Table 1

Characteristics of the studies included in the meta-analysis
Papers (19) Studies (23) Participants Contents Interventions Outcomes
Cardon et al., [19] (2000) Belgium 78 subjects Age: 10.2 E = 42 C = 36 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers The experimental group obtained higher scores than the control group for the behaviors and knowledge in the posttest
C: control
Cardon et al., [27] (2001) Belgium (a) 72 subjects 5th grade Age: 11 E = 38 C = 34 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles (12 weeks) The experimental group obtained higher scores than the control group for the behaviors and knowledge
C: control
(b) 82 subjects 5th grade Age: 11 E = 48 C = 34 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) without extra guidelines of their teachers The experimental group obtained higher scores than the control group for the behaviors and knowledge
C: control
Cardon et al., [28] (2002a) Belgium 706 subjects Age: 10.02 (9–11) E = 347 C = 359 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers Intervention children showed better back care knowledge than control children, and knowledge gained was retained over a period of one year
C: control
Cardon et al., [29] (2002b) Belgium 363 subjects 4th, 5th grade Age: 9–12 E = 198 C = 165 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers The experimental group obtained higher scores than the control group for the behaviors
C: control
Cardon et al., [30] (2007) Belgium 362 subjects 4th, 5th grade E = 190 C = 172 German Back School. Correct realization of different activities of daily life Stretching and strengthening exercises Physical activity: sports, play and active recreation for kids (SPARK) E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines from their teachers to integrate the principles learned and to increase postural dynamics (2 school years) + physical activity promotion program The experimental group obtained higher scores than the control group for the behaviors and knowledge
C: control
Cardoso [33] (2009) Brazil 519 subjects Age: 8–21 E = 269 C = 250 Spinal care principles and how to incorporate this knowledge into everyday life Behavioral intervention E: 4 sessions (twice week) Lecture, demonstration, hands on practice (2 weeks) The experimental group obtained higher scores than the control group for the knowledge
C: control
Dolphens et al., [52] (2011) Belgium 194 subjects Age: 18 E = 96 C = 98 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + 2 hours with the participation of their parents and teachers The experimental group obtained higher scores than the control group for the knowledge
C: control
Geldhof et al., [21] (2006) Belgium 365 subjects 4th, 5th grade E = 193 C = 172 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles and to increase postural dynamics (2 school years) The experimental group obtained higher scores than the control group for the behaviors and knowledge
C: control
Geldhof et al., [53] (2007a) Belgium 69 subjects Age: 8–11 E = 41 C = 28 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles and to increase postural dynamics (2 school years) The effects of 2 years back education showed an increase in trunk flexor endurance in the experimental group compared to a decrease in the controls
C: control
Geldhof et al., [54] (2007b) Belgium 195 subjects 7th, 8th grade E = 94 C = 101 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the principles learned and to increase postural dynamics (2 school years) The experimental group obtained higher scores than the control group for the knowledge in the follow-up (2 years)
C: control
Geldhof et al., [55] (2007c) Belgium 245 subjects 6th,7th grade E = 121 C = 124 German Back School Correct realization of different activities of daily life Stretching and strengthening exercises E: 6 sessions (60 mins; once a week) various tasks based on good understanding of basic back care principles (guided discovery and hands-on methods) + extra guidelines of their teachers to integrate the learned principles and to increase postural dynamics (2 school years) The experimental group obtained higher scores than the control group for the knowledge in the follow-up (1 years)
C: control
Gómez and Méndez [23] (2000a) Spain 67 subjects 5th grade Age: 11 E = 33 C = 34 Anatomy, biomechanics, respiratory mechanism and the way to avoid column overload, risk factors for injury, spinal care principles E: 8 sessions (30 mins; once a week). Lecture to incorporate knowledge about the correct functioning of the body and to avoid vertebral overload and back injuries from childhood. The experimental group obtained higher scores than the control group for the knowledge in the posttest and the follow up carried out in 6 months time.
C: performed with their academic tutor-teacher about related matters.
Gómez and Méndez [40] (2000b) Spain (a) 65 subjects 5th grade Age: 11 E = 33 C = 32 Postural hygiene, how to incorporate this knowledge into everyday life Behavioral intervention E: Information and training from a physiotherapist + parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours) The experimental group obtained higher scores than the control group for the behaviors
C: parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours)
(b) 66 subjects 5th grade Age: 11 E = 34 C = 32 Postural hygiene, how to incorporate this knowledge into everyday lifeBehavioral intervention E: Piece of ergonomics advice from a tutor + parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours) The experimental group obtained higher scores than the control group for the behaviors
C: parents were given information about postural hygiene, training in observation and healthy motive habits registration (2 hours)
Kovacs et al., [56] (2011) Spain 574 subjects Age: 8 E = 320 C = 254 Comic Book of the Back E: Comic Book of the Back handed over by teachers The experimental group obtained higher scores than the control group for the knowledge
C: control
Martínez [34] (2007) Spain 579 subjects (3rd- 6th grade) Age: 7–12 E = 314 C = 265 Spinal care principles and how to incorporate this knowledge into everyday life Behavioral intervention E: 5 sessions (once week) Lecture, demonstration, hands on practice (5 weeks) The experimental group obtained higher scores than the control group for the behaviors and knowledge in the posttest
C: control
Méndez and Gómez [20] (2001) Spain 70 subjects 3rd grade Age: 9 E = 35 C = 35 Anatomy, biomechanics, risk factors for injury, spinal care principles Behavioral intervention Correct realization of different activities of daily life Stretching and strengthening exercises E: 11 sessions (60 mins; once a week): 8 sessions (postural hygiene knowledge and behaviors; each lasted 2 hours) and 3 sessions (physiotherapy exercise; each lasted 1 hour), total of 19 hours The experimental group obtained higher scores than the control group for the knowledge and behaviors in the posttest and the follow up carried out after 12 months
C: took part in different academic activities with related themes
Park and Kim [41] (2011) South Korea (a) 59 subjects 5th grade Age: 11 E = 28 C = 31 Web-based spinal health education program (anatomy, functions of the spine, spinal care principles, stretching and strengthening exercises, backpack use) E: 4 sessions (30 mins; once a week) Web-based program 3 parts (learning, formative evaluation, learning summary sections) (4 weeks) The changes for spinal health knowledge were significantly higher than those of the control group.
C: control
(b) 60 subjects 5th grade Age: 11 E = 29 C = 31 Face-to-face spinal health education program (anatomy, functions of the spine, spinal care principles, stretching and strengthening exercises, backpack use) E: 4 sessions (30 mins; once a week) Face-to-face instruction 3 parts (learning, formative evaluation, learning summary sections) (4 weeks) The changes for spinal health knowledge were significantly higher than those of the control group.
C: control
Spence et al., [22] (1984) US (a) 50 subjects 3rd, 5th grade E = 25 C = 25 Safe lifting techniques E: 1 session: lecture demonstration (5 mins videotape), review of the major principles presented in the tape (5 mins) Showed significantly higher knowledge in the experimental group versus the control group in the posttest, but no significant differences between groups in the follow-up (2 months) Behaviours: Provided inconclusive or statistically insignificant results
C: without intervention
(b) 51 subjects 3rd, 5th grade E = 26 C = 25 Safe lifting techniques E: 1 session: guided self discovery (15 mins) Showed significantly higher knowledge in the experimental group versus the control group in the posttest, but no significant differences between groups in the follow-up (2 months) Behaviours: Provided inconclusive or statistically insignificant results
C: without intervention
Vidal et al., [24] (2009) Spain 137 subjects Age: 10–12 E = 63 C = 74 Anatomy, biomechanics, risk factors for injury, spinal care principles, respiratory mechanism, postural hygiene Behavioral intervention Exercise E: 6 sessions: 4 sessions (knowledges: anatomy, biomechanics, risk factors for injury, spinal care principles, respiratory mechanism, postural hygiene) and 2 sessions (behavioral intervention, exercise); total of 4 weeks The experimental group obtained higher scores than the control group for the knowledge
C: without intervention

E: experimental group / C control group.

All studies are randomized controlled.

Calvo-Muñoz et al.

Calvo-Muñoz et al. BMC Musculoskeletal Disorders 2012 13:152   doi:10.1186/1471-2474-13-152

Open Data