Associations between low back pain and selected health-related physical fitness parameters in Gaborone schoolchildren aged 10–12 years

Abstract

Lower back pain (LBP) is increasingly recognised in children, but its relationship with health-related physical fitness (HRPF) is unclear. This study investigated the prevalence of LBP and its associations with HRPF in schoolchildren aged 10–12 years in Gaborone, Botswana. A cross-sectional study was conducted among 521 children (mean age: 11.14 ± 0.74 years), comprising 46% boys (n=239) and 54% girls (n= 282). HRPF was assessed using the FITNESSGRAM^@ test battery comprising body mass index (BMI), aerobic fitness, curl-ups, trunk lift, and flexibility (sit-and-reach). LBP was assessed using the Young Spine Questionnaire. The children’s mean BMI was 19.30 ± 3.82 kg/m², with 61% meeting the Healthy Fitness Zone (HFZ). Most achieved HFZ for aerobic fitness (75%), but very few met HFZ for curl-ups (1%), trunk lift (32%) or flexibility (8%). In total, 16% of children were classified as having LBP. No significant associations were found between HRPF parameters and LBP. Logistic regression analyses adjusted for age and sex showed a borderline, non-significant inverse association between body mass index (BMI) and LBP status, with lower BMI associated with slightly higher odds of reporting LBP ([OR] = 0.93; 95% CI: 0.87–1.00; p = 0.06). LBP prevalence was relatively low, but most children demonstrated poor muscular endurance, trunk strength and flexibility. HRPF parameters were not significantly associated with LBP, suggesting that non-physical or contextual factors may play a greater role. Longitudinal studies are recommended.