Phys Ther. 2014 Dec 11. [Epub ahead of print]
Daily Exercises and Education for Preventing Low Back Pain in Children: A Cluster Randomized Controlled Trial.
Hill JJ

Abstract
BACKGROUND:
Children report low back pain (LBP) as young as 8 years. Preventing LBP in children may prevent or delay adult incidence.
OBJECTIVES:
To determine whether education and daily exercise affect LBP episodes in children compared to education alone.
DESIGN:
Prospective, multicentre cluster randomized controlled trial.
SETTING:
Seven New Zealand primary schools.
PARTICIPANTS:
Children (n=708), 8 to 11 years. Seven schools, stratified by sample size (36, 114, 151, 168, 113, 45, 83) were randomised and allocated to two masked groups; intervention (4 schools, n=469) or control (3 schools, n=239).
INTERVENTIONS:
Intervention participants were taught four spinal movements for daily practice. Both groups participated in education that emphasized ‘back awareness’.
MEASUREMENTS:
LBP history at baseline was assessed. Children reported episodes of LBP during the previous week on trial Days 7, 21, 49, 105, 161 and 270. Analysis was at the individual participant level, with adjustment for school clusters.
RESULTS:
There were no significant differences between groups in the odds of reporting no LBP in the previous week during the study period (OR0.72, 95%CI=0.46-1.14, p=0.16). Intervention participants reported significantly fewer episodes of LBP (OR0.54, 95%CI=0.39-0.74, p<.001) and significantly fewer lifetime first episodes of LBP (34%, n=86) than controls (47%, n=58) (OR0.60, 95%CI=0.39-0.91, p=0.02). The odds of an episode of LBP were greater in participants with a history of LBP (OR 4.21, 95%CI=3.07-5.78 p<0.001). LBP episodes decreased across the trial period for both groups (OR0.89, 95%CI=0.84-0.95, p<0.001). Adherence to exercise was poor. LIMITATIONS: Replication in other settings is required. CONCLUSIONS: Regular exercise and education appear to reduce LBP episodes in children 8-11 years compared to education alone. © 2014 American Physical Therapy Association. PubMed Reference