Physiotherapist-Led School-Based Back-Health Education Program

March 17, 2026 updated by: Yoana González González, University of Vigo

Effects of a Physiotherapist-Led School-Based Back-Health Education Program on Postural Habits, Physical Activity, Electronic Device Use, and Spinal Pain in Schoolchildren With and Without Symptoms

This study evaluates the effects of a physiotherapist-led, school-based back-health education program delivered in primary school classrooms. The intervention consists of a theoretical-practical workshop focused on postural habits, physical activity, electronic device use, and backpack handling. The study includes schoolchildren with and without spinal pain and assesses changes in spinal pain characteristics, postural behaviors, physical activity patterns, and electronic device use over a three-month period. The main objective is to determine whether this educational program improves back-health behaviors and related outcomes in the school setting.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study investigates the impact of a physiotherapist-led, school-based back-health education program in primary schoolchildren aged 9 to 11 years. The intervention consists of a classroom-based theoretical-practical workshop delivered by physiotherapists in two 45-minute sessions. The program covers fundamental concepts of spinal anatomy and biomechanics, correct postural habits in daily activities (sitting, standing, sleeping, and rising from bed), safe backpack handling and load distribution, regular physical activity recommendations, and ergonomically appropriate use of electronic devices.

Participants complete a 21-item self-administered questionnaire at baseline and three months after the intervention. The questionnaire includes items addressing spinal pain (cervical, thoracic, and lumbar regions), pain duration and intensity, postural habits, backpack-related behaviors, physical activity patterns, and electronic device use. The study includes both symptomatic and asymptomatic schoolchildren to evaluate preventive and therapeutic outcomes.

The primary aim is to examine changes in spinal pain prevalence and characteristics following the intervention. Secondary aims include evaluating changes in postural habits, backpack-related behaviors, physical activity frequency and duration, electronic device use, and back-health knowledge. Data analysis compares pre- and post-intervention outcomes using appropriate statistical tests for paired categorical and non-normally distributed variables. The study seeks to determine whether a physiotherapist-led educational intervention implemented within the school curriculum can effectively improve back-health behaviors and modifiable ergonomic risk factors in primary schoolchildren.

Study Type

Interventional

Enrollment (Actual)

317

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Galicia
      • Pontevedra, Galicia, Spain, 36001
        • Faculty of Physiotherapy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Acceptance by the school administration and the Parents' Association (AMPA) to participate in the project.
  • Commitment from the school administration to ensure that students and teaching staff participating in the project complete the questionnaires on the dates indicated by the research team.
  • Students aged 9 to 11 years at the start of the study.

Exclusion Criteria:

  • Lack of acceptance from the school administration or AMPA to participate in the study.
  • Failure by the school administration to ensure completion of the questionnaires on the scheduled dates.
  • Students with cognitive impairments that prevent them from understanding or responding to the questionnaires.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Postural Education Workshop
Participants receive a two-session educational workshop delivered by physiotherapists. The workshop covers basic spinal anatomy, postural hygiene, the importance of extracurricular physical activity, and strategies to regulate screen use to reduce sedentary behavior. Each session lasts 45 minutes, held 2-3 weeks apart, and includes both theoretical and practical components such as proper sitting and standing posture, ergonomic adjustment of the school workstation, correct backpack use, load handling, and promotion of active habits.
Behavioral: Postural Education Workshop
Participants receive a two-session educational workshop delivered by physiotherapists. The workshop covers basic spinal anatomy, postural hygiene, the importance of extracurricular physical activity, and strategies to regulate screen use to reduce sedentary behavior. Each session lasts 45 minutes, held 2-3 weeks apart, and includes both theoretical and practical components such as proper sitting and standing posture, ergonomic adjustment of the school workstation, correct backpack use, load handling, and promotion of active habits.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in spinal pain prevalence
Time Frame: Baseline, 3 months

Change in the prevalence of spinal pain (cervical, thoracic, and lumbar), assessed using a self-administered questionnaire.

Metric: Proportion of participants reporting spinal pain in each spinal region at both assessment points.
Baseline, 3 months
Change in spinal pain intensity
Time Frame: Baseline, 3 months
Change in spinal pain intensity measured using the Wong-Baker FACES Pain Scale. Metric: Difference in score (0-10) between baseline and 3 months.
Baseline, 3 months
Change in spinal pain duration
Time Frame: Baseline, 3 months
Change in spinal pain duration categories (<12 h, 12-24 h, 1-7 days, >1 week). Metric: Shift in categorical distribution from baseline to 3 months.
Baseline, 3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Postural Habits
Time Frame: Baseline, 3 months

Change in postural habits, including sitting posture, sleeping posture, and method of rising from bed, assessed through a self-administered questionnaire.

Metric: Proportion of participants reporting correct posture in each domain (sitting, sleeping, rising from bed).
Baseline, 3 months
Change in Daily Duration of Habitual Physical Activity
Time Frame: Baseline, 3 months

Assesses changes in the average number of hours per day that children engage in habitual physical activity (e.g., free play, sports participation, structured or unstructured movement).

Daily duration is self-reported through the standardized 21-item questionnaire administered at both time points.

The available response options are: "0 hours per day," "1 hour per day," "2 hours per day," "3 hours per day," and "4 hours per day." Metric: Difference in the daily duration of physical activity (hours per day) between baseline and the three-month follow-up.
Baseline, 3 months
Change in Weekly Frequency of Electronic Device Use
Time Frame: Baseline, 3 months

Assesses changes in the number of days per week in which children report using electronic devices. Frequency is obtained from the same self-reported 21-item questionnaire administered at both time points.

The available response options are: "I don't play," "1-2 times per week," "3-4 times per week," "4-6 times per week," or "every day." Metric: Difference in the weekly frequency of electronic device use (days per week) between baseline and the three-month follow-up.
Baseline, 3 months
Satisfaction with the Educational Intervention
Time Frame: immediately after the final workshop

Assessed with a 5-item ad hoc questionnaire administered after the final workshop.

Item 1: Ratings of duration, printed materials, presenter, theoretical lecture, and practical demonstration using a 0-4 scale (0=very poor, 4=excellent).

Items 2-4: Impact of the workshop rated as "nothing," "a little," or "a lot" (knowledge about spine care; knowledge about physical activity benefits and sedentary risks; opinion on implementing workshops for all students).

Item 5: Open-ended suggestion for improvement.
immediately after the final workshop
Change in Backpack-Related Behaviors
Time Frame: Baseline, 3 months

Change in multiple backpack-related behaviors, including backpack type, weight distribution, organization/inspection routines, and carrying method.

Metric: Proportion of participants reporting recommended behaviors in each category.
Baseline, 3 months
Change in Daily Duration of Electronic Device Use
Time Frame: Baseline, 3 months

Assesses changes in the average number of hours per day that children use electronic devices (e.g., smartphone, tablet, computer, TV).

Daily duration is self-reported through the standardized 21-item questionnaire used in the study.

The available response options are: "0 hours per day," "1 hour per day," "2 hours per day," "3 hours per day," and "4 hours per day." Metric: Difference in the daily duration of electronic device use (hours per day) between baseline and the three-month follow-up.
Baseline, 3 months
Change in Weekly Frequency of Habitual Physical Activity
Time Frame: Baseline, 3 months

Assesses changes in the number of days per week in which children report engaging in physical activity. Weekly frequency is obtained from the same self-reported 21-item questionnaire used in the study.

The available response options are: "1 day per week," "2-3 days per week," "4-6 days per week," "every day," and "never." Metric: Difference in weekly frequency of physical activity (days per week) between baseline and three-month follow-up.
Baseline, 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Vigo

Collaborators

Servicio Gallego de Salud

Investigators

  • Study Director: Yoana Gonzalez Gonzalez, PhD, University ofVigo
  • Principal Investigator: Manuel Fraiz Barbeito, Graduate, Sergas

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2019

Primary Completion (Actual)

July 31, 2023

Study Completion (Actual)

March 27, 2025

Study Registration Dates

First Submitted

March 7, 2026

First Submitted That Met QC Criteria

March 17, 2026

First Posted (Actual)

March 24, 2026

Study Record Updates

Last Update Posted (Actual)

March 24, 2026

Last Update Submitted That Met QC Criteria

March 17, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2019/094

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because the study collected anonymous questionnaire-based information from minors within an educational setting, and the dataset does not include identifiers that allow linkage at the individual level. In addition, the ethical approval and institutional agreements specify that the data may only be used in aggregated form for research purposes. Therefore, no IPD will be made available for public sharing.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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