Developing a guideline framework for school-based interventions to improve spinal health of children and adolescents in South Africa

[摘要] ENGLISH SUMMARY : Background: Spinal pain prevalence in children and adolescents is high, increases with age and may lead to spinal pain in adulthood. Potential predisposing factors for spinal pain in children and adolescents are the usage of schoolbags; posture; sitting duration; psychosocial factors; age; gender and school furniture.Purpose: 1) To determine the effectiveness of school-based interventions in promoting spinal health in children and adolescents; 2) to present a schematic presentation of the effective interventions as part of development of an evidence-based framework. Methods: This study had two phases: 1) conducting a systematic review on the effectiveness of school-based interventions to promote spinal health in children and adolescents, 2) developing a schematic presentation of the evidence-based framework depicting the effective school-based interventions. Two comprehensive search strategies for primary research (strategy A) and grey literature (strategy B) respectively, were performed. School-based interventions which aims were to prevent poor spinal health and/or improve spinal health in school children and adolescents were considered. Spinal health outcomes included levels of pain or discomfort limited to the spinal area and other measurable components which is a direct result of the spinal pain/discomfort and which affects the individual's optimal experience of a sense of well-being.Results: Search strategy A yielded 24 eligible articles and search strategy B, six documents of grey literature. Four main themes of intervention were identified i.e. exercise, education, exercise and education combined and furniture, which resulted in significant positive effects on different aspects of spinal health i.e. exercise only was most effective to address low back pain; education only was most effective to address spinal pain; exercise and education combined influenced neck and lower back pain the most and furniture adjustments impacted mostly neck and spinal pain. However, the grey literature lacked the scientific evidence base of support and the content of only two documents containing education on schoolbag weight and carriage could be incorporated in the schematic presentation of the evidence-based framework.Conclusion: There was a trend that certain school-based interventions might be more beneficial to address certain aspects of spinal health in children and adolescents, despite conflicting results in the literature. The findings from the review can be used towards formulating recommendations for guidelines to be implemented in schools in future.

[发布机构] Stellenbosch University