Cluster-randomized, controlled evaluation of a teacher led multi factorial school based back education program for 10 to 12-year old children

Abstract

BackgroundThe aim of this cluster-randomised, controlled study was to examine whether a teacher-led multifactorial back education programme could improve back pain in pupils, motor skills, back behaviour, and back knowledge over a 10-month period.MethodsThere were 176 children from two schools, who were cluster-randomised into intervention and control groups. The intervention programme consisted of 3 parts: 1) knowledge improvement, 2) posture awareness training, and 3) reducing imbalance of core muscles through mandatory back and abdominal muscle exercises at the beginning of each physical education lesson. Outcome measures included a clinical orthopaedic examination, a health questionnaire, a motor test, a back-behaviour trial, and a knowledge test.ResultsClinical examination showed a reduction of orthopaedic abnormalities in both groups, from 90.5 to 42%, with a posture test showing an improvement in both groups at the post-test. However, the rate of children reporting back pain at least once a month could not be reduced below 30%. Long lasting physical activity, carrying heavy schoolbags, and long periods of sitting were the top three causes for back pain. Push-up number and balancing skills improved significantly in both groups from pre- to post-test. In the water crate carrying task and knowledge test, only the intervention group (IG) showed a statistically significant improvement from pre- to post-test.ConclusionsThe results show that back pain rate could not be decreased. However, back care knowledge and parts of back-friendly behaviour could be significantly improved. On the other hand, the problem of prolonged sitting and using heavy schoolbags persists.Trial registrationDeutsches Register Klinische Studien DRKS00013794; Date of Registration: 15.1.2018; Retrospectively registered.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1280-y) contains supplementary material, which is available to authorized users.

Effectiveness of a theory-based back care intervention on spine-related behavior among pupils: a school-based randomised controlled trial (T-Bak study)

“…Back pain is a major public health problem [1][2][3][4][5][6] on the rise among all ages including adolescents and in particular pupils [1,3,[7][8][9]. Lifetime prevalence of this condition in this age group also varies from 13 to 51% [4].…”

Relationship between cognitive factors and healthy spine-related behavior among pupils

“…The district has a population of variety socio-economic background. In order to explore the predictive factor, the study of Dullien article [1] was referred to determine the required sample size. According to Dullien to conduct a study with power of 80%, and standard deviation of 14.5 for performance score with a minimum precision of 2 at 5% significance level, a sample of 202 pupils would be required.…”

“…Back pain is one of the most important public health problems and nearly 540 million people suffer from it [1]. It is on the rise among adolescent and pupils' population and the prevalence varies between 11% and 52.1%, and is associated with back pain in adulthood [2][3][4][5].…”

“…It is on the rise among adolescent and pupils' population and the prevalence varies between 11% and 52.1%, and is associated with back pain in adulthood [2][3][4][5]. Behavioral risk factors for back pain in children are, among others, prolonged improper backpack loading during the childhood years, carrying the bag in one side of body [1,[5][6][7], physical inactivity [1,8], and improper posture during daily activity [7,9]. Thus it is argued that in order to prevent or reduce burden of back pain in pupils, theory-based back care educational programs for this population are of prime importance [10].…”

“…Studies have shown that although knowledge might improve after back care interventions, the association between knowledge and proper back behavior was not established. For instance, Dullien et al reported that back care knowledge and parts of BB significantly improved from pre-to post-test but increase in the intervention group' knowledge did not significantly affect their behavior[1]. Santos et al also…”