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The Risk Factors of Low Back Pain in Female High School Students

Noormohammadpour, Pardis, MD∗,†; Borghei, Alireza, MD; Mirzaei, Shadi, MD; Mansournia, Mohammad Ali, MD, PhD; Ghayour-Najafabadi, Mahboubeh, PhD∗,§; Kordi, Mahla, Msc; Kordi, Ramin, MD, PhD∗,†

doi: 10.1097/BRS.0000000000002837

Study Design. A prospective cross-sectional study.

Objective. The aim of this study was to evaluate the prevalence and associated factors with low back pain (LBP) in female adolescents of high school age.

Summary of Background Data. The prevalence of LBP in Tehran is high, and the majority of previous studies on LBP in adolescent and its risk factors have been performed in the developed countries. Therefore, identification of risk factors and planning appropriate protocols for prevention of LBP in adolescents may substantially decrease the prevalence of LBP and its burden in developing countries in future.

Methods. In a prospective cross-sectional study, demographic characteristics, including age, body mass index (BMI), weight and mode of using backpack, family history of LBP in first degree relatives, and passive smoking status of the participants along with a history of LBP were recorded. Joint hypermobility was assessed using Beighton scale. Also, anthropometric measurements, spinal flexion, and hip joint range of motion were measured for each participant.

Results. In total, 372 students participated in the study. The mean (SD) age of the participants was 15.8 (0.9) years. The lifetime, more than 3 months, and last month history of LBP was 46.2%, 11.6%, and 31.2%, respectively. Positive history of LBP in the first-degree relatives was significantly associated with LBP in the participants (P < 0.01). The prevalence of passive smoking was significantly higher in the participants with last month history of LBP (P = 0.03). The prevalence of joint hypermobility was 15.9% and was significantly higher in those with the lifetime and last month history of LBP (P < 0.01).

Conclusion. LBP is a common complaint among adolescent and high school girl students. The results of this study identified the prevalence and associated factors with LBP in high school students and will help develop strategies for prevention and treatment of LBP in the adolescent population.

Level of Evidence: 3

The study's results showed that age, sports training hours per week, being passive smoker, positive history of low back pain in first-degree relatives, joint hypermobility, spinal flexibility, and hip joint flexibility were factors associated with low back pain in a sample of female students at high schools in a developing country.

Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

Department of Sports and Exercise Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

§Department of Motor Behaviour, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.

Address correspondence and reprint requests to Ramin Kordi, MD, PhD, Associate Professor of Sports and Exercise Medicine, Tehran University of Medical Sciences, Sports Medicine Research Center No 7, Al-e Ahmad St., Tehran 14117-34143, Iran; E-mail:

Received 6 April, 2018

Revised 19 July, 2018

Accepted 30 July, 2018

The manuscript submitted does not contain information about medical device(s)/drug(s).

Tehran University of Medical Sciences & health Services grant (90-01-30-13242) funds were received in support of this work.

No relevant financial activities outside the submitted work.

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