Szpalski M, Gunzburg R, Balagué F, Nordin M, Mélot C
Department of Orthopedics, Centre Hospitalier Molière Longchamps, Brussels, Belgium.
Eur Spine J. 2002 Oct;11(5):459-64. doi: 10.1007/s00586-002-0385-y. Epub 2002 May 7.
There is increasing evidence that non-specific low back pain (LBP) is common among children and adolescents, but there are few longitudinal studies on this subject. This is a longitudinal prospective study aimed at finding factors associated with the prediction of low back pain in schoolchildren aged 9-12 years, which is a younger age group than has previously been studied. This study was performed on school children in the city of Antwerp, Belgium. A total of 287 children filled out a questionnaire and were examined at the beginning of the study (T1) and 2 years later (T2). The questionnaire asked about back pain, general health, health perceptions, quality of life perceptions, sports, leisure, daily life, school life (weight of satchel.) and some issues related to parents (smoking, LBP). The questionnaire reliability was tested. Logistic regression was used to analyse the data. No predictors for LBP in children could be identified. Using logistic regression techniques, we analysed the children who reported no lifetime episode of LBP at both T1 and T2, the children who did report a lifetime episode at both T1 and T2 and also those who reported a history of LBP at T2 only (New LBP). At T2 there were 51 children (17.8%) reporting suffering at least one lifetime episode of LBP who had not reported such an episode at T1. Only one parameter showed a statistical difference: New LBP was observed significantly more frequently in children who do not walk to school ( P<0.0001). An interesting point of this study is that a number of children who had reported a history of LBP at T1 did not do so at T2. It may be that LBP in children is so benign and its natural history so favourable that the memory of the episode fades away. It is extremely interesting to note that among the few significant variables, those related to general well-being and self-perception of health, are prominent. It appears, therefore, that psychological factors play a role in the experience of LBP in a similar way to what has been reported in adults. Poor self-perception of health (health belief) could be a factor behind the reporting of LBP. Some variables linked to consequences of LBP (absence from school or from gym and visit to a doctor) play a significant role in reporting LBP, which suggests that those "health care" factors may reinforce a feeling of disease severity.
越来越多的证据表明，非特异性腰痛（LBP）在儿童和青少年中很常见，但关于这一主题的纵向研究却很少。这是一项纵向前瞻性研究，旨在找出与9至12岁学童腰痛预测相关的因素，该年龄组比之前研究的年龄更小。这项研究是在比利时安特卫普市的学童中进行的。共有287名儿童在研究开始时（T1）和2年后（T2）填写了问卷并接受了检查。问卷询问了背痛、总体健康状况、健康认知、生活质量认知、运动、休闲、日常生活、学校生活（书包重量）以及一些与父母有关的问题（吸烟、LBP）。对问卷的可靠性进行了测试。使用逻辑回归分析数据。未发现儿童LBP的预测因素。我们使用逻辑回归技术，分析了在T1和T2时均未报告有过LBP发作的儿童、在T1和T2时均报告有过LBP发作的儿童以及仅在T2时报告有LBP病史的儿童（新发LBP）。在T2时，有51名儿童（17.8%）报告至少有过一次LBP发作，而在T1时未报告过此类发作。只有一个参数显示出统计学差异：在不步行上学的儿童中观察到新发LBP的频率显著更高（P<0.0001）。这项研究的一个有趣之处在于，一些在T1时报告有LBP病史的儿童在T2时并未报告。可能是儿童的LBP非常轻微，其自然病程非常有利，以至于对发作的记忆逐渐消失。非常有趣的是，在少数显著变量中，与总体幸福感和健康自我认知相关的变量很突出。因此，似乎心理因素在LBP体验中所起的作用与在成年人中所报道的类似。健康自我认知差（健康信念）可能是报告LBP的一个因素。一些与LBP后果相关的变量（缺课或体育课、看医生）在报告LBP方面起着重要作用，这表明那些“医疗保健”因素可能会强化疾病严重程度的感觉。
