Risk Factors for Back Pain among Southern Brazilian School Children: A 6-Year Prospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample
2.2. Data Collection and Analysis Procedures
2.3. Statistical Analysis
3. Results
4. Discussion
Limitations and Strengths
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Hoy, D.; Bain, C.; Williams, G.; March, L.; Brooks, P.; Blyth, F.; Woolf, A.; Vos, T.; Buchbinder, R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012, 64, 2028–2037. [Google Scholar] [CrossRef] [PubMed]
- Maher, C.; Underwood, M.; Buchbinder, R. Non-specifi c low back pain. Lancet 2016, 389, 736–747. [Google Scholar] [CrossRef] [Green Version]
- Walker, B.F.; Muller, R.; Grant, W.D. Low back pain in Australian adults: The economic burden. Asia-Pacific J. Public Health 2003, 15, 79–87. [Google Scholar] [CrossRef] [PubMed]
- Hurwitz, E.L.; Randhawa, K.; Yu, H.; Côté, P.; Haldeman, S. The Global Spine Care Initiative: A summary of the global burden of low back and neck pain studies. Eur. Spine J. 2018, 27, 796–801. [Google Scholar] [CrossRef]
- Calvo-muñoz, I.; Kovacs, F.M.; Roqué, M.; Fernández, I.G.; Calvo, J.S. Risk Factors for Low Back Pain in Childhood and Adolescence a Systematic Review. Clin. J. Pain 2018, 34, 468–484. [Google Scholar] [CrossRef]
- Kamper, S.J.; Parma, T.; Williams, C.M. The prevalence, risk factors, prognosis and treatment for back pain in children and adolescents: An overview of systematic reviews. Best Pract. Res. Clin. Rheumatol. 2017, 30, 1021–1036. [Google Scholar] [CrossRef]
- Groenewald, C.B.; Essner, B.S.; Wright, D.; Fesinmeyer, M.D.; Palermo, T.M. The economic costs of chronic pain among a cohort of treatment seeking adolescents in the United States. J Pain 2014, 15, 925–933. [Google Scholar] [CrossRef] [Green Version]
- Swain, M.; Henschke, N.; Kamper, S.; Gobina, I.; Ottová-Jordan, V.; Maher, C. An international survey of pain in adolescents. BMC Public Health 2014, 14, 447. [Google Scholar] [CrossRef] [Green Version]
- Hestbaek, L.; Leboeuf-Yde, C.; Kyvik, K.O. Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young population. BMC Musculoskelet. Disord. 2006, 7, 29. [Google Scholar] [CrossRef] [Green Version]
- Miller, M.M.; Meints, S.M.; Hirsh, A.T. Catastrophizing, pain, and functional outcomes for children with chronic pain: A meta-analytic review. Pain 2018, 159, 2442. [Google Scholar] [CrossRef]
- Sá, S.; Silva, A.G. Repositioning error, pressure pain threshold, catastrophizing and anxiety in adolescents with chronic idiopathic neck pain. Musculoskelet. Sci. Pract. 2017, 30, 18–24. [Google Scholar] [CrossRef] [PubMed]
- Miñana-Signes, V.; Monfort-Pañego, M.; Bosh-Bivià, A.H.; Noll, M. Prevalence of low back pain among primary school students from the city of Valencia (Spain). Healthcare 2021, 9, 270. [Google Scholar] [CrossRef] [PubMed]
- Noll, M.; Candotti, C.T.; Rosa, B.N.D.; Vieira, A.; Loss, J.F. Back pain and its risk factors in Brazilian adolescents: A longitudinal study. Br. J. Pain 2019, 15, 16–25. [Google Scholar] [CrossRef] [PubMed]
- Ozdemir, S.; Gencbas, D.; Tosun, B.; Bebis, H.; Sinan, O. Musculoskeletal Pain, Related Factors, and Posture Profiles Among Adolescents: A Cross-Sectional Study from Turkey. Pain Manag. Nurs. 2021, 22, 522–530. [Google Scholar] [CrossRef]
- Sundell, C.G. Low back pain and associated disability in Swedish adolescents. Scand. J. Med. Sci. Sport 2019, 29, 393–399. [Google Scholar] [CrossRef] [Green Version]
- Beales, D.J.; Smith, A.J.; Sullivan, P.B.O.; Straker, L.M. Low Back Pain and Comorbidity Clusters at 17 Years of Age: A Cross-sectional Examination of Health-Related Quality of Life and Specific Low Back Pain Impacts. J. Adolesc. Health 2012, 50, 509–516. [Google Scholar] [CrossRef] [Green Version]
- Kamper, S.J.; Henschke, N.; Hestbaek, L.; Dunn, K.M.; Williams, C.M. Musculoskeletal pain in children and adolescents. Braz. J. Phys. Ther. 2016, 20, 275–284. [Google Scholar] [CrossRef] [Green Version]
- Noll, M.; Candotti, C.T.; da Rosa, B.N.; Loss, J.F. Back pain prevalence and associated factors in children and adolescents: An epidemiological population study. Rev. Saude Publica 2016, 50, 1–10. [Google Scholar] [CrossRef]
- Noll, M.; Candotti, C.T.; Vieira, A.; Loss, J.F. Back Pain and Body Posture Evaluation Instrument (BackPEI): Development, content validation and reproducibility. Int. J. Public Health 2013, 58, 565–572. [Google Scholar] [CrossRef]
- Zou, G. A Modified Poisson Regression Approach to Prospective Studies with Binary Data. Am. J. Epidemiol. 2004, 159, 702–706. [Google Scholar] [CrossRef]
- Ballinger, G.A. Using Generalized Estimating Equations for Longitudinal Data Analysis. Organ. Res. Methods 2004, 7, 127–150. [Google Scholar] [CrossRef]
- Joergensen, A.C.; Hestbaek, L.; Andersen, P.K.; Andersen, A.-M.N. Epidemiology of spinal pain in children: A study within the Danish National Birth Cohort. Eur. J. Pediatr. 2019, 178, 695–706. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fabricant, P.D.; Heath, M.R.; Schachne, J.M.; Doyle, S.M.; Green, D.W.; Widmann, R.F. The Epidemiology of Back Pain in American Children and Adolescents. BMC Musculoskelet. Disord. 2020, 45, 1135–1142. [Google Scholar] [CrossRef] [PubMed]
- Noll, M.; Noll, P.R.; Neto, J.L.R.; Leal, V.N.; da Rosa, B.N.; Candotti, C.T. Back pain and behavioral habits of high school students: A comparative study of two Brazil’s regions. Rev. Bras. Reumatol. (English Ed.) 2017, 57, 495–499. [Google Scholar] [CrossRef] [Green Version]
- Dolphens, M.; Vansteelandt, S.; Cagnie, B.; Vleeming, A.; Nijs, J.; Vanderstraeten, G.; Danneels, L. Multivariable modeling of factors associated with spinal pain in young adolescence. Eur. Spine J. 2016, 25, 2809–2821. [Google Scholar] [CrossRef]
- Mahdavi, S.B.; Riahi, R.; Vahdatpour, B.; Kelishadi, R. Association between sedentary behavior and low back pain; A systematic review and meta-analysis. Heal. Promot. Perspect. 2021, 11, 393–410. [Google Scholar] [CrossRef]
- Booth, F.W.; Lees, S.J. Fundamental questions about genes, inactivity, and chronic diseases. Physiol. Genomics 2007, 28, 146–157. [Google Scholar] [CrossRef]
- Bontrup, C.; Taylor, W.R.; Fliesser, M.; Visscher, R.; Green, T.; Wippert, P.M.; Zemp, R. Low back pain and its relationship with sitting behaviour among sedentary office workers. Appl. Ergon. 2019, 81, 102894. [Google Scholar] [CrossRef]
- Bo Andersen, L.; Wedderkopp, N.; Leboeuf-Yde, C. Association between back pain and physical fitness in adolescents. BMC Musculoskelet. Disord. 2006, 31, 1740–1744. [Google Scholar] [CrossRef]
- Bento, T.P.F.; Cornelio, G.P.; Perrucini, P.d.O.; Simeão, S.F.A.P.; de Conti, M.H.S.; de Vitta, A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J. Pediatr. (Rio. J). 2020, 96, 717–724. [Google Scholar] [CrossRef]
- Domingues-Montanari, S. Clinical and psychological effects of excessive screen time on children. J. Paediatr. Child Health 2017, 53, 333–338. [Google Scholar] [CrossRef] [PubMed]
- Noll, M.; Candotti, C.T.; Da Rosa, B.N.; Sedrez, J.A.; Vieira, A.; Loss, J.F. Layout for assessing dynamic posture: Development, validation, and reproducibility. Pediatr. Phys. Ther. 2016, 28, 435–444. [Google Scholar] [CrossRef] [PubMed]
- Wilke, H.J.; Neef, P.; Caimi, M.; Hoogland, T.; Claes, L.E. New in vivo measurements of pressures in the intervertebral disc in daily life. BMC Musculoskelet. Disord. 1999, 24, 755–762. [Google Scholar] [CrossRef] [PubMed]
- Korovessis, P.; Koureas, G.; Zacharatos, S.; Papazisis, Z. Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: A logistic and multinomial logistic analysis. BMC Musculoskelet. Disord. 2005, 30, 247–255. [Google Scholar] [CrossRef] [PubMed]
- Noll, M.; Fraga, R.A.; da Rosa, B.N.; Candotti, C.T. Risk factors associated with the intensity of back pain in school children of Teutônia (RS). Rev. Bras. Ciências Esporte 2016, 38, 124–131. [Google Scholar] [CrossRef] [Green Version]
- Amro, A. The effect of school bag weight on pain, posture, and vital capacity of lung of three elementary of elementary school in Bethlehem district on Palestine. Middle East J. Fam. Med. 2009, 7, 7–14. [Google Scholar]
- Goodgold, S.; Corcoran, M.; Gamache, D.; Gillis, J.; Guerin, J.; Coyle, J.Q. Backpack Use in Children. Pediatr. Phys. Ther. 2002, 14, 122–131. [Google Scholar] [CrossRef]
- IASP Terminology. Available online: https://www.iasp-pain.org/resources/terminology (accessed on 1 March 2022).
- Lin, I.; Wiles, L.; Waller, R.; Goucke, R.; Nagree, Y.; Gibberd, M.; Straker, L.; Maher, C.G.; O’Sullivan, P.P.B. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: Systematic review. Br. J. Sports Med. 2020, 54, 79–86. [Google Scholar] [CrossRef]
- Pivotto, L.R.; Nichele, B.; Candotti, C.T.; Noll, M.; Vieira, A. Proposition of a General Scoring System to the BackPEI. Head Neck Spine Surg. 2018, 3, 14–16. [Google Scholar] [CrossRef]
- O’Sullivan, P.B.; Caneiro, J.P.; O’Sullivan, K.; Lin, I.; Bunzli, S.; Wernli, K.; O’keeffe, M. Back to basics: 10 facts every person should know about back pain. Br. J. Sports Med. 2020, 54, 698–699. [Google Scholar] [CrossRef]
- Calvo-Muñoz, I.; Gómez-Conesa, A.; Sánchez-Meca, J. Eficacia de los tratamientos de fisioterapia preventivos para el cuidado de la espalda en niños y adolescentes. Revisión sistemática. Fisioterapia 2011, 33, 262–272. [Google Scholar] [CrossRef]
- Calvo-Mũoz, I.; Gámez-Conesa, A.; Sánchez-Meca, J. Preventive physiotherapy interventions for back care in children and adolescents: A meta-analysis. BMC Musculoskelet. Disord. 2012, 13, 152. [Google Scholar] [CrossRef] [Green Version]
Included (n = 165) | Complete (n = 75) | |||
---|---|---|---|---|
Boys (n = 96) | Girls (n = 69) | Boys (n = 35) | Girls (n = 40) | |
Age (Years) | 12 ± 0.2 | 11.6 ± 0.1 | 11.6 ± 0.5 | 11.4 ± 0.5 |
Body mass (kg) | 70.7 ± 14.1 | 44 ± 1 | 65.8 ± 8.1 | 43.3 ± 7.3 |
Height (cm) | 131.9 ± 8.1 | 132.1 ± 8.9 | 153.2 ± 8.6 | 153.3 ± 8.5 |
Exposure Factors | Baseline (2011) | Follow Up 1 (2014) | Follow Up 2 (2017) | ||
---|---|---|---|---|---|
N (%) | N (%) | Back Pain n (%) | N (%) | Back Pain n (%) | |
Physical exercise practice | |||||
Yes | 63 (84%) | 41 (89.1%) | 26 (63.4%) | 58 (78.4%) | 34 (58.6%) |
No | 12 (16%) | 5 (10.9%) | 4 (80%) | 16 (21.6%) | 12 (75%) |
Physical exercise frequency a | |||||
1 to 2 days per week | 31 (53.5%) | 15 (38.4%) | 8 (53.3%) | 29 (50.9%) | 19 (65.5%) |
3 to 4 days per week | 18 (31%) | 18 (46.2%) | 12 (66.7%) | 18 (31.6%) | 8 (44.4%) |
5 days or more | 9 (15.5%) | 6 (15.4%) | 4 (66.7%) | 10 (17.5%) | 5 (50%) |
Competitive practice of physical exercise a | |||||
Yes | 33 (52.4%) | 4 (9.5%) | 0 (0%) | 9 (15.3%) | 5 (55.5%) |
No | 30 (47.6%) | 38 (90.5%) | 26 (68.4%) | 50 (84.7%) | 30 (60%) |
Daily time watching television | |||||
0 to 1 h | 2 (2.7%) | 14 (32.6%) | 11 (78.6%) | 43 (62.3%) | 31 (72.1%) |
2 to 5 h | 51 (68%) | 27 (62.8%) | 16 (59.2%) | 25 (36.2%) | 11 (44%) |
6 or more hours | 22 (29.3%) | 2 (4.6%) | 1 (50%) | 1 (1.4%) | 1 (100%) |
Daily time using computer | |||||
0 to 1 h | 0 (0%) | 17 (43.6%) | 12 (70.6%) | 35 (59.3%) | 23 (65.7%) |
2 to 5 h | 49 (89.1%) | 20 (51.3%) | 11 (55%) | 20 (33.9%) | 13 (65%) |
6 or more hours | 6 (10.9%) | 2 (5.1%) | 1 (50%) | 4 (6.8%) | 1 (25%) |
Read or study on bed | |||||
Yes | 15 (20%) | 13 (28.2%) | 6 (46.1%) | 26 (44.1%) | 19 (73.1%) |
Sometimes | 33 (44%) | 9 (19.6%) | 5 (55.5%) | 0 (0%) | 0 (0%) |
No | 27 (36%) | 24 (52.2%) | 18 (75%) | 33 (55.9%) | 18 (54.5%) |
Posture adopted to sleep | |||||
On its side | 11 (35.5%) | 27 (62.8%) | 19 (70.4%) | 38 (59.4%) | 22 (57.9%) |
Face down | 17 (54.8%) | 11 (25.6%) | 7 (43.6%) | 23 (35.9%) | 17 (73.9%) |
Face up | 3 (9.7%) | 5 (11.6%) | 2 (40%) | 3 (4.7%) | 1 (33.3%) |
Daily time sleeping | |||||
8 h or more | 17 (29.8%) | 16 (39%) | 14 (87.5%) | 16 (25%) | 9 (56.2%) |
0 to 7 h | 40 (70.2%) | 25 (61%) | 10 (40%) | 48 (75%) | 32 (66.7%) |
Posture adopted to write in classroom | |||||
Adequate | 19 (25.3%) | 1 (2.2%) | 1 (100%) | 7 (9.6%) | 3 (42.8%) |
Inadequate | 56 (74.7%) | 44 (97.8%) | 28 (63.6%) | 66 (90.4%) | 42 (63.6%) |
Posture adopted to sit on a bench | |||||
Adequate | 11 (14.9%) | 2 (4.3%) | 2 (100%) | 4 (5.4%) | 2 (50%) |
Inadequate | 63 (85.1%) | 44 (95.7%) | 27 (61.4%) | 70 (94.6%) | 43 (61.4%) |
Posture adopted to use the computer | |||||
Adequate | 9 (12%) | 8 (17.4%) | 6 (75%) | 8 (11%) | 6 (75%) |
Inadequate | 66 (88%) | 38 (82.6%) | 23 (60.5%) | 65 (89%) | 38 (58.5%) |
Posture adopted to lift object from the ground | |||||
Adequate | 25 (36.2%) | 5 (11.6%) | 1 (20%) | 13 (18.6%) | 7 (53.8%) |
Inadequate | 44 (63.8%) | 38 (88.4%) | 26 (68.4%) | 57 (81.4%) | 37 (64.9%) |
Backpack used to carry school supplies | |||||
Backpack with two straps | 6 (8.3%) | 47 (100%) | 30 (63.8%) | 73 (98.6%) | 44 (60.3%) |
Another type of backpack | 66 (91.7%) | 0 (0%) | 0 (0%) | 1 (1.4%) | 1 (100%) |
Way to carry the backpack a | |||||
Symmetric | 21 (28.8%) | 34 (72.3%) | 20 (58.8%) | 52 (70.3%) | 31 (59.6%) |
Asymmetric | 52 (71.2%) | 13 (27.7%) | 10 (76.9%) | 22 (29.7%) | 15 (68.2%) |
Parents with back pain | |||||
No | 2 (25%) | 13 (34.2%) | 6 (46.1%) | 18 (30%) | 8 (44.4%) |
Yes | 6 (75%) | 25 (65.8%) | 19 (76%) | 42 (70%) | 30 (71.4%) |
Exposure Variables | RR Analysis (95% CI) | p a | Adjusted RR Analysis (95% CI) | p a |
---|---|---|---|---|
Control variables | ||||
Sex | ||||
Male | 1 | 0.097 | 1 | 0.158 |
Female | 0.94 (0.88–1.01) | 1.01 (0.94–1.09) | ||
Age (Baseline) | ||||
11 | 1 | <0.001 | 1 | 0.910 |
12 | 1.04 (0.97–1.12) | 1.01 (0.8–1.3) | ||
13 | 0.84 (0.8–0.87) | 0.77 (0.64–0.92) | ||
Factors | ||||
Physical exercise practice | ||||
Yes | 1 | 0.262 | - | |
No | 0.92 (0.81–1.06) | |||
Physical exercise frequency b | ||||
1 to 2x per week | 1 | 0.994 | - | |
3 to 4x per week | 0.99 (0.9–1.1) | |||
5x or more | 1 (0.87–1.14) | |||
Competitive physical exercise practice b | ||||
Yes | 1 | <0.001 | 1 | 0.274 |
No | 0.79 (0.73–0.86) | 0.88 (0.69–1.11) | ||
Daily time watching television | ||||
0 to 1 h | 1 | <0.001 | 1 | 0.007 |
2 to 5 h | 1.39 (1.24–1.56) | 1.4 (0.9–1.99) | ||
6 or more hours | 1.54 (1.38–1.72) | 1.56 (1.15–2.13) | ||
Daily time using computer | ||||
0 to 1 h | 1 | <0.001 | 1 | 0.806 |
2 to 5 h | 1.31 (1.17–1.46) | 1.02 (0.99–1.01) | ||
6 or more hours | 1.38 (1.17–1.63) | 1.01 (0.99–1.02) | ||
Read or study on bed | ||||
Yes | 1 | 0.024 | 1 | 0.345 |
Sometimes | 1.14 (1.02–1.28) | 1.05 (0.99–1.01) | ||
No | 1.02 (0.91–1.15) | 1 (0.98–1.1) | ||
Posture adopted to sleep | ||||
On its side | 1 | 0.068 | 1 | 0.548 |
Face down | 1.07 (0.95–1.21) | 1.16 (0.7–1.93) | ||
Face up | 1.21 (1.02–1.42) | 1.21 (0.85–1.71) | ||
Daily time sleeping | ||||
8 h or more | 1 | 0.856 | - | |
0 to 7 h | 0.99 (0.88–1.11) | |||
Posture adopted to write in classroom | ||||
Adequate | 1 | 0.334 | - | |
Inadequate | 1.1 (0.93–1.22) | |||
Posture adopted to sit on a bench | ||||
Adequate | 1 | 0.145 | - | |
Inadequate | 1.14 (0.78–1.04) | |||
Posture adopted to use the computer | ||||
Adequate | 1 | 0,334 | - | |
Inadequate | 1.1 (0.93–1.27) | |||
Posture adopted to lift object from the ground | ||||
Adequate | 1 | <0.001 | 1 | <0.001 |
Inadequate | 1.82 (1.01–3.27) | 1.18 (1.1–1.3) | ||
Backpack used to carry school supplies | ||||
Backpack with two straps | 1 | <0.001 | 1 | 0.010 |
Another type of backpack | 1.43 (1.34–1.54) | 1.33 (1.1–1.64) | ||
Way to carry the backpack b | ||||
Symmetric | 1 | 0.002 | 1 | <0.001 |
Asymmetric | 1.14 (1.05–1.23) | 1.5 (1.2–1.9) | ||
Parents with back pain | ||||
No | 1 | 0.004 | 1 | 0.510 |
Yes | 0.82 (0.72–0.94) | 0.87 (0.59–1.3) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Rosa, B.N.d.; Noll, M.; Candotti, C.T.; Loss, J.F. Risk Factors for Back Pain among Southern Brazilian School Children: A 6-Year Prospective Cohort Study. Int. J. Environ. Res. Public Health 2022, 19, 8322. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148322
Rosa BNd, Noll M, Candotti CT, Loss JF. Risk Factors for Back Pain among Southern Brazilian School Children: A 6-Year Prospective Cohort Study. International Journal of Environmental Research and Public Health. 2022; 19(14):8322. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148322
Chicago/Turabian StyleRosa, Bruna Nichele da, Matias Noll, Cláudia Tarragô Candotti, and Jefferson Fagundes Loss. 2022. "Risk Factors for Back Pain among Southern Brazilian School Children: A 6-Year Prospective Cohort Study" International Journal of Environmental Research and Public Health 19, no. 14: 8322. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148322