title: Risk factors for the development of neck and upper limb pain in adolescents.
abstract: METHODS
  A prospective, repeated measures cohort study with high school students was conducted in Montreal, Canada.
  
  
  OBJECTIVE
  To determine the incidence of neck and upper limb pain and associated risk factors in a cohort of adolescents.
  
  
  BACKGROUND
  Neck and upper limb pain is frequent in adolescents and may be associated with repetitive motion from certain activities such as playing music, working, and engaging in sports activities.
  
  
  METHODS
  For this study, 502 students in the seventh to ninth grades in three schools were assessed. Data were collected at three times 6 months apart over a 12-month period. Students responded to a questionnaire addressing musculoskeletal health and lifestyle factors and were measured for height and weight. Neck or upper limb pain occurring at least once a week in the preceding 6 months was defined as the outcome. Multivariate methods were used to model the repeated measures dichotomous outcome as a function of engaging in physical activity, working, or playing a musical instrument, adjusted for covariates.
  
  
  RESULTS
  The cumulative annual incidence of neck and upper limb pain was 28.4%. The risk factors for neck and upper limb pain were working (adjusted odds ratio, 1.89; 95% confidence interval, 1.11-3.32) and lower mental health score (adjusted odds ratio, 1.68; 95% confidence interval, 1.19-2). Students involved in childcare were at a higher risk for the development of pain (adjusted odds ratio, 2.25; 95% confidence interval, 1.18-4.29).
  
  
  CONCLUSIONS
  Neck and upper limb pain is common in teenagers. Sports involvement and music participation were not risk factors for the development of neck and upper limb pain. However, pain was more likely to develop in adolescents who worked than in students who had a lower mental health score.
authors.affiliation: Groupe de Recherché Interdisciplinaire en Santé, Ecole de Réadaptation, et Département de Médecine Sociale et Préventive, Université de Montréal, Québec, Canada. debbie.feldman@umontreal.ca
authors.forename: Debbie
authors.initials: D
authors.lastname: Ehrmann Feldman
authors.forename: Ian
authors.initials: I
authors.lastname: Shrier
authors.forename: Michel
authors.initials: M
authors.lastname: Rossignol
authors.forename: Lucien
authors.initials: L
authors.lastname: Abenhaim
mesh_terms: D000293:Adolescent; D001132:Arm; D001416:Back Pain / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D012090:Cumulative Trauma Disorders / Q000453:epidemiology; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D009146:Music; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D020069:Shoulder Pain / Q000453:epidemiology; D013177:Sports / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires