Back School Research Articles

Health questionnaire on back care knowledge and spine disease prevention for 6\u201310\u2009years old children: development and psychometric evaluation

BackgroundBack 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.ResultsCronbach’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.ConclusionFor 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&lt;0.001), trunk flexor (3.615±7.910, 56.885±113.748 sec; p&lt;0.001), trunk extensor (8.962±5.963, 77.000±139.801 sec; p&lt;0.001) static muscle strength, lower limb flexibility (p&lt;0.001), habitual posture (53.846±10.130, 81.154±9.829 points; p&lt;0.001), posture deemed correct 40.962±16.311, 91.346±6.566 points; p&lt;0.001) and lumbar motor control (8.269±5.474, 0.154±0.368 mm; p&lt;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.

Teilnahmebereitschaft für Maßnahmen der Sekundärprävention. Einflussfaktoren am Beispiel des BGW-Rückenkollegs

Willingness to participate in prevention programmes. Key factors based on the example of the BGW back school Objectives: Employees in nursing professions run a high risk of back-related disorders. The German Social Accident Insurance Institution for the health and welfare services (Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege – BGW) has developed a multi-stage programme of secondary individual prevention (SIP) with a back clinic, back school and refresher course in order to counteract the cause of occupational diseases of the lumbar spine. The aim of the study was to identify what factors influence the willingness to participate in these programmes. Methods: The study is based on data from 1011 participants who attended the back clinic at the Hamburg regional office of the BGW between 2012 and 2019. They were collected by means of a standardised questionnaire and an orthopaedic examination. The evaluation was based on a t-test for independent samples and the Levene test, which was used to verify the homogeneity of variance. Results: It was found that increasing age and a higher number of years in the job results in a significant increase of willingness to participate. At the same time, a higher level of BMI and the number of non-back disorders both have a significant inhibitory impact on participation. Conclusions: The use of preventive programmes will increase in terms of relevance. General state of health is a key factor in whether or not programmes are used by potential participants. Finally, the overall objective should be to develop solutions that encourage the willingness to participate even in the early stages of working life. Keywords: lumbar spine – prevention – back clinic – back school

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.

Cost-effectiveness analysis of chronic mechanical back pain treatment modalities.

Objectives This study aims to evaluate and compare the cost-effectiveness of inpatient physical therapy, outpatient physical therapy applications, and back school education in low back pain (LBP) treatment. Patients and methods Between March 2011 and September 2011, a total of 105 patients (43 males, 62 females; mean age 44.8±12.7 years; range, 27 to 58 years) who were treated for chronic LBP were included in this prospective study. Of the patients, 34 received inpatient physical therapy consisting of electrotherapy, superficial-deep heat application, and basic back exercise program, 35 received the same treatment in the outpatient setting, and 36 received back school education. Each patient was evaluated five times during the study using pain intensity Visual Analog Scale (VAS), spinal mobility measurements (inclinometer), general evaluation (VAS), functional disability measurement (Roland-Morris Disability Questionnaire [RMDQ]), and quality of life (Short Form-36 [SF-36]). All expenses and costs for treatment of LBP were estimated. Results At the end of six months of follow-up, all study groups had a statistically significant improvement in all variables. Improvements in spinal mobility, RMDQ, and SF-36 scores were significantly higher in the inpatient physical therapy group (p<0.001). Direct and total costs were the highest in the inpatient treatment group and were the lowest in the back school education group (p<0.001). No statistically significant differences were observed in terms of additional cost of one-unit improvement in these variables among the study groups. Conclusion Our study results suggest that all three treatment modalities are effective in chronic LBP. In patients with LBP-related impairment in functional status and quality of life, inpatient physical therapy and rehabilitation should be preferred.

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.

Effectiveness of the Back School Program in Employees Suffering from Low Back Pain

Effectiveness of the Back School Program in Employees Suffering from Low Back Pain

Effectiveness of a Back School and Postural Education Program on the improvement of literacy about postures and low back pain in adolescents: A 1-year follow-up study

BackgroundSome health problems can be associated with the school environment and lifestyles, so it is necessary to carry out intervention actions that promote health and problem prevention. This study evaluates the effects of a Back School and Postural Education on improving short-term and long-term ergonomic knowledge of postures adopted at school and home, as well as reducing low back pain (LBP) in adolescents. MethodsThe sample comprises 98 students, aged 10–16 years (11.61 ± 1.28 years), with 63 (64.3%) girls. The measuring instruments included a theoretical and a practical test, a low back pain (LBP) questionnaire and a scale. The tests and the scale have been applied 1 week before the intervention, 1 week following the Back School and Postural Education Program, and a 1 year later. The questionnaire was applied 1 week before of intervention and after 1 year. The intervention included three sessions of a theoretical and practical nature, each lasting 45 min, with intervals of 1 week. ResultsThe values of the theoretical test before the intervention, 1 week, and 1 year after the intervention were, respectively, 8.67 ± 2.64, 11.37 ± 1.93, and 11.11 ± 1.92 (p ≤ 0.001), and the practical test were 6.42 ± 2.47, 12.48 ± 2.25, and 12.83 ± 1.78 (p ≤ 0.001). The presence of LBP fell by 42.9%–25.5% after the 1-year period. ConclusionsOur data show an improvement of ergonomic knowledge of postures adopted at school and home as a result of the education program and a decrease of self-reported LBP.

Spinal Injection Techniques, 2nd ed

With 20.4% of the US population suffering from chronic pain, Theodoridis and Kraemer’s, second edition, text aims to address the most sizable subset of these patients, those with spine-related complaints.1,2 The techniques described serve as a bridge between conservative and surgical therapies and are especially well suited for aging populations, the subgroup most likely to suffer these pain diagnoses. The editor’s goal was to create a text that simplifies the challenging day-to-day work of caring for back pain patients in the form of a prescriptive cookbook, but in many ways, they go beyond that objective, and it is appreciated. The book contains 2 sections: part 1 describes an overview of pain with requisite definitions, descriptions of pain pathways, physical examination techniques, and a description of imaging modalities. The attention to chronification and central sensitization is an insightful inclusion often overlooked. The choice to weave this concept through the introductory chapters with descriptive examples represents recognition of a contemporary understanding of chronic pain as a syndrome. The section dedicated to “Back School,” including mention of behavioral therapy, is similarly refreshing; including a simplified prescriptive approach not only serves as an introduction to the concept but also facilitates immediate clinical translation. Balance seems absent elsewhere, with 10 pages of the pharmacotherapy chapter dedicated to orthokine therapy, while only 1 paragraph highlights anticonvulsants, despite their position as one of the most prescribed pharmacotherapeutics, with use exceeding that of aspirin or acetaminophen.3 The bulk of the textbook is contained within part II, the Atlas, which opens with many of the useful anatomic diagrams needed in a reference text. Without exception, the photographs are crisp and illustrative, though it was painful to see some of the injections performed without the use of gloves. Careful attention was paid to the anatomic dissections, which are presented sequentially and often accompanied by cross-sectional cuts of the same target. Photographic overlays are demonstrative of the learning points, without too many extraneous labels to prove bothersome. The entire book contains more than 500 photographs, though dedicating images to placement of skin dressings could have been omitted. Missing was the universal use of procedural image guidance, including the absence of higher risk injections. While the thin patient pictured undergoing the landmark-guided cervical facet injection may have done so without incident, her surface anatomy is unlikely to represent the body habitus of the majority of patients undergoing interventional procedures. Here, there are concerns in the text as well; an intraarticular joint injection in the cervical spine would certainly be unable to accommodate the 2 mL of the injectate recommended. The transforaminal epidural injection, a procedure performed over 1 million times per year in US Medicare beneficiaries, was conspicuously absent.4 Instead, the technique of an “epi-peri or epidural perineural injection” is included. If you are unfamiliar, this involves spearing the dura, the nerve root, or both to deliver injectate into the anterior epidural space. At least there was mention that patients would feel intraprocedural “lightning-like” pain into the leg, and that “every further manipulation of the needle and injection of fluid [would] cause the patient more pain.” I would suggest that the transforaminal approach would most often be a better option. We appreciate the mention that the use of particulate steroid is off-label, but greater emphasis is needed to show how many of the approaches are divergent from 13 multisociety recommendations for safety (absent injection of contrast, no extension tubing, and missing face masks).5 The editor states that he encourages practitioners to comprehensively explore performing spinal techniques without the use of image guidance, but the advantages of this practice philosophy are not elaborated upon sufficiently enough to consider abandoning it. While the editors’ stated goal was for the book to serve as an injection technique “cookbook,” we applaud them for going above the call and including more than just the recipes. We concur that there lies significant value in diagnostic procedures that contribute to understanding pain generators of back pain, though in the absence of image guidance, specificity is eroded.6 Perhaps this text fills a gap for the developing world where a lack of intraprocedural imaging guidance would entirely preclude interventional care, making landmark-based techniques imperative. While not exclusively focused on spine intervention techniques, other texts include fluoroscopic or ultrasound imaging with overlapping subject matter.7–9 Overall, the reader will certainly grow their fund of knowledge from having read the text, and we would just recommend it be considered alongside supplemental learning material from other references that include intraprocedural imaging as well. Robert B. Bolash, MDDepartments of Pain Management and Evidence Based Pain ResearchCleveland ClinicCleveland, Ohio[email protected]Victor Foorsov, MDDepartment of Orthopaedic Surgery/Regional Medical GroupNorthwestern MedicineWarrenville, Illinois

The Swedish Back School in Chronic Low Back Pain. Part II. Factors Predicting the Outcome

The aim of the study was to analyse the factors predicting the outcome of the Swedish back school and spontaneous recovery in chronic low back pain. The predicting variables describing the treatment group (n = 95) and the control group (n = 93) at the initiation of study included sociodemographic factors, variables related to work, severity of low back pain, and a number of clinical measurements and evaluations. The Oswestry Low Back Pain Disability Questionnaire was used for judging recovery factors. It was found that the best predictor for the outcome of the treatment and for spontaneous recovery was work satisfaction.

Assessment the Risk Factors and Incidence of Low Back Pain among Higher Secondary Students in Selected School at Kanchipuram Dist Tamil Nadu India

Cross sectional research design study was conducted to “Assessment of the risk factor and incidenceof low back pain among higher secondary students selected school at Kanchipuram District, TamilNadu, India”. The objectives of the study were to assess the demographic variables with the risk factorsof low back pain. To assess the incidence of low back pain among higher secondary school students. Toassociate the risk factors and incidence of low back pain among higher secondary school students withelected demographic variables. Convenient sampling technique was followed and 102 higher secondarystudents selected school who met inclusion criteria were in the higher secondary school students participatefrom the class 11th to 12th. Students who are available in data collection student who can read and understandTamil/English.The collected data were formulated and analysed by using cross sectional research design and inferentialstatistics. Result shows, that Maximum no of low back pain in secondary school students were in the agegroup of 59(84%), among sex of male participated were 53(52%) are low back pain secondary school studentmajority of playing participation in the games was “Yes” 96(94%),majority of low back pain for secondaryschool students hobbies like sports 62(61%), among the this students maximum height are 55(54%) andmaximum weight of the students 58(57%), the majority of students BMI 58(57%), are low back pain insecondary school students bag weight of 79(77%).There is significant association of assessment of the risk factor and incidence of low back pain among highersecondary school students with demographic variables like participation in the games, bag weight. But thereis no significant of assessment of the risk factor and incidence of low back pain among higher secondaryschool students.

Functional Evaluation Using Inertial Measurement of Back School Therapy in Lower Back Pain.

Lower back pain is an extremely common health problem and globally causes more disability than any other condition. Among other rehabilitation approaches, back schools are interventions comprising both an educational component and exercises. Normally, the main outcome evaluated is pain reduction. The aim of this study was to evaluate not only the efficacy of back school therapy in reducing pain, but also the functional improvement. Patients with lower back pain were clinically and functionally evaluated; in particular, the timed “up and go” test with inertial movement sensor was studied before and after back school therapy. Forty-four patients completed the program, and the results showed not only a reduction of pain, but also an improvement in several parameters of the timed up and go test, especially in temporal parameters (namely duration and velocity). The application of the inertial sensor measurement in evaluating functional aspects seems to be useful and promising in assessing the aspects that are not strictly correlated to the specific pathology, as well as in rehabilitation management.

Are Back Schools beneficial for patients with chronic non-specific low back pain? - A Cochrane Review summary with commentary

Are Back Schools beneficial for patients with chronic non-specific low back pain? - A Cochrane Review summary with commentary

EFFECTIVENESS OF BACK SCHOOL EXERCISE VERSUS YOGASANA AMONG SCHOOL TEACHERS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL.

10Jul 2019 EFFECTIVENESS OF BACK SCHOOL EXERCISE VERSUS YOGASANA AMONG SCHOOL TEACHERS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL. Swati S. Dhrangu and Amit Sharma. MPT in Musculoskeletal condition and sports science, Assistant professor, School of Physiotherapy, R.K. University, Rajkot, Gujarat, India. MPT in Musculoskeletal condition and sports science, Associate professor, School of Physiotherapy, R.K. University, Rajkot, Gujarat, India.

Back pain and school bag weight - a study on Indian children and review of literature.

Back pain in children is a complex phenomenon, which has been shown to be associated with physical and psychosocial factors. None of the studies on Indian children have investigated the possible association between back pain and psychosocial factors. We decided to determine the prevalence of back pain in students and association with both physical and psychosocial factors. A cross-sectional study was conducted on 163 students from two city schools. Physical factors were evaluated using a structured questionnaire. Strengths and difficulties questionnaire was used to assess psychosocial factors. The studied sample consisted of 49.7% boys and 50.3% girls. Mean school bag weight was 6.1±2.4 kg (range: 2.2-15.6 kg). Mean weight of school bag as a percentage of body weight was 13.5±6.2%. Approximately 76% students carried more than 10% of their body weight. The prevalence of back pain (over last 1 month) was 53.9%. No associations were found between back pain and weight of school bag, weight of school bag as a percentage of body weight and physical activities. Significant associations were found between back pain and number of hours spent watching television [odds ratio (OR): 3.3, 95% confidence interval (CI): 1.5-7.5; P=0.003], history of injury to the back (OR: 4.8, 95% CI: 1.47-15.8, P=0.003), presence of a family member complaining of back pain (OR: 1.98, 95% CI: 1.25-3.14, P=0.002), conduct (P=0.042) and hyperactivity problems (P=0.045). Thus, there appears a need to consider psychosocial factors along with physical factors when evaluating a young student with back pain.

Chronic nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP)

Examination of a patient with chronic low back pain (LBP) is aimed at eliminating its specific cause and assessing the social and psychological factors of chronic pain. The diagnosis of chronic nonspecific (musculoskeletal) LBP is based on the exclusion of a specific cause of pain, discogenic radiculopathy, and lumbar stenosis. It is advisable to identify possible pain sources: pathology of intervertebral disc pathology, facet joints, and sacroiliac joint and myofascial syndrome.An integrated multidisciplinary approach (a high level of evidence), including therapeutic exercises, physical activity optimization, psychological treatments (cognitive behavioral therapy), an educational program (back pain school for patients), and manual therapy, is effective in treating chronic musculoskeletal LBP. For pain relief, one may use nonsteroidal anti-inflammatory drugs in minimally effective doses and in a short cycle, muscle relaxants, and a capsaicin patch, and, if there is depressive disorder, antidepressants (a medium level of evidence). Radiofrequency denervation or therapeutic blockages with anesthetics and glucocorticoids (damage to the facet joints, sacroiliac joint), back massage, and acupuncture (a low level of evidence) may be used in some patients.Therapeutic exercises and an educational program (the prevention of excessive loads and prolonged static and uncomfortable postures and the use of correct methods for lifting weights, etc.) are recommended for preventive purposes.

Psychological methods in the treatment of chronic nonspecific low back pain

Among the adult population, every two persons have experienced at least an episode of back pain during their lifetime. Nonspecific (musculoskeletal) low back pain (LBP) becomes chronic in 3–10% of people. These cases require combined interdisciplinary treatment, including optimal pharmacotherapy, rational physical activity, therapeutic exercises, psychological methods, an educational program (back pain school for patients); some cases need manual therapy, massage. Psychological methods assist patients to cope with pain catastrophizing, to increase daily activity, and to reduce the likelihood of disease recurrence. The results of clinical trials and systematic reviews demonstrate that cognitive behavioral therapy and mindfulness therapy (mindfulness-based stress reduction) are effective in treating chronic LBP. The paper describes a clinical case: an example of effective treatment of a female patient with chronic nonspecific LBP, by applying an integral interdisciplinary approach.

Effectiveness of the back school program on the low back pain and functional disability of Iranian nurse.

Low back pain (LBP) as a recurrent and costly health problem and one of the leading causes of disability, is common in nurses. It can have adverse effects on the quality of life of nurses and quality of care of patients. The aim of the study was to evaluate the effectiveness of Back School program on the LBP and functional disability of Iranian nurses. A quasi-experimental methodological design was utilized for this study. Participants were nurses with back pain who participated in the Back School program workshop and completed a self-report visual analogue scales and Roland–Morris Disability questionnaire that measuring LBP and functional disability. Data were analyzed descriptively and comparisons in LBP and functional disability made between groups with t-test for pre-intervention and analysis of covariance for after intervention. Sixty-four participants (16 males, 48 females) completed this survey. The study participants’ mean age was 38.9 ± 8.1 years in intervention group and 38.1 ± 8.2 in control group. There were no significant differences in terms of pain (P = 0.575) and disability scores (P = 0.844) before intervention. Although, the intervention led to a decrease in the functional ability and LBP scores of the nurses (P<0.001) in the intervention group compared with that in the control group. Overall, Back School program as an educational strategy can reduce the LBP and functional disability in nurses. This program can be suitable for preventing of pain and functional disability among nurses working in hospital settings.

Psychological Factors associated with chronic low back pain in community-dwelling elderly women who participated in back school

Psychological Factors associated with chronic low back pain in community-dwelling elderly women who participated in back school

Effect of adding lay-tutors to the educational part of a back school programme for patients with subacute, non-specific low back pain: A randomized controlled clinical trial with a two-year follow-up.

To evaluate the effect of adding a lay-tutor to the educational sessions of a back school programme for patients with subacute low back pain. Patients with subacute low back pain were randomized to a 10-week programme comprising 10 h education and 20 h physical exercise led by a former patient as lay-tutor, or a programme led by a physiotherapist. In the intervention group, former patients served as lay-tutors in the educational sessions, teaching in conjunction with physiotherapists. In the control group, 2 physiotherapists led the entire educational programme. Disability, back pain, leg pain and health status were evaluated blindly at 3 and 24 months. Eighty-seven patients with subacute low back pain referred for treatment at 6 selected physiotherapy clinics were allocated to either an intervention group (n = 42) or a control group (n = 45). No statistically significant difference was found between the 2 groups. Both groups of patients showed a statistically significant improvement in health and pain measurements from the start of the study to the 3- and 24-month follow-up. No short- or long-term effect was found of adding a lay-tutor to the educational sessions of a back school programme for patients with subacute low back pain with regards to functional activity, back pain, leg pain or general health. The main limitations are that the potential effect of including lay-tutors in the educational part of a back school programme as an intervention in itself has to be tested, and the programme has to be tested as a complete protocol. Also, no specific testing has been performed to confirm the ideal number of sessions in the programme.