Back Pain Related with Age, Anthropometric Variables, Sagittal Spinal Curvatures, Hamstring Extensibility, Physical Activity and Health Related Quality of Life in Male and Female High School Students

Frequency of back pain occurrence among high school youth including their physical activity

BACKGROUND

Back pain diseases are among frequently reported health problems. Unfortunately, more often this problem also affects young people, high school students. Lifestyle that people are representing nowadays has a negative impact on their spine. Development of technology and transportation eliminates daily basic physical activity such as taking a walk to the school. Prolonged and inappropriate sitting posture during classes and using the computer at home are predisposing factors for back pain occurrence. The aim of this paper was to analyze the frequency of back pain occurrence among high school youth and attempt to relate their occurrence frequency with sex, time spent in sitting position, anthropometric parameters and physical activity of examined students.

METHODS

The examined group initially counted 272 teenagers, but ultimately 218 were taken into account for the analysis and 54 questionnaires were filled in incorrectly and rejected. All of them were high school students. Customized survey consisting of general part and closed questions regarding physical activity (subjective experience of work load) was used as an examination tool.

RESULTS

Examined youth spent on average 10.04 hours daily in a sitting position. As much as 195 (89.45%) of examined teenagers declared to experience back pain at least once in their lives. The most of teenagers (117; 53.67%) indicated lumbar spine pain. Girls more often felt spine pain issues in comparison to boys. Short stature of teenagers was often related to back pain occurrence. No correlation between time spent in sitting position and frequency of skeleton axis pain occurrence was noted. Among group of boys a relation between more frequent physical activity and less often spine pain occurrence was observed.

CONCLUSIONS

Spine pain is an important health problem of examined youth, occurring more frequent among girls than boys. Body height correlate negatively with frequency of spine pain occurrence among youth. Despite spending more than 10 hours daily in sitting position by examined youth, it did not affect the frequency of back pain issues occurrence. Higher physical activity of examined boys was related to less often back pains.

The Effectiveness of Exercise Programs in Adolescents with Thoracic Kyphosis: A Narrative Review

Thoracic kyphosis is a common postural problem affecting over 20% of adolescents. This condition can contribute to various spinal problems, leading to a decreased ability to perform daily activities, reduced quality of life, and impaired pulmonary function. This review aimed to investigate the effectiveness of exercise programs in adolescents with thoracic kyphosis. We systematically searched the PubMed, Embase, Cochrane Library, and Scopus databases for articles relevant to adolescents with thoracic kyphosis that had been published up to 14 May 2024. Our inclusion criteria focused on studies investigating the effects of exercise on improving thoracic kyphosis. A total of 1883 articles was identified using the search terms. After the titles and abstracts had been screened, 1868 articles were found not to meet our inclusion criteria and were excluded. The remaining 15 articles were then assessed for eligibility. Finally, only seven studies were included in this systematic review. Exercises targeting the entire spinal curvature demonstrated efficacy in enhancing the strength and function of the cervical, thoracic, lumbar, and pelvic muscles, resulting in a corrective effect on thoracic kyphosis in adolescents. Consequently, exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis.

Sagittal spinal curvatures of young adults in the context of their self-reported physical activity and somatic parameters

The objective of this study was to assess the thoracic kyphosis (ThKA) and lumbar lordosis (LLA) in healthy young adults and to investigate potential relationships between spinal curvatures, self-reported physical activity (PA), and somatic parameters. The study included 380 female students and 211 male students aged 20.7 ± 1.5 years. The ThKA and LLA were measured using a Plurimeter-V gravity inclinometer. The level of PA was estimated using the International Physical Activity Questionnaire. ThKA was lower in women compared to men, while LLA was higher in women than in men (p < 0.0001). Female students reported lower PA than male students (p < 0.001). Female students with ThKA within normal values reported a significantly higher amount of low-intensity PA compared to those with ThKA below or above the norm. A correlation was found between ThKA and body mass index (BMI), body adiposity index (BAI), WC, and fat percentage (rho < 0.2), whereas LLA showed correlations with BMI, BAI, waist circumference, and fat percentage (rho < 0.2). Among male students, a correlation was found between LLA and BMI as well as WC (rho < 0.2). Maintaining a healthy body composition may be instrumental in mitigating the risk of developing spinal curvature abnormalities.

Relationship between Physical Activity and Sedentary Behavior, Spinal Curvatures, Endurance and Balance of the Trunk Muscles-Extended Physical Health Analysis in Young Adults

BACKGROUND

Physical inactivity and sedentary behavior are associated with poor well-being in young people with adverse effects extending into adulthood. To date, there are many studies investigating the relationship between physical activity (PA) and posture, but there are no data on the relationship between the type and intensity of PA and sedentary behavior, their association with thoracic and lumbar spine angles, and with endurance and balance of the trunk muscles, especially in healthy young adults aged 18-25 years. Moreover, there are no data on the relationship between PA and sedentary behavior and musculoskeletal and cardiopulmonary health, as well as quality of life (QoL) and sleep that would provide a more comprehensive picture of physical health status.

AIM

Therefore, the aim of this cross-sectional study was to investigate the extent to which PA and sedentary behavior are associated with each other and with changes in spinal curvatures, endurance and balance of trunk muscles in an extended analysis of physical health status in young adults aged 18-25 years by additionally including measures of body composition, cardiorespiratory capacity, and QoL and sleep.

METHODS

A total of 82 students (58% female, 42% male) aged 18-25 years completed all required tests. Primary outcome measures included the following: PA and sedentary behavior calculated from the long form of International PA Questionnaire (IPAQ-LF), spinal curvatures measured by a Spinal Mouse® device, endurance and balance of the trunk muscles measured using trunk endurance tests and their ratio.

RESULTS

Overall, 50% of students were classified as minimally active and 50% as health-enhancing PA (HEPA) active. The angles of thoracic kyphosis and lumbar lordosis showed no correlation with PA or time spent sitting. However, students with the lowest PA had significantly higher scores on the trunk extensor endurance test and trunk extensor/flexor endurance test ratio, indicating imbalanced trunk muscles. Moreover, these students spent the most their time sitting. Only PA of vigorous intensity and PA during recreation, leisure, and sports significantly correlated with QoL related to physical health. QoL related to physical and psychosocial health had significantly higher scores when students spent less time sitting. In addition, we found significantly better respiratory performance and SQ at higher PA values, i.e., PA during recreation, leisure, and sport.

CONCLUSIONS

Our results suggest that students with low PA levels and more time spent sitting have imbalanced trunk muscles, worse respiratory function, and poorer QoL and sleep. Moreover, these findings in college students may reflect their lifestyle and suggest that more PA needs to be promoted to prevent the development of chronic diseases including musculoskeletal disorders.

Analysis of sagittal spinal alignment at the adolescent age: for furniture design

Knowledge of the parameters of the human spine is essential in designing ergonomic furniture. The purpose of this study was to evaluate spinal alignment in adolescents of various ages. The lengths, curvatures, and concave-convex spacings of the spine were investigated in 268 participants aged 9-18 years. Ten ages were classified, and the rate of increase of parameters was calculated for each age and age group. The results showed that spinal parameters, except for cervical lordosis, increased with age. Adolescents were classified as 9-10, 11-12, 13-15, and 16-18 years old. A rapid increment of lengths and concave-convex spacings occurred at ages 13-15, while that of curvatures occurred at ages 16-18. Spinal parameters differed significantly among the age groups (p < 0.05). Concave-convex spacings reflected differences in the spine more clearly than the other parameters. This study suggests the necessity of designing spine-related furniture based on spinal parameters, thus providing adaptive support for the adolescent spine, particularly the lumbar spine. Practitioner summary: This study examined spinal lengths, curvatures, and concave-convex spacings in adolescents aged 9-8 years and then divided them into four age groups. Concave-convex spacings effectively reflected spinal differences between age groups, particularly the lumbar spine. These results can inform the ergonomic design of spine-related furniture.HIGHLIGHTSSpinal parameters increased progressively between 9 and 18 years. Regression analysis showed good linear correlations between TK, LL, SK, TS, and LS with age.Age classification of adolescents was Group I (9-10 years), Group II (11-12 years), Group III (13-15 years), and Group IV (16-18 years). The rapid increment of lengths and concave-convex spacings were in Group III while that of curvatures were in Group IV.Concave-convex spacings were vital parameters to evaluate the global balance of the spine.The lumbar spine is an essential segment for characterizing spinal alignment.

Association Between Body Mass Index and Nonspecific Recurrent Low Back Pain in Over 600,000 Healthy Young Adults

An association between body mass index (BMI; weight (kg)/height (m)2) and low back pain (LBP) has long been debated, but inconsistent measurements of BMI and varying definitions of LBP have produced conflicting findings. We explored this association using measured BMI and physician documentation of recurrent LBP among healthy young adults. Data were extracted from the Israel Defense Forces electronic medical record system. All Israeli citizens with compulsory military service during January 2008-March 2019 were included (n = 705,840). Exclusion criteria were spine deformities, disc pathologies, spinal surgeries, arthropathies, connective tissue diseases, pain syndromes, low bone density disorders, cancers, and psychiatric illnesses. LBP was defined as electronic medical record system documentation of 1) 2 medical visits at least 6 weeks apart with a diagnosis of LBP or "LBP with radiation" or 2) 1 medical visit resulting in referral to an orthopedic surgeon. Logistic regression models were used to explore the association between BMI category and LBP; 619,969 (87.8%) individuals (mean age = 18.9 (standard deviation, 0.97) years; 56.9% male) were included. LBP prevalence was 9.2% (n = 56,918) and higher among males (9.7%) than females (8.5%). Overweight (odds ratio = 1.123, 95% confidence interval: 1.096, 1.151) and obesity (odds ratio = 1.137, 95% confidence interval: 1.096, 1.179) were associated with LBP. The association remained significant after accounting for various sociodemographic factors. Maintaining a healthy BMI may aid in the prevention of LBP in young adults.

Effects of a Pilates programme in spinal curvatures and hamstring extensibility in adolescents with thoracic hyperkyphosis: a randomised controlled trial

AIM

To evaluate the effects of a 9-month Pilates exercise programme on the sagittal spinal posture and hamstring extensibility of adolescents with thoracic hyperkyphosis.

DESIGN

Randomised controlled trial with blinded examiner.

PATIENTS

One-hundred and three adolescents with thoracic hyperkyphosis.

INTERVENTIONS

Participants were randomly placed into an experimental group which participated in a Pilates exercise programme implemented for a total of 38 weeks (two sessions/week, 15 min/session) (Pilates group (PG), sample = 49, or control group (CG), sample = 48).

MAIN OUTCOME MEASURES

The outcome measures were the thoracic curve in sagittal spinal curvature in relaxed standing, sagittal spinal curvatures and pelvic tilt in relaxed standing and sit-and-reach positions, and hamstring extensibility.

RESULTS

There was a significant adjusted mean difference between groups in favour of the PG in the thoracic curve in relaxed standing position (-5.6°, p = 0.003), pelvic tilt (-2.9°, p = 0.03) and all straight leg tests (p<0.001). The PG showed a significant change in thoracic curve (-5.9, p<0.001) and in lumbar angle (4.0, p = 0.001) in relaxed standing position and in all straight leg raise tests (+6.4 to +15°, p<0.0001).

CONCLUSIONS

The adolescents with thoracic hyperkyphosis from the PG had a decreased thoracic kyphosis in relaxed standing position, and improved hamstring extensibility as compared with the CG. More than 50% of the participants obtained kyphosis values inside normality, showing an adjusted mean difference between groups in the thoracic curve of about 73% of the baseline mean, resulting in a large improvement and high clinical importance.

TRIAL REGISTRATION NUMBER

NCT03831867.

The Impact of Low Back Pain on the Quality of Life of Children between 6 and 12 Years of Age

This study aimed to evaluate the impact of low back pain on the perceived health-related quality of life of children between 6 and 12 years of age. This is a cross-sectional study of three hundred seventy-seven students from three schools (two private and one public) located in the city of Botucatu, São Paulo. Data were collected using the Pediatric Quality of Life Inventory (PedsQL, version 4.0), a questionnaire comprising questions on personal background, sociodemographic and socioeconomic information, and a questionnaire about quality of life. Comparisons were made between groups with and without low back pain. The chi-squared test was used for analyzing categorical variables, and the non-parametric Mann–Whitney test was used for continuous variables. According to the findings obtained in this study, it was observed that low back pain in the last month was reported by 27.3% of the total participants. The perceived health-related quality of life was lower among individuals who had low back pain, and the scores of physical and emotional functioning domains were also lower in the presence of low back pain. The prevalence of low back pain among children and adolescents is relatively high. Furthermore, the repercussions of low back pain may lead to a lower overall perception of the health-related quality of life in this population and affect aspects of physical and emotional functioning.

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.

The Quality of Life and Its Relationship With Systemic Family Dynamics and Mental Health in Senior High School Students From Shaanxi, China

Objective

To explore the quality of life (QoL) status of senior high school students in the Shaanxi Province and the relationship of the QoL with systemic family dynamics and mental health.

Methods

This was a cross-sectional observational study in a sample of 1,402 senior high school students; students were asked to complete a questionnaire which comprised the 36-item Short Form Health Survey (SF-36) to assess the QoL, the Self-rating Scale of Systemic Family Dynamics (SSFD) for assessing family functioning, the Symptom Checklist-90-Revised (SCL-90-R) for assessing mental health and general demographic variables.

Results

Grades of senior high school students were defined as Grade 1 (first year), Grade 2 (second year), and Grade 3 (third year). Compared to Grade 3 students, Grade 1 students had higher scores in physical functioning, role-emotional, bodily pain, and reported health transition of the QoL over the last 1 year (P < 0.05). Multiple linear regression showed that the place of residence, subscales of systemic family dynamics, somatization, and depression significantly affected the total QoL score. The results of SEM show that the SCL-90-R score fully mediated the association between the SSFD score and SF-36 score (indirect effect coefficient 0.055; 95% CI, 0.012–0.106; P = 0.042).

Conclusion

The QoL score of senior high school students was low, particularly that of Grade 3 students, who consequently need more emotional support. By improving and enhancing systemic family dynamics, the QOL of high school students will improve and discovering and addressing their mental health problems will be easier.

Assessment of the physical and emotional health concerning the students' physical activity during the COVID-19 pandemic

Introduction. SARS CoV-2 caused the third global pandemic and by applying quarantine / isolation / lockdown, the movement was restricted, the physical contact between people was reduced, the physical activity was low, but the activities using electronic devices at home were frequent. The aim of the study was to assess the physical and emotional health in relation to the physical activities done during quarantine/ isolation during the pandemic. Material and method. The study was cross-sectional and consisted of completing an online questionnaire. It was conducted in a period of 6 months and it included 334 students. In order to point out the symptoms caused by quarantine / isolation/ lockdown, we considered it useful for students to participate by completing an online questionnaire about physical activities, physical health and emotional state, related to the implications of participating in online courses. Results. The questions in this questionnaire were grouped on the following aspects: physical activity, physical health, emotional state, all in the context of the pandemic period, including the period in which the academic activity was online. Thus, in the first year, there is a positive correlation between physical condition, physical activity, emotional signs and cognitive ones. In the second year, the positive correlation is present between the physical and the affective signs, whereas the negative correlation is between the affective signs, the cognitive ones and the physical activity. In the third year, the positive correlation is obvious between the affective signs, the cognitive ones and the physical activity, whereas the negative one between the physical and cognitive signs, as well as between the physical activity and the cognitive and physical signs. Discussions. There is a link between emotional and cognitive symptoms and physical health. Fear, anxiety, behavioral disorders, and limited physical activity among students during this period can be a public health issue. Conclusions. The COVID-19 pandemic affected the physical and mental state, with a greater resonance for youth, especially pupils and students. Many of them had emotional, behavioral, physical and cognitive symptoms. These symptoms are found to a greater extent in students in the final years, due to the social impact, social and professional integration. Keywords: physical health, mental state, students,

Dorsalgia rehabilitation in static disorders of the spine by therapeutic swimming in young adults

The purpose of this paper is to point out and propose the most effective means of therapeutic swimming in the use of work programs for patients with dorsalgia in spinal static disorders. The knowledge degree of therapeutic swimming is not sufficiently promoted and used, which is why we propose the following hypothesis: we start from the premise that therapeutic swimming can reduce the dorsalgia in the spine, improve lung capacity and physical condition in young adults. The objectives of this work are to identify subjects with spinal static dorsalgia and to establish the sample for the experiment; in the selection of therapeutic swimming means for the elaboration of the work program; in the registration and interpretation of the data in the form of tables and charts. The experiment took place at the Kinetic Therapy Practice of Mr. Constantinescu Mihai, as well as at the swimming pool in Cornisa, Botoşani county, with a sample consisting of 15 subjects aged between 18 and 22, all of whom suffered dorsalgia (in the spine). In this respect, we set out to implement a therapeutic swimming program for 6 months to achieve positive results. Keywords: dorsalgia, spinal static disorders, therapeutic swimming,