Workshop report

A cross-sectional survey of 2083 schoolchildren. To investigate the prevalence of nonspecific low back pain (LBP) among schoolchildren aged between 10 and 18 years in China. LBP have been a serious health problem in schoolchildren. On the basis of literature, the lifetime occurrence of nonspecific LBP in children and adolescents varies between 7% and 72%, but little is known about LBP among this demographic group in China. Schoolchildren aged 10 to 18 years were sampled from two grades in an elementary school and four grades in a secondary school. Participants were asked to fill in a questionnaire on LBP. The questionnaire addressed demographic items, anthropometric factors and characteristics of nonspecific LBP, such as frequency, duration, nature, pain scale. Nonspecific LBP is defined as the pain in the back from the 12th ribs to the buttock area without organic factors. A total of 2235 questionnaires were distributed, of which 2100 were answered, a response rate of 93.7%. Among those answers, 2083 (977 from male students and 1106 from female students) provided measurable data. The occurrence of nonspecific LBP was high, with 29.1% students suffering from this condition in the past 3 months (24.7% in boys, 33.1% in girls). In addition, an increased occurrence was observed with age. The occurrences of LBP in 10 to 14 years and 15 to 18 years were 21.5% and 38.2%, respectively. In several aspects of LBP, statistically significant differences were observed between boys and girls, including the frequency of the pain (P = 0.003), the nature of the pain (P = 0.000), the likelihood of seeking for medical assistance (P = 0.007), the impact on normal daily life (P = 0.016), and the occurrence of LBP after bending over the desk for a period of time (P = 0.024). Female students had more frequent LBP and were less willing to see a physician. In addition, more female students (45/366) had LBP accompanied with radiating pain than male students (20/241). There is a high prevalence of LBP in Chinese schoolchildren. The occurrence of LBP increases with age in both sexes. LBP is significantly more prevalent in girls.

Isodynamic evaluation of trunk muscles and low-back pain among workers in a steel factory.

A cohort study of patients with nonspecific low back pain (LBP) participated in a 4-week multidisciplinary rehabilitation program. To identify factors that predict work retention 24 months after treatment in patients with nonspecific LBP. There is evidence that select physical, psychologic, and psychosocial factors are related to positive outcome for work-related nonspecific LBP. However, there is very little information related to work retention following an episode of nonspecific LBP. This is an exploratory study to identify select physical and psychosocial factors related to work retention. Patients who returned to work after treatment (n = 67) were followed for 2 years. Physical baseline measures included tests of flexibility, strength, and functional capacity. Psychosocial baseline measures were The Symptoms Checklist 90-R, The Pain Beliefs and Perceptions Inventory, The Oswestry Scale of perceived disability, The Work Stress Inventory, and The Quality of Life Scale. All physical parameters, perceived disability, and quality of life were tested before and after treatment. The dependent variable, work retention, was defined as the number of days that the subject worked during the 2-year follow-up period. Survival analysis was used to establish the predictive model. The average time out of work before treatment was 9 months (standard deviation 12.8) for 67 subjects (mean age 40 years [standard deviation 9.6]), including 18 females and 49 males. There were 18 participants (25%) that had interruption of work retention at follow-up. Average work retention was 362 days (range 47-682). Variables that reached a P value of <0.10 in the bivariate analysis were included in the multivariate analysis. They were trunk flexion (hazard ratio [HR = 2.4], 95% confidence interval [CI] 1.24-4.38; P = 0.01), trunk extension (HR = 2.1, 95% CI 1.02-4.16; P = 0.04), the somatization scale from the Symptom Checklist 90 revised (HR = 2.0, 95% CI 1.03-4.05; P = 0.04), and the obsessive-compulsiveness scale from the Symptom Checklist 90 revised (HR = 0.4, 95% CI 0.12-1.15; P = 0.09). Results showed that post-test trunk flexion, somatization, and obsessive compulsiveness predicted work retention (final trunk flexion HR = 2.5 [95% CI 1.26-4.79; P = 0.01], somatization scale HR = 2.5 [95% CI 1.25-4.93; P = 0.01], and obsessive compulsion HR = 0.2 [95% CI 0.07-0.77; P = 0.02]). Psychosocial and physical factors are associated with work retention for patients with nonspecific LBP. The predictive value of certain constructs may vary with the time when they are assessed and how outcome is operationalized. Further studies are needed to confirm these findings.

Background: The hip musculature is globally known to support the pelvis, which in turn can aid in reducing the occurrence of low back pain (LBP). Previous research has shown a decrease in strength of the hip abductors in patients with LBP. The hip abductors also have an important role in stabilizing the pelvis while walking. The hip adductors attach to the pubic symphysis and assist in stabilizing the pelvis. Due to the ability to activate and assist with hip and leg motions, the adductor muscles may have an effect on controlling hip motion to reduce LBP and sacroiliac dysfunction. The hip adductors have also shown to stabilize the femur during low extremity injuries. However, it is unknown if the hip adductors respond in a similar fashion when pertaining to those with LBP. Objective: To test the strength of the hip abductor and hip adductor musculature in patients with and without low back pain (LBP). Concurrently, the researchers attempted to produce a strength ratio measurement for the corresponding muscles in both healthy and LBP populations. Participants: Participants were allocated into either control (n=15, 179.9cm + 8.3, 75.6kg + 16.0, age 21.9 + 1.8) or LBP (n=15, 169.3cm + 9.3, 76.2kg + 18.5, age 21.9 + 4.3) groups based on the inclusion criteria. For the control group, the participant must have no pain, 0% on the Oswestry Disability Index (ODI), 0 on the Visual Analogue Scale (VAS), and be between the age of 18-40. For the LBP group, the participant must score > 3 on the VAS, 20-40% on the ODI, and meet 3 out of 4 of the clinical predictor rules for LBP, and between the age of 18-40. Those with previous surgeries from the low back and down, a specific diagnosis for LBP, or current pregnancy, were excluded from the study. Methods: Participants performed a straight leg raise (SLR) for hip adduction and hip abduction of both legs. Participants isometrically contracted at maximal force into a mobilization belt for 5 seconds. The mobilization belt was adjusted to desired range of motion, 10 of hip adduction and 30 of hip abduction. Data was recorded using a hand-held dynamometer connected to the mobilization belt to enforce an immoveable object. The highest value of the 3 trails was used. A strength ratio was calculated by dividing hip adductor strength from hip abductor strength for each leg. A ratio greater than 1 indicated stronger

BackgroundUntil recently, non-specific low back pain (NSLBP) in adolescents was considered a rare phenomenon unlike in adults. The last two decades has shown an increasing amount of research highlighting the prevalence in this age group. Recent studies estimate lifetime prevalence at 7%-80%, point prevalence at 10%-15%, and prevalence of recurrent NSLBP at 13%-36%. In Zimbabwe, there is dearth of literature on the magnitude of the problem in adolescents. Therefore, the aims of the study were to determine the prevalence (lifetime, point, recurrent) and the nature of recurrent NSLBP reported by adolescents in secondary schools.MethodsA cross-sectional study was conducted using a questionnaire. A cluster sample of 544 adolescents (age 13–19 years) randomly derived from government schools participated in the study. Lifetime prevalence, point prevalence and prevalence of recurrent NSLBP were presented as percentages of the total population. Exact 95% confidence intervals were given. Chi-square test was used to evaluate the effect of gender and age on prevalence.ResultsThe students’ response rate was 97.8%. The lifetime prevalence was 42.9% [95% confidence interval = 40.8-44.6] with no significant difference between sexes [χ2 (1) =0.006, p = 0.94]. However, NSLBP peaked earlier in female students (13.9 years) than in male students (15 years) [t (226) = 4.21, p < 0.001]. About 10% of the adolescents reported having an episode of NSLBP on the day of the survey. However, female students (14.2%) were more affected on the day [χ2 (1) = 11.2, p < 0.001]. Twenty-nine percent of the adolescents experienced recurrent NSLBP with 78% experiencing at least three episodes in the last 12 months. On average, recurrent NSLBP reported was mild in intensity (4.8 ± 1.9) on the visual analogue scale (VAS) and short in duration. Recurrent NSLBP was associated with sciatica in 20.9% of adolescents.ConclusionsNSLBP is a common occurrence among Zimbabwean adolescents in secondary schools. It increases with chronological age and is recurrent in the minority of adolescents. Although much of the symptomatology may be considered benign, the existence of recurrent NSLBP in adolescents before their work-life begins should be a concern to health professionals, teachers and parents.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-381) contains supplementary material, which is available to authorized users.

Low back pain (LBP) is a significant musculoskeletal problem during pregnancy with potential to negatively affect the woman's quality of life. Data on LBP among pregnant women in Malawi is almost non-existent. We investigated the prevalence and risk factors of LBP and its association with functional activities in pregnant women in Malawi. We conducted a cross-sectional study in Blantyre, Malawi, from December 2017 to January 2018. Participants were drawn from low-risk antenatal clinics in selected local health facilities. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages. The association between occurrence of LBP and selected factors was assessed using the Chi-Square test (X2) (α=5%) followed by a multiple logistic regression. Odds ratios (OR) and their 95% confidence intervals were calculated. We interviewed 404 pregnant women; the mean age of respondents was 25.83 years old (SD: ±5.91). Prevalence of LBP in pregnancy was 62% (n=249); 172 (69%) of these reported LBP for the first time during the current pregnancy. Gestational age was significantly associated with presence of LBP (P= 0.03). LBP was associated with the women's sleep patterns, mobility, lifting techniques and sexual activities. However, a reasonable high proportion of those with LBP (34%) did not seek care for their low back pain. LBP is highly prevalent and an important clinical condition among pregnant women in Blantyre, Malawi. Given the significant effect of LBP on quality of life, health workers need to be proactive in identifying LBP and provide the appropriate management.

ObjectiveThe objective of the study was to identify the occurrence and outcome of low back ache amongst computer users and their relation to age, gender, occupation and duration of computer use.Materials and MethodsA self reported questionnaire tailored from Occupational Health and Safety Act of the Ministry of Labor, Ontario, Canada was used.Results416 participants 55.5% males and 45% females using computers for a minimum of five years with age range 22 to 59 years belonged to different occupational groups. Consecutive hours of computer work was found to be associated with work related backache or discomfort in 27.4% (n = 114) participants (16.1% male, 11.3% female). Frequent short breaks improved backache (p value <0.001) in 93 (22.4%) participants (13.2% male, 9.2% female). No significant relation was observed with the duration of computer usage or usage per day; between the two genders or occupational groups. Backache had no significance within age groups.ConclusionOur study identifies the occurrence of low back pain among those who are using computer for consecutive hours without breaks and the results suggest the need to create health awareness especially use of short breaks to minimize the risk and occurrence of low back pain. The result of this study can also be used to improve ergonomic design and standards.

The research aims to determine the relationship between sitting habits (position and duration) and the occurrence of low back pain in administrative employees at the Regional General Hospital of Prof. Dr. H. M. Anwar Makkatutu Bantaeng Regency in 2024. This study employs a quantitative descriptive design with cross-sectional study. A sample of 28 participants from 30 populations based on inclusion criteria using total sampling techniques. Data analysis used the chi-square test (X2) and Spearman's rank correlation coefficient (ρ) with a confidence level of 95%. Based on the analysis, there is a relationship between sitting position and the incidence of low back pain (p= 0.025), the level of relationship is moderate (ρ=0,573), and there is a relationship between sitting duration and the occurrence of low back pain (p= 0.044), the level of relationship is moderate (ρ=0.534).

The objective of the study was to determine the occurrence of low back pain and its relationship to back strength and physical activity in children. The study included 53 boys and 43 girls aged 10 to 19 years from a group of 116 children who had undergone isometric strength testing 4 years previously. No intervention was performed. Each child was asked five questions concerning low back pain. A questionnaire to quantify participation in athletic activities and manual labor was used as the basis for calculation of each child's activity level. Isometric back flexor and extensor strength were measured with the same method used 4 years previously. Statistical analyses were performed with appropriate correction for confounding factors. The frequency of low back pain and the relationship between low back pain and age, between low back pain and back strength, and between low back pain and physical activity were determined. There was a history of low back pain in 51%, and the frequency of low back pain in the past year was 35%. Eight percent of the children had been limited by low back pain, and 7% had seen a doctor for the pain. The first incident of low back pain occurred at a mean age of 12.3 years. The frequencies of a history of low back pain and of low back pain in the past year increased significantly with age (p = 0.02 and 0.01 respectively). Increased physical activity was significantly associated with a history of low back pain (p = 0.03), and increased back flexor strength was significantly associated with a history of low back pain and of low back pain in the past year (p = 0.03 and 0.008, respectively). The rate of low back flexor or strength over 4 years had a significantly positive association with the occurrence of low back pain in the past year (p = 0.008). Low back pain is common in children, and, in contrast to adults, low back pain in these children was more common with increased physical activity and stronger back flexors. We believe the main causes of low back pain in children are musculotendinous strains and ligamentous sprains.

The research aims to determine the relationship between sitting habits (position and duration) and the occurrence of low back pain in administrative employees at the Regional General Hospital of Prof. Dr. H. M. Anwar Makkatutu Bantaeng Regency in 2024. This study employs a quantitative descriptive design with cross-sectional study. A sample of 28 participants from 30 populations based on inclusion criteria using total sampling techniques. Data analysis used the chi-square test (X2) and Spearman's rank correlation coefficient (ρ) with a confidence level of 95%. Based on the analysis, there is a relationship between sitting position and the incidence of low back pain (p= 0.025), the level of relationship is moderate (ρ=0,573), and there is a relationship between sitting duration and the occurrence of low back pain (p= 0.044), the level of relationship is moderate (ρ=0.534).

Background Studies elsewhere suggest a lifetime rate of low back pain of about 50–80% and neck pain of about 12% in women and 9% in men. Objectives To identify the lifetime rate of neck pain and prevalence of low back pain in the urban population of Antalya, Turkey. Methods This survey study forms a part of larger cross-sectional study still being conducted in the urban area of Antalya (508.840 population according to 1997 national census). So far, 1521 subjects aged 16 or over were interviewed at home visits by 10 trained physicians and 20 accompanying medical students. The subjects were chosen by random cluster sampling from the registries of local offices of the Ministry of Health. Individuals were requested to respond to the questions whether they had at least one episode of neck pain and/or low back pain (both inflammatory and noninflammatory). Additional questions regarding the occurrence of low back pain at present, and in the previous year; loss of work-days in the previous year, the relation of occupation with the symptoms, and whether and how they searched for a solution for the relief of their low back pain were asked to the subjects. Results We found a lifetime rate of neck pain of 351(46,4%) of women and 252(33,8%) of men (totally 611(40,3%) individuals) and low back pain of 430(57%) of women and 303(%40,8) of men (totally 739(48,9%) individuals). The point prevalence of low back pain was calculated as 39,9%(324 individuals), of these 210 were women and 110 were men. The point prevalence was 27,3%(n = 21) in men aged over 50 and 34,3%(n = 93) in men aged 50 or under, while it was 57,6%(n = 49) in women aged over 50 and 42,5%(n = 161) in women aged 50 or under. Conclusion The lifetime rate of neck and low back pain were both higher in women. The increasing age seems to be associated with the point prevalence of low back pain in women contrary to men. This study is supported by the Akdeniz University Research Fund.

Introduction: Non-specific low back pain (LBP) can be understood through the interaction of biopsychosocial factors such as education. Unfortunately, it remains unclear whether education can be considered an important risk and prognostic factor for the occurrence of LBP. Objective: To investigate the association between education and LBP. Methods: The following databases were searched: MEDLINE, EMBASE, Cochrane, AMED and PsyINFO. Results: Thirteen studies were included in the review. The Prevalence Critical Appraisal Instrument (PCAI) was used to assess risk of bias. Methodological quality scores ranged from 7 to 10 on a scale of 0-10. There was a 23% (95% CI, 13-37) prevalence of LBP (10,582 out of a total of 99,457 cases) in the general sample at the time of assessment. The meta-analysis of studies on the prevalence of LBP in people with low, medium or high educational level found the following results, respectively: 24% (95% CI, 12-43), 27% (95% CI, 9-56), and 18% (95% CI, 5-50). The meta-regression identified heterogeneity among the studies included in the review. This can be explained by educational differences (p &lt; 0.05). Conclusion: Occurrence of LBP varies according to educational level. Individuals with higher educational levels are less often affected by LBP than individuals with medium or low educational levels.

Low back pain (LBP) is prevalent in children and its incidence continues to rise into adolescence, highlighting a need for early prevention. A systematic review of the incidence and prevalence of LBP in this study identified a noticeable increase in the prevalence of LBP between the ages of 12 to 15 years. There is a recognised association between the presence of LBP in childhood and the development of LBP in adults, and we know the risk of LBP is greater for people with a history of LBP than for those without. This indicates a need for primary prevention of the first episode of LBP. Strategies for the prevention of LBP require knowledge of the risk factors for LBP. A number of risk factors were identified in a systematic review in this study, but none of the nine significant risk factors identified were validated in independent studies. The review was confounded by method variations in included studies: a) a large variation in the methods used to measure risk factors made direct comparison difficult; b) definitions of risk factors varied; c) definitions of LBP varied making sensible pooling of data difficult; d) the methods used to collect and analyse data limited meaningful interpretation; and e) the long periods involved in the recall of events questions the accuracy of the reports. It is also difficult to determine at what point the presence of a risk factor becomes a problem or which risk factors are inter-related. The method issues found in this review concur with reports of method confounders in previous reviews of LBP studies. The constraints of predictive studies and the many covariates indicate that the measurement of predictors may be futile and a focus on intervention could be more useful in the search for strategies for preventing LBP. The evidence for specific interventions for LBP prevention in children is sparse. However, given the evidence of the benefits of exercise as a preventative measure for reoccurrence of LBP in adults, exercise for the prevention of LBP in children justified investigation. A randomised controlled trial (RCT) of daily exercise and education in children revealed that children participating in the exercise and back-awareness education program reported significantly fewer episodes of LBP and fewer lifetime first episodes of LBP than those who received only education. The reduction in LBP episodes could not be attributed solely to the specific spine exercises: it is possible that drawing attention to the spine by emphasizing awareness and regular movement in the back had beneficial effects. Further exercise intervention studies are needed as the RCT indicates that exercise has the potential to influence good back health in children. Adherence to exercise is a frequently reported problem with exercise-intervention studies. The RCT was designed to facilitate adherence. An observational study embedded in the RCT investigated adherence of children to the exercise program and the factors that have the potential to influence adherence. Exercise adherence declined through the nine months of the study despite a range of strategies designed to encourage it. This concurs with longer term studies of exercise adherence in adults and children. Innovative strategies need to be implemented if children are to develop new habits. This possibly requires the integration of spine exercises into sports regimens, and the use of modern technology to capture and maintain the attention of children over longer periods to facilitate the development of habits with the potential to improve spine health. Researching children in schools presented many challenges. The logistical issues and design features of the RCT are reported, and the strategies required in the planning of this type of study are reviewed. The research in this study indicated an appropriate time for the implementation of prevention strategies in children. The back awareness program investigated in this thesis showed promise for an effect on future LBP. School-based back awareness programs in some format require further development. This thesis uses a combination of published, accepted and prepared papers supplemented by a framework of chapters providing supporting work and knowledge.

Introduction : Low Back Pain is a feeling of pain in the lower back.Several factors can cause Low Back Pain complaints, namely individual factors: sex, and occupational factors: work posture and length of work per day.The purpose of this study was to determine the relationship between the Ergonomic Risk of Shuttlecock Workers and the occurrence of Low Back Pain.Methods : Correlation study design with a cross sectional approach was carried out on April 23-25, 2018 with a population of 89 respondents who met the inclusion criteria of 71 respondents with a sampling technique of Proportinate Stratified Random Sampling.Independent variables of Shuttlecock Worker Ergonomic Risk with REBA Observation and Dependent Variable Low Back Pain occurrence with Nordic Body Map (NBM) questionnaire.Data were analyzed by spearman rank test with a significance of = 0.05.Result :The results of the study showed that of 71 respondents, the majority of them were 45 respondents (63.4%) had moderate risk of ergonomics.Most of the 36 respondents (50.7%) had complaints of low back pain with moderate complaints.The results obtained value 0,030 0,05, so Ha is accepted.This shows that there is a relationship between the risk of ergonomics of shuttlecock workers and the occurrence of low back pain in Sumengko Village, Sukomoro District, Nganjuk Regency.Conclusion : Shuttlecock worker working posture is proven as a factor in the occurrence of low back pain complaints, working with awkward work postures such as sitting and standing bent can cause complaints of pain in muscles and bones.

A retrospective nested case-control study. To identify occupational factors related to low back pain, and to study how interactions between psychosocial and physical factors, and between work-related and leisure-related factors affect low back pain in women and men. A cohort of 484 subjects drawn from the general population was examined in 1969 and 1993, with a focus on occupational working conditions and musculoskeletal disorders. Information about the physical and psychosocial working conditions and low back pain during the period 1970 to 1993 was collected retrospectively. Odds ratios and confidence intervals were calculated for different potential risk factors. During the 24-year period, 46% of the subjects became patients with low back pain. Among women, heavy physical workload, sedentary work, smoking, and the combination of whole-body vibrations and low influence over work conditions were associated with an excess risk of low back pain. Among men, excess risk for low back pain was seen in heavy physical workload, sedentary work, high perceived load outside work, and the combination of poor social relations and overtime. Factors at work were seen to be risk indicators for low back pain among both genders. Low influence over work conditions among women and poor social relations at work among men, in combination with other factors, seem to be of high relevance for the occurrence of low back pain.