Can motor development at age seven predict spinal pain at age eleven?

Abstract

Introduction The combination of three arguments has led us to hypothesize that improvement of early motor skills might have potential for prevention of spinal pain: –a large body of experimental and clinical research implicates disordered motor control, or core stability, in adults with low back pain; –there is evidence that spinal pain originates in childhood or adolescence; –motor development deficits observed in childhood have been shown to track into adolescence. This study is a first step in this line of inquiry and aims to investigate the relationship between motor skills and coordination at age seven and spinal pain at age eleven. Methods The mothers of 43,000 seven-year-old children answered the Developmental Coordination Disorder Questionnaire (DCDQ), which has three subscales: ‘control during movement’, ‘fine motor skills’ and ‘general coordination’. At age eleven, 30,000 of these children answered a questionnaire (YSQ) about frequency and intensity of cervical, thoracic and lumbar pain. Pain was described as either ‘pain’ or ‘severe pain’, both with a frequency of ‘sometimes’ or ‘often’. ‘Pain’ required an intensity of ≥ 2 on the FacesPainScale-Revised (FPS-R) (equivalent to ≥ 3 on an 11-point scale) and ‘severe pain’ ≥ 3 on the FPS-R (equivalent to ≥ 5 on an 11-point scale). Associations were explored by logistic regression analyses and all estimates were adjusted for sex, mother's schooling, height, and weight at age 7. Results The total DCDQ score was significantly associated with spinal pain (OR: 1.29; 95% CI: 1.10–1.50). This association was driven by associations with cervical and thoracic pain; there was no association with lumbar pain detected. The general coordination subscale score was the strongest predictor of pain. Compared to the children in the top 10%, those in the bottom 10% had higher odds of cervical (OR: 1.42, 95% CI: 1.18–1.69), and thoracic pain (OR: 1.51; 95% CI: 1.18–1.92). The results were almost identical for severe pain. Conclusions Other health-related aspects or psychological factors are not included in these analyses and their influence on the shown associations is unknown. Future research should explore the relationship between motor skills, health and psychological measures to optimize strategies for improving spinal health. In the prevention of spinal pain, motor- and coordination skills may be a possible risk indicator and a potential target for intervention.