Pain and Moderate to Vigorous Physical Activity in Adolescence: An International Population-Based Survey.
To evaluate whether individual types of pain (headache, stomach-ache, and backache) or multiple pains affect the odds of young people achieving the recommended 60 minutes of moderate to vigorous physical activity (MVPA) per day in a large representative sample.



Multicenter cross-sectional survey.



Twenty-eight countries across Europe and North America.



Adolescents (N = 242,103).



An analysis of data collected in two waves (2001/02 and 2005/06) of the health behavior in school-aged children (HBSC) study was performed. Survey questions included the HBSC symptoms checklist and the amount of regular physical activity. Multilevel logistic regression was used to account for clustering effect of MVPA within countries. Models investigated the relationship between pain and physical activity, adjusted for the HBSC study year. Six models were conducted separately for gender and age-group (11, 13, and 15 years) strata.



In general, the presence of pain was associated with reduced physical activity. Headache alone was associated with reduced physical activity in all six strata (odd ratios 0.77-0.84), stomach-ache alone in five strata (0.77-0.92), and backache alone in four strata (0.86-0.96). In 11- and 13-year-old girls, headache, stomach-ache, and backache, individually and in combination, were associated with decreased odds of being physically active (odds ratios ranging from 0.73 to 0.91). Within the other four age and gender strata, the relationship was less consistent.



Pain is associated with reduced physical activity in adolescents but this association varies according to gender, age, and the type of pain experienced.
Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia.
Michael Steven
MS
Swain
Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Institute of Public Health, Heidelberg Medical School, University of Heidelberg, Heidelberg, Germany.
Nicholas
N
Henschke
Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Department of Epidemiology and Biostatistics, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.
Steven James
SJ
Kamper
Department of Public Health and Epidemiology, Riga Stradinš University, Latvia.
Inese
I
Gobina
Department of Child and Adolescent Psychiatry, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Veronika
V
Ottová-Jordan
Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Christopher Gerard
CG
Maher
Adolescent; Epidemiology; Health Behavior in School-Aged Children; Pain; Physical Activity