Prevalence of Low Back Pain among School-Aged Children between 10 and 12 Years

Round 1

Reviewer 1 Report

From my point of view, the use of only one questionnaire does not seem to me to be a valid method of drawing some pertinent conclusions. We do not know whether by self-administration the conditions of a proper application of the questionnaire were observed. However, being children aged 10-12, can we be sure that their answers were completely sincere and were not influenced by other factors (parents, teachers, older siblings, friends, etc.)? I believe that these aspects should be clarified first, so that there is a slightly higher probability that the answers collected and processed later can be a valid source to draw objective conclusions.

Author Response

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Reviewer 2 Report

This manuscript entitled “Prevalence of Low Back Pain Among School-Aged Children Be-tween 10 and 12 Years” primarily aimed to determine the prevalence of low back pain in children, which includes the lifetime, point, and 7-day prevalence.The authors presented an interesting study, but there are still some problems should be properly addressed. Some suggestions are listed in the specific comments below.

 

Specific comments:

1. In the abstract part, line 11-12, “This cross-sectional study evaluated 849 participants aged 10–12 from ten primary schools,” it is recommended to add the gender information within these particpants.
2. In the abstract part, line 14, what does the abbreviation “VAS” refer to? Please provide the full name of it.
3. In the introduction part, line 32-36, “According to the literature, the lifetime prevalence of nonspecific LBP…” it is recommended to add more relevant references here.
4. In the introduction part, The novelty and value of the study should be highlighted.
5. In the introduction part, line 51-53, “Therefore, to obtain more detailed information about LBP among school-children, we conducted a study with the main objective to determine the lifetime, point, and 7-day prevalence of LBP in children aged 10-12 years.” The aim of this study should be put at the end of the introduction part.
6. In the materials and methods, instruments, it is recommended to add the questionnaire used in this study as a supplemental material.
7. In the results part, line 119-121, “Chi-square analysis identified a significant difference between boys and girls in LBP lifetime prevalence (p<0.001), 7-day prevalence (p=0.035), and point prevalence (p=0.014). Student’s T-Test in pain intensity shown the same differences (p=0.007).” it is recommended to describe that variables were greater in which group.
8. In the discussion part, it is recommended to provide a brief description of the aim and main findings in the first paragraph of the manuscript.
9. In the discussion part, line 152-156, “This wide range of percentage values may be due to different study designs, the strategy for extracting data and the methodology used, sample age, sample size, the definition of LBP or geo-graphical factors, including sociocultural, demographic, economic, and occupational dif-ferences of the locations investigated.” Please write this sentence to improve clarity. It is recommended to separate it into two sentences.
10. In the discussion part, line 162-163, “Despite these differences, most studies show that girls have a higher prevalence of back pain than boys.” Please write this sentence in the past tense.
11. In the conclusion part, in the opinion of the reviewer, the description in the conclusion part was too verbose, and the reviewer suggests that the authors should abbreviate the section and focus on the main findings of this study.
12. Please check the language and grammar mistakes throughout the whole article to further improve clarity.

Author Response

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Reviewer 3 Report

This paper investigated prevalence of low backpain in 10-12 year old boys and girls in Mallorca.

The goal is to test differences in LBP between boys and girls and between ages in a cross-sectional study.

LBP (lifetime, sevendays and point) prevalence are meaured by a self-administered questionnaire.

They found significant higher LBP in girls than in boys. Most of the differences in age are not significant.

1. The method of measuring LBP by this Questionnaire is doubtfull when it is used in this relative young population. Moreover because the Questions could be answered also at home (with parents). Validation was only done by the same authors.
2. Differences between boys and girls with calendar age goups are confounded by big differences in biological age of individuals within the same calendar age groups. This explains why most of the LBP parameters are not significant
3. In the paper 2849 participants are mentioned. Is this the total population that was invited? This can have influenced the outcomes.
4. In table 1 and 2  LBP life must be LBP  life-time prevalence
5. 5 in the results also BMI is reported: this is not mentioned in methods and also abbreviation must be explained. How is this meaured or is bodyweight and body height asked in the questionnaire?
6. In the conclusion nothing is summarized about the results of the prevalences of LBP and age and sex differences. However speculations of prevention are reported, while the cause of LBP is not measured at all.
7. Only when the paper is focussed on the prevance of LBP and the age and sex differences are reported and my comments are accepted a rejection can be avoided.

Author Response

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Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

I have no comment

Reviewer 2 Report

Authors are commended for the substantial revisions made to increase the clarity of the manuscript. Several language polish are still required.

Reviewer 3 Report

Paper is changed accordingly my comments