PA. BP was associated with the SOR test. The association between BP and gender was mediated by SOR results.

Factors associated with intensity and frequent low back pain in high school students

Introduction: Low back pain is frequent among schoolchildren and the variables related to high intensity and high back frequency are important predictors for the increase of such complaints in adulthood. Objective: To determine the high intensity and high frequency of low back pain and its associated factors in high school students. Methods: This cross-sectional study included 760 students (319 boys and 441 girls) who reported low back pain. Demographic, socioeconomic, electronic devices, habitual physical activity practice, mental health, and high frequency and high intensity low back pain data were collected. Descriptive analyzes and bivariate and multivariate logistic regressions were used. Results: Of the total number of subjects with low back pain, 14.6% reported high frequency of pain, being 36.9% boys and 63.1% girls, while 42.6% reported high intensity, being 35.8% boys and 47.2% girls. The variables associated with the high frequency of low back pain were altered mental health, posture lying on the use of tablet, time of daily use of the cell phone and distance of the screen to the eyes of the computer user, while the female sex, mental health problem, posture lying on the use of cell phone and the distance of the screen to the eyes of the computer user with severe intensity of low back pain. Conclusion: The demographic factors and related to the use of electronic devices were associated with high intensity and high frequency of low back pain.

One Year of COVID-19 Pandemic in Italy: Effect of Sedentary Behavior on Physical Activity Levels and Musculoskeletal Pain among University Students

The COVID-19 outbreak forced Italian students to reduce their daily activities, inducing a seden-tary attitude that was worsened by distanced learning. This study aimed to survey the physical activity levels that were maintained before and during the social restrictions following the pan-demic, their correlation to musculoskeletal pain, as well as analyzing the impact of these COVID-19 restrictions on pain and fatigue that affects daily life activities. A total of 2044 students completed the online questionnaire, of which the results of 1654 participants were eligible. Before the pandemic, the levels of physical activity were distributed as: 19.9% no activity, 30.1% light ac-tivity, 21.5% moderate activity, and 28.5% high activity. After one year of the pandemic, 30.6% of the participants were inactive, 48.1%, 10.9%, and 10.5% stated as maintaining, respectively, light, moderate and high levels of physical activity. Furthermore, 43.5% reported neck pain and 33.5% stated to experience low back pain. Physical activity levels lower than 150 min/week may have predisposed students to suffer from neck pain (1.95 OR at 95% CI, 1.44-2.64) and low back pain (1.79 OR at 95% CI, 1.29-2.49). A positive correlation between physical activity levels, Verbal Descriptive Scale (VDS), and pain frequency have been observed for neck and low back pain (p-value < 0.05). Finally, low physical activity levels were associated with musculoskeletal pain onset and pain worsening.

Risk factors and risk profiles for neck pain in young adults: Prospective analyses from adolescence to young adulthood-The North-Trøndelag Health Study

The objective was to investigate risk factors and risk profiles associated with neck pain in young adults using longitudinal data from the North-Trøndelag Health Study (HUNT). Risk factors were collected from adolescents (13-19 years of age), and neck pain was measured 11 years later. The sample was divided into two: Sample I included all participants (n = 1433), and Sample II (n = 832) included only participants who reported no neck/shoulder pain in adolescence. In multiple regression analyses in Sample I, female sex (OR = 1.9, 95% CI [1.3-2.9]), low physical activity level (OR = 1.6, 95% CI [1.0-2.5]), loneliness (OR = 2.0, 95% CI [1.2-3.5]), headache/migraine (OR = 1.7, 95% CI [1.2-2.6]), back pain (OR = 1.5, 95% CI [1.0-2.4]) and neck/shoulder pain (OR = 2.0, 95% [CI 1.3-3.0]) were associated with neck pain at the 11-year follow-up. Those with a risk profile including all these risk factors had the highest probability of neck pain of 67% in girls and 50% in boys. In Sample II, multiple regression analyses revealed that female sex (OR = 2.2, 95% CI [1.3-3.7]) and perceived low family income (OR = 2.4, 95% CI [1.1-5.1]) were associated with neck pain at the 11-year follow-up. Girls and boys with a perceived low family income had a 29% and 17% higher probability of neck pain than adolescents with a perceived high family income. The risk profiles in both samples showed that co-occurrence of risk factors, such as headache/migraine, neck/shoulder pain, back pain, low physical activity level, loneliness, and perceived low family income cumulatively increased the probability of neck pain in young adulthood. These results underline the importance of taking a broad perspective when studying, treating, and preventing neck pain in adolescents.

Chronic Back Condition and the Level of Physical Activity as Well as Internet Addiction among Physiotherapy Students during the COVID-19 Pandemic in Poland

Objectives: The aim of this study was to assess back pain and its relation to physical activity as well as Internet addiction among Polish university students during the COVID-19 pandemic. Methods: The research was conducted via the Internet in student groups of three universities in Poland (141 people). Back pain was examined by ODI—The Oswestry Disability Index and NDI—Neck Disability Index. The Polish-language International Physical Activity Questionnaire (IPAQ) was used to assess physical activity and the level of Internet addiction was tested using the Kimberly Young Questionnaire. Results: The respondents mostly suffered from pain originating in the cervical spine. In the study group, only every fifth person had a high level of physical activity. Sex differentiates the level of the measures considered. Sitting in front of the computer affects the pain in the spine. Conclusions: Research results suggest that the pandemic is negatively affecting students. Frequent occurrence of back pain is observed with a simultaneous low level of physical activity. Maintaining regular activity during a pandemic, at least at home, is an indispensable preventive measure for physical health.

Influence of physical activity and postural habits in schoolchildren with scoliosis

BACKGROUND

Scoliosis is considered one of the main musculoskeletal changes in childhood, and is characterized by three-dimensional changes in the spine. Schoolchildren is a group who are directly exposed to this condition because they go through a rapid growth phase in adolescence, added to other external factors such as school environment and daily living habits such as little physical activity. This study aimed to identify the risk factors associated with scoliosis in schoolchildren.

METHODS

An observational, retrospective case control study with a quantitative approach was carried out in the city of Santa Cruz/RN. The presence of scoliosis was assessed using the Adams test and physical activity by the Daily Physical Activity Index (IPAQ) and by a questionnaire on competitive sports practice, in addition to a questionnaire on postural habits in childhood and adolescence. Conditional multiple logistic regression was performed for statistical analysis, and the adjusted Odds Ratios (OR) and the respective confidence intervals (95%) of the outcome variable were estimated.

RESULTS

A total of 156 schoolchildren participated in the study, with an average age of 13.9 years, with 55.1% being female and 44.9% male, attending between the 6th grade of elementary school and the 3rd year of high school. Furthermore, 42.9% of these participants were considered irregularly active and only 33.3% practiced physical activity on a regular basis. After bivariate analysis and conditional logistic regression, little physical activity was shown to be a risk factor for scoliosis (p = 0.041; OR: 2.81; 95% CI: 1.04-7.57), while the postural habits evaluated in this study did not show a statistical association with scoliosis.

CONCLUSION

Low practice of physical activity and schoolchildren being classified as irregularly active were considered as risk factors for scoliosis, however postural habits do not seem to be associated with this condition.

Spinal pain in pre-adolescence and the relation with screen time and physical activity behavior

Background

To investigate how screen time and physical activity behavior were associated with spinal pain in pre-adolescence.

Methods

This study included 45,555 pre-adolescents who participated in the 11-year follow-up of the Danish National Birth Cohort. The 11-year follow-up included self-reported information on computer and TV behavior, aspects of physical activity, as well as frequency and intensity of spinal pain (neck-, mid back- and low back pain). Data were linked with parental socioeconomic data from Statistics Denmark registers. Associations were estimated using multinomial logistic regression models. To account for sample selection, we applied inverse probability weighting.

Results

Duration of screen time was stepwise associated with the degree of spinal pain. Compared with those spending < 2 h/day in front of a screen, screen time of ≥6 h/day was associated with a substantially increased relative risk ratio (RRR) of severe pain for both girls (RRR: 2.49, 95% CI: 2.13–2.92) and boys (RRR: 1.95, 95% CI: 1.65–2.32). Being physical inactive was likewise associated with higher likelihood of severe spinal pain (RRR: 1.22, 95% CI: 1.10–1.34) relative to those being moderately active. We observed that being physically active was seemingly associated with lower risk of spinal pain among boys with high frequency of screen time.

Conclusion

Findings indicate that both duration of screen time and physical inactivity are correlated with spinal pain in pre-adolescents with the strongest associations for screen time. Reducing screen time or increasing physical activity might help preventing spinal pain in pre-adolescents, particularly among high frequent screen users. Future prospective studies investigating the causal relationship are necessary.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04263-z.

Investigating the effect of smartphone addiction on musculoskeletal system problems and cognitive flexibility in university students

BACKGROUND

Smartphone usage has become more common in daily life, and in certain situations, this may lead to addictive behavior.

OBJECTIVE

This study aims to investigate the relationship between smartphone addiction and musculoskeletal problems and cognitive flexibility in university students.

METHODS

Smartphone addiction was evaluated with the Smartphone Addiction Scale (SAS), the Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal symptoms, and pain was measured with Visual Analog Scale (VAS). Cognitive flexibility was assessed with the Cognitive Flexibility Inventory (CFI).

RESULTS

A significant correlation was found between SAS total score and musculoskeletal problems in the upper back, lower back, hip and feet (p < 0.05, r = 0.11; r = 0.16; r = 0.11; r = 0.13, r = 0.14). Smartphone addiction showed a significant positive correlation with neck pain, right hand pain and right arm pain (p < 0.05, r = 0.13; r = 0.17; r = 0.14). There was a significant negative correlation between CFI total score and SAS total score (p < 0.05, r = - 0.13).

CONCLUSIONS

Smartphone addiction is associated with musculoskeletal problems, pain and cognitive flexibility in university students. Encouraging an active lifestyle, physical activity, ergonomic arrangements, individual behavioral modification as well as environmental regulations and policies may eliminate the negative effects of smartphone addiction.

The association between problematic internet use and neck pain among Japanese schoolteachers

OBJECTIVES

Problematic internet use (PIU) has been suggested in relation to psychological symptoms among schoolteachers, but the relationship with physical symptoms remains unclear. We examined whether PIU or longer Internet usage time is associated with neck pain in schoolteachers.

METHODS

We conducted a cross-sectional study among 2582 teachers aged 20 years or older (35.6% women) in Shimane and Tottori, Japan in 2018. Neck pain was defined as ≥5 points on the Neck Disability Index. The Compulsive Internet Use Scale (CIUS) was used to assess PIU. Internet usage time on weekdays and weekends was divided into five groups: 0, 1-29, 30-59, 60-119, and ≥120 min/day. Logistic regression analysis was conducted to examine the association of the CIUS score and Internet usage time on weekdays or weekends with neck pain, adjusting for sex, age, position at school, insomnia, and psychological distress.

RESULTS

We observed 800 (31.0%) teachers with neck pain. The median (interquartile range) of their CIUS scores was 7 (2, 14). A higher CIUS score was independently associated with a higher prevalence of neck pain (odds ratio of 4th vs. 1st quartiles, 1.41; 95% confidence interval, 1.06-1.87; trend P = .006). Compared with non-Internet users, Internet users on weekdays had almost double the odds of neck pain although the difference did not reach the customary level for designating statistical significance.

CONCLUSIONS

In conclusion, teachers with higher scores in CIUS were associated with a higher prevalence of neck pain in Japan, suggesting adults with PIU being at risk of physical disorders.

Relationship between postural changes and physical and functional variables in schoolchildren aged 6-12 years

Abstract The aim of this study was to evaluate the prevalence of postural changes and their relationship with BMI, pain, postures adopted in activities of the daily living (ADL), physical activity practice, gender and age (6 to 12 years). This study is characterized as cross-sectional, quantitative and descriptive. The convenience sample consisted of 840 schoolchildren. Regarding the sample characteristics, 477 (56.79%) were female aged 6-12 years (average=8.90±1.71years). Evaluations were carried out at the school premises and a questionnaire was used to collect data on gender, age, pain report, practice of out-of-school physical activities and postures adopted in ADLs. Body mass, height and posture were evaluated. Some schoolchildren (43.21%) reported not practicing physical activity outside of school, 544 (64.76%) correctly carried their backpack and 51.9% adopted correct postures to study and watch TV. Musculoskeletal pain was reported by 62.73%, and shoulders were the most affected. BMI indicated 55.6% of the sample with leanness/normal weight and 44.40% with overweight/obesity. Postural changes were present in 97.02% of students and the region with the highest number of alterations was the upper limbs. Girls presented greater number of trunk alterations (p=0.001), as well as those who did not practice physical activity (p=0.02) and alterations in the lower limbs for younger students (p=0.02) and female students (p=0.01). This study identified high prevalence of postural changes in schoolchildren.

Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health

OBJECTIVES

To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems.

METHODS

Cross-sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used.

RESULTS

The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR=1.70), daily TV use for more than 3hours (PR=1.17), use of laptop computer (PR=1.40), use of the cell phone in the supine position (PR=1.23), use of the cell phone in semi-supine position (PR=1.49), daily cell phone use for more than 3hours (PR=1.36), use of tablet (PR=1.67), daily tablet use for more than above 3hours (PR=1.46), and clinically important mental health problems (PR=2.62).

CONCLUSION

There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.

Smartphone usage duration is not associated with increased pain or proprioception deficit in young adults with chronic mechanical low back pain: a cross-sectional study

Background

Smartphone use has been associated with pain in the upper quadrant; however, the relationship between usage duration and low back pain is still unclear. This study investigated the association between continuous smartphone use up to 30-min and back pain severity and proprioception acuity in patients with chronic low back pain. Fifty-eight patients with chronic mechanical LBP played a game for 10- and 30-min. In each session, pain and back repositioning errors were measured at baseline and immediately after task completion.

Results

Pain significantly but slightly increased following smartphone use, regardless to the duration (after 10 min: mean increase = 0.75 ± 1.17, P value < 0.001, 95% CI 0.44–1.06; after 30 min: mean increase = 0.96 ± 1.93, P value < 0.001, 95% CI 0.44–1.46). However, changes in perceived pain scores were not significantly different between the two tested durations (P value = 0.42). Proprioception repositioning error was not significantly different within the same testing session (mean change = 0.08 ± 1.83, 0.13 ± 1.77, P value = 0.73, 0.58, 95% CI − 0.40–0.56, − 0.60–0.33, for the 10 and 30 min, respectively). The changes in proprioception were not significant between the two-tested durations (P value = 0.56). Further, smartphone addiction did not significantly affect changes in pain and proprioception after game playing, regardless of the duration (P > 0.05).

Conclusions

These findings show that smartphone use slightly increases back pain immediately after continuous use; with no effect on back proprioception within the duration tested in this study. Changes in pain and proprioception were not influenced by smartphone addiction.

A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage

BACKGROUND

In the past decade, mobile phone usage rates have increased and there have been concerns that overuse of mobile phones may contribute to various musculoskeletal (MSK) problems.

OBJECTIVES

The aim of the present study was to systematically review available literature on the prevalence of MSK complaints, symptoms, and pathologies associated with mobile phone use.

STUDY DESIGN

Systematic review.

METHOD

In this systematic review, Medline (Pubmed), Wiley, WOS, and EMBASE electronic databases were searched for studies published in English between January 1, 2000 and March 25, 2019 using the following. KEY TERMS: 'mobile phone', 'smartphone', 'musculoskeletal pain', 'pain', 'musculoskeletal symptoms', and 'musculoskeletal pathology'.

RESULTS

The search strategy identified 196 papers, of which 18 met the inclusion criteria. Among the studies included in the systematic review, five were high quality, twelve were of acceptable quality, and one was of low quality. The review demonstrated that the prevalence of MSK complaints among mobile phone users ranged 8.2%-89.9%, and that neck and upper back complaints had the highest prevalence rates ranging from 55.8% to 89.9%. The most common MSK symptom associated with mobile phone use was pain. Myofascial pain syndrome, fibromyalgia, thoracic outlet syndrome, tendonitis, and De Quervain's syndrome were the most commonly associated MSK pathologies.

CONCLUSION

The evidence concerning MSK complaints among mobile phone is somewhat limited because the data were obtained from cross-sectional and case-control study results. Consequently, there is need for higher quality and prospective studies to better understand the relationship between mobile phone use and MSK symptoms and pathologies.

Back and neck pain and poor sleep quality in adolescents are associated even after controlling for confounding factors: An epidemiological study

Objective

Back pain and poor sleep quality are public health issues. Relating to adolescents particularly, the way in which this relationship can occur is still unclear. The aim of this study was to investigate whether low back and neck pain are associated with sleep quality among adolescents.

Material and Methods

In total, 1011 randomly selected adolescents participated in this study. Neck and back pain were assessed using the Nordic questionnaire, while sleep quality was assessed through the Mini-Sleep Questionnaire. The confounding variables used in the statistical analysis were age, socioeconomic status, physical activity, and body mass index. To analyze the associations between sleep quality and low back and neck pain, multivariate models and binary logistic regression were used.

Results

19.9% of the girls reported low back pain while 18.9% reported neck pain. 15.6% of the boys reported low back or neck pain. Regarding low sleep quality, the prevalence was 46.0% for girls and 49.6% for boys. An association was observed between low back pain and sleep quality among girls (OR=1.98 [1.25 - 3.12]) and boys (OR=2.58 [1.48 - 4.50]). An association between neck pain and sleep quality was also observed among girls (OR=2.27 [1.41 - 3.64]) and boys (OR=2.80 [1.59 - 4.91]).

Conclusion

Low back pain and neck pain were associated with poor sleep quality among adolescents even after the insertion of confounding variables.

Low back pain rehabilitation in 2020: new frontiers and old limits of our understanding

Low back pain (LBP) is the most common musculoskeletal condition affecting the quality of life of individuals, especially if persistent. Over the decades, a lot of work has been done in an attempt to reduce the negative impact of back pain, and help patients recover and maintain a better quality of life. New insights are coming from different fields of research, with a lot of work being done in searching for the etiology of LBP, describing the different phenotypes of symptomatic spines, and identifying factors involved in the persistence of the disease. Nevertheless, still a lot remains to be done to fully understand the problem of back pain and its causes. Even today, there appears to be a wide gap between basic science and applied rehabilitation research on LBP. The first is still searching in many different ways for the "holy grail" of the pain generator and providing very interesting results with particular relevance to surgical, drug-related and other biological approaches, while the second is pragmatically focusing on modifiable factors that may influence back pain outcomes. Yet, personalized, effective spine care has not been fully realized. While we recognize the potential of basic science advances, there is an immediate need for more translational rehabilitation research, as well as studies focused on the effectiveness of rehabilitation approaches.

Gaming patterns and related symptoms in adolescents using cluster analysis: Baseline results from the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study

PURPOSE

The risk and protective factors of Internet gaming disorder (IGD) could vary by individual. The identification of more homogeneous subgroups may lead to better understanding of gaming behaviors and their consequences in adolescents. The purpose of this study was to investigate the prevalence of IGD among the subgroups defined by cluster analysis in adolescents.

METHODS

A total of 2319 adolescents were enrolled in the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study at baseline. Self-reported IGD was assessed with a DMS-5 adapted measurement. Smartphone addiction, musculoskeletal discomfort, and dry eye symptoms were evaluated by self-administered questionnaires. Cluster analysis was performed using risk and protective factors of IGD after considering multicollinearity.

RESULTS

Three different clusters were identified. Cluster 1 (19.2%) was users with combined potential psychological and social issues. Cluster 2 (32.3%) was users with potential social but no psychological issues. Cluster 3 (45.6%) was users with no potential issues of either a social or psychological nature. Adolescents from both clusters 1 and 2 showed higher degrees of IGD, smartphone addiction, musculoskeletal discomfort, and dry eye symptoms than did those from cluster 3. Also compared with adolescents in cluster 3, those in cluster 1 showed statistically higher risks of IGD (aOR:11.9, 95%CI:7.5-19.9), smartphone addiction (aOR:5.4, 95%CI:4.0-7.2), musculoskeletal discomfort (aOR:2.6, 95%CI:2.1-7.4), and dry eye symptoms (aOR:3.8, 95%CI:3.0-4.9). Those in cluster 2 also showed statistically higher risk of IGD, smartphone addiction, musculoskeletal discomfort, and dry eye symptoms compared with cluster 3 (aOR:4.5, 95%CI:2.8-7.6; aOR:2.8, 95%CI:2.1-3.7; aOR:1.6, 95%CI:1.3-1.9; and aOR:1.9, 95%CI:1.6-2.4, respectively).

CONCLUSIONS

Clustering based on the risk and preventive factors of IGD may be suitable for determination of high risk of IGD in adolescents. However, we need to confirm the usefulness and clinical application of the classifications by observing their longitudinal changes.

Anxiety and depression and their relation to the use of electronic devices among secondary school students in Al-Khobar, Saudi Arabia, 2018-2019

BACKGROUND:

Adolescence is a critical transitional period for the development of mental illnesses such as depression or anxiety, and these days, adolescents spend less time playing outside than they do using electronic devices. The aim of this study was to examine the relationship between the use of electronic devices and anxiety and depression in female secondary school students in Al-Khobar City, KSA.

MATERIALS AND METHODS:

This cross-sectional study included 903 female students selected from the four educational districs (Al-Khobar, Al-Thuqbah, Al-Dhahran and Al-Rakah). Data was collected using a self-administered anonymous questionnaire that included questions related sociodemographics and the use of electronic devices, the Beck Depression Inventory, and the Generalized Anxiety Disorder 7-item scale. Data analysis included descriptive statistics frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables. Chi-square test was performed to test for significance for association between categorical variable. Odds ratios were calculated for association of anxiety and depression with various independent variables including the use of electronic devices. A binary logistic regression model was used to determine factors associated with anxiety and depression. All test were performed at 5% significance level.

RESULTS:

The mean age of the participants was 16.29 years (SD=0.84). About 98% reported using electronic devices; 67.3% used electronic devices 2 or more hours daily, and 81.5% used them at bedtime. About 66% students had moderate-to-severe anxiey and 70/5% had mild-to-severe depression. The logistic regression model showed that users of electronic devices at bedtime were 1.524 more likely to have anxiety (P=0.026), while spending more than 2 hours on the devices at bedtime were significantly associated with depression.

CONCLUSION:

The high prevalence of anxiety and depression among female students is worrisome. Finding suggests that adolescents might benefit from a restricted use of electronic devices. It is necessary to develop age-specific guidelines regarding duration of the use of electronic devices and to integrate the development of psychosocial skills into the school curriculum.

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

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.

Back pain and its risk factors in Brazilian adolescents: a longitudinal study

Owing to the lack of longitudinal studies in Latin American countries, we aimed to evaluate back pain and its risk factors in a 3-year longitudinal study of Brazilian adolescents. We analysed data of 525 adolescents (aged 11-16 years) attending primary school (fifth to eighth grade) in Brazil. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument (BackPEI) questionnaire in 2011 and at a follow-up evaluation that was conducted 3 years later (2014). Back pain was the outcome variable; the exposure variables included exercise, behavioural, hereditary and postural factors. Generalized estimating equations were used to perform a Poisson regression model with robust variance to evaluate the risk factors for back pain. The prevalence of back pain at baseline was 56% (n = 294); this increased significantly at the 3-year follow-up evaluation to 65.9% (n = 346). The frequency of experiencing back pain also significantly increased after 3 years in both boys (p = 0.002) and girls (p = 0.001). The prevalence of back pain increased significantly in adolescents up to the age of 13 years, stabilized in those aged 14 years and older and was higher among girls. A family history of back pain (in the parents), watching television for lengthy periods and carrying a backpack asymmetrically were predictors for back pain.

Visual implications of digital device usage in school children: a cross-sectional study

PURPOSE

To evaluate the use of digital devices, reading habits and the prevalence of eyestrain among urban Indian school children, aged 11-17 years.

METHODS

The study included 576 adolescents attending urban schools who were surveyed regarding their electronic device usage. Additional information on the factors that may have an effect on ocular symptoms was collected.

RESULTS

Twenty percent of students aged 11 in the study population use digital devices on a daily basis, in comparison with 50% of students aged 17. In addition to using these devices as homework aids, one third of study participants reported using digital devices for reading instead of conventional textbooks. The majority of students preferred sitting on a chair while reading (77%; 445 students), with only 21% (123 students) preferring to lie on the bed and 8 students alternating between chair and bed. There was a significant association between the students who preferred to lie down and those who experienced eyestrain, as reported by a little over one fourth of the student population (27%). Out of 576 students, 18% (103) experienced eyestrain at the end of the day after working on digital devices.

CONCLUSIONS

The increased use of digital devices by adolescents brings a new challenge of digital eyestrain at an early age. Our study reports the patterns of electronic device usage by school children, evaluates factors associated with eyestrain and highlights the need for further investigation of these issues.

Determination of musculoskeletal system pain, physical activity intensity, and prolonged sitting of university students using smartphone

Study aim: The purpose of this study was to examine smartphone-using university students’ musculoskeletal system pain complaints, duration of smartphone and computer usage, participation in moderate-vigorous physical activities (MVPA), and prolonged sitting time.

Material and methods: This study was conducted on Hitit University students (n = 387; 206 female, 181 male) in the province of Çorum. The International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Physical Activity Assessment Ques­tionnaire (PAAQ) (sports/exercise activities section), and a personal information form prepared by the researchers were used as data collection tools. Descriptive statistics and the t-test were used to determine differences between groups. The Pearson chi-square test was used to examine the relationship between categorical variables.

Results: It was observed that half of the participants with musculoskeletal system pain complaints (54.5%) feel the pain in all four areas (neck, shoulder, upper and lower back). There was no statistically significant relationship between physical activity intensity and pain complaint (p > 0.05). The students with musculoskeletal pain complaints spend more time on the smartphone and computer than students who do not have pain complaints (p < 0.05). During electronic device usage, the students who are in the low-intensity physical activity category spend more time sitting down than students in the moderate/vigorous intensity physical activity category (p < 0.05).

Conclusions: In consequence, information can be provided about the importance of reducing sitting time during smartphone use and increasing the duration of moderate/vigorous-intensity physical activity (PA) so awareness can be raised on the issue among university students.

Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices

OBJECTIVE

To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes.

METHODS

A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome.

RESULTS

Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10-18] vs. 14 [10-18] years, p=0.032) and years of education (10 [5-12] vs. 9 [5-12] years, p=0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p=0.019), cell phone use (93% vs. 81%, p=0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p=0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p=0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0-10] vs. 3 [0-17]h/day, p=0.006).

CONCLUSIONS

A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes.

Back and neck pain prevalence and their association with physical inactivity domains in adolescents

PURPOSE

Back pain affects people of all ages. This may be associated with physical inactivity, and in the case of physical activity in different domains, the relationship with back pain is not clear in the literature. The aim of this study was to estimate the prevalence of low back and neck pain and investigate their association in different domains of physical inactivity.

METHODS

1011 randomly selected students participated in this study. Neck and back pain were assessed using the Nordic questionnaire, whereas the Baecke Physical Activity questionnaire was used to measure physical activity domains. Separate Binary Logistic Regression models were performed to investigate the association of physical activity domains with neck or back pain.

RESULTS

17.4% of the students reported cervical pain, while 18.0% reported low back pain. Older adolescents had a higher prevalence of cervical pain (24.4%) than younger adolescents (11.9%) (p value <0.001), as well as lumbar pain, being 25.1% in older adolescents and 12.4% in younger (p value <0.001). Adolescents physically inactive in the school environment were less likely to have pain in the cervical region [OR 0.67 (0.44-0.99)] or back pain [OR 0.60 (0.40-0.91)]. Being inactive in occupational activities was associated with cervical pain [OR 1.49 (1.06-2.10)]. Being inactive in the sports environment presented a marginal relationship with pain in the cervical region [OR 1.41 (0.99-2.02)].

CONCLUSIONS

The prevalence of neck and low back pain was higher in older adolescents and physical inactivity in the sporting context and occupational activities could be a risk factor to increase the chances of back pain.