Ellen Aartun1, Jan Hartvigsen2, Lise Hestbaek3. 1. Research Fellow, Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. Electronic address: ellenaartun@hotmail.com. 2. Professor, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Senior Researcher, Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark. 3. Senior Researcher, Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark; Associate Professor, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Abstract
OBJECTIVE: The overall aim of this study was to determine the ability of 2 selected clinical tests to detect or predict neck pain, mid back pain, and low back pain in a school-based cohort of Danish 11- to 15-year-olds. METHODS: A school-based 2-year prospective cohort study was conducted. Data were collected at the age of 11 to 13 (n = 1224) and 2 years later (n = 963). Spinal pain (neck pain, mid back pain, and low back pain) was assessed by an electronic survey completed during school time, and reference standard was defined as both lifetime prevalence and frequent pain as a proxy of severity. The tests included assessments of scoliosis, hypermobility, global mobility, intersegmental mobility, end range pain, and isometric endurance of back extensors. Sensitivity, specificity, negative and positive predictive values, and odds ratios were calculated for each test individually, and area under the receiver operating characteristic curve was calculated for evaluation of all tests combined. RESULTS: The sensitivity was low, and specificity was high for all tests at both baseline (age, 11-13 years) and follow-up (age, 13-15 years). When all tests were evaluated collectively in 1 model, the area under the receiver operating characteristic curve ranged from 0.60 to 0.65. None of the selected tests could predict incidence cases of neck pain, mid back pain, or low back pain. CONCLUSION: Clinical tests commonly used in spinal screening in adolescents could not detect present spinal pain or predict future spinal pain. However, some statistically significant associations between spinal pain and tests involving a pain response from the participant were found.
OBJECTIVE: The overall aim of this study was to determine the ability of 2 selected clinical tests to detect or predict neck pain, mid back pain, and low back pain in a school-based cohort of Danish 11- to 15-year-olds. METHODS: A school-based 2-year prospective cohort study was conducted. Data were collected at the age of 11 to 13 (n = 1224) and 2 years later (n = 963). Spinal pain (neck pain, mid back pain, and low back pain) was assessed by an electronic survey completed during school time, and reference standard was defined as both lifetime prevalence and frequent pain as a proxy of severity. The tests included assessments of scoliosis, hypermobility, global mobility, intersegmental mobility, end range pain, and isometric endurance of back extensors. Sensitivity, specificity, negative and positive predictive values, and odds ratios were calculated for each test individually, and area under the receiver operating characteristic curve was calculated for evaluation of all tests combined. RESULTS: The sensitivity was low, and specificity was high for all tests at both baseline (age, 11-13 years) and follow-up (age, 13-15 years). When all tests were evaluated collectively in 1 model, the area under the receiver operating characteristic curve ranged from 0.60 to 0.65. None of the selected tests could predict incidence cases of neck pain, mid back pain, or low back pain. CONCLUSION: Clinical tests commonly used in spinal screening in adolescents could not detect present spinal pain or predict future spinal pain. However, some statistically significant associations between spinal pain and tests involving a pain response from the participant were found.
Authors: Michael Frosch; Maximilian D Mauritz; Stefan Bielack; Susanne Blödt; Uta Dirksen; Michael Dobe; Florian Geiger; Renate Häfner; Lea Höfel; Bettina Hübner-Möhler; Thekla von Kalle; Burkhard Lawrenz; Andreas Leutner; Frauke Mecher; Kiril Mladenov; Heike Norda; Lorin Stahlschmidt; Marc Steinborn; Ralf Stücker; Ralf Trauzeddel; Regina Trollmann; Julia Wager; Boris Zernikow Journal: Children (Basel) Date: 2022-02-02