Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression

摘要

OBJECTIVES: This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-schoolstudents.METHODS: In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistagestratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements wereassessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and DifficultiesQuestionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularizationmethod was used for variable selection and data analysis (α=0.05). The chi-square test was also used.RESULTS: In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95%confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seatbackrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks(OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder(OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) wereassociated with LBP.CONCLUSIONS: A high prevalence of LBP was found among elementary-school students. This study underscores the importanceof recognizing vulnerable children and teenagers and developing interventional health promotion programs to preventLBP based on an appropriate consideration of its contributory factors.