Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up

Associations between pain, health, and lifestyle factors in 10-year-old boys and girls from a Swedish birth cohort

BACKGROUND

Pain is common in children and its associations with various biopsychosocial factors is complex. Comprehensive pain assessments could contribute to a better understanding of pediatric pain, but these assessments are scarce in literature. The aim of this study was to examine differences in pain prevalence and pain patterns in 10-year-old boys and girls from a Swedish birth cohort and to study associations between pain, health-related quality of life and various lifestyle factors stratified by sex.

METHODS

866 children (426 boys and 440 girls) and their parents from the "Halland Health and Growth Study" participated in this cross-sectional study. Children were categorized into two pain groups, "infrequent pain" (never-monthly pain) or "frequent pain" (weekly-almost daily pain), based on a pain mannequin. Univariate logistic regression analyses, stratified by sex, were performed to study associations between frequent pain and children's self-reports of disease and disability and health-related quality of life (Kidscreen-27, five domains), and parents' reports of their child's sleep (quality and duration), physical activity time, sedentary time, and participation in organized physical activities.

RESULTS

The prevalence of frequent pain was 36.5% with no difference between boys and girls (p = 0.442). Boys with a longstanding disease or disability had higher odds of being in the frequent pain group (OR 2.167, 95% CI 1.168-4.020). Higher scores on health-related quality of life in all five domains for girls, and in two domains for boys, was associated with lower odds of being categorized into the frequent pain group. Frequent pain was associated with poor sleep quality (boys OR 2.533, 95% CI 1.243-5.162; girls OR 2.803, 95% CI 1.276-6.158) and more sedentary time (boys weekends OR 1.131, 95% CI 1.022-1.253; girls weekdays OR 1.137, 95% CI 1.032-1.253), but not with physical activity.

CONCLUSIONS

The high prevalence of frequent pain needs to be acknowledged and treated by school health-care services and the healthcare sector in order to prevent pain from influencing health and lifestyle factors negatively in children.

Changes in Athletic Performance in Children Attending a Secondary School with a Physical Activity Profile

The longitudinal and multidisciplinary research project Malmö Youth Sport Study measured the sports results achieved by two cohorts of pupils using a variable named ACHIEVE, dividing the pupils into three categories (an elite group competing at the national or international level, a group competing at the district level, and a third group either not competing at all or below district level). This was assessed three and six years after baseline at age 13. An additional hypothetical measure, based on information from the athletes’ trainers, predicted the category the pupils were expected to belong to after twelve years (age 25). Social variables related to the ACHIEVE variable are sex, socio-economic position of the parents, ethnicity, completed secondary sports school, sports capital, and quartile of birth. After three years, 28% of the pupils belonged to the elite group and after six years, 26%. Thirty-two and 48%, respectively, had abandoned their elite efforts. The elite group remained fairly stable over time but fewer girls than boys advanced to the elite group. The pupils at the school have a homogenous middle-class background. We found little evidence that socio-economic factors affected ACHIEVE. Nearly all parents had been engaged in sports, either competing or as coaches. On admission to the school, there was a pronounced relative age effect (RAE). This remained after three years as the age was significantly different between the three groups but was reduced after six years. According to the prognosis made by the coaches, the elite group would be considerably smaller when the subjects reached the age of 25. The RAE was again significant in the prognosis. A further follow-up when the subjects are 25 years old will reveal not only what proportion of subjects are actively competing, but also if they are engaged in recreational sports, to what extent the RAE is present, and how accurately coaches can predict success.