Background It is known that adolescent low back pain (LBP) is a significant public health problem and 29-71% of the adolescents suffer from LBP in a period of their lives (1). Investigations have shown that significant correlation between abnormal postural alignment and spinal pain (2,3). To prevent or reduce LBP in adolescents, more research is needed.
Objectives The aim of this study was to compare the postural displacements of pelvis in adolescents with and without a history of LBP.
Methods Thirty-two adolescent students (20 females, 12 males) aged between 12 and 17 years participated in this study. The data were collected through personal interviews using a structured questionnaire about LBP. The participants were asked if they had ever suffered LBP at some point of their lives. Students were divided into two groups; with a history of LBP (Group 1) and without a history of LBP (Group 2). For three dimensional evaluation of posture, students were instructed to stand in a normally comfortable posture. Three digital photographs were obtained (antero-posterior, left and right lateral) and were analyzed through the PosturePrint internet-based computer system. Postural displacements of pelvis were calculated as rotations (Rx, Ry, Rz) in degrees and translations (Tx, Tz) in millimeters. The posture index score which is total postural displacements score (grades: slightly, significantly, moderately, seriously and severely displaced posture) was calculated by the system. Differences in median values between groups were analyzed with the Mann-Whitney U test. The significance level was set at p<0.05.
Results As a result of LBP history questionnaire, 40.6% of the students (n=13, Group 1) reported low back pain while 59.4% of the students (n=19, Group 2) had no history of LBP. 12.5% (n=4) of the adolescents had slight, 68.8% (n=22) had significant and 18.7% (n=6) had moderate displacement in their posture. The posture index score was similar between the groups. There were no significant differences in postural displacements of pelvis (p values; Rx:0.922, Ry:0.646, Rz:0.791, Tx:0.769, Tz:0.409) between the groups (p>0.05).
Conclusions Overall, 40.6% of the adolescents reported history of LBP. Although similar influences (mainly forward pelvis position) were found in pelvic posture in both groups, majority of students had significantly displaced posture. These results suggest that LBP and abnormal posture in adolescents may be a serious health problem. Future research in this population should analyze the postural changes and associated risk factors more comprehensively.
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Smith A, O'Sullivan P, Straker L. Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain. Spine (Phila Pa 1976). 2008;33(19):2101-7
Acknowledgements The authors would like to thank to Dokuz Eylül University, Scientific Research Fund for providing financial support for this project (Project number: 2009.KB.SAG.095).
Disclosure of Interest None declared