title: Lower limb pain in a preadolescent population: prognosis and risk factors for chronicity--a prospective 1- and 4-year follow-up study.
abstract: OBJECTIVE
  To determine the short-term and long-term prognosis of preadolescent lower limb pain and to assess factors that contribute to pain persistence at 1-year follow-up and pain recurrence at 4-year follow-up.
  
  
  METHODS
  A 1- and 4-year follow-up was conducted of a population-based 10- and 12-year old cohort of schoolchildren with lower limb pain at baseline.
  
  
  RESULTS
  Of the baseline students with lower limb pain, 32% reported pain persistence at 1-year follow-up and 31% reported pain recurrence at 4-year follow-up. Vigorous exercise was the only statistically significant predictor of lower limb pain persistence at 1-year follow-up (odds ratio [OR]: 2.43; 95% confidence interval [CI]: 1.16-5.05), whereas at 4-year follow-up (at adolescence), hypermobility was predictive of pain recurrence (OR: 2.93; 95% CI: 1.13-7.70). Traumatic lower extremity pain had a 50% lower risk for pain recurrence compared with nontraumatic pain (OR: 0.48; 95% CI: 0.19-0.92).
  
  
  CONCLUSIONS
  Trauma-induced lower extremity pain in preadolescents has a favorable long-term natural course. Children's involvement in vigorous exercise predicts short-term outcome of lower limb pain, whereas hypermobile children have a worse long-term prognosis.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Rheumatism Foundation Hospital, Heinola, Finland. ae71607@uta.fi
authors.forename: Ashraf
authors.initials: A
authors.lastname: El-Metwally
authors.forename: Jouko J
authors.initials: JJ
authors.lastname: Salminen
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Marja
authors.initials: M
authors.lastname: Mikkelsson
mesh_terms: D002648:Child; D002908:Chronic Disease; D003625:Data Collection; D015444:Exercise; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000150:complications; D007869:Leg Injuries / Q000150:complications; D035002:Lower Extremity; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors