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Table 1 Characteristics of the studies included in the meta-analysis

From: Preventive physiotherapy interventions for back care in children and adolescents: a meta-analysis

Papers (19)

Studies (23)

Participants

Contents

Interventions

Outcomes

Cardon et al., [19] (2000) Belgium

 

78 subjects Age: 10.2 E = 42 C = 36

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers

The experimental group obtained higher scores than the control group for the behaviors and knowledge in the posttest

    

C: control

 

Cardon et al., [27] (2001) Belgium

(a)

72 subjects 5th grade Age: 11 E = 38 C = 34

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles (12 weeks)

The experimental group obtained higher scores than the control group for the behaviors and knowledge

    

C: control

 
 

(b)

82 subjects 5th grade Age: 11 E = 48 C = 34

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) without extra guidelines of their teachers

The experimental group obtained higher scores than the control group for the behaviors and knowledge

    

C: control

 

Cardon et al., [28] (2002a) Belgium

 

706 subjects Age: 10.02 (9–11) E = 347 C = 359

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers

Intervention children showed better back care knowledge than control children, and knowledge gained was retained over a period of one year

    

C: control

 

Cardon et al., [29] (2002b) Belgium

 

363 subjects 4th, 5th grade Age: 9–12 E = 198 C = 165

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers

The experimental group obtained higher scores than the control group for the behaviors

    

C: control

 

Cardon et al., [30] (2007) Belgium

 

362 subjects 4th, 5th grade E = 190 C = 172

German Back School. Correct realization of different activities of daily life Stretching and strengthening exercises Physical activity: sports, play and active recreation for kids (SPARK)

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines from their teachers to integrate the principles learned and to increase postural dynamics (2 school years) + physical activity promotion program

The experimental group obtained higher scores than the control group for the behaviors and knowledge

    

C: control

 

Cardoso [33] (2009) Brazil

 

519 subjects Age: 8–21 E = 269 C = 250

Spinal care principles and how to incorporate this knowledge into everyday life Behavioral intervention

E: 4 sessions (twice week) Lecture, demonstration, hands on practice (2 weeks)

The experimental group obtained higher scores than the control group for the knowledge

    

C: control

 

Dolphens et al., [52] (2011) Belgium

 

194 subjects Age: 18 E = 96 C = 98

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers

The experimental group obtained higher scores than the control group for the knowledge

    

C: control

 

Geldhof et al., [21] (2006) Belgium

 

365 subjects 4th, 5th grade E = 193 C = 172

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles and to increase postural dynamics (2 school years)

The experimental group obtained higher scores than the control group for the behaviors and knowledge

    

C: control

 

Geldhof et al., [53] (2007a) Belgium

 

69 subjects Age: 8–11 E = 41 C = 28

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles and to increase postural dynamics (2 school years)

The effects of 2 years back education showed an increase in trunk flexor endurance in the experimental group compared to a decrease in the controls

    

C: control

 

Geldhof et al., [54] (2007b) Belgium

 

195 subjects 7th, 8th grade E = 94 C = 101

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the principles learned and to increase postural dynamics (2 school years)

The experimental group obtained higher scores than the control group for the knowledge in the follow-up (2 years)

    

C: control

 

Geldhof et al., [55] (2007c) Belgium

 

245 subjects 6th,7th grade E = 121 C = 124

German Back School Correct realization of different activities of daily life Stretching and strengthening exercises

E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles and to increase postural dynamics (2 school years)

The experimental group obtained higher scores than the control group for the knowledge in the follow-up (1 years)

    

C: control

 

Gómez and Méndez [23] (2000a) Spain

 

67 subjects 5th grade Age: 11 E = 33 C = 34

Anatomy, biomechanics, respiratory mechanism and the way to avoid column overload, risk factors for injury, spinal care principles

E: 8 sessions (30 mins; once a week). Lecture to incorporate knowledge about the correct functioning of the body and to avoid vertebral overload and back injuries from childhood.

The experimental group obtained higher scores than the control group for the knowledge in the posttest and the follow up carried out in 6 months time.

    

C: performed with their academic tutor-teacher about related matters.

 

Gómez and Méndez [40] (2000b) Spain

(a)

65 subjects 5th grade Age: 11 E = 33 C = 32

Postural hygiene, how to incorporate this knowledge into everyday life Behavioral intervention

E: Information and training from a physiotherapist + parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours)

The experimental group obtained higher scores than the control group for the behaviors

    

C: parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours)

 
 

(b)

66 subjects 5th grade Age: 11 E = 34 C = 32

Postural hygiene, how to incorporate this knowledge into everyday lifeBehavioral intervention

E: Piece of ergonomics advice from a tutor + parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours)

The experimental group obtained higher scores than the control group for the behaviors

    

C: parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours)

 

Kovacs et al., [56] (2011) Spain

 

574 subjects Age: 8 E = 320 C = 254

Comic Book of the Back

E: Comic Book of the Back handed over by teachers

The experimental group obtained higher scores than the control group for the knowledge

    

C: control

 

Martínez [34] (2007) Spain

 

579 subjects (3rd- 6th grade) Age: 7–12 E = 314 C = 265

Spinal care principles and how to incorporate this knowledge into everyday life Behavioral intervention

E: 5 sessions (once week) Lecture, demonstration, hands on practice (5 weeks)

The experimental group obtained higher scores than the control group for the behaviors and knowledge in the posttest

    

C: control

 

Méndez and Gómez [20] (2001) Spain

 

70 subjects 3rd grade Age: 9 E = 35 C = 35

Anatomy, biomechanics, risk factors for injury, spinal care principles Behavioral intervention Correct realization of different activities of daily life Stretching and strengthening exercises

E: 11 sessions (60 mins; once a week): 8 sessions (postural hygiene knowledge and behaviors; each lasted 2 hours) and 3 sessions (physiotherapy exercise; each lasted 1 hour), total of 19 hours

The experimental group obtained higher scores than the control group for the knowledge and behaviors in the posttest and the follow up carried out after 12 months

    

C: took part in different academic activities with related themes

 

Park and Kim [41] (2011) South Korea

(a)

59 subjects 5th grade Age: 11 E = 28 C = 31

Web-based spinal health education program (anatomy, functions of the spine, spinal care principles, stretching and strengthening exercises, backpack use)

E: 4 sessions (30 mins; once a week) Web-based program 3 parts (learning, formative evaluation, learning summary sections) (4 weeks)

The changes for spinal health knowledge were significantly higher than those of the control group.

    

C: control

 
 

(b)

60 subjects 5th grade Age: 11 E = 29 C = 31

Face-to-face spinal health education program (anatomy, functions of the spine, spinal care principles, stretching and strengthening exercises, backpack use)

E: 4 sessions (30 mins; once a week) Face-to-face instruction 3 parts (learning, formative evaluation, learning summary sections) (4 weeks)

The changes for spinal health knowledge were significantly higher than those of the control group.

    

C: control

 

Spence et al., [22] (1984) US

(a)

50 subjects 3rd, 5th grade E = 25 C = 25

Safe lifting techniques

E: 1 session: lecture demonstration (5 mins videotape), review of the major principles presented in the tape (5 mins)

Showed significantly higher knowledge in the experimental group versus the control group in the posttest, but no significant differences between groups in the follow-up (2 months) Behaviours: Provided inconclusive or statistically insignificant results

    

C: without intervention

 
 

(b)

51 subjects 3rd, 5th grade E = 26 C = 25

Safe lifting techniques

E: 1 session: guided self discovery (15 mins)

Showed significantly higher knowledge in the experimental group versus the control group in the posttest, but no significant differences between groups in the follow-up (2 months) Behaviours: Provided inconclusive or statistically insignificant results

    

C: without intervention

 

Vidal et al., [24] (2009) Spain

 

137 subjects Age: 10–12 E = 63 C = 74

Anatomy, biomechanics, risk factors for injury, spinal care principles, respiratory mechanism, postural hygiene Behavioral intervention Exercise

E: 6 sessions: 4 sessions (knowledges: anatomy, biomechanics, risk factors for injury, spinal care principles, respiratory mechanism, postural hygiene) and 2 sessions (behavioral intervention, exercise); total of 4 weeks

The experimental group obtained higher scores than the control group for the knowledge

    

C: without intervention

 
  1. E: experimental group / C control group.
  2. All studies are randomized controlled.