Musculoskeletal pain in 6-year-old children: the Generation R Study

Benefits of musculoskeletal health promotion in school communities through service-learning: a mixed-method approach

Background

Service-learning (S-L) is an educational method that enhances social and civic engagement among health science students, addressing unmet community needs. Musculoskeletal disorders (MSKD) represent a public health issue with increasing prevalence among school-aged population as reported by at least 1 on 5 children. Prevention programs for MSKD in schools are scarce, although evidence supports the efficacy of health education provided by physical therapists. This study aimed to evaluate the impact of a musculoskeletal health promotion program through S-L on school students, teachers, and physical therapy students.

Methods

A mixed-methods approach was used. A quasi-experimental design assessed the learning and satisfaction of school students and teachers using pre-and post-intervention questionnaires. Additionally, qualitative data from reflective diaries of fourth-year physical therapy students were analyzed to capture their experiences. The intervention was conducted in 10 schools in Spain over two academic years, targeting children aged 10-14 and their teachers.

Results

A total of 1,051 school students and 32 teachers participated. Pre-post evaluations revealed significant learnings on MSKD prevention and body awareness in both groups (p < 0.05), highlighting the increase in knowledge about MSKD prevention and self-treatment for school students and on MSKD derived from inadequate postures for schoolteachers. Satisfaction was high, with students and teachers rating the program 4.4/5. Teachers highlighted the value of training for their professional practice, while students appreciated learning about self-care. Physical therapy students were 4 and reflected on their motivation for the project, learning experiences, as well as positive and negative aspects of the service.

Discussion

The S-L community-based intervention effectively increased awareness of musculoskeletal health and self-management skills. The peer learning environment and participatory approach encouraged engagement and knowledge retention in both students and teachers.

Conclusion

S-L is a valuable strategy for promoting musculoskeletal health in schools while improving health education skills among the future physical therapists through experiential learning.

Association of self-reported musculoskeletal pain with school furniture suitability and daily activities among primary school and university students

Students spend a considerable amount of time in school. This study aimed to determine the prevalence of musculoskeletal pain and the association between the pain and suitability of school furniture and daily activities among primary school and university students. A total of 238 primary and university students participated in the study. The adapted Nordic questionnaire was used to assess pain prevalence, the BackPEI questionnaire was used to assess school-related factors, and student furniture mismatch calculations were performed to determine the anthropometric suitability of school furniture. Most students did not have a proper body posture while sitting, did not lift objects properly, and used TV and computer frequently. A high student-furniture mismatch was found for seat and desk height. The neck, lower back, shoulders, and upper back were the most affected body parts. Our study confirmed that musculoskeletal pain occurs in primary school students and increases with age, especially lower back pain. Proper backpack wearing was found to be an important factor in alleviating neck pain. Students who sat or lifted objects properly were more likely to report upper back pain, and students whose backrest height was appropriate were more likely to report lower back pain. Further efforts should be made to establish a comparable study protocol using objective methods to obtain more valid and reliable data to study school-related risk factors for musculoskeletal pain in students using prospective study protocols.

The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis

ABSTRACT

Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and other) in children and adolescents. EMBASE, PubMed, CINAHL, and PsycINFO were searched for publications between January 1, 2009, and June 30, 2023. Studies reporting population-based estimates of chronic nondisease related pain prevalence in children or adolescents (age ≤ 19 years) were included. Two independent reviewers screened articles based on a priori protocol. One hundred nineteen studies with a total of 1,043,878 children (52.0% female, mean age 13.4 years [SD 2.4]) were included. Seventy different countries were represented, with the highest number of data points of prevalence estimates coming from Finland and Germany (n = 19 each, 4.3%). The overall prevalence of chronic pain in children and adolescents was 20.8%, with the highest prevalence for headache and musculoskeletal pain (25.7%). Overall, and for all types of pain except for back pain and musculoskeletal pain, there were significant differences in the prevalence between boys and girls, with girls having a higher prevalence of pain. There was high heterogeneity (I 2 99.9%). Overall risk of bias was low to moderate. In summary, approximately 1 in 5 children and adolescents experience chronic pain and prevalence varies by pain type; for most types, there is higher pain prevalence among girls than among boys. Findings echo and expand upon the systematic review conducted in 2011.

Musculoskeletal pain in 13-year-old children: the generation R study

ABSTRACT

Musculoskeletal (MSK) pain is a common reason for consultation in general practice and frequently reported in children and adolescents. This study examined the prevalence of MSK pain in 13-year-old children and assessed associations with physical and psychosocial factors. Data from the Generation R Study, a population-based birth cohort, was used. Prevalence and characteristics of MSK pain were assessed, using a pain mannequin, at 13 years of age (N = 3062). Demographics and data on physical activity, sedentary behaviors, previous reported MSK pain, and behavioral problems were extracted from questionnaires. The body mass index (BMI) SD-score was calculated from objectively measured weight and height. A prevalence of 23.3% was found for MSK pain in children of which 87.2% persisted for more than 3 months (ie, chronic), 45.5% experienced pain daily. More physically active children and children with a higher BMI reported MSK pain more frequently compared with non-MSK pain and no pain. The knee was the most often reported location. Children with MSK pain were more likely to have reported MSK pain at 6 years. Multivariable analyses showed significant associations for male sex (OR 0.74, 95% CI 0.56-0.98), high maternal educational (OR 0.69, 95% CI 0.49-0.96), higher BMI (OR 1.19, 95% CI 1.05-1.35), being physically active (OR 1.41, 95% CI 1.03-1.91), and behavioral problems (OR 1.85, 95% CI 1.33-2.59) with the presence of MSK pain. The chronic nature of MSK pain in combination with the relatively high prevalence of MSK pain in this study shows that MSK pain is already an important problem at a young age.

Factors associated with back pain in children aged 6 to 12 years of age, an eight months prospective study

Associated factors of back pain (BP) development before puberty and its persistence are poorly documented. We investigated the association and possible temporality between prior BP history (PBPH), muscular endurance (ME), aerobic capacity (AC), sport activity variables (SAV) and BP in children aged 6 to 12. We collected baseline characteristics (demographics, PBPH, ME, AC and SAV) of children from three primary schools in Canada. Parents replied to weekly text messages regarding their children BP status over an 8-month period. Logistic regression models were adjusted for potential confounders. Data from 242 children (46% female; 8.6 ± 1.7 years) were included. Over the 8-month survey BP prevalence was 48.1%, while the cumulative incidence was 31.9%. The occurrence of at least one BP event was associated with PBPH [OR (IC 95%) = 6.33 (2.35-17.04)] and high AC [2.89 (1.21-6.90)]. High AC was also associated with the development of a first BP episode [2.78 (1.09-7.07)], but ME and SAV were not. BP appears to be relatively common before puberty. BP history seems to be strongly associated with BP recurrence in children. Aerobic capacity is associated with first BP episode development.

Parents' Perspectives on Adaptive Sports in Children with Profound Intellectual and Multiple Disabilities

Children with profound intellectual and multiple disabilities (PIMD) need adaptations to participate in sports and it is more difficult for them to access these activities. We investigated the effects of adaptive sports in children with PIMD as perceived by their parents. The parents answered a postal questionnaire exploring the effects of adaptive sports during the 3 days following an activity. The questionnaire explored twelve domains of children’s daily lives, such as sleep and appetite. We calculated a composite score, including all of these domains, to assess whether the children globally benefited from adaptive sports. Of the families, 27/63 responded (participation 42.9%). Four domains improved after the sports activity in an important proportion of children (improvement in 64.0% of children for wellbeing, 57.6% for mood, 56.0% for comfort and 48.1% for sleep). Among the majority of children, the other eight domains remained mostly stable. Three quarters of parents reported a globally positive effect of adapted physical activities on their child. These findings support the further development and provision of adaptive sports for children with severe neurological impairments.