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Back education in elementary schoolchildren: the effects of adding a physical activity promotion program to a back care program

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Abstract

Promoting a physically active lifestyle whilst optimizing the spinal load at a young age seems to be advocated within the scope of early back pain prevention efforts. The present study aimed at evaluating the effects of combining a back care program with a physical activity promotion program in elementary schoolchildren. In a pre–post design over two school years, back care knowledge, back care behavior, fear avoidance beliefs and back pain reports were evaluated in children classified into three categories—those who received a back care and a physical activity promotion program (n=190), those who received only a back care program (n=193) and those in a control group (n=172) (mean age at baseline: 9.7 years±0.7). Physical activity levels were evaluated in a sub-sample of 26 pupils in each group. The back care program and the physical activity promotion program were both comprehensive ones. In both intervention groups, the scores for back care related knowledge and back care behavior were significantly higher than the control group. The increase in the sum score for back care behavior was significantly higher in the back care group than in the back care plus physical activity promotion group. Significant interaction effects showed an increase in fear-avoidance beliefs between pre- and post-tests in the control group, significantly different from the better scores in both intervention groups. Interaction effects were not significant for pain reports. In the back care plus physical activity promotion group, the daily moderate to vigorous physical activity levels decreased by 8 min per day while a decrease by 31 min per day was found in the back care group and a decrease by 36 min per day in the control group. However, group differences were not significant. The present study findings favor the addition of a physical activity promotion program to a back care program in elementary schools within the scope of early back pain prevention efforts. However, the findings also emphasize the disadvantages of implementing both programs simultaneously in a school curriculum that is already full.

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References

  1. Adams M, Mannion A, Dolan P (1999) Personal risk factors for first-time low back pain. Spine 24:2497–2505

    Article  PubMed  CAS  Google Scholar 

  2. Balagué F, Dudler J, Nordin M (2003) Low-back pain in children. Lancet 361:1403–1404

    Article  PubMed  Google Scholar 

  3. Balagué F, Nordin M, Dutoit G, Waldburger M (1996) Primary prevention, education, and low back pain among schoolchildren. Bull Hosp Jt Dis 55:130–134

    PubMed  Google Scholar 

  4. Biddle SJH, Gorely T, Stensel DJ (2004) Health-enhancing physical activity and sedentary behavior in children and adolescents. J Sport Sci 22:679–701

    Article  Google Scholar 

  5. Burton AK, Clarke RD, McClune TD, Tillotson KM (1996) The natural history of low back in adolescents. Spine 21:2323–2328

    Article  PubMed  CAS  Google Scholar 

  6. Burton K (1996) Low back pain in children and adolescents: to treat or not. Bull Hosp Jt Dis 3:127–129

    Google Scholar 

  7. Cardon G, Balagué F (2004) Low back pain prevention’s effects in schoolchildren. What is the evidence? Eur Spine J 13: 663–679

    Article  PubMed  Google Scholar 

  8. Cardon G, De Clercq D, De Bourdeaudhuij I (2004) Sitting habits in elementary schoolchildren: comparative study between a traditional and a moving school. Patient Educ Counsel 54:133–142

    Article  Google Scholar 

  9. Cardon G, De Bourdeaudhuij I, De Clercq D (2001) Back care education in elementary school: a pilot study investigating the complementary role of the class teacher. Patient Educ Couns 45:219–226

    Article  PubMed  CAS  Google Scholar 

  10. Cardon G, De Bourdeaudhuij I, De Clercq D (2002) Back education in elementary school: knowledge and perceptions of pupils, parents and teachers. J Sch Health 72:100–106

    PubMed  Google Scholar 

  11. Cardon G, De Clercq D, De Bourdeaudhuij IMM (2002) Back education efficacy in elementary schoolchildren—a 1-year follow-up study. Spine 27:299–305

    Article  PubMed  Google Scholar 

  12. Chometon E, Braize C, Levy A (1999) A primary educational prevention program for low back pain in Saint-Etienne primary schools. In: Troussier B, Phelip X (eds) Le dos de l’enfant et de l’adolescent et la prevention des lombalgies (The back of children and teenagers and the prevention of backache). Paris, pp 242–245

  13. Duggleby T, Kumar S (1997) Epidemiology of juvenile low back pain: a review. Disabil Rehabil 19:505–512

    Article  PubMed  CAS  Google Scholar 

  14. European Commission COST B 13 Management Committee (2002) European guidelines for the management of low back pain. Acta Orthop Scand [suppl 305] 73:20–25 (www.backpaineurope.org)

    Google Scholar 

  15. Goubert L, Crombez G, De Bourdeaudhuij I (2004) Low back pain, disability and back pain myths in a community sample: prevalence and interrelationships. Eur J Pain 8:385–394

    Article  PubMed  Google Scholar 

  16. Grimmer K, Williams M (2000) Gender–age environmental associates of adolescent low back pain. Appl Ergon 31:343–360

    Article  PubMed  CAS  Google Scholar 

  17. Harreby M, Neergaard K, Hesselsoe G, Kjer J (1995) Are radiologic changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? Spine 20:2298–2302

    Article  PubMed  CAS  Google Scholar 

  18. Janz KF (1994) Validation of the CSA accelerometer for assessing children’s physical activity. Med Sci Sports Exerc 26:369–375

    PubMed  CAS  Google Scholar 

  19. Johnson J, Deshpande C (2000) Health education and physical education: disciplines preparing students as productive, healthy citizens for the challenges of the 21st century. J Sch Health 70:66–68

    Article  PubMed  CAS  Google Scholar 

  20. Kjaer P, Leboeuf-Yde C, Sorensen JS, Bendix T (2005) An epidemiologic study of MRI and low back pain in 13-year-old children. Spine 30:798–806

    Article  PubMed  Google Scholar 

  21. Kohl HW, Fulton JE, Caspersen CJ (2000) Assessment of physical activity among children and adolescents: a review and synthesis. Prev Med 31:54–76

    Article  Google Scholar 

  22. Kristjansdottir G (1996) Prevalence of self-reported back pain in schoolchildren: a study of sociodemographic differences. Eur J Pediatr 155:984–986

    Article  PubMed  CAS  Google Scholar 

  23. Leboeuf-Yde C, Kyvik KO (1998) At what age does low back pain become a common problem? Spine 23:228–234

    Article  PubMed  CAS  Google Scholar 

  24. Lefevre J, Philippaerts R, Delvaux K, Thomis M, Vanreusel B, Vanden Eynde B, Claessens A., Lysens R, Renson R, Beunen G (2000) Daily physical activity and physical fitness from adolescence to adulthood: a longitudinal study. Am J of Hum Biol 12:487–497

    Article  Google Scholar 

  25. Malina R (1996) Tracking of physical activity and physical fitness across the lifespan. Res Q Exer Sport 67:48–57

    Google Scholar 

  26. McMeeken J, Tully E, Stillman B, Nattrass C, Bygott IL, Story I (2001) The experience of back pain in young Australians. Man Ther 6:213–220

    Article  PubMed  CAS  Google Scholar 

  27. Mendez FJ, Gomez-Conesa A (2001) Postural hygiene program to prevent low back pain. Spine 26:1280–1286

    Article  PubMed  CAS  Google Scholar 

  28. Murphy S, Buckle P, Stubss D (2004) Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon 35:113–120

    Article  PubMed  Google Scholar 

  29. National Association of Physical Education and Sports. Guidelines for appropriate physical activity for elementary schoolchildren: update 2003. Reston (VA): National Association of Physical Education and Sports

  30. Pate RR, Freedson PS, Sallis JF, Taylor WC, Sirard J, Trost SG, Dowda M (2002) Compliance with physical activity guidelines: prevalence in a population of children and youth. Ann Epidemiol 12:303–308

    Article  PubMed  Google Scholar 

  31. Riddoch CJ, Andersen LB, Wedderkopp N, Harro M, Klasson-Heggebo L, Sardinha LB, Cooper AR, Ekelund U (2004) Physical activity levels and patterns of 9- and 15-yr-old European children. Med Sci Sports Exerc 36:86–92

    Article  PubMed  Google Scholar 

  32. Roberts C, Tynjala J, Komkov A (2004) Physical activity. In: Currie C, Roberts C, Morgan A et al. (eds) Young people’s health in context. Health behavior in school-aged children (HBSC) study: international report from 2001/2002 survey. Copenhagen: World Health Organization pp 90–97

  33. Sallis JF, McKenzie TL, Alcaraz JE, Kolody B, Faucette N, Hovell MF (1997) The effect of a 2-year physical education program (SPARK) on physical activity and fitness in elementary school students. Am J Public Health 87:1328–1334

    Article  PubMed  CAS  Google Scholar 

  34. Salminen JJ, Erkintalo MO, Pentti J, Oksanen A, Kormano MJ (1999) Recurrent low back pain and early disc degeneration in the young. Spine 24:1316–1321

    Article  PubMed  CAS  Google Scholar 

  35. Seefeldt V, Malina RM, Clark MA (2002) Factors affecting levels of physical activity in adults. Sports Med 32:143–68

    Article  PubMed  Google Scholar 

  36. Sheldon MR (1994) Lifting instruction to children in an elementary school. J Orthop Sports Phys Ther 19:105–110

    PubMed  CAS  Google Scholar 

  37. Szpalski M, Gunzburg R, Balagué F, Nordin M, Melot C (2002) A 2-year prospective longitudinal study on low back pain in primary schoolchildren. Eur Spine J 11:459–464

    Article  PubMed  CAS  Google Scholar 

  38. Taimela S, Kujala UM, Salminen JJ, Viljanen T (1997) The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland. Spine 22:1132–1136

    Article  PubMed  CAS  Google Scholar 

  39. Trost SG, Pate RR, Sallis JF, Freedson PS, Taylor WC, Dowda M, Sirard J (2002) Age and gender differences in objectively measured physical activity in youth. Med Sci Sports Exerc 34:350–355

    Article  PubMed  Google Scholar 

  40. van Tulder M, Koes B (2004) Evidence based handelen bij lage rugpijn (Evidence based practice for low back pain). Bohn Stafleu Van Loghum, Houten

    Google Scholar 

  41. Vicas-Kunse P (1992) Educating our children: the pilot school program. Occup Med 7:173–177

    PubMed  CAS  Google Scholar 

  42. Viry P, Creveuil C, Marcelli C (1999) Nonspecific back pain in children—a search for associated factors in 14-year-old schoolchildren. Rev Rhum 66:381–388

    CAS  Google Scholar 

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Acknowledgment

The study is part of a broader research project entitled: Sport, Physical activity and Health (Sport, Beweging en Gezondheid), carried out by the Policy Research Centre, a consortium of researchers from KULeuven, Ghent University and VUBrussel, funded by the Flemish Government.

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Correspondence to Greet M. Cardon.

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Cardon, G.M., de Clercq, D.L.R., Geldhof, E.J.A. et al. Back education in elementary schoolchildren: the effects of adding a physical activity promotion program to a back care program. Eur Spine J 16, 125–133 (2007). https://doi.org/10.1007/s00586-006-0095-y

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  • DOI: https://doi.org/10.1007/s00586-006-0095-y

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