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Risk Factors for Low Back Pain in Childhood and Adolescence. A Systematic Review

Calvo-Muñoz Inmaculada PT PhD; Kovacs, Francisco M. MD, PhD; Roqué, Marta BSc; Gago Fernández, Inés PT; Seco Calvo, Jesús MD, PT,PhD
The Clinical Journal of Pain: Post Acceptance: September 14, 2017
doi: 10.1097/AJP.0000000000000558
Review Article: PDF Only

Objectives:

To identify factors associated with low back pain (LBP) in children and adolescents.

Methods:

A systematic review was conducted (Prospero CRD42016038186). Observational studies analyzing LBP risk factors among subjects aged between 9 and 16 were searched for in 13 electronic databases and 8 specialized journals until March 31st, 2016, with no language restrictions. Additionally, references in the identified studies were manually tracked. All identified studies which included ≥50 subjects aged 9 to 16, were reviewed. Their methodological quality was assessed by two reviewers separately, using validated tools which scored, from worst to best, 0-100 for cross-sectional and 0-12 for cohort studies. A sensitivity analysis only included studies which had adjusted for confounders, ≥500 subjects and a methodological score of ≥50%.

Results:

5142 citations were screened and 61 studies, including 137,877 subjects from 5 continents, were reviewed. Their mean (range) methodological scores were 74.56 (50-100) for cross-sectional studies, and 7.36 (5-9) for cohort ones. Studies had assessed 35 demographic, clinical, biological, family, psychological, ergonomic and lifestyle risk factors. Mean (range) prevalence of LBP ranged between 15.25% (3.20,57.00) for point prevalence, and 38.98% (11.60, 85.56) for lifetime prevalence. Results on the association between LBP and risk factors were inconsistent. In the sensitivity analysis, “older age” and “participation in competitive sports” showed a consistent association with LBP.

Discussion:

Future studies should focus on muscle characteristics, the relationship between body and backpack weights, duration of carry, characteristics of sport practice, and factors associated with chronic pain.

Source of Funding: This study was funded by the Spanish Back Pain Research Network, a non-profit private organization specializing in medical research on neck and back pain, with no links to the health industry.

Conflicts of Interest: The authors do not have any conflicts of interest to report.

Reprints: Francisco M. Kovacs, MD, PhD, Unidad de la Espalda Kovacs. Hospital Universitario Moncloa. Avda. Valladolid Nº 83. 28008 Madrid. Spain (e-mail: fmkovacs@kovacs.org).

Received February 13, 2017

Accepted August 29, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.