Skaggs David L, Early Sean D, D'Ambra Phyllis, Tolo Vernon T, Kay Robert M
Children's Orthopaedic Center, Children's Hospital Los Angeles, and the Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA.
J Pediatr Orthop. 2006 May-Jun;26(3):358-63. doi: 10.1097/01.bpo.0000217723.14631.6e.
Back pain in adults is common and well studied. In contrast, back pain in children has received comparatively little scientific study, despite recent media attention. The purpose of this study is to see what factors influence the prevalence of back pain in middle school children, with particular attention to the weight of children's backpacks and the availability of school lockers.
A population-based sample of 1540 children ages 11-14 years in a large metropolitan area was studied. A questionnaire was used to determine presence and severity of back pain, availability of lockers, backpack use, use of 1 or 2 straps to carry backpack, activity limitations due to back pain, and use of pain medication for back pain. Gender, age, weight of the child, and weight of his or her backpack were recorded. Results of scoliosis screening were evaluated with regard to the above information. Data were analyzed using the chi test and univariate or multivariate logistic regression analysis as appropriate.
Overall, 37% of the children reported back pain. Backpacks were used by 97% of children, hence there were too few students not using backpacks to treat backpack use as an independent variable. Multivariate analysis found back pain associated with use of a heavier backpack (P=0.001), younger age (P<0.001), female sex (P<0.001), and a positive screening examination for scoliosis (P=0.009). Children with lockers available reported less back pain (P=0.016). The use of 1 or 2 straps to carry the backpack did not have a significant association with back pain (P=0.588). Of the children who reported back pain, 34% limited their activity due to the pain, 14% use medication for pain relief, and 82% believed their backpack either caused or worsened their pain.
The incidence of back pain in early adolescence approaches that seen in adults. Recommendations for an "acceptable" weight of backpacks cannot be made from this study, as the weights of students' backpacks seem directly proportional to the likelihood of back pain. This study identifies 2 factors associated with self-reported back pain in early adolescents that are amenable to change: availability of school lockers and lighter backpacks. These findings may be useful in advising families and influencing school policies.
成人背痛很常见且已得到充分研究。相比之下，尽管最近受到媒体关注，但儿童背痛却相对较少受到科学研究。本研究的目的是了解哪些因素会影响中学生背痛的患病率，尤其关注儿童书包的重量和学校储物柜的配备情况。
对一个大都市地区1540名11至14岁的儿童进行了基于人群的抽样研究。使用问卷调查来确定背痛的存在和严重程度、储物柜的配备情况、书包的使用情况、用单肩还是双肩背书包、因背痛导致的活动受限情况以及用于缓解背痛的药物使用情况。记录了性别、年龄、儿童体重及其书包重量。根据上述信息对脊柱侧弯筛查结果进行了评估。数据采用卡方检验以及适当的单变量或多变量逻辑回归分析进行分析。
总体而言，37%的儿童报告有背痛。97%的儿童使用书包，因此不使用书包的学生太少，无法将书包使用情况作为一个独立变量来处理。多变量分析发现背痛与使用较重的书包（P = 0.001）、年龄较小（P < 0.001）、女性（P < 0.001）以及脊柱侧弯筛查呈阳性（P = 0.009）有关。有储物柜的儿童报告的背痛较少（P = 0.016）。用单肩还是双肩背书包与背痛没有显著关联（P = 0.588）。在报告有背痛的儿童中，34%因疼痛而限制了活动，14%使用药物缓解疼痛，82%认为他们的书包导致或加重了疼痛。
青春期早期背痛的发生率接近成年人。由于学生书包的重量似乎与背痛的可能性直接成正比，因此本研究无法给出关于书包“可接受”重量的建议。本研究确定了与青少年早期自我报告的背痛相关的两个可改变因素：学校储物柜的配备情况和较轻的书包。这些发现可能有助于为家庭提供建议并影响学校政策。
