Cartable et pathologie rachidienne

Prevalence and factors associated with low back pain in schoolchildren in Cameroon, sub-Saharan Africa

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.

Adolescent idiopathic scoliosis for the primary care physician: frequently asked questions

PURPOSE OF REVIEW

Provide primary care physicians with the best available evidence to support answers to frequently asked questions by caregivers of patients with adolescent idiopathic scoliosis (AIS).

RECENT FINDINGS

A review of best available evidence shows that schoolbag design and weight are not associated with higher odds of developing AIS. However, patients with AIS are more prone to balance problems with asymmetric backpack carrying and with rising weights. In patients with AIS, the backpack should be worn in a symmetric way and should never exceed 10% of the child's body weight. Although no relationship was found between systematic exercising in general and development of AIS, classical ballet and professional swimming in skeletally immature adolescents were associated to higher odds of having AIS. Since AIS affects adolescent girls mainly, women health issues are of paramount importance in this disease. Except for limited sexual activity and higher need for infertility treatment, patients with AIS perform similar to controls in marriage rates, age at first pregnancy, gestational age, offspring, labor and delivery. Best available evidence shows that adults with AIS diagnosed during adolescence have similar physical activity level compared with controls. In patients with AIS, adults with surgically treated idiopathic scoliosis have slightly lower physical activity level than previously braced and untreated patients.

SUMMARY

Although schoolbag weight isn't associated with higher odds of developing AIS, classical ballet and professional swimming in adolescents are. Except for limited sexual activity, patients with AIS perform similar to controls in remaining women health issues. Adults with AIS diagnosed during adolescence have similar physical activity level compared with controls.

Quality of life, school backpack weight, and nonspecific low back pain in children and adolescents

OBJECTIVES

To describe the degree of disability, anthropometric variables, quality of life (QoL), and school backpack weight in boys and girls aged 11-17 years. The differences in QoL between those who did or did not report low back pain (LBP) were also analyzed.

METHODS

Eighty-six girls (13.9 ± 1.9 years of age) and 63 boys (13.7 ± 1.7 years of age) participated. LBP was assessed by questionnaire, and disability using the Roland-Morris Disability Questionnaire. QoL was assessed by the Pediatric Quality of Life Inventory (PedsQL). Multivariate analyses of variance and covariance were used to assess differences between groups.

RESULTS

Girls reported higher disability than boys (p = 0.01), and lower QoL in the domains of physical (p < 0.001) and emotional functioning (p < 0.01), psychosocial health (p = 0.02) and physical health summary score (p < 0.001), and on the total PedsQL score (p < 0.01). School backpack weight was similar in both genders (p = 0.61) and in participants with and without LBP (p = 0.15). After adjustments, participants with LBP reported lower physical functioning (p < 0.01), influencing lower physical health summary score (p < 0.01).

CONCLUSIONS

Girls had higher disability and lower QoL than boys in the domains of physical and emotional functioning, psychosocial health, and physical health summary scores, and on the total PedsQL score; however, similar school backpack weight was reported. Participants with LBP revealed lower physical functioning and physical health summary score, yet had similar school backpack weight to those without LBP.

Effects of carrying a backpack in an asymmetrical manner on the asymmetries of the trunk and parameters defining lateral flexion of the spine

OBJECTIVE

The aim of this study was to examine changes in the body posture parameters defining asymmetry of the trunk and lateral flexion of the spine in children while carrying a backpack weighing 10% of a child's weight.

BACKGROUND

Carrying a backpack may negatively affect the posture of schoolchildren and contribute to spinal pain.

METHOD

The study involved 162 primary school students ages 11 to 13 years. The parameters describing body posture were assessed with a backpack carried on the right or left shoulder as well as without a load. To assess the predefined parameters, we used the CQ Elektronik System, employing the photogrammetric method.

RESULTS

Trunk inclination shifted significantly in the opposite direction to the shoulder the backpack was carried on, and an increase in shoulder asymmetry was also found. We also observed a more pronounced right-side lateral flexion of the spine when the backpack was carried on the right shoulder and an analogous relationship for the left side.

CONCLUSION

The results of this study show that carrying a backpack in an asymmetrical manner negatively affects spine, even if the backpack weight constitutes 10% of the child's weight, which has been previously recommended as a safe load for a child's shoulders.

APPLICATION

We suggest that the issue of safe backpack weight be reassessed and that students be taught basic ergonomic principles on how to carry loads. Changes to the management pattern of carrying textbooks to and from school also should be considered.

The effects of backpack load and carrying method on the balance of adolescent idiopathic scoliosis subjects

BACKGROUND CONTEXT

Concerns have been raised about the effect of backpack carrying on adolescent balance. For adolescent idiopathic scoliosis (AIS) subjects, the effect of backpack carrying method on their balance has not been determined. Our aim is to examine the effects of backpack load and carrying method on AIS subjects' balance.

STUDY DESIGN/SETTING

Paired sample matched for age and sex.

PATIENT SAMPLE

Twelve healthy adolescents matched for age and sex with 14 adolescents with mild AIS participated in this study.

OUTCOME MEASURES

A test battery including clinical examination, radiological assessment, and stabilometric measurements of the postural sways in the upright standing posture were conducted.

METHODS

Center of pressure excursions of our subjects were recorded with a stabilometric platform during the upright standing posture without a backpack and while carrying a backpack symmetrically and asymmetrically on each shoulder. For each carrying method, the backpack is loaded at 10% and 15% of body weight (BW).

RESULTS

Our results indicated that postural sways increased with increasing backpack load. These postural sways were observed when normal adolescents carried a backpack loaded with 15% BW load, whereas, for age- and sex-matched AIS subjects, these postural responses were observed for the 10% BW load. The symmetrical backpack carrying induced better balance compared with the asymmetrical one. Asymmetrical carrying on the convex side of the scoliotic curve affects AIS subjects' balance more than carrying it on the concave side.

CONCLUSIONS

Load carriage of 10% BW seems to alter AIS subjects' balance. Asymmetrical carrying should be avoided especially on the convex side of the scoliotic curve because it causes balance impairments that may increase spinal pain.

Effects of carrying a backpack in a symmetrical manner on the shape of the feet

The aim of this study was to assess changes in the shape of the feet while carrying a backpack constituting 10% of a child's weight. It was an observational, cross-sectional study involving 118 primary school children aged 11-13 years. Selected parameters of foot shape were assessed in both a normal position and with a backpack using podoscopy and a CQ-ST examination device. The study revealed significant differences in the length and width of the right and left feet between assessments. Moreover, the longitudinal arch of the foot was significantly lowered and deformity of the great toe was reported. Carrying a backpack constituting 10% of a child's weight results in lowering of the longitudinal and traverse arches of the feet and advanced toe deformities.

PRACTITIONER SUMMARY

We performed an observational, cross-sectional study examining the effect of carrying a backpack constituting 10% of a child's weight on parameters of foot shape and observed significant lowering of the longitudinal and traverse arches of the feet and advanced toe deformities.

Les tumeurs osseuses rachidiennes chez l'enfant et l'adolescent

The occurrence of back pain in children and adolescents varies from 30 to 51% in the literature. Bone tumors can be responsible for back pain. This paper presents the more common spinal bone tumors in children and adolescents, and specifies their etiology, their natural history, and their treatment as well.