PAIN PRESENCE, PAIN INTENSITY AND DISABILITY IN HIGH SCHOOL STUDENTS ARE DIFFERENTLY ASSOCIATED WITH PHYSICAL ACTIVITY, SCREENING HOURS AND SLEEP

Silva A.^1,2, Sa-Couto P.³, Queirós A.¹, Neto M.⁴, Pacheco N.⁵

¹University of Aveiro, School of Health Sciences, Aveiro, Portugal, ²University of Aveiro, CINTESIS.UA, Aveiro, Portugal, ³University of Aveiro, Department of Mathematics, Aveiro, Portugal, ⁴Primary Healthcare Center, Av. Dr. Rocha Madail, S/N, Ílhavo, Portugal, ⁵University of Aveiro, Department of Medical Sciences, Aveiro, Portugal

Background: The association between physical activity, screen time and sleep and pain is conflicting. Existing studies tend to assess a limited number of body sites and to investigate the individual association between each of these variables and pain.

Purpose: This study aims to explore and compare the association between time spent in self-reported physical activity, in screen based activities and sleeping and i) pain reporting in the last 7-days for nine different body sites, ii) pain intensity at nine different body sites and iii) global pain disability.

Methods: 969 adolescents completed a series of questionnaires on pain (an adaptation of the Nordic Musculoskeletal Questionnaire), pain disability, time spent in moderate and vigorous physical activity, screen based time and sleeping hours. Multivariate associations between physical activity, screen based time and sleeping hours (independent variables) and pain presence, pain intensity and pain disability (dependent variables) were explored using independent models for each dependent variable.

Results: A total of 652 (67.3%) students reported pain in the last 7 days in at least one body site. Of these, 371 (56.9%) students reported difficulty due to pain with at least one daily activity. Mean pain intensity(±SD) varied between 3.6±1.8 in the neck and 4.3±2.1 in the low back. Pain presence: More time in moderate physical activity increased the risk of pain in the neck, shoulders, wrists, hips and ankles/feet (OR between 1.06-1.09; p 0.05); more time in vigorous physical activity increased the risk of pain in mid back, knees and ankles/feet (OR between 1.05-1.08, p 0.05); fewer sleeping hours increased the risk of pain in the neck, shoulders and mid back (OR between 3.43-6.95); more time spent in screen based activities increased the risk of pain in the low back (OR= 2.43, p 0.05). Pain intensity: More time spent in moderate physical activity was significantly associated with higher pain intensity in the wrists (R2=0.04, p 0.05); more time spent in screen based activities was significantly associated with higher pain intensity in the neck, shoulders, mid back, low back, knee and ankle/feet (R2 between 0.02 and 0.08, p 0.05). Vigorous physical activity and sleeping hours were not associated with pain intensity. Pain disability: No significant association was found between time spent in physical activity, screen based activities and sleeping and pain disability.

Conclusion(s): Results suggest that physical activity, screening time and sleeping hours are differently associated with pain in the last 7-days, pain intensity and pain disability in high school students and that the existence of an association depends on the body site considered.

Implications: Results suggest that depending on the aim of a physiotherapy programme and on the body region for which it is being developed, the relative importance of targeting physical activity, screen time and sleep time may vary. For example, physical activity and sleep may be more relevant when aiming to prevent pain, while screen based time seems more relevant when managing pain and aiming to decrease pain intensity.

Funding acknowledgements: No funding.

Topic: Musculoskeletal

Ethics approval: Council of Ethics and Deontology, Faculty of Medicine, University of Porto, Portugal.

All authors, affiliations and abstracts have been published as submitted.