Effectiveness of an at-work exercise program in the prevention and management of neck and low back complaints in nursery school teachers. IMPLEmenting a clinical practice guideline for acute low back pain evidence-based manageMENT in general practice (IMPLEMENT): Cluster randomised controlled trial study protocol [Back school for patients with non-specific chronic low-back pain: benefits from the association of an exercise program with patient's education]. Back posture education in elementary schoolchildren: a 2-year follow-up study Spinal pain in adolescents: prevalence, incidence, and course: a school-based two-year prospective cohort study in 1,300 Danes aged 11–13 Low back pain education and short term quality of life: a randomized trial A comprehensive pain management programme comprising educational, cognitive and behavioural interventions for neuropathic pain following spinal cord injury. Effectiveness of a back school program in low back pain. Testing the feasibility of a knowledge translation intervention designed to improve chiropractic care for adults with neck pain disorders: study protocol for a pilot cluster-randomized controlled trial Effectiveness of manual therapies: the UK evidence report Coping effectiveness training for people with spinal cord injury: preliminary results of a controlled trial. [Feasability of a back school assessment programme]. Long-term outcomes of a multidisciplinary cognitive behavioural programme for coping with chronic neuropathic spinal cord injury pain. A Controlled, Prospective Study to Evaluate the Effectiveness of a Back School in the Relief of Chronic Low Back Pain The CONECSI trial: Results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury Multimodal cognitive-behavioural treatment for workers with chronic spinal pain: a matched cohort study with an 18-month follow-up A back school in The Netherlands: evaluating the results.
The aim of the study was to determine the effectiveness of an extension-oriented exercise program in the prevention and management of low back/neck pain in nursery school teachers . A Cluster R and omized Controlled Trial was utilized . Seventy-one nursery school teachers working in nine school buildings were r and omly divided into two groups , with each school as a unit of r and omization . All the teachers in both groups received an ergonomic brochure ; teachers in the experimental group also received an extension-oriented exercise program , conducted by a physical therapist . Data were collected at baseline and at a two-month follow-up . The primary outcome measure recorded was the level of disability ( Rol and Morris Disability Question naire and Oswestry Disability Index ) , while secondary outcome measure included the evaluation of cervical and lumbar physical discomfort ( Visual Analogue Scale ) . At follow-up , a significant improvement was registered in the experimental group as compared to the control group for all the outcomes evaluated . In conclusion an extension-oriented exercise program may be a useful strategy to prevent low back and neck complaints and to reduce consequent LBP functional disability among nursery school teachers Background Evidence generated from reliable research is not frequently implemented into clinical practice . Evidence -based clinical practice guidelines are a potential vehicle to achieve this . A recent systematic review of implementation strategies of guideline dissemination concluded that there was a lack of evidence regarding effective strategies to promote the uptake of guidelines . Recommendations from this review , and other studies , have suggested the use of interventions that are theoretically based because these may be more effective than those that are not . An evidence -based clinical practice guideline for the management of acute low back pain was recently developed in Australia . This provides an opportunity to develop and test a theory-based implementation intervention for a condition which is common , has a high burden , and for which there is an evidence - practice gap in the primary care setting . Aim This study aims to test the effectiveness of a theory-based intervention for implementing a clinical practice guideline for acute low back pain in general practice in Victoria , Australia . Specifically , our primary objectives are to establish if the intervention is effective in reducing the percentage of patients who are referred for a plain x-ray  , and improving mean level of disability for patients three months post-consultation . Methods / Design This study protocol describes the details of a cluster r and omised controlled trial . Ninety-two general practice s ( clusters ) , which include at least one consenting general practitioner , will be r and omised to an intervention or control arm using restricted r and omisation . Patients aged 18 years or older who visit a participating practitioner for acute non-specific low back pain of less than three months duration will be eligible for inclusion . An average of twenty-five patients per general practice will be recruited , providing a total of 2,300 patient participants . General practitioners in the control arm will receive access to the guideline using the existing dissemination strategy . Practitioners in the intervention arm will be invited to participate in facilitated face-to-face workshops that have been underpinned by behavioural theory . Investigators ( not involved in the delivery of the intervention ) , patients , outcome assessors and the study statistician will be blinded to group allocation . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN012606000098538 ( date registered 14/03/2006 ) OBJECTIVE < < Back School > > has been used as a way of preventing and treating back pain since 1969 , but reports in the literature on its effectiveness remain controversial . The purpose of this trial was to evaluate efficacy of a back school program for non- -specific chronic low-back pain . PATIENTS AND METHODS Seventy patients were r and omized into two groups : experimental group ( 34 patients ) and control group ( 36 patients ) . Experimental group patients participated in a theoretical and practical back school program , which was composed of 4 weekly classes of 60 minutes .  Control group patients  were allocated at a waiting list . Three evaluations took place ( baseline , after 4 and 16 weeks ) . The following variables were analyzed : pain intensity ( visual numeric analogue scale ) , functional disability ( Rol and -Morris Disability Question naire ) and spinal mobility ( Schöber index ) . Statistical analysis for intra-group and inter-group used significance level of p < 0.05 . RESULTS 57 patients were analyzed ( 29 in experimental group and 28 in control group ) . A statistically significant improvement was observed only in the experimental group , regarding pain intensity , functional disability and spine mobility . Such improvements have persisted after 16 weeks in pain intensity and functional disability variables . In the inter-group analysis we observed a statistically significant difference in the second and third evaluations concerning the functional disability variables and spinal mobility . CONCLUSION The Back School program proposed in this study seems to be effective for non-specific chronic low back pain Within the scope of primary prevention regarding back functioning in children , research on the stability of intervention effects is indispensable . Along this line , the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological dem and s related to adolescence . The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up , in youngsters aged 13–14 years , on back posture knowledge , fear-avoidance beliefs and self-reported pain . An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters ’ lifestyles . At 2-year follow-up , the study sample included 94 secondary schoolchildren in the intervention group ( mean age 13.3 ± 0.8 years ) and 101 controls ( mean age 13.2 ± 0.7 years ) . The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes . A question naire was completed comparable to the pretest , posttest and follow-up evaluations . The current study demonstrated at 2-year follow-up stability of the improved general ( F = 1.590 , ns ) and specific ( F = 0.049 , ns ) back posture knowledge in children who had received early back posture education .  Back posture education did not result in increased fear-avoidance beliefs ( F = 1.163 , ns ) or mounting back and /or neck pain reports ( F = 0.001 , ns ) . Based on self-reports for postural behavior , youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior . The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence . Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential Background The severity and course of spinal pain is poorly understood in adolescents . The study aim ed to determine the prevalence and two-year incidence , as well as the course , frequency , and intensity of pain in the neck , mid back , and low back ( spinal pain ) . Methods This study was a school-based prospect i ve cohort study . All 5th and 6th grade students ( 11–13 years ) at 14 schools in the Region of Southern Denmark were invited to participate ( N = 1,348 ) . Data were collected in 2010 and again two years later , using an e-survey completed during school time . Results The lifetime prevalence of spinal pain was 86 % and 89 % at baseline and follow-up , respectively . A group of 13.6 % ( 95 % CI : 11.8 , 15.6 ) at baseline and 19.5 % ( 95 % CI : 17.1 , 22.0 ) at follow-up reported that they had pain frequently . The frequency of pain was strongly associated with the intensity of pain , i.e. , the majority of the participants reported their pain as relatively infrequent and of low intensity , whereas the participants with frequent pain also experienced pain of higher intensity . The two-year incidence of spinal pain varied between 40 % and 60 % across the physical locations . Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period . Conclusions Spinal pain is common at the age of 11–15 years , but some have more pain than others . The pain is likely to progress , i.e. , to more locations , higher frequency , and higher pain intensity over a two-year period Background Different interventions can reduce the burden of the chronic low back pain . One example is the use of a ' Back School Programme ' . This is a brief therapy that uses a health education method to empower participants through a procedure of assessment , education and skill development . This study aim ed to evaluate to what extent the programme could improve quality of life in those who suffer from the condition . Methods This was a r and omized controlled trial . One-hundred and two female patients with low back pain ( n = 102 ) were r and omly allocated into two groups , matched in terms of age , weight , education , socioeconomic status , occupation and some aspects of risk behavior . Group 1 ( back school group , n = 50 ) but not group 2 ( clinic group , n = 52 ) received the ' Back School Programme ' . Then quality of life using the Short Form Health Survey ( SF-36 ) was assessed at two time points : at baseline and at three months follow-up . The findings were compared both within and between two groups . Results The ' Back School Programme ' was effective in improving patients ' quality of life ; significant differences were found on all eight subscales of the SF-36 for group 1 . In the clinic group ( group 2 ) , improvement was observed on three scales ( bodily pain , vitality and mental health ) but these improvements were less than in group 1 . The mean improvement over all eight subscales of the SF-36 was significantly better for the ' Back School Programme ' group . Conclusion The ' Back School Programme ' is an effective intervention and might improve the quality of life over a period of 3 months in patients who experience chronic low back pain OBJECTIVE To assess whether a comprehensive multidisciplinary pain management programme could contribute to improvement regarding sleep quality , mood , life satisfaction , health-related quality of life , sense of coherence and pain for patients with a spinal cord injury and neuropathic pain . DESIGN A prospect i ve intervention study . PATIENTS Twenty-seven patients with spinal cord injury and neuropathic pain participated in a pain management programme  in parallel with 11 patients in a control group . METHODS A comprehensive pain management programme comprising educational , cognitive , and behavioural interventions was created for patients with spinal cord injury and neuropathic pain . The pain management programme consisted of 20 sessions over a 10-week period and included educational sessions , behavioural therapy , relaxation , stretching , light exercise and body awareness training . All patients were followed-up 3 , 6 and 12 months after completion of the programme . RESULTS At the 12-month follow-up , levels of anxiety and depression in the treatment group decreased compared with baseline values , and a tendency towards better quality of sleep was seen . In comparison with the control group , patients in the treatment group improved regarding sense of coherence and depression . CONCLUSION This study implies that a multidimensional pain management programme can be a valuable complement in the treatment of spinal cord injured patients with neuropathic pain OBJECTIVES To evaluate the effectiveness of a back school program in pain , functional status , quality of life , and in anxiety and depression in patients with non-specific low back pain . METHODS Sixty patients with low back pain were r and omized to an intervention and control group . The intervention group underwent a five-weekly back school program . The control group was seen in weekly medical visits , without educative approaches . Both groups took acetaminophen as analgesic medication . All subjects were evaluated by a blind physiotherapist after r and omization , 30 , 60 and 120 days . Roll and -Morris , SF-36 , STAI and Beck question naires , pain visual analogical scale and Schober 's test were applied . Non-steroidal anti-inflammatory drugs ( NSAID ) consumption was considered co-intervention . The statistical analyses were performed using Pearson 's Chi-Square analysis and Student 's t-test to compare the baseline characteristics of the groups and the analysis of variance ( ANOVA ) with repeated measures to assess changes inter/intra groups . RESULTS There were no significant differences in the baseline characteristics between the two groups . Fifty-five patients completed the study . The intervention group showed a significant improvement in the general health domain , assessed by SF-36 , and also in the reduction of acetaminophen and NSAID intake . There was no significant difference between the groups in pain , functional status , anxiety or depression . CONCLUSION The back school program was more effective than any educational intervention in general health status and in decreasing acetaminophen and NSAID intake . It was ineffective in the other quality of life domains , in pain , functional status , anxiety and depression Background Neck pain in adults is common and a leading cause of physical disability . Recently , a guideline was developed for the management of non-specific neck pain ( NSNP ) with an aim to improve the quality of the delivery of chiropractic care . One key guideline recommendation is to undertake multimodal care for patients with NSNP . The aim of this pilot study is to determine the feasibility of implementing a multifaceted knowledge translation intervention by promoting the use of multimodal care by chiropractors managing patients with NSNP . Methods / design The design is a cluster-r and omized controlled pilot and feasibility trial . Chiropractors in private practice in Canada will be approached to participate in the study . Thirty consenting chiropractors will be r and omized to receive either a theory-based educational intervention in the experimental group or simply a printed copy of the guideline in the control group .  Each chiropractor will recruit five neck pain patients ( a total of 150 patients ) into the study . Development of the multifaceted intervention was informed by the results of a related qualitative study based on the Theoretical Domains Framework and consists of a series of three webinars , two online case scenarios , a self-management video on Brief Action Planning , and a printed copy of the practice guideline . Primary feasibility outcomes for both chiropractors and patients include rates of ( 1 ) recruitment , ( 2 ) retention , and ( 3 ) adherence to the intervention . A checklist of proxy measures embedded within patient encounter forms will be used to assess chiropractors ’ compliance with guideline recommendations ( e.g. exercise and self-care prescriptions ) at study onset and at 3 months . Secondary outcomes include scores of behavioural constructs ( level of knowledge and self-efficacy ) for recommended multimodal care . Clinical outcomes include pain intensity and neck pain-specific disability . Analyses from this study will focus on generating point estimates and corresponding 95 % confidence intervals for parameters of a priori interest ( recruitment , retention , adherence , pain intensity , Neck Disability Index ) . Discussion Results of this study will inform the design of a larger cluster-r and omized controlled trial aim ed at evaluating the effectiveness of the theory-based tailored intervention and increasing the use of multimodal care by chiropractors managing patients with NSNP.Trial registration https:// clinical trials.gov/ , Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions . Methods The conclusions are based on the results of systematic review s of r and omized clinical trials ( RCTs ) , widely accepted and primarily UK and United States evidence -based clinical guidelines , plus the results of all RCTs not yet included in the first three categories . The strength/ quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs . Results By September 2009 , 26 categories of conditions were located containing RCT evidence for the use of manual therapy :  13 musculoskeletal conditions , four types of chronic headache and nine non-musculoskeletal conditions . We identified 49 recent relevant systematic review s and 16 evidence -based clinical guidelines plus an additional 46 RCTs not yet included in systematic review s and guidelines .Additionally , brief references are made to other effective non-pharmacological , non-invasive physical treatments . Conclusions Spinal manipulation/mobilization is effective in adults for : acute , subacute , and chronic low back pain ; migraine and cervicogenic headache ; cervicogenic dizziness ;  manipulation/mobilization is effective for several extremity joint conditions ; and thoracic manipulation/mobilization is effective for acute/subacute neck pain . The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration , and for manipulation/mobilization for mid back pain , sciatica , tension-type headache , coccydynia , temporom and ibular joint disorders , fibromyalgia , premenstrual syndrome , and pneumonia in older adults . Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation , or for Stage 1 hypertension when added to an antihypertensive diet . In children , the evidence is inconclusive regarding the effectiveness for otitis media and enuresis , and it is not effective for infantile colic and asthma when compared to sham manipulation . Massage is effective in adults for  chronic low back pain and chronic neck pain . The evidence is inconclusive for knee osteoarthritis , fibromyalgia , myofascial pain syndrome , migraine headache , and premenstrual syndrome . In children , the evidence is inconclusive for asthma and infantile colic OBJECTIVES To develop and evaluate a brief group-based psychological intervention for improving psychological adjustment and enhancing adaptive coping following spinal cord injury . The Coping Effectiveness Training ( CET ) programme is grounded on the cognitive theory of stress and coping of Lazarus & Folkman ( 1984 ) , and represents an original adaptation of the theory to the needs of this client group . DESIGN A controlled trial comparing patients receiving the CET intervention  to matched controls in measures of psychological adjustment and coping was used . METHODS Nineteen intervention group participants and 19 matched controls were selected from in- patients at a hospital-based spinal injury rehabilitation centre . Outcome measures of depression , anxiety and coping were collected before , immediately after and six weeks after the intervention . RESULTS Intervention group participants showed significantly greater reductions in levels of depression ( p < .01 ) and anxiety ( p < .05 ) compared to matched controls immediately after the intervention and at six weeks follow-up . There was no evidence of a significantly greater change in the coping strategies used by the intervention group . Participants highlighted their interactions with other group members as the most helpful aspect of the intervention . CONCLUSIONS This evidence suggests that the CET intervention facilitated a significant improvement , in psychological adjustment to spinal cord injury . It is proposed this may be understood in terms of changes in participants ' appraisal of the implication s of spinal cord injury and of the coping skills needed to continue living meaningful and satisfying lives OBJECTIVES Testing the feasability of a back school assessment programme in two population s of people suffering with chronic low back pain . MATERIAL Twenty-nine patients were r and omly included in a chronic low back pain assessment programme ( 15 patients waiting for back school and 14 patients after back school ) . METHODS The programme was made of the measure of the age , the sex , the body mass index , the pain ( VAS , St Antoine Hospitals Pain Question naire - SAPQ ) , the anxiety , the depression , the RIII nociceptive reflex , the fingertip-floor distance , the strength of the flexors and of the extensors of the lumbar spine ( CybexR 6000 isocinetic dynamometer ) , the lumbar function ( EIFEL , Dougados ) , the Dallas self- question naire . The Back School Education programme was made of five sessions ( information , ergonomics , extension exercises ) . RESULTS Comparing the two population s we did not observe significant differences concerning the age , the body mass index , the anxiety and depression levels , the pain ( VAS , SAPA , RIII nociceptive reflex ) , the lumbar stiffness , the lumbar disability , the quality of life ; the patients who had achieved back school had a peak torque of the flexors and a ratio flexors/extensors significantly lower . Comparing men and women we observed significant differences in the SAPQ and the muscles strength . The SAPQ was correlated with the depression and anxiety levels , the lumbar disability , the peak torque of the flexors . The VAS was correlated with the age , the lumbar stiffness , the depression level , the peak torque of the flexors . The RIII nociceptive reflex was correlated with the ratio flexors/extensors . CONCLUSION This study present some biases but this objective assessment of chronic low back pain appeared as feasible . The pain must be investigated in term of intensity , expression , alleviation . The impairment of the flexors muscles in women and after back school has to be confirmed . The different tests are relevant to determinate the efficiency of the back school programmes OBJECTIVE To explore the long-term outcomes of CONECSI ( COping with NEuropathiC Spinal cord Injury pain ) , a multidisciplinary cognitive behavioural treatment programme in persons with spinal cord injury . DESIGN Long-term follow-up pre-post-intervention design . SUBJECTS A total of 29 subjects with a spinal cord injury and chronic neuropathic pain from 4 Dutch rehabilitation centres . METHODS Primary outcomes were pain intensity and pain-related disability ( Chronic Pain Grade question naire ) . Secondary outcomes were mood ( Hospital Anxiety and Depression Scale ) , participation in activities ( Utrecht Activities List ) , and life satisfaction ( Life Satisfaction Question naire ) . R and om coefficient analysis was used for the analyses of measurements before ( t1 ) , immediate post-intervention ( t2 ) , and 6 ( t3 ) , 9 ( t4 ) , and 12 ( t5 ) months follow-up . RESULTS The analyses showed significant improvements on pain intensity ( t1-t2 and t1-t5 ) and pain-related disability ( t1-t2 , t1-t4 , and t1-t5 ) , anxiety and participation in activities ( t1-t2 , t1-t3 , and t1-t5 ) . CONCLUSION This exploratory study suggests that a multidisciplinary cognitive behavioural programme might have lasting improvements on pain intensity , pain-related disability , anxiety , and participation in activities in people with chronic neuropathic spinal cord injury pain and highlights the potential of such programmes Ninety-two chronic low back pain patients were r and omly allocated to two groups to evaluate the effectiveness of a back school compared with an exercise-only regimen according to specified outcome variables . The data from 78 patients with 7 years mean duration of symptoms was analyzed . Three assessment s were made : before treatment and 6 and 16 weeks after treatment . Changes in patients ' levels of pain , functional disability , and other related variables were compared in the two groups . Almost all variables showed an improvement at 6 weeks . At 16 weeks , functional disability and pain levels showed a significant difference . Back school patients continued to make an improvement . This method of managing low back pain makes maximal use of limited re sources and appears to be effective , especially in the longer term Summary A multidisciplinary cognitive behavioral program might have beneficial effects on people with chronic neuropathic spinal cord injury pain . ABSTRACT Many people with spinal cord injury ( SCI ) rate chronic neuropathic pain as one of the most difficult problems to manage . The aim of the CONECSI ( COping with NEuropathiC Spinal cord Injury pain ) trial was to evaluate a multidisciplinary cognitive behavioral treatment program for persons with chronic neuropathic pain after SCI . The intervention consisted of educational , cognitive , and behavioral elements .  A total of 61 people were r and omized to either the intervention group or the waiting list control group in 4 Dutch rehabilitation centers . Primary outcomes were pain intensity and pain‐related disability ( Chronic Pain Grade question naire ) , and secondary outcomes were mood ( Hospital Anxiety and Depression Scale ) , participation in activities ( Utrecht Activities List ) , and life satisfaction ( Life Satisfaction Question naire ) . Measurements were performed at baseline , and at 3 , and 6 months follow‐up . The primary statistical technique was r and om coefficient analysis . The analyses showed significant changes over time on both primary ( t1–t2 ) , and 2 out of 4 secondary outcomes ( both t1–t2 and t1–t3 ) . Significant intervention effects ( Time * Group interactions ) were found for anxiety and participation in activities , but not for the primary outcomes . Subsequent paired t tests showed significant changes in the intervention group that were not seen in the control group : decrease of pain intensity , pain‐related disability , anxiety , and increase of participation in activities . This study implies that a multidisciplinary cognitive behavioral program might have beneficial effects on people with chronic neuropathic SCI pain & NA ; An outpatient multimodal cognitive‐behavioural treatment program ( MMCBT ) for chronic spinal pain was evaluated during an 18‐month follow‐up period . The treatment included a 1‐day course for the patients ’ work supervisors . The aim of the study was to evaluate the long‐term effect of the treatment program as well as the effect of a work supervisor‐training program on the patients ’ return to work . The design was a matched cohort study with four repeated measures . Two groups of subjects suffering from non‐specific spinal pain ( treatment group n=67 , no treatment control group n=29 ) were assessed with regard to pain intensity , sick‐leave , pain coping ability and behavioural changes at work and in personal life . Recordings on supervisors attending the course and changes of supervisory behaviour were also obtained . The results show a significant between group difference in pain intensity and perceived pain coping ability at work , favouring the MMCBT group . Further , the MMCBT intervention enhances self‐reported behavioural changes in areas within the subjects ’ own control . There is not sufficient statistical support to accept the assumption of MMCBT being superior in reducing sick‐leave , either with or without the education of supervisors . Even when supervisors changed their behaviour as reported by the patient , no significant effect was found on patients ’ return to work . In conclusion , the MMCBT do not seem to be effective in reducing sick‐leave compared to no treatment , but the MMCBT program is superior in decreasing pain intensity , enhancing self‐reported behavioural changes in personal life and improving pain coping ability at work The use of an education program for patients with chronic low back pain ( Back School ) has been investigated . The effect evaluation is based on a pretest-post-test-control group design , including a follow-up after 8 weeks . The Maastricht Back School is based on the theory that pain is also maintained by emotional , cognitive and environmental factors . Information and training are given on these and physical factors . The purpose of the course is to teach patients to manage their own pain problem . The results suggest that the Back School program for patients with chronic low back pain can have a positive effect
Results of these studies indicate that school-based spinal health interventions may be effective in increasing spinal care knowledge and decreasing the prevalence of spinal pain .
However , overall the evidence is inconclusive regarding spinal care behaviors .
The poor quality of the review ed studies limits the conclusions that can be made regarding the effectiveness of school-based spinal health interventions
OBJECTIVES To establish the effectiveness of  school-based spinal health interventions  in terms of : 1 ) improving knowledge about the spine/spinal care ; 2 ) changing spinal care behaviors ; and 3 ) decreasing the prevalence of spinal pain .
SUMMARY OF BACKGROUND DATA Spinal pain is a significant problem in children and adolescents that has been addressed through school-based spinal health interventions .
No systematic review has been carried out on this topic to date .