School-based interventions for spinal pain: a systematic review.
METHODS
Systematic review.


OBJECTIVE
To establish the effectiveness of school-based spinal health interventions in terms of: 1) improving knowledge about the spine/spinal care; 2) changing spinal care behaviors; and 3) decreasing the prevalence of spinal pain.


BACKGROUND
Spinal pain is a significant problem in children and adolescents that has been addressed through school-based spinal health interventions. No systematic review has been carried out on this topic to date.


METHODS
A systematic literature review sought studies that evaluated school-based spinal health interventions. Using clearly defined study inclusion criteria, 11 databases were searched from their inception to March 2004. To identify further literature, three relevant journals were hand searched, reference lists were checked, and authors of included papers were contacted. Two reviewers independently appraised the quality of identified papers and extracted data regarding intervention and study characteristics, statistical analyses performed, and study results. Data were examined using a narrative synthesis of results, and the outcomes of interest were considered individually (knowledge, behaviors, pain prevalence).


RESULTS
Twelve papers were included in this review; all papers received a "weak" quality rating. Results of these studies indicate that school-based spinal health interventions may be effective in increasing spinal care knowledge and decreasing the prevalence of spinal pain. However, overall the evidence is inconclusive regarding spinal care behaviors.


CONCLUSIONS
The poor quality of the reviewed studies limits the conclusions that can be made regarding the effectiveness of school-based spinal health interventions.
Steele
Emily J
EJ
Department of Public Health, University of Adelaide, North Terrace, Adelaide, South Australia, Australia. emily.steele@adelaide.edu.au
Dawson
Anna P
AP
Hiller
Janet E
JE
D001416:Back Pain / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012572:School Health Services / Q000639:trends; D013122:Spinal Diseases / Q000453:epidemiology* / Q000628:therapy*