Motor performance and back pain in children and adolescents: A systematic review

Abstract

Background and Objective Motor performance during childhood and adolescence is recognized as a relevant determinant of present and future health, but its effects on back pain (BP) remain unclear. In this systematic review, we aimed to identify the association between motor performance and BP in children and adolescents. Databases and Data Treatment A literature search was performed in the MEDLINE, Scopus, Embase, SPORTDiscus and CINAHL databases. We included cross‐sectional, cohort, case‐control and controlled clinical trials (data from control groups). The inclusion criteria were as follows: (a) participants aged 6–19 years; (b) assessment motor performance components; (c) assessment of BP and (d) reported measures of association. The risk of bias was assessed by the Downs and Black instrument and the quality of evidence by the grading of recommendations, assessment, development and evaluation (GRADE). Results A total of 2360 articles were identified, 25 of which were included in our systematic review. Of the 25 studies, 19 were evaluated as having a low risk of bias. GRADE indicated that 20 studies presented low or very low quality. Most of the studies evaluated flexibility (n = 16), muscle endurance (n = 18) and muscle strength (n = 9). Aerobic capacity, balance and speed were also examined in some studies (n < 5). Overall, motor performance (flexibility, muscle endurance, muscle strength, aerobic capacity, balance and speed) was not associated with BP. Most of the results were inconsistent because of the lack of studies, risk of bias and low quality of evidence. Only trunk extensor muscle endurance was associated with decreased BP with moderate quality of the supporting evidence. Prospective studies with a low risk of bias are warranted to further clarify this relationship in childhood and adolescence and findings may support more targeted and effective health promotion interventions. Significance This systematic review shows that motor performance (flexibility, muscle endurance, muscle strength, aerobic capacity, balance and speed) was not associated with BP in children and adolescents. Most of the results were inconsistent because of the lack of studies, risk of bias and low quality of evidence. Only trunk extensor muscle endurance was associated with decreased BP with moderate quality of supporting evidence.

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis

“…Of these, after applying the eligibility criteria, 288 were selected for full-text reading, after which a total of 51 articles were selected. However, as 21 of these required additional data [ 6 , 25–44 ], we contacted the respective authors, and obtained eight responses [ 6 , 29 , 30 , 37 , 40 , 44 , 46 , 47 ]. Thus, 33 articles were included in this systematic review [ 11 , 12 , 27 , 34 , 54–82 ], of which 16 were included [ 12 , 27 , 34 , 54 , 56 , 58–60 , 64 , 68 , 69 , 71 , 74 , 77–79 ] in the meta-analysis ( Figure 1 ).…”

“…The risk of bias during the process of selection of studies was assessed using the Downs & Black Scale [ 46 ]. However, only the items related to observational studies [ 1–3 , 5–12 , 17 , 19 , 20 , 24 , 25 ] were applied [ 47 ]. Studies with scores higher than 70% were considered as having a low risk of bias [ 46 ].…”

Prognostic Role of PD-L1 Expression in Invasive Breast Cancer: A Systematic Review and Meta-Analysis

“…The proportion of PD-L1 expression was significantly higher in patients aged <50 years vs. those aged ≥50 years in TCs and ICs: 33% vs. 67% in TCs ( p < 0.001; I 2 = 88.86%) [ 17 , 20 , 36 , 38 ] and 38% vs. 62% in ICs ( p < 0.001; I 2 = 73.97%) [ 19 , 20 , 36 ] ( Figure S1A,B ). The pooled meta-analysis showed no significant difference in PD-L1 expression between TCs and ICs in women aged ≥50 years ( p = 0.283).…”

“…The authors who participated in the eligibility assessments were trained regarding the study inclusion/exclusion criteria and completed a practice eligibility assessment on 50 test abstracts before starting to code articles. Moreover, the authors were also trained in performing risk of bias instruments on five articles not included in the study as well as standardized analyses using Mendeley and Rayyan software [ 17 ].…”

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“…24 The methodological quality of studies was assessed through an adapted version of the Downs and Black Risk of Bias Checklist, 25 which is recommended by the Cochrane Handbook for Systematic Reviews of Interventions 21 and used widely in systematic reviews of case-control studies. [26][27][28][29] The scale was adapted by excluding items referring to intervention assessment (items 4, 8, 9, 13, 14, 16, 17, 19, 21-24, and 26). The risk of bias was calculated through the quality index (QI), classifying the studies into low, moderate, or high quality.…”