Effects of a postural education program on backpack use habits in schoolchildren: The PEPE Study.

Authors

  • Josep Vidal-Conti Physical Activity and Sport Sciences Research Group (GICAFE). Institute for Educational Research and Innovation (IRIE). University of the Balearic Islands
  • Aina Galmés-Panadés Physical Activity and Sport Sciences Research Group (GICAFE). Institute for Educational Research and Innovation (IRIE). University of the Balearic Islands
  • Adrià Muntaner-Mas Physical Activity and Sport Sciences Research Group (GICAFE). Institute for Educational Research and Innovation (IRIE). University of the Balearic Islands
  • Pere Palou Physical Activity and Sport Sciences Research Group (GICAFE). Institute for Educational Research and Innovation (IRIE). University of the Balearic Islands
  • Pere Borràs Physical Activity and Sport Sciences Research Group (GICAFE). Institute for Educational Research and Innovation (IRIE). University of the Balearic Islands

DOI:

https://doi.org/10.21134/eurjhm.2023.51.6

Keywords:

school bags, backpack, low back pain, postural education, health promotion

Abstract

One of the concerns of educational and health authorities, parents, and professionals from different sectors is the incorrect use of the school backpack and its repercussions on the musculoskeletal system, especially on the back. Health Literacy education programs have been carried out in the primary and secondary education system with the aim of preventing musculoskeletal disorders in children and adolescents and initiatives are being taken to reduce the weight that students carry in their backpacks. The aim of the current study is to investigate the effects of a postural education program on backpack use habits related to LBP in schoolchildren aged 10-12 years. This randomized controlled trial (RCT) was carried out in Majorca (Spain), with 224 primary schoolchildren aged 10 to 12. The sample was selected from different clusters (schools) using convenience sampling and randomly distributed into an experimental group (5 schools) or a control group (5 schools). A 16-week intervention program was implemented, which was carried out telematically because it was in times of COVID-19. Three structured and self-administered questionnaires were used to examine the prevalence of low back pain and backpack use habits. Results showed how backpack habits and single questions related to the use of backpack did not improve after the intervention in the experimental group, and in the control group also. The main conclusion is that no improvements were observed in the intervention group attributable to the effect of the intervention.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Cheung, J. M. Y., Bartlett, D. J., Armour, C. L., Laba, T. L., & Saini, B. (2018). To drug or not to drug: A qualitative study of patients’ decision-making processes for managing insomnia. Behavioral Sleep Medicine, 16(1), 1-26. doi:10.1080/15402002.2016.1163702

Alberola López, S., Pérez García, I., Casares Alonso, I., Cano Garcinuño, A., & Andrés De Llano, J. M. (2010). Mochilas escolares y dolor de espalda en la población infantil. Revista Pediatría de Atención Primaria, 47, 385–397.

Bian, R. R., Piatt, G. A., Sen, A., Plegue, M. A., de Michele, M. L., Hafez, D., Czuhajewski, C. M., Iuis, L. R., Kaufman, N., & Richardson, C. R. (2017). The Effect of Technology-Mediated Diabetes Prevention Interventions on Weight: A Meta-Analysis. Journal of Medical Internet Research, 19(3). https://doi.org/10.2196/JMIR.4709

Borras, P. A., & Vidal-Conti, J. (2022). An on-line school-based randomised controlled trial to prevent non-specific low back pain in children: Health Education Journal, 81(3), 352–362. https://doi.org/10.1177/00178969221077408

Bort Saborit, N., & Simó Pitarch, A. (2002). Carritos o mochilas en la edad escolar. Fisioterapia, 24(2), 63–72. https://doi.org/10.1016/S0211-5638(02)72983-0

Burton, A. K., Clarke, R. D., McClune, T. D., & Tillotson, K. M. (1996). The natural history of low back pain in adolescents. Spine, 21(20), 2323–2328.

Calvo-Muñoz, I., Kovacs, F. M., Roqué, M., Fernández, I. G., & Calvo, J. S. (2018). Risk Factors for Low Back Pain in Childhood and Adolescence: A Systematic Review. The Clinical Journal of Pain, 34(5), 468–484. https://doi.org/10.1097/AJP.0000000000000558

Castelli, D. M., & Valley, J. A. (2007). Chapter 3: The Relationship of Physical Fitness and Motor Competence to Physical Activity. Journal of Teaching in Physical Education, 26(4), 358–374.

Chiang, H. Y., Jacobs, K., & Orsmond, G. (2006). Gender-age environmental associates of middle school students’ low back pain. Work, 26(1), 19–28.

DeWalt, D. A., & Hink, A. (2009). Health literacy and child health outcomes: a systematic review of the literature. Pediatrics, 124 Suppl 3(SUPPL. 3). https://doi.org/10.1542/PEDS.2009-1162B

Diepenmaat, A. C., van der Wal, M. F., de Vet, H. C., & Hirasing, R. A. (2006). Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics, 117(2), 412–416. https://doi.org/117/2/412 [pii]

Dullien, S., Grifka, J., & Jansen, P. (2018). Cluster-randomized, controlled evaluation of a teacher led multi factorial school based back education program for 10 to 12-year old children. BMC Pediatrics, 18(1). https://doi.org/10.1186/s12887-018-1280-y

Fischer, H. H., Fischer, I. P., Pereira, R. I., Furniss, A. L., Rozwadowski, J. M., Moore, S. L., Durfee, M. J., Raghunath, S. G., Tsai, A. G., & Havranek, E. P. (2016). Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial. Diabetes Care, 39(8), 1364–1370. https://doi.org/10.2337/DC15-2137

Geldhof, E., Cardon, G., de Bourdeaudhuij, I., & de Clercq, D. (2006a). Effects of a two-school-year multifactorial back education program in elementary schoolchildren. Spine, 31(17), 1965–1973. https://doi.org/10.1097/01.BRS.0000228722.12968.D2

Geldhof, E., Cardon, G., de Bourdeaudhuij, I., & de Clercq, D. (2007). Back posture education in elementary schoolchildren: a 2-year follow-up study. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(6), 841–850. https://doi.org/10.1007/S00586-006-0227-4

Health Promotion Glossary of Terms. (2021). Retrieved January 21, 2022, from https://www.who.int/publications/i/item/9789240038349

Hernández, T. L., Ferré, M. C., Martí, S. G., & Salvat, I. S. (2020). Relationship between School Backpacks and Musculoskeletal Pain in Children 8 to 10 Years of Age: An Observational, Cross-Sectional and Analytical Study. International Journal of Environmental Research and Public Health, 17(7). https://doi.org/10.3390/IJERPH17072487

Hong, Y., Li, J. X., Wong, A. S. K., & Robinson, P. D. (2000). Effects of load carriage on heart rate, blood pressure and energy expenditure in children. Ergonomics, 43(6), 717–727. https://doi.org/10.1080/001401300404698

Hwang, J., Louie, P. K., Phillips, F. M., An, H. S., & Samartzis, D. (2019). Low back pain in children: a rising concern. European Spine Journal, 28(2), 211–213. https://doi.org/10.1007/s00586-018-5844-1

Kovacs, F. M., Gestoso, M., Gil del Real, M. T., Lopez, J., Mufraggi, N., & Mendez, J. I. (2003). Risk factors for non-specific low back pain in schoolchildren and their parents: a population based study. Pain, 103(3), 259–268. https://doi.org/S0304395902004542 [pii]

Kovacs, F., Oliver-Frontera, M., Plana, M. N., Royuela, A., Muriel, A., & Gestoso, M. (2011). Improving schoolchildren’s knowledge of methods for the prevention and management of low back pain: a cluster randomized controlled trial. Spine, 36(8). https://doi.org/10.1097/BRS.0B013E3181DCCEBC

MacDonald, J., Stuart, E., & Rodenberg, R. (2017). Musculoskeletal Low Back Pain in School-aged Children: A Review. JAMA Pediatrics, 171(3), 280–287. https://doi.org/10.1001/JAMAPEDIATRICS.2016.3334

Masiero, S., Carraro, E., Celia, A., Sarto, D., & Ermani, M. (2008). Prevalence of nonspecific low back pain in schoolchildren aged between 13 and 15 years. Acta Paediatrica, 97(2), 212–216. https://doi.org/10.1111/j.1651-2227.2007.00603.x [doi]

Michaleff, Z. A., Kamper, S. J., Maher, C. G., Evans, R., Broderick, C., & Henschke, N. (2014). Low back pain in children and adolescents: a systematic review and meta-analysis evaluating the effectiveness of conservative interventions. European Spine Journal, 23(10), 2046–2058. https://doi.org/10.1007/s00586-014-3461-1

Minghelli, B., Nunes, C., & Oliveira, R. (2021). Back school postural education program: Comparison of two types of interventions in improving ergonomic knowledge about postures and reducing low back pain in adolescents. International Journal of Environmental Research and Public Health, 18(9). https://doi.org/10.3390/ijerph18094434

Monfort-Pañego, M., Molina-García, J., Miñana-Signes, V., Bosch-Biviá, A. H., Gómez-López, A., & Munguía-Izquierdo, D. (2016). Development and psychometric evaluation of a health questionnaire on back care knowledge in daily life physical activities for adolescent students. European Spine Journal, 25(9), 2803–2808. https://doi.org/10.1007/s00586-016-4627-9

Nanditha, A., Thomson, H., Susairaj, P., Srivanichakorn, W., Oliver, N., Godsland, I. F., Majeed, A., Darzi, A., Satheesh, K., Simon, M., Raghavan, A., Vinitha, R., Snehalatha, C., Westgate, K., Brage, S., Sharp, S. J., Wareham, N. J., Johnston, D. G., & Ramachandran, A. (2020). A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent type 2 diabetes in India and the UK: a randomised controlled trial. Diabetologia, 63(3), 486–496. https://doi.org/10.1007/S00125-019-05061-Y

Noll, M., Tarragô Candotti, C., Vieira, A., & Fagundes Loss, J. (2013). Back Pain and Body Posture Evaluation Instrument (BackPEI): Development, content validation and reproducibility. International Journal of Public Health, 58(4), 565–572. https://doi.org/10.1007/s00038-012-0434-1

Palou, P., Kovacs, F. M., Vidal, J., Gili, M., Borràs, P. A., Gestoso, M., & Ponseti, X. (2010). Validation of a questionnaire to determine risk factors for back pain in 10-12 year-old school children. Gazzetta Medica Italiana Archivio per Le Scienze Mediche, 169(5).

Perrone, M., Orr, R., Hing, W., Milne, N., & Pope, R. (2018). The Impact of Backpack Loads on School Children: A Critical Narrative Review. International Journal of Environmental Research and Public Health, 15(11). https://doi.org/10.3390/IJERPH15112529

Quintana Aparicio, E., Martín Nogueras, A. M., López Sendín, N., Romero Alonso, A. B., Sánchez Pedraz, L., & Calvo Arenillas, J. I. (2005). Influencia del tipo de jornada escolar en el peso de las mochilas escolares. Fisioterapia, 27(1), 6–15. https://doi.org/10.1016/S0211-5638(05)73410-6

Ramos Espada, D., González Montesinos, J., Mora Vicente, J., Ares Camerino, A., & Martínez González, J. (2004). Desarrollo y aplicación de un cuestionario en una población escolar sobre el transporte de mochilas y su influencia en el dolor de espalda. Revista de Pediatría de Atención Primaria, 6(22), 199–208.

Rusek, W., Baran, J., Leszczak, J., Adamczyk, M., Baran, R., Weres, A., Inglot, G., Czenczek-Lewandowska, E., & Pop, T. (2021). Changes in Children’s Body Composition and Posture during Puberty Growth. Children, 8(4). https://doi.org/10.3390/CHILDREN8040288

Santos, E. D. S., Bernardes, J. M., Noll, M., Gómez-Salgado, J., Ruiz-Frutos, C., & Dias, A. (2021). Prevalence of Low Back Pain and Associated Risks in School-Age Children. Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses, 22(4), 459–464. https://doi.org/10.1016/J.PMN.2021.01.017

Skaggs, D. L., Early, S. D., D’Ambra, P., Tolo, V. T., & Kay, R. M. (2006). Back pain and backpacks in school children. Journal of Pediatric Orthopedics, 26(3), 358–363. https://doi.org/10.1097/01.bpo.0000217723.14631.6e

Steffens, D., Maher, C. G., Pereira, L. S. M., Stevens, M. L., Oliveira, V. C., Chapple, M., Teixeira-Salmela, L. F., & Hancock, M. J. (2016). Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 176(2), 199–208. https://doi.org/10.1001/jamainternmed.2015.7431

Taimela, S., Kujala, U. M., Salminen, J. J., & Viljanen, T. (1997). The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland. Spine, 22(10), 1132–1136.

Vidal-Conti, J., Borràs, P. A., Palou, P., & Muntaner-Mas, A. (2021). Prevalence of low back pain among school-aged children between 10 and 12 years. Sustainability (Switzerland), 13(21). https://doi.org/10.3390/su132112254

Winkelman, T. N. A., Caldwell, M. T., Bertram, B., & Davis, M. M. (2016). Promoting Health Literacy for Children and Adolescents. Pediatrics, 138(6). https://doi.org/10.1542/PEDS.2016-1937

Yamato, T. P., Maher, C. G., Traeger, A. C., Wiliams, C. M., & Kamper, S. J. (2018). Do schoolbags cause back pain in children and adolescents? A systematic review. British Journal of Sports Medicine, 52(19), 1241–1245. https://doi.org/10.1136/BJSPORTS-2017-098927

Zwerver, J., & de Vos, R. (2018). Bag to school. British Journal of Sports Medicine, 52, 1219–1220.

Downloads

Published

2023-12-31

Issue

Section

Original Research