Back pain prevalence and associated factors in children and adolescents: an epidemiological population study

Noll, Matias; Candotti, Cláudia Tarragô; Rosa, Bruna Nichele da; Loss, Jefferson Fagundes

doi:10.1590/S1518-8787.2016050006175

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Original Articles • Rev. Saúde Pública 50 • 2016 • https://doi.org/10.1590/S1518-8787.2016050006175 copy

Back pain prevalence and associated factors in children and adolescents: an epidemiological population study

Dor nas costas e fatores associados em crianças e adolescentes: um estudo epidemiológico populacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To identify the prevalence of back pain among Brazilian school children and the factors associated with this pain.

METHODS

All 1,720 schoolchildren from the fifth to the eight grade attending schools from the city of Teutonia, RS, Southern Brazil, were invited to participate in the study. From these, 1,597 children participated. We applied the Back Pain and Body Posture Evaluation Instrument. The dependent variable was back pain, while the independent one were demographic, socioeconomic, behavior and heredity data. The prevalence ratio was estimated by multivariate analysis using the Poisson regression model (α = 0.05).

RESULTS

The prevalence of back pain in the last three months was 55.7% (n = 802). The multivariate analysis showed that back pain is associated with the variables: sex, parents with back pain, weekly frequency of physical activity, daily time spent watching television, studying in bed, sitting posture to write and use the computer, and way of carrying the backpack.

CONCLUSIONS

The prevalence of back pain in schoolchildren is high and it is associated with demographic, behavior and heredity aspects.

Child; Adolescent; Back Pain, epidemiology; Risk Factors; Posture; Cross-Sectional Studies

Age (years)	Male		Female		Total

	n	%	n	%	n	%
11	99	11.6	107	14.4	206	12.9
12	192	22.4	181	24.4	373	23.4
13	197	23.0	179	24.2	376	23.5
14	203	23.7	172	23.2	375	23.5
15	120	14.0	83	11.2	203	12.7
16	45	5.3	19	2.6	64	4.0
Total	856	100	741	100	1,597	100

Variable	Male		Female		Total

	n	%	n	%	n	%
Frequency
Only once	126	34.1	112	26.0	238	29.8
Once a month	135	36.6	188	43.6	323	40.4
Once a week	32	8.7	47	10.9	79	9.9
Two to three times per week	25	6.8	35	8.1	60	7.5
Four times or more per week	18	4.9	17	3.9	35	4.4
No answer	33	8.9	32	7.5	65	8.0
Impediment of performing activities of daily living
Yes	40	10.8	84	19.5	124	15.5
No	311	84.1	323	74.9	634	79.1
No answer	19	5.1	24	5.6	43	5.4

Variable	n	%	Back pain (n)	Back pain (%)	χ^2a	Prevalence ratio	95%CI
Behavioral
Physical exercise (n = 1,437)
Yes	1,287	89.6	727	56.5	0.103	1
No	150	10.4	74	49.3		0.95	0.9–1.01
Physical exercise weekly frequency (n = 1,295)^d
Zero day per week	150	11.6	74	49.3	0.003^b	1
One to two days per week	627	48.4	382	60.9		1.07	1.01–1.14
Three; four days per week	357	27.6	181	50.7		1.01	0.94–1.07
Five or more days per week	161	12.4	85	52.8		1.02	0.95–1.11
Practice competitive exercise (n = 1,273)^c
Yes	560	44.0	302	53.9	0.128	1
No	713	56.0	415	58.2		1.02	0.99–1.06
Time spent watching television per day (n = 1,229)
Zero; three hours per day	698	56.8	359	51.4	0.001^b	1
Four; seven hours per day	421	34.2	252	59.9		1.05	1.01–1.09
Eight or more hours per day	110	9.0	77	70.0		1.12	1.06–1.18
Time spent using computer per day (n = 1,102)
Zero; three hours per day	735	66.7	407	55.4	0.536	1
Four; five hours per day	231	21.0	132	57.1		1.01	0.96–1.06
Six or more hours per day	136	12.3	82	60.3		1.03	0.97–1.09
Time sleeping per night (n = 1,225)
Zero; seven hours per day	409	33.4	239	58.4	0.449	1
Eight; nine hours per day	624	50.9	341	54.6		0.97	0.93–1.01
Ten or more hours per day	192	15.7	105	54.7		0.97	0.92–1.03
Read or study in bed (n = 733)
No	285	38.9	144	50.5	0.021^b	1
Yes	448	61.1	266	59.4		1.05	1.01–1.11
Postural
Sleeping posture (n = 1,308)
Supine	103	7.9	44	42.7	0.005^b	1
Lateral decubitus	838	64.1	458	54.7		1.08	1.01–1.16
Prone	367	28.0	222	60.5		1.12	1.04–1.21
Sitting posture; write (n = 1,401)
Adequate	213	15.2	100	46.9	0.008^b	1
Inadequate	1,188	84.8	678	57.1		1.06	1.01–1.12
Sitting posture on a bench (n = 1,394)
Adequate	183	13.1	93	50.8	0.126	1
Inadequate	1,211	86.9	690	57.0		1.04	0.98–1.09
Sitting posture; use computer (n = 1,394)
Adequate	301	21.6	150	49.8	0.018^b	1
Inadequate	1,093	78.4	630	57.6		1.05	1.01–1.09
Posture; lift object from the floor (n = 1,339)
Adequate	105	7.8	67	63.8	0.069	1
Inadequate	1,234	92.2	680	55.1		0.94	0.89–1.04
Carrying school supplies (n = 1,439)
Backpack	1,332	92.6	749	56.2	0.190	1
Another (briefcase, purse, and others)	107	7.4	53	49.5		0.95	0.89–1.02
Way; carry backpack (n = 1,320)^c
Adequate (symmetrical handles on both shoulders)	1,166	88.3	639	54.8	0.019^b	1
Inadequate (asymmetric)	154	11.7	99	64.3		1.06	1.01–1.11

Variable	n	%	Back pain (n)	Back pain (%)	χ^2a	Prevalence ratio	95%CI
Demographics
Sex (n = 1,439)
Male	765	53.2	371	48.5	0.001^b	1
Female	674	46.8	431	63.9		1.11	1.06–1.14
Age (n = 1,439)
11 and 12 years	513	35.6	273	53.2	0.363	1
13 and 14 years	682	47.4	390	57.2		1.02	0.98–1.06
15 and 16 years	244	17.0	139	57.0		1.02	0.97–1.07
Socioeconomics
Education network (n = 1,439)
@ State	569	39.5	327	57.5	0.43	1
Town	745	51.8	403	54.1		0.97	0.94–1.01
Private	125	8.7	72	57.6		1	0.94–1.06
Mother education (n = 1,151)
Did not attend school	8	0.7	3	37.5	0.357	1
Elementary school	699	60.7	398	56.9		1.14	0.89–1.45
High school	336	29.2	194	57.7		1.14	0.89–1.46
College degree	108	9.4	69	63.9		1.19	0.92–1.53
Father education (n = 1,097)
Did not attend school	13	1.2	8	61.5	0.974	1
Elementary school	677	61.7	391	57.8		0.97	0.82–1.15
High school	306	27.9	173	56.5		0.96	0.82–1.14
College degree	101	9.2	58	57.4		0.97	0.81–1.16
Hereditary
Parents with back pain (n = 1,174)
No	447	38.1	170	38.0	0.001^b	1
Yes	727	61.9	491	67.5		1.21	1.16–1.26

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[1] Correspondence
: Matias Noll. Rua 17, Qd 53, Lote 10A Centro. 76310-000 Rialma, GO, Brasil. E-mail: matias.noll@ifgoiano.edu.br