Dor nas costas e hábitos comportamentais de estudantes do ensino médio: estudo comparativo entre duas regiões do Brasil

Comics as a Physical Education Tool for Health Promotion in Brazilian Primary Education, Based on Paulo Freire's Principles of Empowerment

Incorrect postural habits developed already at an early age are predictors of low back pain and functional limitations in adult life. Postural education programs (PEPs) are activities developed in Physical Education classes with the aim of promoting healthy habits. One tool used by PEPs is comics. The objective of this study was to develop comics and apply them as a teaching tool in PEPs for students aged seven to ten years. The procedures were based on individual empowerment principles, including creation activities, reading, painting, crosswords, and discussion of comics. The activities strengthened the students' interactions, gaining new knowledge that required cognitive and expressive resources to interpret, associate, and conceptualize themes of correct body posture. During six weeks of intervention, knowledge about body posture, anatomy, and health promotion exercises increased significantly in relation to the beginning of activities. The comic book proved to be an effective, attractive, and low-cost didactic resource.

Risk Factors for Back Pain among Southern Brazilian School Children: A 6-Year Prospective Cohort Study

Risk factors associated with back pain vary in different countries. Given the lack of studies in Latin America, our study aimed to assess back pain and its associated factors for six years in Southern Brazilian school children. All children attending the fifth grade of Teutônia, Brazil, were invited to participate in the study. Only schoolchildren who did not report back pain were included in the first assessment. The schoolchildren completed the Back Pain and Body Posture Evaluation Instrument (BackPEI) during three assessments (2011, 2014, and 2017). BackPEI assesses the presence of back pain and possible associated risk factors (postural, behavioral, and sociodemographic). Generalized estimated equations (GEE) were used to perform a Poisson regression model with robust variance for longitudinal analysis. After six years of follow-up, 75 schoolchildren completed all the assessments. The risk factors associated with back pain were spending more than six hours daily watching television, lifting objects from the ground adopting an inadequate posture, using another backpack type different from those with two straps, and carrying a backpack in an asymmetric way. These results are important in guiding the planning of public policies to minimize this public health problem.

Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA): Expansion, Content Validation, and Reliability

The Back Pain and Body Posture Evaluation Instrument (BackPEI) was created in 2013 to assess back pain and its risk factors in school children. However, it does not assess neck pain or the habits of mobile device usage, which are aspects that are often part of school children’s lives. Therefore, we aimed to update the BackPEI questionnaire to include new questions assessing aspects related to neck pain and the use of mobile devices and to test the content validity and reliability of the new questions. The updated questionnaire was named Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA). The content was validated by eight experts using the content validity index (CVI). To assess reliability, the BackPEI-CA questionnaire was applied at two different times in 105 school children, and Cohen’s kappa (k) and intraclass correlation coefficient (ICC) were calculated. All aspects assessed regarding content validity had a CVI higher than 0.8. The new questions presented moderate and good kappa values and excellent ICC values. The updated version of BackPEI-CA can be used as a clinic tool for assessing the presence, frequency, and intensity of back and neck pain and their risk factors.