Anthropometric measurements and the incidence of low back pain in a cohort of pubertal children.

STUDY DESIGN

The authors studied the anthropometric measurements to predict low back pain (LBP) in a cohort of growing adolescents.

SUMMARY OF BACKGROUND DATA

The cohort consisted of all the fourth-grade school children of the western school district of Helsinki, Finland, in the spring of 1986. They were examined annually from the mean age of 11.8 to 13.8 years.

METHODS

The forward bending test, measurements of total arm length, pelvic equilibrium, and spinal pantographs were carried out by the same physiatrist. A standardized pain questionnaire presented at the final examination obtained the history of LBP. Of the original cohort of 1060 children, those 859 (408 girls and 451 boys) who participated in all the examinations and had not had LBP until the age of 12.8 years were included in this study.

RESULTS

The 1-year (from 12.8 to 13.8 years) incidence of LBP was 18.4% in girls and 16.9% in boys. Trunk asymmetry measured by the forward bending test and sitting height were significant determinants of the incidence of LBP. In the whole cohort, the odds ratio (OR) of trunk asymmetry adjusted for all the other risk determinants was 1.19 and its confidence interval (CI) was 1.00-1.39 per one standard deviation increase of the trunk hump. In the multivariate analysis comprising both sexes, OR per one standard deviation increase of sitting height was 1.24, (95% CI 1.03-1.46). In boys, standing height (OR 1.40, 95% CI 1.13-1.65, per one standard deviation) and sitting height (OR 1.35, 95% CI 1.09-1.63, per one standard deviation) were positively associated with the risk of LBP. These associations were not significant in girls.

CONCLUSIONS

Sitting height and trunk asymmetry may contribute to LBP in pubertal children. The role of anthropometric characteristics seems, however, modest.