Risk Factors For Low Back Pain Research Articles

Effects of fear-avoidance beliefs on low back pain in Japanese nurses

Background: Low back pain (LBP) is a common health problem. Fear-avoidance beliefs were recently reported to be an important risk factor for chronic LBP. According to previous studies, >80% of the nurses in Japan have LBP, and this number is increasing. In spite of fear-avoidance beliefs being considered an important risk factor, their impact on LBP in nurses has not been studied in Japan.

Low back pain among Italian rowers: A cross-sectional survey.

Low Back Pain is commonly reported to be a very frequent disorder in rowing, but it is still unclear if its prevalence is higher than in other sports or even in a non-athletes group. To determine prevalence of low back pain (LBP) with and without irradiated pain and possibly related risk factors in a group of elite Italian rowers. The study was conducted during the 2010 Italian Indoor Rowing Championship held in Bari from 30th to 31st January. All the 415 rowers who qualified for the national championship were asked to complete a three-page questionnaire on LBP, assisted by a physiotherapist. One hundred and thirty-three athletes (32%) completed the assessment. LBP was very common, with a lifetime and 1 year prevalence of 64.7% and 40.6% respectively. During the last episode, the LBP intensity, measured by a numeric rating scale (NRS), presented a median value of 6/10, and 40% of rowers reported some limitation in daily living activities (ADL). Odds ratio (OR) to suffer from LBP was 2.62 in males compared to females; athletes who row both in sculling and sweep or only sweep showed an OR of 4.43 and 3.32 respectively. The prevalence of low back pain among rowers seems to be comparable to the one of the general population, even if the recovery appears to be faster. The risk of developing LBP is associated with the rowing typology and the gender, but a prospective study with an adequate sample size is necessary to clearly identify risk factors for LBP in rowers and to implement effective prevention strategies.

Non-specific low back pain: occupational or lifestyle consequences?

Nursing occupation was identified as a risk occupation for the development of low back pain (LBP). The aim of our study was to find out how much occupational factors influence the development of LBP in hospital nursing personnel. Non-experimental approach with a cross-sectional survey and statistical analysis. Nine hundred questionnaires were distributed among nursing personnel, 663 were returned and 659 (73.2 %) were considered for the analysis. Univariate and multivariate statistics for LBP risk was calculated by the binary logistic regression. The χ(2), influence factor, 95 % confidence interval and P value were calculated. Multivariate binary logistic regression was calculated by the Wald method to omit insignificant variables. Not performing exercises represented the highest risk for the development of LBP (OR 2.8, 95 % CI 1.7-4.4; p < 0.001). The second and third ranked risk factors were frequent manual lifting > 10 kg (OR 2.4, 95 % CI 1.5-3.8; p < 0.001) and duration of employment ≥ 19 years (OR 2.4, 95 % CI 1.6-3.7; p < 0.001). The fourth ranked risk factor was better physical condition by frequent recreation and sports, which reduced the risk for the development of LBP (OR 0.4, 95 % CI 0.3-0.7; p = 0.001). Work with the computer ≥ 2 h per day as last significant risk factor also reduced the risk for the development of LBP (OR 0.6, 95 % CI 0.4-0.1; p = 0.049). Risk factors for LBP established in our study (exercises, duration of employment, frequent manual lifting, recreation and sports and work with the computer) are not specifically linked to the working environment of the nursing personnel. Rather than focusing on mechanical causes and direct workload in the development of non-specific LBP, the complex approach to LBP including genetics, psychosocial environment, lifestyle and quality of life is coming more to the fore.

The epidemiological profile of a middle-aged population with low back pain in southern Brazil.

Cross-sectional study. To assess the prevalence and the general characteristics of low back pain (LBP) in a middle-aged population living in southern Brazil. LBP is a widespread musculoskeletal condition. It is the main cause of disability in developed countries. It is necessary and relevant to study the risk factors for LBP to plan preventative action. A cross-sectional study of a middle-aged population in the South of Brazil was designed to look at the prevalence and general characteristics of LBP. A cross-sectional study was developed in a city located in southern Brazil. Data were collected from 1005 individuals at randomized public locations. A protocol was designed to evaluate the general characteristics of the population: age, sex, level of education, socioeconomic status, body mass index, occupation, smoking, physical activity, anxiety, and depression. After the initial evaluation, the individuals were asked if they had had low back pain at least once in their lifetime. Those who answered "Yes" continued the questionnaire that evaluated pain intensity, characteristics, and related disability. After the entire group was analyzed (N = 1005), a separate study was performed on the participants younger than 40 years (N = 701). The mean age was 33.74 years (±14.76) and 61.6% of the participants were females. Seventy-two percent of the participants had had LBP at least once in their lives. The mean of visual analogue scale intensity of pain was 4.51 (±2.27). The prevalence of female sex (P = 0.006) and anxiety (P < 0.001) was higher in those with LBP. In the group younger than 40 years, the prevalence of LBP was 69.7% and anxiety (P < 0.001) was the only factor related to LBP. Low back pain is a highly prevalent condition in a middle-aged population living in southern Brazil. Higher levels of anxiety and female sex were related to this condition in all groups, but when it was analyzed in the participants younger than 40 years, anxiety was the only significant variable related with LBP. 3.

Chapter 21 - Low-back pain

Low-back pain is one of the most common painful conditions experienced by humans throughout their life. Some occupational risk factors (namely, heavy manual material handling) may also contribute to the development of low-back pain: due to the high prevalence of both low-back pain and manual material handling in the adult working population, it has been estimated that low-back pain is probably the most common occupational disorder worldwide. Lifetime prevalence of low-back pain has been reported to be as high as 84%, depending on the case definition used, and no age group is spared, even children. Although low-back pain is not a lethal condition, it was estimated at the third rank among all diseases by disability-adjusted life-years in 2010 in the USA, after ischemic heart disease and chronic obstructive pulmonary disease, and at the first rank by years lived with disability. It also ranked high (13th) globally for the same year, in disability-adjusted life-years. Low-back pain is currently classified as nonspecific/specific as to putative cause and as acute (lasting less than 6 weeks), subacute (6-12 weeks), or chronic (more than 12 weeks) according to duration of symptoms. The distinction between nonspecific/specific and acute/subacute/chronic low-back pain is useful not only for epidemiologic studies, but also (mainly) for choosing the appropriate strategy for the diagnosis and treatment of the disorder. Workplace risk factors for low-back pain include manual lifting and whole-body vibration exposure. This chapter will provide an overview of modern concepts of low-back pain (in general) and will then outline some distinctive features of work-related low-back pain.

Low Back Pain in Athletes Is Associated with General and Sport Specific Risk Factors: A Comprehensive Review of Longitudinal Studies.

We aimed to examine systematically the available evidence on risk factors of low back pain (LBP) in athletes. We performed search without language restriction in PubMed, Ovid, Google Scholar, Scopus, and CINAHL. Longitudinal studies that examined possible risk factors of LBP in athletes were included in this systematic review. Based on methodological quality of studies, a best-evidence synthesis was conducted. Seven longitudinal studies were included, four of which had high methodological quality. Results showed that previous LBP, decreased lumbar flexion, and decreased lumbar extension are positively associated with LBP. There was moderate evidence for hip flexor tightness and high body weight as a risk factor. We found insufficient evidence for association between forward bending, previous injury, and amount of training per week, active years, age, and sex with LBP. In conclusion this study would provide a list of risk factors for LBP in athletes, though it showed a strong evidence for only a few including decrease lumbar flexion or extension, previous LBP, and high body weight. This review indicated a high heterogeneity of study characteristics including assessed risk factors and statistical techniques might limit the quality of evidence.

Reliability of Musculoskeletal Fitness Tests and Movement Control Impairment Test Battery in Female Health-Care Personnel with Re-Current Low Back Pain

Background: Low back pain (LBP) is one of the most important causes of work absenteeism in health-care personnel. Low performance levels for fitness components, and movement control impairment (MCI) of the spine have been posited to be risk factors for persistent LBP. The aims of this study were to examine the long-term reliability (test I – test II) of selected motor and musculoskeletal fitness tests and the standard MCI test battery in female health-care personnel with nonspecific LBP, and to investigate associations between change in intensity of LBP and variation in test results in two measurement points. Methods: The participants (n=47) were workers in geriatric wards. Long-term reliability of six field tests assessing motor abilities, flexibility and muscular strength, and the MCI test battery were studied. Mean test I – test II time-span was 18 days (SD 7.9). The estimates of reliability for interval-scale measurements (fitness) were typical error (s) of measurement and the coefficient of variation (CV). The reliability of nominal-scale measurements was analysed by the kappa coefficient. Results: The lowest within-subject variation was found in running figure of eight test (s=0.22 s, CV=2.8%) and the highest for modified push-ups (s=1.04 repetitions, CV=12.2%). The kappa values for the dorsal pelvic tilt, sitting knee extension, the anterior pelvic tilt, and lying-prone knee flexion varied between 0.71 and 0.45 but were lower for rocking forwards and backwards (k=0.31) and the one-leg stance (k=0.16). Change in the pain intensity was associated only with variation in test I – test II results for modified push-ups (p=0.045). Conclusions: All of the tests assessing musculoskeletal fitness and four of the MCI tests had an acceptable level of long-term reliability. The two tests for MCI that had poor reliability need to be better standardised in order to serve as reliable clinical measurement tools.

Lower back pain

Lower back pain (LBP) is one of the most common and costly medical problems today [1, 2]. Pain is usually transitory and can arise from the intervertebral discs, bones, ligaments and muscles of the spine. Risk factors for LBP include genetic, environmental, psychosocial and biomechanical influences [3]. However, although 85% of LBP cases have no clear etiology, 97% may be due to musculoskeletal issues [4]. Lumbar curvature (lordosis) is one factor that generates shearing between adjacent vertebrae and at intervertebral joints. People with high degrees of lumbar lordosis, including pregnant women, can experience excessive shearing (Fshear) and compression (Fcompression) forces between lumbar vertebrae, most often between the last lumbar and the sacrum [3, 5]. In addition to other factors, including age-related spinal degeneration, high levels of Fshear and Fcompression can lead to painful muscle strain, joint capsule pain, disc herniation, inflammation (spondylitis), bone degeneration (spondylolysis) and vertebral displacement (spondylolisthesis) [3–5]. Evolutionary perspectives

Young individuals with a more ankle-steered proprioceptive control strategy may develop mild non-specific low back pain

Altered proprioceptive postural control has been demonstrated in people with non-specific low back pain (LBP). However, the cause-effect relation remains unclear. Therefore, more prospective studies are necessary.Proprioceptive postural control of 104 subjects was evaluated at baseline using a force plate and with application of vibration stimulation on ankle and back muscles. Spinal postural angles were measured with digital photographs. Psychosocial variables and physical activity were registered using questionnaires. Ninety subjects were followed over two years concerning their LBP status, 14 were lost to follow-up.Four distinct groups were determined after two years based on pain and disability scores: never LBP, no LBP at intake with future mild LBP, mild LBP at intake with no further LBP, LBP at intake with further episodes of mild LBP. Risk factors for developing or sustaining LBP were calculated using logistic regression analysis.A more ankle-steered proprioceptive postural control strategy in upright standing increased the risk for developing or having recurrences of mild LBP within two years (Odds: 3.5; 95% CI: 1.1–10.8; p<0.05). Increased postural sway, altered spinal postural angles, psychosocial and physical activity outcomes were not identified as risk factors for future mild LBP. These findings could contribute to improving the prevention and rehabilitation of LBP.

Low back pain among school teachers in Botswana, prevalence and risk factors.

BackgroundAlthough low back pain (LBP) represents a common occupational problem, few epidemiological studies have investigated the prevalence and risk factors for LBP among school teachers, particularly in Africa. School teachers are known to represent an occupational group among which there appears to be a high prevalence of LBP. The objective of this study was, therefore, to conduct one of the first epidemiological investigations of LBP among teachers in Botswana.MethodsA cross-sectional study was conducted among teachers in Botswana using self-administered questionnaires which were distributed to 3100 randomly selected school teachers and collected over a five-month period between July and November 2012. The questionnaire included low back pain information, demographic data, lifestyle, work-related characteristics and psychosocial factors. Data were analysed using Chi-squared and logistic regression models. The 12 month prevalence and LBP disability and associated risk factors were also analysed.ResultsA total of 1747 teachers returned completed questionnaires, yielding a response rate of 56.3%. The 12-month prevalence of LBP was 55.7%, with 67.1% of them reporting minimal disability. The results of logistic regression analysis revealed that female gender [OR: 1.51, 95% CI: 1.14-2.00] and previous back injury [OR: 9.67, 95% CI: 4.94-18.93] were positively correlated to LBP. Awkward arm position [OR: 1.81, 95% CI: 1.24-2.62] and high psychological job demands [OR: 1.40, 95% CI: 1.02-1.93] were also significantly associated with LBP. Regular physical exercise was negatively associated with LBP [OR: 0.63, 95% CI: 0.43-0.93]. Female gender [OR: 2.67, 95% CI: 1.52-3.99] and previous back injury [OR: 3.01, 95% CI: 1.92-4.74] were also positively associated with LBP disability.ConclusionThe prevalence of LBP appears to be high among school teachers in Botswana. A wide variety of LBP risk factors were identified in this study. Female gender and previous injury were both associated with LBP presence and disability. The complex nature of LBP risk factors found in this study suggests than no single specific preventative or intervention strategy will help in reducing these conditions. As such, to help reduce the prevalence, progression and burden of LBP among Botswana teachers, a greater emphasis should now be placed on ergonomics education, regular physical exercise and occupational stress.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-359) contains supplementary material, which is available to authorized users.

Radiological Signs of Scheuermann's Disease and Low Back Pain: Lumbar MR Classification and Six-Year Low Back Pain Follow-Up in 188 Hospital Staff Members

Although the concept of Scheuermann's disease (SD) is not new, the mix-up between SD and Scheuermann's kyphosis occurred and still occurs frequently. In fact, SD is a broader concept than thoracic kyphosis and also includes an atypical (lumbar) form. Also, signs of SD can be observed in 18% to 40% of the general population, suggesting that it may be more related to a variant of normal spine morphology rather than a major disease. However, we do not know the clinical significance of “having SD-like spine” in the general population. It is noteworthy that both classical SD and atypical SD are associated with low back pain (LBP). All this information made us speculate whether having “SD-like” spine is a risk factor of LBP in general people. Previous studies on the relationship of SD and LBP only focused on patients who had SD, back pain or sciatica, and few studies aimed at general people, among which radiological diagnosis of SD was actually frequent.

Effects of physical factors on neck or shoulder pain and low back pain of adolescents

To explore the incidence of self-reported neck or shoulder pain (NSP) and lower back pain (LBP) among Chinese adolescents in Shanghai and identify the influencing factors for the incidences of NSP and LBP. A total of 3 600 students were selected from 30 high schools randomly chosen from 237 regular full-time high schools registered in Shanghai. From each school, 40 students were selected from each of the tenth, eleventh and twelfth grades for a total of 120 students per school. The questionnaire involved questions pertaining to demographic profiles, learning environment and exercise habits of each student. And it also contained questions regarding the amount of weight carried by each student while commuting to and from school, and it was also used to collect specific information related to the occurrence of NSP and LBP. Logistic regression was performed to analyze the potential risk factors for NSP and LBP. Among 3 600 questionnaires, a total of 2 842 valid ones were returned. The results revealed that the incidence of NSP and LBP in the Chinese adolescent population was 41.1% and 32.8% respectively. Both NSP and LBP were more common in girls than in boys, and 6.3% students reported at least one NSP- or LBP-induced absence from school. A relatively large portion of Chinese adolescents reported experiencing problems such as sedentary behavior (26.7% of the students continued to sit for more than 3 hours after school), a lack of exercise (29.3% exercised less than once each week and 38.2% of students reported that their exercise duration was less than half an hour each time) and overweight backpacks (53.0% complained that their backpack was too heavy). Multivariate logistic regression analysis revealed that gender, grade, physical activity and learning environment were all significantly correlated with the occurrences of NSP and LBP. The incidences of NSP and LBP are relatively high among adolescents in Shanghai. And several factors, including sedentary behavior, personal exercise habits and backpack weight, influence the occurrences of NSP and LBP in adolesents.

The effect of the presence and characteristics of an outlying group on exposure-outcome associations.

Physical exposures (eg, lifting or bending) are believed to be risk factors for low-back pain (LBP), but the literature is inconsistent. Exposure and LBP prevalence differ considerably between occupations, and exposure-outcome associations could be severely modified by the presence of particular occupational groups. We aimed to investigate the influence of such outlying groups on the properties of associations between exposure and LBP. Lifting and trunk flexion were observed for 371 of 1131 workers within 19 groups. LBP was obtained from all workers during three follow-up years. Both exposure variables were associated with LBP (P<0.01) in this parent dataset. By removing the 19 groups one-by-one and performing logistic regressions analysis on the 18 remaining groups, we demonstrated that one group, mainly road workers, with outlying exposures and LBP prevalence substantially affected the exposure-outcome association in the total population. In order to further examine this phenomenon, we assessed, by simulation, the influence of realistic sizes (n=4, 8, 16, 32, 64, 128), mean exposures (e=2000, 3000, 4000 lifts and e=30, 40, 50% trunk flexion time) and LBP prevalences (p=70, 80, 90, 100%) of the outlying group on the strength and certainty of the eventual relationship between exposure and LBP. For each combination of n, e and p, 3000 virtual studies were constructed, including the simulated group together with the other 18 original groups from the parent data-set. Average odds ratios (OR), 95% confidence limits, and power (P<0.05) were calculated across these 3000 studies as measures of the properties of each virtual study design. OR were attenuated more towards 1 and power decreased with smaller values of n, e, and p in the outlying group. Changes in group size and prevalence had a larger influence on OR and power than changes in mean exposure. The size and characteristics of a single group with high exposure and outcome prevalence can strongly influence both the OR point estimate and the likelihood of obtaining significant exposure-outcome associations in studies of large populations. These findings can guide interpretations of prior epidemiological studies and support informed design of future studies.

Occupational Low Back Pain in Primary and High School Teachers: Prevalence and Associated Factors

ObjectiveThe purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP. MethodsIn this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires. ResultsPoint, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P < .05 in all instances). Prolonged sitting and standing, working hours with computer, and correcting examination papers were the most aggravating factors, respectively. Rest and participation in physical activity were found to be the most relieving factors. ConclusionThe prevalence of LBP in teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population.

The prevalence and characteristics of low back pain among sitting workers in a Japanese manufacturing company.

Low back pain (LBP) is a major public health problem and the most common cause of workers' disability, resulting in substantial economic burden in terms of workers' compensation and medical costs. Sitting is a recognized potential risk factor for developing LBP. Therefore, eliminating risk factors associated with working conditions and individual work capacity may be beneficial in preventing LBP in sitting workers. The purpose of this prospective cross-sectional study is to investigate the prevalence of LBP and examine risk factors that contribute to the development of LBP in sitting workers at an electronics manufacturing company. A cross-sectional survey was administered to all subjects to assess the prevalence of LBP persisting for at least 48 h during the recent week. Data on demographic characteristics and potential risk factors for LBP were collected at routine annual check-ups. Patients with LBP completed the Roland-Morris Disability Questionnaire (RDQ), which provided information on the attributes of LBP. Univariate and multivariate regression analyses examined the association between LBP and potential risk factors. Of the 1,329 sitting workers, 201 (15.1 %) acknowledged experiencing LBP during the recent week. In female workers, weight and body mass index were significantly correlated with the RDQ score. Univariate analyses identified male sex, prior history of LBP, height ≥170 cm, and weight ≥70 kg as significant risk factors of LBP. Multivariate logistic regression analyses identified prior history of LBP and past history of lumbar spine surgery as significant risk factors of LBP. This study characterized the prevalence and attributes of LBP in Japanese sitting workers and provided information about potential risk factors contributing to occurrence of LBP in the workplace.

Low back pain risk factors associated with persistence, recurrence and delayed presentation

There is little knowledge in the literature on the role of time-related variables for the prognosis of acute and subacute low back pain (LBP). The aim of this study was to estimate the relationship between time-related LBP characteristics and prognostic factors for acute/subacute LBP. We performed a prospective inception cohort study of 315 patients attending a health practitioner for acute/subacute LBP or recurrent LBP. One-tailed correlations were conducted between patient characteristics and time-related variables. The pattern of correlation between risk factors for and resources against persistent LBP differed between three time-related variables. 'Subacute LBP' and 'delayed presentation' were positively associated with psychological factors. Both indicators were negatively correlated with resources against development of persistent LBP. Moreover, 'delayed presentation' was related positively with occupational stressors. In contrast, 'recurrent LBP' was only related to more impaired health-related factors. Patients with current LBP waiting longer until seeking help in primary care have a more disadvantageous profile of occupational and psychological risk factors and lower resource levels. A similar but less pronounced pattern occurred in those with subacute LBP compared to those with acute LBP. Consideration of time characteristics of LBP may help to better understand LBP.

The Influence of Ergonomic Training on Low Back and Neck Pains in Female Hospital Personnel

Background: Prevalence of low back pain (LBP) and neck pain (NP) in workers, especially in nurses is high, but their knowledge of ergonomics is not enough. Objectives: The aim of this study was to evaluate the impact of ergonomic training on low back pain and neck pain, posture, and function in female hospital personnel of Najaf-Abad, Iran. Patients and Methods: In this queasy experimental study, 47 female staffs with LBP or NP were selected through a simple consecutive sampling method. The subjects completed a questionnaire on LBP and NP and were evaluated for posture, back tests, and cost of related treatments. Afterward, they participated in an ergonomic training program, including face to face and group education sessions on ergonomic risk factors for LBP and NP, in the work place. After six months of follow up, all the tests and data collection were repeated and data was analyzed using paired t-test and regression analysis. Results: Prevalence of LBP and NP were 87% and 45.7%, respectively. Repetitive motions were the most frequent cause of pain (67%). Pain intensity, posture, risk of musculoskeletal disorders, weight, waist circumference, sick leaves, and the costs of treatments reduced significantly after intervention (P < 0.05). Conclusions: With regards to the influence of ergonomic training on improving LBP and NP and decreasing the treatment costs, this intervention beside others can be useful for controlling musculoskeletal disorders in hospital personnel.

Risk factors for low back pain: insights from a novel case-control twin study

Background contextPrevious research has failed to identify strong consistent risk factors for low back pain (LBP). A plausible solution is to conduct hypothesis-generating studies, such as twin case-control surveys. PurposeTo investigate twins' perceptions of the factors responsible for within-pair differences in LBP. Study designA case-control twin survey. Patient sampleTwenty-four twin pairs that were generally and broadly discordant for LBP history. Outcome measuresThe participants' perceptions of the factors that could explain within-pair differences in LBP history. MethodsTwins were asked to identify the factors responsible for within-pair differences in LBP. Closed questioning collected information on the known risk factors and open-ended questioning was used to reveal novel factors. The frequency of risk factors was presented to investigate the individual's perception of the contribution of factors in the development of their own and/or their twin's experience of LBP. ResultsThe most frequent factors reported in the closed questioning related to the physical workload of the lumbar spine, specifically, the engagement in different types of work (n=23/24 pairs, 96%). Types of work included those involving heavy loads, lifting, manual tasks, awkward postures, and gardening. Single trauma or injury and vigorous physical activity participation were perceived as the contributors by 79% (n=19/24 pairs) and 88% (n=21/24 pairs) of the pairs, respectively. Open-ended questioning did not reveal new risk factors for LBP. ConclusionsTwins attributed the differences in LBP history to risk factors related to physical workload. Future studies investigating the risk factors for LBP should include valid and comprehensive assessments of these factors.

Effect of a Core Conditioning Intervention on Tests of Trunk Muscular Endurance in School-Aged Children

Trunk and core muscular development has been advocated to increase athletic performance and for maintenance of musculoskeletal health, especially related to the prevention of low back pain (LBP). The purpose of this study was to examine the effects of a simple core conditioning routine on tests of trunk and core muscular endurance in school-aged children. Participants included 164 students (86 girls, 78 boys; mean age, 11.5 ± 2.5 years) recruited from a grade school in a metropolitan area located in the southwestern United States. Students performed an equipment-free, moderate-to-high intensity, dynamic core conditioning warm-up routine once a week for a period of 6 weeks during the start of their physical education classes. The intervention consisted of 10 different dynamic core conditioning exercises performed at a 30-second duration per exercise totaling 5 minutes per session. Pre- and post-assessments of muscular endurance consisted of 5 different trunk and core muscular endurance tests: Parallel Roman Chair Dynamic Back Extension, Prone Plank, Lateral Plank, Dynamic Curl-Up, and Static Curl-up. A generalized estimation equation was used to analyze differences in pre- and post-intervention muscular fitness assessments controlling for gender and grade level. Analysis of the data revealed significant increases in muscular fitness test performance for each of the 5 measured outcomes (p < 0.001). Because risk factors of LBP are thought to commence during childhood, results of this study suggest that it may be desirable for children and adolescents to perform moderate-to-high intensity dynamic core exercises during physical education warm-up to improve trunk and core muscular endurance.

Prevalence of low back pain in working nurses in Zagazig University Hospitals: an epidemiological study

Nursing is one of the occupations with a high risk for back injuries. The etiology of low back pain (LBP) among nurses is usually multifactorial, probably because job demands in nursing is a mixture of physically demanding and mentally demanding tasks. The aim of this study was to identify the prevalence of and risk factors for chronic LBP in nursing personnel working in Zagazig University Hospitals. This study is a quantitative, retrospective, analytical, cross-sectional one. It included 150 female nurses who are currently working in Zagazig University Hospitals. All participants completed a self-administered Oswestry Low Back Disability Questionnaire. Data for risk factors of LBP (age, height, weight, BMI, marital state, parity) and working conditions (duration of employment in the current work, average working hours per week, work demands, duration of absence from work in the last year) were collected. LBP prevailed in 79.3% of the studied group of working nurses. The highest percentage was found among nurses working in the ICU (95.0%) and the least among those working in the outpatient clinics (64.0%). There was a highly significant association between LBP and body mass index (BMI) (P < 0.001). A higher incidence of LBP was associated with lifting heavy loads, followed by twisting, prolonged standing, prolonged sitting, walking for long distances, and bending forward. Prevalence of LBP is high among nurses, resulting in significant medical and socioprofessional consequences. Risk factors necessitate multidisciplinary involvement to reduce the incidence of LBP and related costs.