Chiwaridzo Matthew, Naidoo Nirmala
Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe.
Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Cape Town, Faculty of Health Sciences, Cape Town, South Africa.
Arch Physiother. 2015 Dec 1;5:13. doi: 10.1186/s40945-015-0014-9. eCollection 2015.
Recurrent non-specific low back pain (NSLBP) is increasingly becoming common among adolescents worldwide. A recent study in Zimbabwe showed a relatively high prevalence (28.8 %) among high school students. Influential associated factors, however, remain unclear. This is a significant shortcoming. The aim was to determine personal or lifestyle-related factors associated with recurrent NSLBP among high school adolescents in Harare, Zimbabwe.
This study was part of a large epidemiological study conducted in two continuous parts. Part one sought to determine self-reported associated factors among 532 participants (mean age =16 ± 1.72 years) drawn randomly from selected government schools using a reliable and content-validated questionnaire (Kappa coefficient, k = 0.32-1). Part two purposively identified adolescents ( = 64, median age =17 years, interquartile range, IQR = 15-18 years) with a history of 'severe' recurrent NSLBP from part one based on a specific eligibility criteria and compared body mass index, relative school bag weight and hamstring flexibility with matched adolescents without NSLBP. Data was analysed using Statistica version 11. Independent -tests or χ tests of association were used for continuous and categorical data, respectively. The statistical significance was set at < .05.
Recurrent NSLBP was associated with self-reported factors such as perceptions of a heavy school bag [χ (1) = 85.9, < 0.001]. A significant proportion of adolescents with recurrent NSLBP spent over 30 min carrying the school bag to and from school [χ (1) =32.2, < 0.001]. It was also associated with prolonged sitting ( < 0.001), not playing sports [χ (1) =5.85, = 0.02] and tight hamstrings [χ (1) =7.6, = 0.006].
Although conclusions from this study are hesitant because of the cross-sectional nature of the study and the relatively small sample size in follow-up study, recurrent NSLBP is associated with perceptions of a heavy school bag, duration of school bag carriage, no sports participation, prolonged sitting on entertainment activities, and tight hamstrings. These findings add to the importance of promoting physical activity at school or home especially aimed at improving muscle flexibility.
复发性非特异性下腰痛（NSLBP）在全球青少年中日益普遍。最近在津巴布韦进行的一项研究显示，高中生中的患病率相对较高（28.8%）。然而，有影响的相关因素仍不清楚。这是一个重大缺陷。目的是确定津巴布韦哈拉雷市高中青少年中与复发性NSLBP相关的个人或生活方式因素。
本研究是一项大型流行病学研究的一部分，分两个连续部分进行。第一部分旨在使用一份可靠且内容有效的问卷（卡帕系数，k = 0.32 - 1），从选定的政府学校中随机抽取的532名参与者（平均年龄 = 16 ± 1.72岁）中确定自我报告的相关因素。第二部分根据特定的纳入标准，从第一部分中有“严重”复发性NSLBP病史的青少年中（n = 64，中位年龄 = 十七岁，四分位间距，IQR = 15 - 18岁）进行有目的的挑选，并将体重指数、相对书包重量和腘绳肌柔韧性与匹配的无NSLBP青少年进行比较。使用Statistica 11版软件进行数据分析。分别对连续数据和分类数据使用独立样本t检验或χ²检验进行相关性分析。统计学显著性设定为p < 0.05。
复发性NSLBP与自我报告的因素相关，如感觉书包沉重[χ²(1) = 85.9，p < 0.001]。相当一部分复发性NSLBP青少年往返学校携带书包的时间超过30分钟[χ²(1) = 32.2，p < 0.001]。它还与久坐（p < 0.001）、不参加体育活动[χ²(1) = 5.85，p = 0.02]和腘绳肌紧张[χ²(1) = 7.6，p = 0.006]有关。
尽管由于本研究的横断面性质以及随访研究中样本量相对较小，本研究的结论存在不确定性，但复发性NSLBP与感觉书包沉重、携带书包的时间、不参加体育活动、长时间坐着进行娱乐活动以及腘绳肌紧张有关。这些发现增加了在学校或家庭中促进体育活动的重要性，特别是旨在提高肌肉柔韧性。
