Health questionnaire on back care knowledge and spine disease prevention for 6–10 years old children: development and psychometric evaluation

Background Back school programs, that improve back care and spine disease prevention knowledge are recommended at the age of 4-14 years. There is Health Questionnaire on Back Care Knowledge in the literature for children aged 14-17 years. At other ages, there is no questionnaire examining this knowledge. We aimed to develop a Health Questionnaire on Back Care and Spine Disease Prevention Knowledge for 6-10 years old children and validate its psychometric properties (internal consistency, test-retest reliability, agreement, convergent validity, discriminant validity) in 6-10 years old children, who attended back school program or not. Methods 463 children took part in the research (6-10 years old). The development was performed according to the Delphi method. The final version contained 7 questions. 463 participants completed the questionnaire twice with an interval of 7 days to evaluate test-retest reliability. The internal consistency was tested by Cronbach’s alpha value, test–retest reliability was calculated by Intraclass Correlation Coefficients (ICC), Standard Error of Measurement (SEM) and 95% of Minimal Detectable Change (MDC95) and Bland–Altman plots. Convergent validity was tested against the age variable and discriminant validity was tested by Kruskal-Wallis tests among the different subgroups. Results Cronbach’s alpha of the total score was (α=0.797), showed a strong internal consistency with minimal SEM (0.606) and MDC95 (1.680). The test-retest result for the total score was strong (0.989), for the questions showed moderate to strong results (0.742-0.975), the limits of agreement of the Bland-Altman plot showed a narrow error of measurement range (-3.49-1.29), and the value of mean differences was −1.10 (SD ± 1.22). The convergent validity showed a weak, but significant relationship between total score and age (R=0.171; p < 0.001). The discriminant validity showed significantly different mean scores in non-back school and back school groups. Conclusion For the examination of back care and spine disease prevention knowledge of 6-10 years old children, the questionnaire proved to be a valid and reliable tool. The knowledge requested in the questionnaire covers the knowledge material of the theoretical part of the back school for children aged 4-10 years.

Back School Program: Development of Back Care Knowledge and Spine Disease Prevention and Trunk State Among 6-7-Year-Old Children

ABSTRACT. Introduction: The prevalence of posture deformities and muscle weakness among primary school children is high (50-65%). Objective: To assess and improve the back care knowledge and spine disease prevention, the strength of the trunk muscles, the flexibility of the lower limb muscles, the posture, and the lumbar motor control ability of primary school children by a 1-school year back school program. Methods: 102 (mean age: 6.549±0.500 years) children were examined at the baseline, and 48 (23 boys, 25 girls) were chosen for the program. Back care knowledge was examined by validated questionnaire, trunk muscle strength, and muscle flexibility by Lehmann tests, posture by New York Posture Rating Chart, and lumbar motor control by Sitting Forward Lean Test. Results: The complete back care knowledge (2.423±3.911, 19.115±2.833 points; p<0.001), trunk flexor (3.615±7.910, 56.885±113.748 sec; p<0.001), trunk extensor (8.962±5.963, 77.000±139.801 sec; p<0.001) static muscle strength, lower limb flexibility (p<0.001), habitual posture (53.846±10.130, 81.154±9.829 points; p<0.001), posture deemed correct 40.962±16.311, 91.346±6.566 points; p<0.001) and lumbar motor control (8.269±5.474, 0.154±0.368 mm; p<0.001) significantly improved in the intervention group for the end of the program. Conclusions: The back school program improves the back care knowledge and the trunk state among 6-7 years old children.

Knowledge and Practices of Back Care, Experience in Colombian Children

Early back care has become the preventive strategy to mitigate bad postural habits and musculoskeletal alterations that trigger inadequate postural patterns in the body schema. The objective was to determine the knowledge and practice of back care in first-grade school children after applying an educational intervention for back care. Quasi-experimental study with pre-test and post-tests in a sample of 71 first grade school students. Knowledge and practices for back care were evaluated before and after of the intervention. During 5 weeks, a program of education for back care was developed in the intervention group, formed by concepts about anatomy, physiology, alterations of the spine, adoption of appropriate postures and movements in school life and the execution of adequate movements learned. Simultaneously, physical exercises based on aerobic work, strengthening and stretching the back muscles were carried out with the children in the control group. A linear regression model and a two-level hierarchical model were applied to estimate the effect of the intervention. After the execution of the back care education program, a better score was found in the knowledge and practice questionnaire, which was different between the intervention group and the control group (1.72 95% CI 1.21-2.24). The development of an education program generated a change in the score of the questionnaire on knowledge of back care in the intervnetion group, which suggests the implementation of these strategies in the school context during early childhood, contributing to the prevention of back disorders and deficiencies

Back-Health-Related Physical Activity and Exercise Knowledge in Adolescents

The aim of this study was to analyze the level of specific back-health-related physical activity and exercise knowledge. This is a cross-sectional study. A representative sample of 1500 students were recruited with a confidence level of 95% and an accepted standard error of &plusmn;2.53%. Individuals were aged between 13 and 18 years old (mean age= 15.18; SD = &plusmn;1.446). Self-reported questionnaires were used to record back-health-related physical activity and exercise knowledge concerning back care in adolescents. The level of specific knowledge of back health education related to physical activity and exercise in adolescents was low (X = 2.05, SD = &plusmn;2.264). Only 10.9% of the students passed the specific knowledge test, achieving a grade equal or superior to 5. The boys average score was higher (X = 2.17, SD = &plusmn;2.312) than the girls (X = 1.94, SD = &plusmn;2.212) with statistically significant differences (p = .048). The level of specific knowledge increased with age (F = 11.531; p &amp;lt; .001). High school students have a low level of specific knowledge. Physical Education teachers should apply the conceptual content properly. Knowledge is the first step towards changing behavioral habits. Back care education in the school curriculum is recommended.

The association between back pain, individual determinants, and posture habits among schoolchildren in Iran

Back pain is considered as a public health problem and it may be predictive of adult disability, and is on the rise among the schoolchildren population. The aim of this study was to explore the association between back pain, posture habits and individual factors (knowledge, self-efficacy, beliefs, and behavior) among schoolchildren. A self-reported questionnaire was used to collect the demographics characteristics, individual factors, posture habits, and back pain. Chi-square test and binary logistic regression analyses were used to examine the association between variables. Among 610 pupils, the prevalence of back pain was 23.6% (n = 144). There were 530 (86.9%) pupils that indicated that they had carried the school backpack of ideal posture. There were significant relationships between the sitting at work on the computer (p = 0.006, OR = 1.66, 95% CI = 1.11-2.49) and on a chair (p = 0.021, OR = 1.61, 95% CI = 1.01 - 2.57) habits with back pain respectively. Self-efficacy significantly associated with back pain (p = 0.001). Similarly, individual factors significantly associated with posture habits. The findings suggest that back care educational programmes are needed to address individual factors in order to promote proper posture habits and reduce backache.