Prevention of Low Back Pain in Adults with a Back School-Based Intervention

Background: Low back pain is highly prevalent and has a major socio-economic impact worldwide. Among the rehabilitation options is the Back School, which consists of programmes that include exercise and educational interventions to treat and prevent back pain. The effects of this type of programme are usually evaluated in patients with low back pain. The aim of this study was to evaluate the effects on low back functionality and the prevention of medical visits due to low back pain during one year of follow-up in a healthy adult population. Methods: A quasi-experimental study was conducted with 56 healthy participants who were divided into an experimental group (n = 30), who underwent the programme consisting of a total of 16 sessions, and a control group (n = 26), who did not undergo the intervention. All participants were administered the Partial Curl-up Test, Biering Sorense Test, Modified Schöber Test, and Toe Touch Test, and they completed the Short Form 36 Health Survey before and after the intervention. In addition, a telephone call was made to ask whether they attended a doctor for low back pain in the following year post-intervention. Results: In the experimental group, statistically significant improvements were observed in trunk muscle strength, spinal flexion joint range of motion, and hamstring flexibility, and they had fewer visits to the doctor for low back pain in the following year. Conclusions: The theoretical–practical programme based on the Back School seems to have beneficial effects on low back functionality by increasing its strength and flexibility in an adult population. In addition, this programme reduced the number of medical visits due to low back pain during the following year after the intervention.

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.

Back School Postural Education Program: Comparison of Two Types of Interventions in Improving Ergonomic Knowledge about Postures and Reducing Low Back Pain in Adolescents

This study aimed to compare the impact of two Back School Postural Education Programs on improving ergonomic knowledge of postures adopted at school and home, as well as on reducing low back pain (LPB) in adolescents. The sample was constituted by 153 students, aged 10–16 years, with 96 (62.7%) girls, divided into 2 intervention groups (GA, GB). Two tests (theoretical and practical) and LBP questionnaire were applied 1 week before and 1 year after the end of the program. In GA, three sessions were performed for each class separately, on theoretical and practical issues, lasting 45 min and at intervals of 1 week, and in GB, only one theoretical session (90 min) was given to all students. Statistically differences on GA were obtained between the values 1 week before and after 1 year of evaluation in both theoretical and practical tests (p ≤ 0.001). In GB, only the values of the practical test present a statistical difference (p ≤ 0.001). GA obtained higher values on both tests after 1 year of follow-up compared with GB (p ≤ 0.001). The number of students with LBP decreased on GA (p ≤ 0.001). The program with longer duration, higher weekly frequency, and more practical and individualized character promotes better effects.

Effectiveness of The Back School and The Pilates Method in Disability and Pain of Patients With Chronic Non-Specific Low Back Pain. Randomized Controlled Clinical Trial.

Objective: The purpose was to compare the effectiveness of the Pilates Method versus the Back School in specialized care, assessing improving the disability with the Roland Morris questionnaire and the perceived pain with the visual analog scale (VAS) in people with non-specific chronic low back pain. Method: Single-blind randomized controlled trial to determine the effects of the Pilates Method for patients with low back pain compared to Back School exercises, two groups of 48 patients, 3-month treatment period. Results: The Pilates Group (GP) recorded significant improvements in all of the variables that were the subject for this research, compared to those provided by the Back School Group (GEE). In the Roland Morris questionnaire of 0,41 points [GP (Mean difference [MD] Pretreatment-posttreatment =2,08; 95% confidence interval [CI] = 1,21 to 2,95; p=0,001) vs GEE ( MD=1,66; 95% confidence interval [CI] = 0,90 to 2,43; p=0,001 )]. In the visual analog scale (VAS) of 0,40 points [ GP (Mean difference [MD] Pretreatment-posttreatment =1,82; 95% confidence interval [CI] = 1,24 to 2,40; p=0,001 ) vs GEE (MD=1,42; 95% confidence interval [CI] = 0,82 to 2,04; p=0,001)]. Conclusions: The treatment of nonspecific low back pain with therapeutic Pilates is more effective than the therapeutic treatment of the Back School, both in terms of functional disability and intensity of pain. Trial registration : This trial is registered in http://www.ensaiosclinicos.gov.br/rg/RBR-5nk2tr/ , with the ID number of RBR-5nk2tr

Interactive Low Back Pain Intervention Module Based on the Back School Program: A Cluster-Randomized Experimental Study Evaluating Its Effectiveness among Nurses in Public Hospitals

The prevalence of low back pain (LBP) among nurses is high. The main aim of this study was to evaluate the effectiveness of an interactive LBP module based on the Back School Program in improving Oswestry Disability Scores (ODSs) among nurses in government hospitals in Penang, Malaysia. A cluster-randomized experimental study was conducted within four public hospitals. These hospitals were randomized to intervention and control groups. A total of 284 nurses from the selected hospitals were randomly selected (142 in each group). An interactive LBP intervention module based on the Back School Program was designed and prescribed. Both the intervention and control groups were assessed using the Oswestry Disability Questionnaire at baseline and at the end of the third and sixth weeks. Out of 284 participants, 281 completed this study. A between-group comparison revealed that ODSs were significantly lower in the intervention group than in the control group at the ends of the third (p = 0.006) and sixth weeks (p < 0.001). Within-group changes revealed a significant reduction in ODSs within the intervention group from baseline to the third (p < 0.001) and sixth weeks (p < 0.001) of the intervention. This simple interactive LBP module was effective in reducing symptoms of LBP among nurses as early as three weeks, and this effect was sustained until the sixth week of the intervention.