title: Biological risk indicators for recurrent non-specific low back pain in adolescents.
abstract: OBJECTIVE
  A matched case-control study was carried out to evaluate biological risk indicators for recurrent non-specific low back pain in adolescents.
  
  
  METHODS
  Adolescents with recurrent non-specific low back pain (symptomatic; n = 28; mean (SD) age 14.9 (0.7) years) and matched controls (asymptomatic; n = 28; age 14.9 (0.7) years) with no history of non-specific low back pain participated. Measures of stature, mass, sitting height, sexual maturity (Tanner self assessment), lateral flexion of the spine, lumbar sagittal plane mobility (modified Schober), hip range of motion (Leighton flexometer), back and hamstring flexibility (sit and reach), and trunk muscle endurance (number of sit ups) were performed using standardised procedures with established reliability. Backward stepwise logistic regression analysis was performed, with the presence/absence of recurrent low back pain as the dependent variable and the biological measures as the independent variables.
  
  
  RESULTS
  Hip range of motion, trunk muscle endurance, lumbar sagittal plane mobility, and lateral flexion of the spine were identified as significant risk indicators of recurrent low back pain (p<0.05). Follow up analysis indicated that symptomatic subjects had significantly reduced lateral flexion of the spine, lumbar sagittal plane mobility, and trunk muscle endurance (p<0.05).
  
  
  CONCLUSIONS
  Hip range of motion, abdominal muscle endurance, lumbar flexibility, and lateral flexion of the spine were risk indicators for recurrent non-specific low back pain in a group of adolescents. These risk indicators identify the potential for exercise as a primary or secondary prevention method.
authors.affiliation: Edge Hill College, Ormskirk, UK. jonesmi@edgehill.ac.uk <jonesmi@edgehill.ac.uk>
authors.forename: M A
authors.initials: MA
authors.lastname: Jones
authors.forename: G
authors.initials: G
authors.lastname: Stratton
authors.forename: T
authors.initials: T
authors.lastname: Reilly
authors.forename: V B
authors.initials: VB
authors.lastname: Unnithan
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D016059:Range of Motion, Articular; D012008:Recurrence; D012307:Risk Factors
references.citation: Spine (Phila Pa 1976). 1989 May;14(5):526-8
references.pmid: 2524892
references.citation: J Manipulative Physiol Ther. 1994 Jun;17(5):296-301
references.pmid: 7930962
references.citation: Am J Phys Med Rehabil. 1997 Jan-Feb;76(1):52-8
references.pmid: 9036912
references.citation: Phys Ther. 1998 Jul;78(7):754-65
references.pmid: 9672547
references.citation: Acta Paediatr. 2002;91(7):849-54
references.pmid: 12200915
references.citation: Spine (Phila Pa 1976). 1993 Jul;18(9):1199-205
references.pmid: 8362327
references.citation: Acta Paediatr. 2002;91(12):1339-43
references.pmid: 12578292
references.citation: Pain. 2003 Jan;101(1-2):33-43
references.pmid: 12507698
references.citation: Spine (Phila Pa 1976). 1999 Jul 1;24(13):1316-21
references.pmid: 10404573
references.citation: Spine (Phila Pa 1976). 1993 Feb;18(2):245-51
references.pmid: 8441940
references.citation: Disabil Rehabil. 1997 Dec;19(12):505-12
references.pmid: 9442988
references.citation: Clin Biomech (Bristol, Avon). 2002 Feb;17(2):99-105
references.pmid: 11832259
references.citation: J Biomech. 1991;24(2):117-26
references.pmid: 2037611
references.citation: Appl Ergon. 2000 Aug;31(4):343-60
references.pmid: 10975661
references.citation: Int J Sports Med. 1993 Oct;14(7):406-10
references.pmid: 8244608
references.citation: Spine (Phila Pa 1976). 1989 Jun;14(6):584-90
references.pmid: 2526376
references.citation: Spine (Phila Pa 1976). 1995 Jun 1;20(11):1265-70
references.pmid: 7660235
references.citation: Acta Paediatr. 1992 Dec;81(12):1035-9
references.pmid: 1290849
references.citation: Eur Spine J. 2002 Oct;11(5):459-64
references.pmid: 12384754
references.citation: Spine (Phila Pa 1976). 2001 Apr 15;26(8):897-908
references.pmid: 11317112
references.citation: Spine (Phila Pa 1976). 1992 Apr;17(4):405-11
references.pmid: 1533731
references.citation: BMJ. 2002 Oct 5;325(7367):743
references.pmid: 12364301
references.citation: Eur Spine J. 1999;8(6):444-50
references.pmid: 10664301
references.citation: J Orthop Sports Phys Ther. 2001 Feb;31(2):96-100
references.pmid: 11232744
references.citation: Pediatrics. 2003 Apr;111(4 Pt 1):822-8
references.pmid: 12671119
references.citation: Scand J Public Health. 2000 Sep;28(3):164-73
references.pmid: 11045747
references.citation: Spine (Phila Pa 1976). 1999 Dec 1;24(23):2492-6
references.pmid: 10626312
references.citation: Eur Spine J. 1999;8(6):429-38
references.pmid: 10664299
references.citation: Spine (Phila Pa 1976). 1984 Jul-Aug;9(5):461-4
references.pmid: 6238421
references.citation: Arch Dis Child. 2003 Jan;88(1):12-7
references.pmid: 12495949
references.citation: Spine (Phila Pa 1976). 1994 Jun 15;19(12):1367-70
references.pmid: 8066517
references.citation: Eur Spine J. 1996;5(5):312-8
references.pmid: 8915636
references.citation: Pain. 2002 May;97(1-2):87-92
references.pmid: 12031782
references.citation: Spine (Phila Pa 1976). 1996 Oct 15;21(20):2323-8
references.pmid: 8915066
references.citation: Clin Biomech (Bristol, Avon). 1996 Jan;11(1):1-15
references.pmid: 11415593