Backfit-our school takes care. Study protocol of a cluster-randomized, controlledmultifactorial intervention study for primary prevention of back pain in 10- to 12-year old pupils

Back pain is not only a worldwide problem in adults, but also in children and adolescents. The prevalence rates increase with age. Risk factors for back pain in children are among others asymmetries of the spine, too heavy and asymmetrically carried school backpacks, and a sedentary lifestyle. This paper presents a multifactorial school-based intervention program and the corresponding study protocol for a cluster-randomized, controlled evaluation of this program to address these risk factors. The intervention program should be tested on pupils aged 10-12 at a German "Gymnasium" (secondary school) over the course of one school year. It contains 5 lessons on back care, 3 exercise posters for the class room, and exercises for physical education classes that strengthen and mobilize core muscles and train body perception. The evaluation instruments are motoric tests, a back-behavior test, a knowledge test, a clinical-orthopedic examination, and several questionnaires. The presented intervention program and evaluation instruments aim to show one way of planning and evaluating an intervention in the daily school environment. There is a need for high-quality studies on prevention of back pain in children and adolescents. This is a topic that has received little attention in Germany.