Abstract
Background: Low back pain (LBP) in children of school age has become an increasingly recognized health concern. Moreover, poor posture among children has emerged as a significant problem. However, large-scale studies evaluating the relationship between LBP prevalence and objectively measured spinal alignment using Spinal Mouse technology remain limited. This study aimed to determine the prevalence of LBP in children of school age and identify associated factors.
Methods: This cross-sectional study included 899 children (451 males, 448 females, mean age 10.6 years) who participated in the 2023 Katsuragi Integrated Defense for Locomotive Syndrome in Children (KID Locomo) study. LBP was assessed through questionnaires. Body composition and spinal alignment parameters including lumbar lordosis and sacral inclination were measured using Spinal Mouse. Associations between these parameters and LBP were evaluated considering age, sex, physical activity time, muscle mass, and postural awareness. Statistical analysis was performed using Student's t-test.
Results: LBP was present in 45 children (5.0%), with no significant sex difference (p=0.17). The LBP group showed significantly higher values for age (12.6 vs. 10.5 years), longer weekly physical activity time (385.5 minutes vs. 219.3 minutes), appendicular skeletal muscle mass (16.0 kg vs. 12.6 kg), trunk muscle mass (18.3 kg vs. 14.9 kg), and skeletal muscle index (all p<0.05). In addition, the LBP group had significantly higher rates of neck stiffness (46.7% vs. 7.5%), parental awareness of poor posture (75.6% vs. 52.9%), student awareness of poor posture (77.8% vs. 51.3%), and lower sitting sacral inclination (14.1° vs. 16.5°) (p<0.05).
Conclusions: The prevalence of LBP in children of school age was 5.0%. Associated factors included older age, longer weekly physical activity time, increased muscle mass, decreased sacral inclination in sitting position, and awareness of poor posture. LBP may increase owing to growth-related changes, lifestyle factors, and postural influences.
