School-based Education Programmes for Improving Knowledge of Back Health, Ergonomics and Postural Behaviour of School Children

Background: Musculoskeletal and back Health of school aged children is a global health problem with evidence that the prevalence of these problems is increasing. Many modern school systems require children to assume sedentary positions for extended periods of time, and the increasing use of classroom-based technology adds to the number of hours seated. With the incidence of musculoskeletal pain reported not only in adult populations but increasingly in young people, an understanding of spinal health and posture may be essential for students.
Objective/s: The main objective was to assess the effectiveness of school-based education programs on back health for improving knowledge of back health, ergonomics and postural behaviour in school children aged 4-18 years.
Search Methods: We searched 21 electronic databases (MEDLINE, EMBASE, ERIC, CINAHL, CENTRAL, SCOPUS, Best Evidence Medical Education, Web of Knowledge, Google Scholar, PsycInfo etc) and dissertation databases (ProQuest) for relevant studies. We complemented our search with a thorough examination of reference lists of identified studies and searched trial registries for on-going studies, grey literature, proceedings, and PhD theses.
Selection Criteria: Two authors independently screened the titles and abstracts for relevant studies. Full texts of studies with seemingly relevant abstracts were retrieved and assessed for eligibility using the pre-specified inclusion criteria. Studies were classified as either included, excluded, awaiting assessment, or on-going.
Results: In this best evidence systematic review, 1,327 possibly relevant papers were found through searches of academic databases, while no study was identified through searches of grey literature and reference lists. After removing 1,256 duplicates, 71 remained for screening. 38 articles were excluded based on screening the titles and abstracts. This left 32 articles for further examination of full texts which continued to the quality assessment/ROB stage. Only three papers, by Candotti (2011), Habybabady (2012) and Gallardo (2013) all of which scored 22 (good) on the Downs and Black ROB form (D&B) were found to be eligible to be included within this review. The quality of the remaining papers (based on the D&B criteria) was found to be fair or poor with a high risk of bias.
Conclusions: Despite the comprehensive search only 3 studies which were conducted over 10 years ago, were found, that provided good evidence on the effectiveness of school-based education programs on knowledge of back health, ergonomics and postural behaviour. We did not find any papers that achieved an “excellent” score. This highlights the urgent need for high quality studies to be conducted to assess the effects of these programmes due to the importance of ergonomics and posture in the activities of daily living of school children.