title: Effects of a two-school-year multifactorial back education program in elementary schoolchildren.
abstract: METHODS
  A quasi-experimental pre/post design.
  
  
  OBJECTIVE
  To investigate effects of a 2-school-year multifactorial back education program on back posture knowledge and postural behavior in elementary schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance beliefs were evaluated.
  
  
  BACKGROUND
  Epidemiologic studies report mounting nonspecific back pain prevalence among youngsters, characterized by multifactorial risk factors. Study findings of school-based interventions are promising. Furthermore, biomechanical discomfort is found in the school environment.
  
  
  METHODS
  The study sample included 193 intervention children and 172 controls (baseline, 9-to-11-year-olds). The multifactorial intervention consisted of a back education program and the stimulation of postural dynamism in the class through support and environmental changes. Evaluation consisted of a questionnaire, an observation of postural behavior in the classroom, and an observation of material handling during a movement session.
  
  
  RESULTS
  The intervention resulted in increased back posture knowledge (P < 0.001), improved postural behavior during material handling (P < 0.001), and decreased duration of trunk flexion (P < 0.05) and neck torsion (P < 0.05) during lesson time. The intervention did not change fear-avoidance beliefs. There was a trend for decreased pain reports in boys of the intervention group (P < 0.09).
  
  
  CONCLUSIONS
  The intervention resulted in improved postural aspects related to spinal loading. The long-term effect of improved postural behavior at young age on back pain prevalence later in life is of interest for future research.
authors.affiliation: Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium. elisabeth.geldhof@ugent.be
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Geldhof
authors.forename: Greet
authors.initials: G
authors.lastname: Cardon
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.forename: Dirk
authors.initials: D
authors.lastname: De Clercq
mesh_terms: D001415:Back; D002648:Child; D002652:Child Behavior; D004493:Education; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D011187:Posture; D012574:Schools; D011795:Surveys and Questionnaires