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Published in: European Spine Journal 6/2007

01-06-2007 | Original Article

Effects of back posture education on elementary schoolchildren’s back function

Authors: Elisabeth Geldhof, Greet Cardon, Ilse De Bourdeaudhuij, Lieven Danneels, Pascal Coorevits, Guy Vanderstraeten, Dirk De Clercq

Published in: European Spine Journal | Issue 6/2007

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Abstract

The possible effects of back education on children’s back function were never evaluated. Therefore, main aim of the present study was to evaluate the effects of back education in elementary schoolchildren on back function parameters. Since the reliability of back function measurement in children is poorly defined, another objective was to test the selected instruments for reliability in 8–11-year olds. The multi-factorial intervention lasting two school-years consisted of a back education program and the stimulation of postural dynamism in the class. Trunk muscle endurance, leg muscle capacity and spinal curvature were evaluated in a pre-post design including 41 children who received the back education program (mean age at post-test: 11.2 ± 0.9 years) and 28 controls (mean age at post-test: 11.4 ± 0.6 years). Besides, test–retest reliability with a 1-week interval was investigated in a separate sample. Therefore, 47 children (mean age: 10.1 ± 0.5 years) were tested for reliability of trunk muscle endurance and 40 children (mean age: 10.2 ± 0.7 years) for the assessment of spinal curvatures. Reliability of endurance testing was very good to good for the trunk flexors (ICC = 0.82) and trunk extensors (ICC = 0.63). The assessment of the thoracic (ICC = 0.69) and the lumbar curvature (ICC = 0.52) in seating position showed good to acceptable reliability. Low ICCs were found for the assessment of the thoracic (ICC = 0.39) and the lumbar curvature (ICC = 0.37) in stance. The effects of 2 year back education showed an increase in trunk flexor endurance in the intervention group compared to a decrease in the controls and a trend towards significance for a higher increase in trunk extensor endurance in the intervention group. For leg muscle capacity and spinal curvature no intervention effects were found. The small samples recommend cautious interpretation of intervention effects. However, the present study’s findings favor the implementation of back education with focus on postural dynamism in the class as an integral part of the elementary school curriculum in the scope of optimizing spinal loading through the school environment.
Literature
1.
go back to reference Adams MA, Mannion AF, Dolan P (1999) Personal risk factors for first-time low back pain. Spine 24:2497–2505PubMedCrossRef Adams MA, Mannion AF, Dolan P (1999) Personal risk factors for first-time low back pain. Spine 24:2497–2505PubMedCrossRef
2.
go back to reference Alaranta H, Hurri H, Heliovaara M, Soukka A, Harju R (1994) Non-dynamometric trunk performance tests—reliability and normative data. Scand J Rehabil Med 26:211–215PubMed Alaranta H, Hurri H, Heliovaara M, Soukka A, Harju R (1994) Non-dynamometric trunk performance tests—reliability and normative data. Scand J Rehabil Med 26:211–215PubMed
3.
go back to reference Balagué F, Damidot P, Nordin M, Parnianpour M, Waldburger M (1993) Cross-sectional study of the isokinetic muscle trunk strength among school-children. Spine 18:1199–1205PubMed Balagué F, Damidot P, Nordin M, Parnianpour M, Waldburger M (1993) Cross-sectional study of the isokinetic muscle trunk strength among school-children. Spine 18:1199–1205PubMed
4.
go back to reference Balagué F, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk-factors. Eur Spine J 8:429–438PubMedCrossRef Balagué F, Troussier B, Salminen JJ (1999) Non-specific low back pain in children and adolescents: risk-factors. Eur Spine J 8:429–438PubMedCrossRef
5.
go back to reference Biering-Sörensen F (1984) Physical measurement as risk indicators for low back trouble over a one-year period. Spine 9:143–148 Biering-Sörensen F (1984) Physical measurement as risk indicators for low back trouble over a one-year period. Spine 9:143–148
6.
go back to reference Cardon G, Balagué F (2004) Low back pain prevention’s effects in schoolchildren. What is the evidence? Eur Spine J 13:663–679PubMedCrossRef Cardon G, Balagué F (2004) Low back pain prevention’s effects in schoolchildren. What is the evidence? Eur Spine J 13:663–679PubMedCrossRef
7.
go back to reference Cardon G, De clercq D, De Bourdeaudhuij I, Breithecker D (2004) Sitting habits in elementary schoolchildren: a traditional versus a ‘Moving school’. Patient Educ Couns 54:133–142PubMedCrossRef Cardon G, De clercq D, De Bourdeaudhuij I, Breithecker D (2004) Sitting habits in elementary schoolchildren: a traditional versus a ‘Moving school’. Patient Educ Couns 54:133–142PubMedCrossRef
8.
go back to reference Cardon GM, de Clercq DL, Geldhof EJ, Verstraete S, de Bourdeaudhuij IM (2006) Back education in elementary schoolchildren: the effects of adding a physical activity promotion program to a back care program.Eur Spine J. Epub ahead of print Cardon GM, de Clercq DL, Geldhof EJ, Verstraete S, de Bourdeaudhuij IM (2006) Back education in elementary schoolchildren: the effects of adding a physical activity promotion program to a back care program.Eur Spine J. Epub ahead of print
9.
go back to reference Coorevits P, Danneels L, Ramon H, Van Audekercke R, Cambier D, Vanderstraeten G (2005) Statistical modelling of fatigue-related electromyographic median frequency characteristics of back and hip muscles during a standardized isometric back extension test. J Electromyogr Kines 15:444–451CrossRef Coorevits P, Danneels L, Ramon H, Van Audekercke R, Cambier D, Vanderstraeten G (2005) Statistical modelling of fatigue-related electromyographic median frequency characteristics of back and hip muscles during a standardized isometric back extension test. J Electromyogr Kines 15:444–451CrossRef
10.
go back to reference Deighan M, Croix M, Armstrong N (2003) Reliability of isokinetic concentric and eccentric knee and elbow extension and flexion in 9/10 year old boys. Isokinet Exerc Sc 11:109–115 Deighan M, Croix M, Armstrong N (2003) Reliability of isokinetic concentric and eccentric knee and elbow extension and flexion in 9/10 year old boys. Isokinet Exerc Sc 11:109–115
11.
go back to reference Drouin JM, Valovich-mcLeod TC, Shultz SJ, Gansneder BM, Perrin DH (2004) Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol 91:22–29PubMedCrossRef Drouin JM, Valovich-mcLeod TC, Shultz SJ, Gansneder BM, Perrin DH (2004) Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol 91:22–29PubMedCrossRef
12.
go back to reference Elftman H (1966) Biomechanics of muscle with particular application to studies of gait. J Bone Joint Surg Am 48:363–377PubMed Elftman H (1966) Biomechanics of muscle with particular application to studies of gait. J Bone Joint Surg Am 48:363–377PubMed
13.
go back to reference Escamilla RF, Fleisig GS, Lowry TM, Barrentine SW, Andrews JR (2001) A three-dimensional biomechanical analysis of the squat during varying stance widths. Med Sci Sport Exer 33:984–998CrossRef Escamilla RF, Fleisig GS, Lowry TM, Barrentine SW, Andrews JR (2001) A three-dimensional biomechanical analysis of the squat during varying stance widths. Med Sci Sport Exer 33:984–998CrossRef
14.
go back to reference Essendorp M, Schibye B, Hey-Knudsen C (2002) Intra-abdominal pressure increases during exhausting back extension in humans. Eur J Appl Physiol 87:167–173CrossRef Essendorp M, Schibye B, Hey-Knudsen C (2002) Intra-abdominal pressure increases during exhausting back extension in humans. Eur J Appl Physiol 87:167–173CrossRef
15.
go back to reference Feldman DE, Shrier I, Rossignol M, Abenhaim L (2001) Risk factors for the development of low back pain in adolescence. Am J Epidemiol 154:30–36PubMedCrossRef Feldman DE, Shrier I, Rossignol M, Abenhaim L (2001) Risk factors for the development of low back pain in adolescence. Am J Epidemiol 154:30–36PubMedCrossRef
16.
go back to reference Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D (2006) Effects of a two-school-year multi-factorial back education program in elementary schoolchildren. Spine 31(17):1965–1973PubMedCrossRef Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D (2006) Effects of a two-school-year multi-factorial back education program in elementary schoolchildren. Spine 31(17):1965–1973PubMedCrossRef
17.
go back to reference Harreby M, Neergaard K, Hesseloe G (1995) Are radiologic changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? Spine 20:2298–2302PubMedCrossRef Harreby M, Neergaard K, Hesseloe G (1995) Are radiologic changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? Spine 20:2298–2302PubMedCrossRef
18.
go back to reference Harrison DD, Harrison SO, Croft AC, Harrison DE, Troyanovich SJ (1999) Sitting biomechanics part I: review of the literature. J Manipulative Physiol Ther 22:594–609PubMedCrossRef Harrison DD, Harrison SO, Croft AC, Harrison DE, Troyanovich SJ (1999) Sitting biomechanics part I: review of the literature. J Manipulative Physiol Ther 22:594–609PubMedCrossRef
19.
go back to reference Heather C, Shrawan K, Sharon W (1995) Postural aberrations in low back pain. Arch Phys Med Rehab 76:218–224CrossRef Heather C, Shrawan K, Sharon W (1995) Postural aberrations in low back pain. Arch Phys Med Rehab 76:218–224CrossRef
20.
go back to reference Ho CW, Chen LC, Hsu HH, Chiang SL, Li MH, Jiang SH, Tsai KC (2005) Isokinetic muscle strength of the trunk and bilateral knees in young subjects with lumbar disc herniation. Spine 30:528–533CrossRef Ho CW, Chen LC, Hsu HH, Chiang SL, Li MH, Jiang SH, Tsai KC (2005) Isokinetic muscle strength of the trunk and bilateral knees in young subjects with lumbar disc herniation. Spine 30:528–533CrossRef
21.
go back to reference Hyytiainen K, Salminen JJ, Suvitie T, Wickstrom G, Pentti J (1991) Reproducibility of 9 tests to measure spinal mobility and trunk muscle strength. Scand J Rehabil Med 23:3–10PubMed Hyytiainen K, Salminen JJ, Suvitie T, Wickstrom G, Pentti J (1991) Reproducibility of 9 tests to measure spinal mobility and trunk muscle strength. Scand J Rehabil Med 23:3–10PubMed
22.
go back to reference Jones GT, Watson KD, Silman AJ, Symmons DP, Macfarlane GJ (2003) Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. Pediatrics 111:822–828PubMedCrossRef Jones GT, Watson KD, Silman AJ, Symmons DP, Macfarlane GJ (2003) Predictors of low back pain in British schoolchildren: a population-based prospective cohort study. Pediatrics 111:822–828PubMedCrossRef
23.
go back to reference Jones MA, Stratton G, Reilly T, Unnithan VB (2005) Biological risk indicators for recurrent non-specific low back pain in adolescents. Br J Sports Med 39:137–140PubMedCrossRef Jones MA, Stratton G, Reilly T, Unnithan VB (2005) Biological risk indicators for recurrent non-specific low back pain in adolescents. Br J Sports Med 39:137–140PubMedCrossRef
24.
go back to reference Kristjansdottir G, Rhee H (2002) Risk factors of back pain frequency in schoolchildren: a search for explanations to a public health problem. Acta Paediatr 91:849–854PubMedCrossRef Kristjansdottir G, Rhee H (2002) Risk factors of back pain frequency in schoolchildren: a search for explanations to a public health problem. Acta Paediatr 91:849–854PubMedCrossRef
25.
go back to reference Latimer J, Maher CG, Refshauge K, Colaco I (1999) The reliability and validity of the Biering-Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine 24:2085–2089PubMedCrossRef Latimer J, Maher CG, Refshauge K, Colaco I (1999) The reliability and validity of the Biering-Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine 24:2085–2089PubMedCrossRef
26.
go back to reference Lee JH, Ooi Y, Nakamura K (1995) Measurement of muscle strength of the trunk and the lower extremities in subjects with history of low back pain. Spine 20:1994–1996PubMedCrossRef Lee JH, Ooi Y, Nakamura K (1995) Measurement of muscle strength of the trunk and the lower extremities in subjects with history of low back pain. Spine 20:1994–1996PubMedCrossRef
27.
go back to reference Lee JH, Hoshino Y, Nakamura K, Kariya Y, Saita K, Ito K (1999) Trunk muscle weakness as a risk factor for low back pain—a 5-year prospective study. Spine 24:54–57PubMedCrossRef Lee JH, Hoshino Y, Nakamura K, Kariya Y, Saita K, Ito K (1999) Trunk muscle weakness as a risk factor for low back pain—a 5-year prospective study. Spine 24:54–57PubMedCrossRef
28.
go back to reference Malmstrom EM, Karlberg M, Melander A, Magnusson M (2003) Zebris versus Myrin: a comparative study between a three-dimensional ultrasound movement analysis and an inclinometer/compass method: intradevice reliability, concurrent validity, intertester comparison, intratester reliability, and intraindividual variability. Spine 28:433–440CrossRef Malmstrom EM, Karlberg M, Melander A, Magnusson M (2003) Zebris versus Myrin: a comparative study between a three-dimensional ultrasound movement analysis and an inclinometer/compass method: intradevice reliability, concurrent validity, intertester comparison, intratester reliability, and intraindividual variability. Spine 28:433–440CrossRef
29.
go back to reference Mannion AF, Klein GN, Dvorak J, Lanz C (2000) Range of global motion of the cervical spine: intraindividual reliability and the influence of measurement device. Eur Spine J 9:379–385PubMedCrossRef Mannion AF, Klein GN, Dvorak J, Lanz C (2000) Range of global motion of the cervical spine: intraindividual reliability and the influence of measurement device. Eur Spine J 9:379–385PubMedCrossRef
30.
go back to reference McGill SM, Childs A, Liebenson C (1999) Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehab 80:941–944CrossRef McGill SM, Childs A, Liebenson C (1999) Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehab 80:941–944CrossRef
31.
go back to reference McIntosh G, Wilson, Affleck M, Hall H (1998) Trunk and lower extremity muscle endurance: normative data for adults. J Rehabil Outcomes Meas 2:20–39 McIntosh G, Wilson, Affleck M, Hall H (1998) Trunk and lower extremity muscle endurance: normative data for adults. J Rehabil Outcomes Meas 2:20–39
32.
go back to reference Newcomer K, Sinaki M (1996) Low back pain and its relationship to back strength and physical activity in children. Acta Paediatr 85:1433–1439PubMed Newcomer K, Sinaki M (1996) Low back pain and its relationship to back strength and physical activity in children. Acta Paediatr 85:1433–1439PubMed
33.
go back to reference Newcomer K, Sinaki M, Wollan PC (1997) Physical activity and four-year development of back strength in children. Am J Phys Med Rehabil 76:52–58PubMedCrossRef Newcomer K, Sinaki M, Wollan PC (1997) Physical activity and four-year development of back strength in children. Am J Phys Med Rehabil 76:52–58PubMedCrossRef
34.
go back to reference Nordin M, Kahanovitz N, Verderame R, Parnianpour M, Yabut S, Viola K, Viola K, Greenidge N, Mulvihill M (1987) Normal trunk muscle strength and endurance in women and the effect of exercises and electrical-stimulation. Part 1: Normal endurance and trunk muscle strength in 101 women. Spine 12:105–111PubMedCrossRef Nordin M, Kahanovitz N, Verderame R, Parnianpour M, Yabut S, Viola K, Viola K, Greenidge N, Mulvihill M (1987) Normal trunk muscle strength and endurance in women and the effect of exercises and electrical-stimulation. Part 1: Normal endurance and trunk muscle strength in 101 women. Spine 12:105–111PubMedCrossRef
35.
go back to reference Oksanen A, Salminen JJ (1996) Tests of spinal mobility and muscle strength in the young: reliability and normative values. Physiother Theory Pract 12:151–160 Oksanen A, Salminen JJ (1996) Tests of spinal mobility and muscle strength in the young: reliability and normative values. Physiother Theory Pract 12:151–160
36.
go back to reference O’Sullivan PB, Grahamslaw KM, Kendell MM, Lapenskis SC, Möller NE, Richards KV (2001) The effect of different standing and sitting postures on trunk muscle activity in a pain free population. In: Proceedings of the interdisciplinary World congress on low back and pelvic pain, Montreal, pp 180–183 O’Sullivan PB, Grahamslaw KM, Kendell MM, Lapenskis SC, Möller NE, Richards KV (2001) The effect of different standing and sitting postures on trunk muscle activity in a pain free population. In: Proceedings of the interdisciplinary World congress on low back and pelvic pain, Montreal, pp 180–183
37.
go back to reference Poussa MS, Heliovaara MM, Seitsamo JT, Kononen MH, Hurmerinta KA, Nissinen MJ (2005) Predictors of neck pain: a cohort study of children followed up from the age of 11 to 22 years. Eur Spine J 14:1033–1036PubMedCrossRef Poussa MS, Heliovaara MM, Seitsamo JT, Kononen MH, Hurmerinta KA, Nissinen MJ (2005) Predictors of neck pain: a cohort study of children followed up from the age of 11 to 22 years. Eur Spine J 14:1033–1036PubMedCrossRef
38.
go back to reference Salminen JJ, Maki P, Oksanen A, Pentti J (1992) Spinal mobility and trunk muscle strength in 15-year-old schoolchildren with and without low-back-pain. Spine 17:405–411PubMedCrossRef Salminen JJ, Maki P, Oksanen A, Pentti J (1992) Spinal mobility and trunk muscle strength in 15-year-old schoolchildren with and without low-back-pain. Spine 17:405–411PubMedCrossRef
39.
go back to reference Salminen JJ, Erkintalo M, Laine M, Pentti J (1995) Low-back-pain in the young—a prospective 3-year follow-up-study of subjects with and without low-back-pain. Spine 20:2101–2107PubMedCrossRef Salminen JJ, Erkintalo M, Laine M, Pentti J (1995) Low-back-pain in the young—a prospective 3-year follow-up-study of subjects with and without low-back-pain. Spine 20:2101–2107PubMedCrossRef
40.
go back to reference Salminen JJ, Erkintalo M, Pentti J, Oksanen A, Kormano M (1999) Recurrent low back pain and early disc degeneration in the young. Spine 24:1316–1321PubMedCrossRef Salminen JJ, Erkintalo M, Pentti J, Oksanen A, Kormano M (1999) Recurrent low back pain and early disc degeneration in the young. Spine 24:1316–1321PubMedCrossRef
41.
go back to reference Sjölie AN, Ljunggren AE (2001) The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents. Spine 26:2629–2636PubMedCrossRef Sjölie AN, Ljunggren AE (2001) The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents. Spine 26:2629–2636PubMedCrossRef
42.
go back to reference Strimpakos N, Sakellari V, Gioftsos G, Papathanasiou M, Brountzos E, Kelekis D, Kapreli E, Oldham J (2005) Cervical spine ROM measurements: optimizing the testing protocol by using a 3D ultrasound-based motion analysis system. Cephalalgia 25:1133–1145PubMedCrossRef Strimpakos N, Sakellari V, Gioftsos G, Papathanasiou M, Brountzos E, Kelekis D, Kapreli E, Oldham J (2005) Cervical spine ROM measurements: optimizing the testing protocol by using a 3D ultrasound-based motion analysis system. Cephalalgia 25:1133–1145PubMedCrossRef
43.
go back to reference Suter E, Lindsay D (2001) Back muscle fatigability is associated with knee extensor inhibition in subjects with low back pain. Spine 26:361–366CrossRef Suter E, Lindsay D (2001) Back muscle fatigability is associated with knee extensor inhibition in subjects with low back pain. Spine 26:361–366CrossRef
44.
go back to reference Udermann BE, Mayer JM, Graves JE, Murray SR (2003) Quantitative assessment of lumbar paraspinal muscle endurance. J Athl Train 38:259–262PubMed Udermann BE, Mayer JM, Graves JE, Murray SR (2003) Quantitative assessment of lumbar paraspinal muscle endurance. J Athl Train 38:259–262PubMed
45.
go back to reference van Dieen JH, Hoozemans MJM, Toussaint HM (1999) Stoop or squat: a review of biomechanical studies on lifting technique. Clin Biomech 14:685–696CrossRef van Dieen JH, Hoozemans MJM, Toussaint HM (1999) Stoop or squat: a review of biomechanical studies on lifting technique. Clin Biomech 14:685–696CrossRef
46.
go back to reference Verstraete SJ, De Bourdeaudhuij IM, Cardon GM (2003) Validation of a physical activity questionnaire for children. In: Proceedings of the American College of Sports Medicine. Med Sci Sport Exer 35(5):64 Verstraete SJ, De Bourdeaudhuij IM, Cardon GM (2003) Validation of a physical activity questionnaire for children. In: Proceedings of the American College of Sports Medicine. Med Sci Sport Exer 35(5):64
47.
go back to reference Wang SF, Teng CC, Lin KH (2005) Measurement of cervical range of motion pattern during cyclic neck movement by an ultrasound-based motion system. Man Ther 10:68–72PubMedCrossRef Wang SF, Teng CC, Lin KH (2005) Measurement of cervical range of motion pattern during cyclic neck movement by an ultrasound-based motion system. Man Ther 10:68–72PubMedCrossRef
48.
go back to reference Watson KD, Papageorgiou AC, Jones GT Taylor S, Symmons DP, Silman AJ, Macfarlane GJ (2002) Low back pain in schoolchildren: occurrence and characteristics. Pain 97:87–92PubMedCrossRef Watson KD, Papageorgiou AC, Jones GT Taylor S, Symmons DP, Silman AJ, Macfarlane GJ (2002) Low back pain in schoolchildren: occurrence and characteristics. Pain 97:87–92PubMedCrossRef
49.
go back to reference Widhe T (2001) Spine: posture, mobility and pain—a longitudinal study from childhood to adolescence. Eur Spine J 10:118–123PubMedCrossRef Widhe T (2001) Spine: posture, mobility and pain—a longitudinal study from childhood to adolescence. Eur Spine J 10:118–123PubMedCrossRef
Metadata
Title
Effects of back posture education on elementary schoolchildren’s back function
Authors
Elisabeth Geldhof
Greet Cardon
Ilse De Bourdeaudhuij
Lieven Danneels
Pascal Coorevits
Guy Vanderstraeten
Dirk De Clercq
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 6/2007
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-006-0199-4

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