Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health

Bento, Thiago Paulo Frascareli; Cornelio, Guilherme Porfirio; Perrucini, Priscila de Oliveira; Simeão, Sandra Fiorelli Almeida Penteado; de Conti, Marta Helena Souza; de Vitta, Alberto

doi:10.1016/j.jped.2019.07.008

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Original article • J. Pediatr. (Rio J.) 96 (6) • Nov-Dec 2020 • https://doi.org/10.1016/j.jped.2019.07.008 copy

Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health^✰ ✰ Please cite this article as: Bento TP, Cornelio GP, Perrucini PO, Simeão SF, Conti MH, de Vitta A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr (Rio J). 2020;96:717–24.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems.

Methods:

Cross-sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used.

Results:

The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR = 1.70), daily TV use for more than 3 hours (PR = 1.17), use of laptop computer (PR = 1.40), use of the cell phone in the supine position (PR = 1.23), use of the cell phone in semi-supine position (PR = 1.49), daily cell phone use for more than 3 hours (PR = 1.36), use of tablet (PR = 1.67), daily tablet use for more than above 3 hours (PR = 1.46), and clinically important mental health problems (PR = 2.62).

Conclusion:

There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.

KEYWORDS
Adolescent; Low back pain; Epidemiology; Risk factors

Factors	Sex
	Male (n = 798)		Female (n = 830)
	n	%	n	%
Watch TV
No	123	15.4	67	8.1
Yes	675	84.6	763	91.9
How many times TV/week
Up to 2 times	168	24.7	205	21.1
3 times or more	507	67.2	558	63.5
Number of hours of TV/day
Up to 2 h	383	48.0	376	45.3
Above 3 h	292	36.6	387	46.6
Use of computer
No	105	13.2	215	25.9
Yes	693	86.8	615	74.1
Type of computer
Desktop	344	43.1	224	27.0
Laptop	263	33.0	339	40.8
Desktop and laptop	86	10.8	52	6.3
Height of the computer screen
Above the midpoint	153	19.2	114	13.7
At the midpoint	473	59.3	435	52.4
Below the midpoint	67	8.4	66	8.0
How many times/week
Up to 2 times	184	23.1	295	35.5
3 times or more	509	63.8	320	38.6
How many hours/day
Up to 2 h	250	31.3	341	41.1
3 h or more	443	55.5	274	33.0
Use of cell phone
No	33	4.1	9	1.1
Yes	765	95.9	821	98.9
What posture is the cell phone used
Standing	276	34.6	282	34.0
Sitting	403	50.5	441	53.1
Lying down	436	54.6	491	59.2
Semi-lying	215	26.9	344	41.4
Daily use time
Up to 2 h	220	27.6	125	15.1
3 h or more	545	68.3	696	83.9
Use of tablet
No	656	82.2	649	78.2
Yes	142	17.8	181	21.8
What posture is the tablet used
Standing	25	3.0	47	5.6
Sitting	83	10.4	102	12.3
Lying down	68	8.5	82	9.9
Semi-lying	26	3.3	56	6.7
Daily use time
Up to 2 h	94	11.8	149	18.0
3 h or more	48	6.0	32	3.9

Factors	Low back pain
Factors	n	%	PR (95% CI)
Gender
Male	319	42.0	1.00
Female	441	58.0	1.33 (1.20-1.48)^a a Factor associated.
Age range
14 years	108	14.2	1.00
15 to 18 years	652	85.8	1.09 (0.94-1.27)
Marital status
Married	30	3.9	1.00
Single	730	88.6	1.10 (0.82-1.48)
Ethnicity
White	395	52.0	1.00
Black	54	7.1	0.77 (0.62-0.97)^a a Factor associated.
Brown/Mixed-race	262	34.5	0.93 (0.83-1.04)
Yellow	30	3.9	1.04 (0.80-1.35)
Native Brazilian	19	2.5	1.02 (0.74-1.42)
Level of physical activity
Very active	196	25.8	1.00
Sufficiently active	370	48.7	0.97 (0.86-1.11)
Insufficiently active	194	25.5	0.95 (0.82-1.10)
Mental health problems
Normal	357	47.0	1.00
Borderline	188	24.7	1.33 (0.97-1.51)
Clinical	215	28.3	1.61 (1.43-1.81)^a a Factor associated.

Factors	Low back pain
Factors	n	%	PR (95% CI)
Watch TV
No	79	10.4	1.00
Yes	681	89.6	1.14 (0.95-1.36)
How many times TV/week
Up to 2 times	174	22.9	1.00
3 times or more	507	66.7	1.02 (0.90-1.16)
Number of hours of TV/day
Up to 2 h	345	45.4	1.00
Above 3 h	336	44.2	1.09 (0.98-1.21)
Use of PC/videogame
No	612	80.5	1.00
Yes	148	19.5	0.99 (0.87-1.3)
Type of computer
Desktop	243	32.0	1.00
Laptop	304	40.0	1.18 (1.04-1.34)^a a Factor associated.
Desktop and laptop	65	8.6	0.91 (0.74-1.11)
Height of the computer screen
Below the midpoint	138	18.2	1.00
At the midpoint	416	54.7	0.89 (0.77-1.02)
Below the midpoint	58	7.6	0.84 (0.67-1.06)
How many times/week
Up to 2 times	233	30.7	1.00
3 times or more	379	49.9	0.94 (0.84-1.06)
How many hours/day
Up to 2 h	274	36.1	1.00
3 h or more	338	44.5	1.02 (0.91-1.14)
Use of a cell phone
No	22	2.9	1.00
Yes	738	97.1	0.89 (0.66-1.19)
What posture is the cell phone used
Standing	285	37.5	1.16 (1.04-1.29)^a a Factor associated.
Sitting	411	54.1	1.10 (0.99-1.23)
Lying down	458	60.3	1.16 (1.04-1.30)^a a Factor associated.
Semi-lying	301	39.6	1.27 (1.14-1.40)^a a Factor associated.
Daily use time
Up to 2 h	136	17.9	1.00
3 h or more	602	79.2	1.23 (1.06-1.42)^a a Factor associated.
Use of tablet
No	576	75.8	1.00
Yes	184	24.2	1.29 (1.15-1.44)^a a Factor associated.
What posture is the tablet used
Standing	44	5.8	1.12 (0.90-1.38)
Sitting	107	14.1	1.04 (0.86-1.27)
Lying down	85	11.2	0.99 (0.82-1.20)
Semi-lying	52	6.8	1.16 (0.95-1.41)
Daily use time
Up to 2 h	136	17.9	1.00
3 h or more	48	6.3	1.07 (0.87-1.32)

Factors	Low back pain.
Factors	Value of p	PR adjusted (95% CI)
Sex
Male	< 0.001	1.00
Female	< 0.001	1.70 (1.39-2.07)
Number of hours of TV/day
Up to 2 h	0.032	1.00
Above 3 h	0.032	1.17 (1.01-1.36)
Type of computer
Desktop		1.00
Laptop	0.005	1.40 (1.10-1.77)
Desktop and laptop	0.499	1.18 (0.72-1.94)
What posture is the cell phone used
Lying down
No	0.042	1.00
Yes	0.042	1.23 (1.00 1.52)
Semi-lying down
No	< 0.001	1.00
Yes	< 0.001	1.49 (1.20-1.83)
Daily use time (cell phone)
Up to 2 h	0.003
3 h or more	0.003	1.36 (1.11-1.68)
Use of tablet
No	< 0.001	1.00
Yes	< 0.001	1.67 (1.31-2.14)
Daily use time (tablet)
Up to 2 h	< 0.001	1.00
3 h or more	< 0.001	1.46 (1.21-1.76)
Mental health problems
Normal	< 0.001	1.00
Borderline		1.67 (0.98-2.13)
Clinical		2.62 (2.03-3.38)

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[1] ∗ Corresponding author. thibento10@gmail.com (T.P. Bento).