Download PDF
Int J Sports Med 2011; 32(4): 303-308
DOI: 10.1055/s-0030-1270469
Behavioural Sciences

© Georg Thieme Verlag KG Stuttgart · New York

Effects of Postural Education on Daily Habits in Children

J. Vidal1 , P. A. Borras1 , F. B. Ortega2 , 3 , J. Cantallops1 , X. Ponseti1 , P. Palou1
  • 1University of Balearic Islands, Exercise and Sports Science Research Group, Palma of Majorca, Spain
  • 2School of Medicine, University of Granada, Department of Physiology, Granada, Spain
  • 3Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden
Further Information

Publication History

accepted after revision December 5, 2010

Publication Date:
04 March 2011 (online)

Also available at
    Permissions and Reprints

Abstract

A group-randomized controlled trial was carried out to investigate the effects of a postural education program on daily life habits related to low back pain in children. The study sample included 137 children aged 10.7 years. 6 classes from 2 primary schools were randomly allocated into an experimental group (EG) (N=63) or a control group (CG) (N=74). The EG received a postural education program over 6 weeks consisting of 6 sessions, while the CG followed the usual school curriculum. A questionnaire was completed by the participants at pretest, post-test and 3 months after the intervention finished. The outcomes collected were: correct use of sofa, stooping correctly, take care to sit correctly at home/school and frequent posture change on chair at home/school. A sum score was computed from the 6 items. To examine the effect of the intervention, we used repeated measures analysis of co-variance (ANCOVA); with baseline, post-test and follow-up outcome values as dependent variables, study group as fixed factor, and sex and age as covariates. Single healthy items mostly improved after the intervention and remained improved after 3 month follow-up in EG, while no substantial changes were observed in the CG. Healthy habits score was significantly increased at post-test compared to baseline in the EG (P<0.001), and remained significantly increased after 3-months, compared to baseline (P<0.001). No significant changes were observed in the CG (P>0.6). The results suggest that children are able to learn healthy daily life habits which might contribute to future prevention of low back pain.

Key words

low back pain - early intervention - primary schools

References

  • 1 Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4. European guidelines for the management of chronic nonspecific low back pain.  Eur Spine J. 2006;  15 (S 02) S192-S300
    CrossrefPubMedGoogle Scholar
  • 2 Balague F, Dutoit G, Waldburger M. Low back pain in schoolchildren. An epidemiological study.  Scand J Rehabil Med. 1988;  20 175-179
    PubMedGoogle Scholar
  • 3 Balague F, Nordin M, Skovron ML, Dutoit G, Yee A, Waldburger M. Non-specific low-back pain among schoolchildren: a field survey with analysis of some associated factors.  J Spinal Disord. 1994;  7 374-379
    PubMedGoogle Scholar
  • 4 Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents.  Spine (Phila Pa 1976). 1996;  21 2323-2328
    CrossrefPubMedGoogle Scholar
  • 5 Burton AK, Balague F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Muller G, van der Beek AJ. Chapter 2. European guidelines for prevention in low back pain: November 2004.  Eur Spine J. 2006;  15 (S 02) S136-S168
    CrossrefPubMedGoogle Scholar
  • 6 Cardon GM, de Clercq DL, Geldhof EJ, Verstraete S, De Bourdeaudhuij IM. Back education in elementary schoolchildren: the effects of adding a physical activity promotion program to a back care program.  Eur Spine J. 2007;  16 125-133
    CrossrefPubMedGoogle Scholar
  • 7 Cardon G, De Bourdeaudhuij I, De Clercq D. Knowledge and perceptions about back education among elementary school students, teachers, and parents in Belgium.  J Sch Health. 2002;  72 100-106
    CrossrefPubMedGoogle Scholar
  • 8 Cardon GM, De Clercq DL, De Bourdeaudhuij IM. Back education efficacy in elementary schoolchildren: a 1-year follow-up study.  Spine (Phila Pa 1976). 2002;  27 299-305
    CrossrefPubMedGoogle Scholar
  • 9 Cardon G, De Bourdeaudhuij I, De Clercq D. Back care education in elementary school: a pilot study investigating the complementary role of the class teacher.  Patient Educ Couns. 2001;  45 219-226
    CrossrefPubMedGoogle Scholar
  • 10 Cardon G, Balague F. Low back pain prevention's effects in schoolchildren. What is the evidence?.  Eur Spine J. 2004;  13 663-679
    CrossrefPubMedGoogle Scholar
  • 11 Chiang HY, Jacobs K, Orsmond G. Gender-age environmental associates of middle school students’ low back pain.  Work. 2006;  26 19-28
    PubMedGoogle Scholar
  • 12 Costa-Black KM, Loisel P, Anema JR, Pransky G. Back pain and work.  Best Pract Res Clin Rheumatol. 2010;  24 227-240
    CrossrefPubMedGoogle Scholar
  • 13 Deyo RA, Weinstein JN. Low back pain.  N Engl J Med. 2001;  344 363-370
    CrossrefPubMedGoogle Scholar
  • 14 Diepenmaat AC, van der Wal MF, de Vet HC, Hirasing RA. Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents.  Pediatrics. 2006;  117 412-416
    CrossrefPubMedGoogle Scholar
  • 15 Gil del Real MT, Kovacs FM, Gestoso M, Mufraggi N, Diéguez JM. Evaluation of two questionnaires to determine exposure to risk factors for non-specific low back pain in Mallorcan schoolchildren and their parents.  Eur J Public Health. 1999;  9 194-199
    CrossrefPubMedGoogle Scholar
  • 16 Feingold AJ, Jacobs K. The effect of education on backpack wearing and posture in a middle school population.  Work. 2002;  18 287-294
    PubMedGoogle Scholar
  • 17 Feldman DE, Rossignol M, Shrier I, Abenhaim L. Smoking. A risk factor for development of low back pain in adolescents.  Spine (Phila Pa 1976). 1999;  24 2492-2496
    CrossrefPubMedGoogle Scholar
  • 18 Geldhof E, Cardon G, De Bourdeaudhuij I, Danneels L, Coorevits P, Vanderstraeten G, De Clercq D. Effects of back posture education on elementary schoolchildren's back function.  Eur Spine J. 2007;  16 829-839
    CrossrefPubMedGoogle Scholar
  • 19 Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D. Back posture education in elementary schoolchildren: a 2-year follow-up study.  Eur Spine J. 2007;  16 841-850
    CrossrefPubMedGoogle Scholar
  • 20 Gunzburg R, Balague F, Nordin M, Szpalski M, Duyck D, Bull D, Melot C. Low back pain in a population of school children.  Eur Spine J. 1999;  8 439-443
    CrossrefPubMedGoogle Scholar
  • 21 Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A, Fisker I, Laegaard E. Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study.  Eur Spine J. 1999;  8 444-450
    CrossrefPubMedGoogle Scholar
  • 22 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Research.  Int J Sports Med. 2009;  30 701-702
    Google Scholar
  • 23 Jones GT, Watson KD, Silman AJ, Symmons PM, Macfarlane GJ. Predictors of low back pain in British schoolchildren: A population-based prospective cohort study.  Pediatrics. 2003;  111 822-828
    CrossrefPubMedGoogle Scholar
  • 24 Korovessis P, Koureas G, Papazisis Z. Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents.  J Spinal Disord Tech. 2004;  17 33
    CrossrefPubMedGoogle Scholar
  • 25 Kovacs FM, Gestoso M, Gil del Real MT, Lopez J, Mufraggi N, Mendez JI. Risk factors for non-specific low back pain in schoolchildren and their parents: a population based study.  Pain. 2003;  103 259-268
    CrossrefPubMedGoogle Scholar
  • 26 Kujala UM, Taimela S, Viljanen T. Leisure physical activity and various pain symptoms among adolescents.  Br J Sports Med. 1999;  33 325-328
    CrossrefPubMedGoogle Scholar
  • 27 Limon S, Valinsky LJ, Ben-Shalom Y. Children at risk: risk factors for low back pain in the elementary school environment.  Spine (Phila Pa 1976). 2004;  29 697-702
    CrossrefPubMedGoogle Scholar
  • 28 Maniakis A, Gray A. The economic burden of back pain in the UK.  Pain. 2000;  84 95-103
    CrossrefPubMedGoogle Scholar
  • 29 Mendez FJ, Gomez-Conesa A. Postural hygiene program to prevent low back pain.  Spine (Phila Pa 1976). 2001;  26 1280-1286
    CrossrefPubMedGoogle Scholar
  • 30 Pellise F, Balague F, Rajmil L, Cedraschi C, Aguirre M, Fontecha CG, Pasarin M, Ferrer M. Prevalence of low back pain and its effect on health-related quality of life in adolescents.  Arch Pediatr Adolesc Med. 2009;  163 65-71
    CrossrefPubMedGoogle Scholar
  • 31 Robertson HC, Lee V. Effects of back care lessons on sitting and lifting by primary students.  Aust Physiother. 1990;  36 245-248
    PubMedGoogle Scholar
  • 32 Siambanes D, Martinez JW, Butler EW, Haider T. Influence of school backpacks on adolescent back pain.  J Pediatr Orthop. 2004;  24 211-217
    PubMedGoogle Scholar
  • 33 Storr-Paulsen A. “The body-consciousness in school” – a back pain-school.  Ugeskr Laeger. 2002;  165 37-41
    PubMedGoogle Scholar
  • 34 Taimela S, Kujala UM, Salminen JJ, Viljanen T. The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland.  Spine (Phila Pa 1976). 1997;  15 1132-1136
    PubMedGoogle Scholar
  • 35 Tissota F, Messingab K, Stock S. Studying the relationship between low back pain and working postures among those who stand and those who sit most of the working day.  Ergonomics. 2009;  52 1402-1418
    CrossrefPubMedGoogle Scholar
  • 36 van Tulder MW, Koes BW, Bouter LM. A cost-of-illness study of back pain in The Netherlands.  Pain. 1995;  62 233-240
    CrossrefPubMedGoogle Scholar
  • 37 van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A, Koes B, Laerum E, Malmivaara A. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care.  Eur Spine J. 2006;  15 (S 02) S169-S191
    CrossrefPubMedGoogle Scholar
  • 38 Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DPM, Silman AJ, Macfarlane GJ. Low back pain in schoolchildren: occurrence and characteristics.  Pain. 2002;  97 87-92
    CrossrefPubMedGoogle Scholar
  • 39 Williams CD, Jacobs K. The effectiveness of a home-based ergonomics intervention on the proper use of computers by middle school children.  Work. 2002;  18 261-268
    PubMedGoogle Scholar

Correspondence

Dr. Josep Vidal

University of Balearic Islands

Exercise and Sports Science

Research Group

Ctra. Valldemossa km.7'5 Ed.

Guillem Cifre

07122 Palma of Majorca

Spain

Phone: + 34/9711/72095

Fax: + 34/9711/73190

Email: josep.vidal@uib.es

      >