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Graça C1,2, Cavalheiro L1,3, Gonçalves RS1,3
1Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal, 2Rainha Santa Isabel Center, Diocesan Caritas of Coimbra, Coimbra, Portugal, 3University of Coimbra, Centre for Health Studies and Research, Coimbra, Portugal
Background: Physiotherapists would have an increasingly important role to play in health promotion of school-aged children and youth. A broader understanding of HRQoL determinants in school-aged children and youth might help in designing more specific and effective physical therapy interventions, and maximizing individual´s potential according to its specific characteristics and needs.
Purpose: The aim of this study was to evaluate the relationships between characteristics of schoolbags, physical fitness performance, back pain intensity and health-related quality of life (HRQoL) profile; and, to estimate the contributions of the different characteristics of schoolbags, physical fitness components and back pain intensity to variations in HRQoL dimensions.
Methods: The sample included 308 Portuguese school-aged children and youth (gender: 44.8% females, 55.2 % males; age: 13.6± 2.5 years; grade: 14.3% 5th, 14.0% 6th, 8.1% 7th, 12.3% 8th, 18.2% 9th, 9.1% 10th, 9.4% 11th, 14.6% 12th). Characteristics of schoolbags were assessed with a questionnaire (type, method of carrying, duration of carrying) and a portable digital luggage scale (weight). Physical fitness performance was assessed with the FITescola battery of tests. The FITescola tests assess the components of body composition, cardiorespiratory fitness, muscular strength, muscular endurance and flexibility. Back pain intensity was assessed with four visual analogue scales (VAS): lumbar pain, dorsal pain, cervical pain and shoulders pain. HRQoL profile was measured with the validated Portuguese Pediatric Quality of Life Inventory (PedsQL), child self-report 8-12 and 13-18, which includes four subscales: physical functioning, emotional functioning, social functioning and school functioning. Statistical analyses were performed using Pearson's correlation coefficients, independent samples t-test and multiple stepwise regression models.
Results: Specific characteristics of schoolbags (type: backpacks with two shoulder straps; method of carrying: one both shoulders; weight: lower), better FITescola tests scores and lower back pain intensity VAS scores were related to higher PedsQL subscales scores (p 0.05). Multiple stepwise regression analysis revealed that gender, grade, specific characteristics of schoolbags (method of carrying), FITescola tests (total handgrip strength, lower limb flexibility test, abdominal strength test, upper limb flexibility test and body mass index) and back pain intensity VAS (cervical pain, dorsal pain and shoulder pain) were predictors of PedsQL subscales. In the final models, selected combinations of those predictors explained 5.3% to 29.6% of the variance in PedsQL subscales scores: physical functioning 29.6%, emotional functioning 16.6%, social functioning 5.3% and school functioning 8.0%. The cervical pain intensity was the variable with highest predictive value to all PedsQL subscales.
Conclusion(s): This study highlighted the importance of gender, grade, method of carrying the schoolbag, cervical pain intensity, dorsal pain intensity, shoulder pain intensity, body composition, muscular strength, muscular endurance and flexibility as predictors of HRQoL dimensions among school-aged children and youth.
Implications: Prevention and rehabilitation programs for school-aged children and youth should emphasize the most relevant characteristics of schoolbags, physical fitness components and back pain intensity.
Keywords: physical fitness, back pain, health-related quality of life
Funding acknowledgements: The work was unfunded.
Purpose: The aim of this study was to evaluate the relationships between characteristics of schoolbags, physical fitness performance, back pain intensity and health-related quality of life (HRQoL) profile; and, to estimate the contributions of the different characteristics of schoolbags, physical fitness components and back pain intensity to variations in HRQoL dimensions.
Methods: The sample included 308 Portuguese school-aged children and youth (gender: 44.8% females, 55.2 % males; age: 13.6± 2.5 years; grade: 14.3% 5th, 14.0% 6th, 8.1% 7th, 12.3% 8th, 18.2% 9th, 9.1% 10th, 9.4% 11th, 14.6% 12th). Characteristics of schoolbags were assessed with a questionnaire (type, method of carrying, duration of carrying) and a portable digital luggage scale (weight). Physical fitness performance was assessed with the FITescola battery of tests. The FITescola tests assess the components of body composition, cardiorespiratory fitness, muscular strength, muscular endurance and flexibility. Back pain intensity was assessed with four visual analogue scales (VAS): lumbar pain, dorsal pain, cervical pain and shoulders pain. HRQoL profile was measured with the validated Portuguese Pediatric Quality of Life Inventory (PedsQL), child self-report 8-12 and 13-18, which includes four subscales: physical functioning, emotional functioning, social functioning and school functioning. Statistical analyses were performed using Pearson's correlation coefficients, independent samples t-test and multiple stepwise regression models.
Results: Specific characteristics of schoolbags (type: backpacks with two shoulder straps; method of carrying: one both shoulders; weight: lower), better FITescola tests scores and lower back pain intensity VAS scores were related to higher PedsQL subscales scores (p 0.05). Multiple stepwise regression analysis revealed that gender, grade, specific characteristics of schoolbags (method of carrying), FITescola tests (total handgrip strength, lower limb flexibility test, abdominal strength test, upper limb flexibility test and body mass index) and back pain intensity VAS (cervical pain, dorsal pain and shoulder pain) were predictors of PedsQL subscales. In the final models, selected combinations of those predictors explained 5.3% to 29.6% of the variance in PedsQL subscales scores: physical functioning 29.6%, emotional functioning 16.6%, social functioning 5.3% and school functioning 8.0%. The cervical pain intensity was the variable with highest predictive value to all PedsQL subscales.
Conclusion(s): This study highlighted the importance of gender, grade, method of carrying the schoolbag, cervical pain intensity, dorsal pain intensity, shoulder pain intensity, body composition, muscular strength, muscular endurance and flexibility as predictors of HRQoL dimensions among school-aged children and youth.
Implications: Prevention and rehabilitation programs for school-aged children and youth should emphasize the most relevant characteristics of schoolbags, physical fitness components and back pain intensity.
Keywords: physical fitness, back pain, health-related quality of life
Funding acknowledgements: The work was unfunded.
Topic: Paediatrics; Primary health care; Musculoskeletal
Ethics approval required: Yes
Institution: Polytechnic Institute of Coimbra, Coimbra, Portugal
Ethics committee: Ethics Committee of the Polytechnic Institute of Coimbra
Ethics number: PCEPC Nº30/2018
All authors, affiliations and abstracts have been published as submitted.
