Efeitos de um programa de exercícios no desempenho de crianças nos testes de flexibilidade e impulsão vertical

Effectiveness of physiotherapy interventions for back care and the prevention of non-specific low back pain in children and adolescents: a systematic review and meta-analysis

Background

Non-specific low back pain in children and adolescents has increased in recent years. The purpose of this study was to upgrade the evidence of the most effective preventive physiotherapy interventions to improve back care in children and adolescents.

Methods

The study settings were children or adolescents aged 18 years or younger. Data were obtained from the Cochrane Library, MEDLINE, PEDro, Web of Science, LILACS, IBECS, and PsycINFO databases and the specialized journals BMJ and Spine. The included studies were published between May 2012 and May 2020. Controlled trials on children and adolescents who received preventive physiotherapy for back care were considered. Data on all the variables gathered in each individual study were extracted by two authors separately. Two authors assessed risk of bias of included studies using the RoB2 and quality of the body of evidence using the GRADE methodology. Data were described according to PRISMA guidelines. To calculate the effect size, a standardized mean difference “d” was used and a random-effects model was applied for the following outcome variables: behaviour, knowledge, trunk flexion muscle endurance, trunk extension muscle endurance, hamstring flexibility and posture.

Results

Twenty studies were finally included. The most common physiotherapy interventions were exercise, postural hygiene and physical activity. The mean age of the total sample was 11.79 years. When comparing the change from baseline to end of intervention in treatment and control groups, the following overall effect estimates were obtained: behaviour d₊ = 1.19 (95% CI: 0.62 and 1.76), knowledge d₊ = 1.84 (0.58 and 3.09), trunk flexion endurance d₊ = 0.65 (-0.02 and 1.33), trunk extension endurance d₊ = 0.71 (0.38 and 1.03), posture d₊ = 0.65 (0.24 and 1.07) and hamstrings flexibility d₊ = 0.46 (0.36 and 0.56). At follow-up, the measurement of the behaviour variable was between 1 and 12 months, with an effect size of d₊ = 1.00 (0.37 and 1.63), whereas the knowledge variable obtained an effect size of d₊ = 2.08 (-0.85 and 5.02) at 3 months of follow-up.

Conclusions

Recent studies provide strong support for the use of physiotherapy in the improvement of back care and prevention of non-specific low back pain in children and adolescents. Based on GRADE methodology, we found that the evidence was from very low to moderate quality and interventions involving physical exercise, postural hygiene and physical activity should be preferred.

Supplementary information

The online version contains supplementary material available at 10.1186/s12891-022-05270-4.

Scoping Review on Interventions for Physical Activity and Physical Literacy Components in Brazilian School-Aged Children and Adolescents

This scoping review mapped the existing evidence on interventions to promote physical activity (PA) and/or components of physical literacy (PL) in Brazilian school-aged children and adolescents. Nine electronic databases and gray literature were consulted in May 2020, with no limit on year or language. School-based intervention studies (6 to 18 years old, primarily) that assessed PA or PL components (PA-related factors or attributes) were eligible. The studies were stratified by children (<12 years of age) and adolescents (≥12 years of age). A total of 63 documents were included, which refer to 42 different intervention studies. Twenty-five interventions focused on adolescents and 17 on children. The most-used strategies in the interventions were changes in physical and environmental education classes, extracurricular PA sessions, and health education. No study has analyzed all components of PL or evaluated PL using specific protocols or instruments. PA attributes were the most studied components (30 studies). This review identified the need to conduct interventions with strategies that target all components of PL, representing important elements for a research agenda that underlies school interventions that contribute to an active lifestyle.