Back functioning: the effectiveness of an intervention promoting good body mechanics in elementary schoolchildren

While back pain in childhood is a common condition, at young age symptoms are generally mild, do not often lead to restrictions of daily activities and represent little health consequences. However, the predictive value of back pain at young age for back pain as an adult, stresses the need for primary prevention. The multi-factorial nature of the risk for developing back pain in childhood is widely accepted. On the other hand, the causative mechanisms for back pain occurrence at young age remain largely undetermined. Based on epidemiological evidence in relation to the biomechanical concept suggesting a U-shaped relationship for optimal loading, several correlates may influence children’s back function. In this way, environmental factors that may counterbalance optimal spinal loading of children’s young body structures may be present at school, which is the workplace of the young. In this line, children’s postural behavior in the Flemish class environment was pictured. This pilot study was grounded because sitting is the most reported factor in relation to back pain reporting at young age and due to the reality that standard school managements prescribe long sitting periods. The study findings pointed out that prolonged static kyphotic sitting without use of the backrest is common in Flemish elementary schoolchildren and children who spend more time sitting with a flexed trunk reported significantly more thoraco-lumbar pain

Back posture education in elementary schoolchildren: a 2-year follow-up study

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13–14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters’ lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 ± 0.8 years) and 101 controls (mean age 13.2 ± 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential

Physical fitness, physical activity and self-reported back and neck pain in elementary schoolchildren.

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Static and dynamic standing balance: test-retest reliability and reference values in 9 to 10 year old children

Introduction Based on the literature, reliability reports and normative data for bilateral stance assessments in elementary schoolchildren are limited. The present study was designed to report test-retest reliability and reference values for postural stability in 9 to 10 years old schoolchildren using the Balance Master system. Materials and methods Twenty children participated in the reproducibility study (mean age 10.1 +/- 0.7) including test and retest measurement with a one-week interval. The modified clinical test of sensory interaction on balance (mCTSIB) quantified children's static standing balance. The test for the limits of stability (LOS) measured dynamic standing balance. The study sample to determine reference values consisted of 99 children (mean age 9.8 +/- 0.5). Results The ICCs for inter-item reliability of the four sensory conditions of the mCTSIB showed fair to excellent reliability (ICCs between 0.62 and 0.80). The reproducibility between test and retest was non-significant for the condition 'firm surface with eyes closed' (ICC of 0.37), fair to good for the three other sensory conditions (ICCs between 0.59 and 0.68), and excellent for the composite sway velocity (ICC of 0.77). For all LOS parameters, the significant ICCs showed fair to good reproducibility (ICCs between 0.44 and 0.62), with the exception of the non-significant ICC for the composite reaction time. The ICCs for the separate LOS parameters showed fair to good and excellent reliability for nine parameters (ICCs between 0.46 and 0.81), while 11 separate LOS scores did not demonstrate significant ICCs. Discussion Analysing reference values, girls performed better on all the composite balance parameters compared to boys, with the exception of reaction time and movement velocity. No differences were found on standing balance scores between 9 and 10 year olds. Conclusion In conclusion, the Balance Master showed fair to good reliability for most postural parameters in 9 to 10 year olds. The current data on postural control in children aged 9 to 10 years are relevant for research in other domains within the clinical field, like obesitas and developmental coordination disorder or in relation to back pain prevalence at early age