Wedderkopp N, Kjaer P, Hestbaek L, Korsholm L, Leboeuf-Yde C
The Back Research Center, Hospital of Funen, Part of Clinical Locomotion Science, University of Southern Denmark, Ringe, Denmark.
Spine J. 2009 Feb;9(2):134-41. doi: 10.1016/j.spinee.2008.02.003. Epub 2008 May 20.
The evidence on the impact of physical activity on back pain in children and adolescents has been contradicting. It has also been shown that the physical activity cannot accurately be estimated in children using questionnaires.
The aim of this study was to establish if physical activity in childhood had any impact on back pain reporting in early adolescence (3 years later), using an objective instrumental measurement of physical activity.
Prospective cohort study.
Representative random sample of Danish children from the city of Odense sampled at age 9 years and followed-up at age 12 years.
The 1-month period prevalence of back pain (neck pain, mid back pain, and low back pain) was established using a structured interview.
Physical activity was assessed with the MTI-accelerometer. The accelerometer provides a minute-by-minute measure of the physical activity performed. An overall measure of physical activity and time spent in high activity were studied in relation to back pain using logistic regression. The analyses were performed on the total sample and then stratified on back pain (yes/no) at baseline.
High physical activity (HPA) levels seem to protect against future low back pain and appear to actually "treat" and reduce the odds of future mid back pain. When comparing the least active children to the most active children, the least active had a multivariate odds ratio of 3.3 of getting low back pain and 2.7 of getting mid back pain 3 years later. When stratified on back pain at baseline, this effect on mid back pain was especially noticeable in children who had had mid back pain already at baseline, with an odds ratio of 7.2.
HPA in childhood seems to protect against low back pain and mid back pain in early adolescence. Larger prospective studies with repetitive follow-ups and preferably intervention studies should be performed, to see if these findings can be reproduced.
关于体育活动对儿童和青少年背痛影响的证据一直相互矛盾。研究还表明，使用问卷无法准确评估儿童的体育活动情况。
本研究旨在通过对体育活动进行客观仪器测量，确定儿童时期的体育活动是否对青春期早期（3年后）的背痛报告有任何影响。
前瞻性队列研究。
从欧登塞市抽取的具有代表性的丹麦儿童随机样本，9岁时采样，12岁时进行随访。
采用结构化访谈确定背痛（颈部疼痛、中背部疼痛和下背部疼痛）的1个月患病率。
使用MTI加速度计评估体育活动。加速度计可逐分钟测量所进行的体育活动。使用逻辑回归研究体育活动的总体测量值和高活动时间与背痛的关系。对总样本进行分析，然后根据基线时的背痛情况（是/否）进行分层。
高体育活动（HPA）水平似乎可预防未来的下背部疼痛，实际上似乎还能“治疗”并降低未来中背部疼痛的几率。将最不活跃的儿童与最活跃的儿童进行比较时，最不活跃的儿童在3年后患下背部疼痛的多变量优势比为3.3，患中背部疼痛的多变量优势比为2.7。在根据基线时的背痛情况进行分层时，这种对中背部疼痛的影响在基线时就已患有中背部疼痛的儿童中尤为明显，优势比为7.2。
儿童时期的高体育活动水平似乎可预防青春期早期的下背部疼痛和中背部疼痛。应开展更大规模的前瞻性重复随访研究，最好是干预研究，以确定这些发现是否能够重现。
