This study evaluates the effects of a physiotherapist-led, school-based back-health education program delivered in primary school classrooms. The intervention consists of a theoretical-practical workshop focused on postural habits, physical activity, electronic device use, and backpack handling. The study includes schoolchildren with and without spinal pain and assesses changes in spinal pain characteristics, postural behaviors, physical activity patterns, and electronic device use over a three-month period. The main objective is to determine whether this educational program improves back-health behaviors and related outcomes in the school setting.
This study investigates the impact of a physiotherapist-led, school-based back-health education program in primary schoolchildren aged 9 to 11 years. The intervention consists of a classroom-based theoretical-practical workshop delivered by physiotherapists in two 45-minute sessions. The program covers fundamental concepts of spinal anatomy and biomechanics, correct postural habits in daily activities (sitting, standing, sleeping, and rising from bed), safe backpack handling and load distribution, regular physical activity recommendations, and ergonomically appropriate use of electronic devices. Participants complete a 21-item self-administered questionnaire at baseline and three months after the intervention. The questionnaire includes items addressing spinal pain (cervical, thoracic, and lumbar regions), pain duration and intensity, postural habits, backpack-related behaviors, physical activity patterns, and electronic device use. The study includes both symptomatic and asymptomatic schoolchildren to evaluate preventive and therapeutic outcomes. The primary aim is to examine changes in spinal pain prevalence and characteristics following the intervention. Secondary aims include evaluating changes in postural habits, backpack-related behaviors, physical activity frequency and duration, electronic device use, and back-health knowledge. Data analysis compares pre- and post-intervention outcomes using appropriate statistical tests for paired categorical and non-normally distributed variables. The study seeks to determine whether a physiotherapist-led educational intervention implemented within the school curriculum can effectively improve back-health behaviors and modifiable ergonomic risk factors in primary schoolchildren.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
317
Participants receive a two-session educational workshop delivered by physiotherapists. The workshop covers basic spinal anatomy, postural hygiene, the importance of extracurricular physical activity, and strategies to regulate screen use to reduce sedentary behavior. Each session lasts 45 minutes, held 2-3 weeks apart, and includes both theoretical and practical components such as proper sitting and standing posture, ergonomic adjustment of the school workstation, correct backpack use, load handling, and promotion of active habits.
Faculty of Physiotherapy
Pontevedra, Galicia, Spain
Change in spinal pain prevalence
Change in the prevalence of spinal pain (cervical, thoracic, and lumbar), assessed using a self-administered questionnaire. Metric: Proportion of participants reporting spinal pain in each spinal region at both assessment points.
Time frame: Baseline, 3 months
Change in spinal pain intensity
Change in spinal pain intensity measured using the Wong-Baker FACES Pain Scale. Metric: Difference in score (0-10) between baseline and 3 months.
Time frame: Baseline, 3 months
Change in spinal pain duration
Change in spinal pain duration categories (\<12 h, 12-24 h, 1-7 days, \>1 week). Metric: Shift in categorical distribution from baseline to 3 months.
Time frame: Baseline, 3 months
Change in Postural Habits
Change in postural habits, including sitting posture, sleeping posture, and method of rising from bed, assessed through a self-administered questionnaire. Metric: Proportion of participants reporting correct posture in each domain (sitting, sleeping, rising from bed).
Time frame: Baseline, 3 months
Change in Daily Duration of Habitual Physical Activity
Assesses changes in the average number of hours per day that children engage in habitual physical activity (e.g., free play, sports participation, structured or unstructured movement). Daily duration is self-reported through the standardized 21-item questionnaire administered at both time points. The available response options are: "0 hours per day," "1 hour per day," "2 hours per day," "3 hours per day," and "4 hours per day." Metric: Difference in the daily duration of physical activity (hours per day) between baseline and the three-month follow-up.
Time frame: Baseline, 3 months
Change in Weekly Frequency of Electronic Device Use
Assesses changes in the number of days per week in which children report using electronic devices. Frequency is obtained from the same self-reported 21-item questionnaire administered at both time points. The available response options are: "I don't play," "1-2 times per week," "3-4 times per week," "4-6 times per week," or "every day." Metric: Difference in the weekly frequency of electronic device use (days per week) between baseline and the three-month follow-up.
Time frame: Baseline, 3 months
Satisfaction with the Educational Intervention
Assessed with a 5-item ad hoc questionnaire administered after the final workshop. Item 1: Ratings of duration, printed materials, presenter, theoretical lecture, and practical demonstration using a 0-4 scale (0=very poor, 4=excellent). Items 2-4: Impact of the workshop rated as "nothing," "a little," or "a lot" (knowledge about spine care; knowledge about physical activity benefits and sedentary risks; opinion on implementing workshops for all students). Item 5: Open-ended suggestion for improvement.
Time frame: immediately after the final workshop
Change in Backpack-Related Behaviors
Change in multiple backpack-related behaviors, including backpack type, weight distribution, organization/inspection routines, and carrying method. Metric: Proportion of participants reporting recommended behaviors in each category.
Time frame: Baseline, 3 months
Change in Daily Duration of Electronic Device Use
Assesses changes in the average number of hours per day that children use electronic devices (e.g., smartphone, tablet, computer, TV). Daily duration is self-reported through the standardized 21-item questionnaire used in the study. The available response options are: "0 hours per day," "1 hour per day," "2 hours per day," "3 hours per day," and "4 hours per day." Metric: Difference in the daily duration of electronic device use (hours per day) between baseline and the three-month follow-up.
Time frame: Baseline, 3 months
Change in Weekly Frequency of Habitual Physical Activity
Assesses changes in the number of days per week in which children report engaging in physical activity. Weekly frequency is obtained from the same self-reported 21-item questionnaire used in the study. The available response options are: "1 day per week," "2-3 days per week," "4-6 days per week," "every day," and "never." Metric: Difference in weekly frequency of physical activity (days per week) between baseline and three-month follow-up.
Time frame: Baseline, 3 months
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