{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T10:59:45Z","timestamp":1768215585550,"version":"3.49.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non-specific back pain in adolescents is widely prevalent, with potential for chronicity in adulthood. Evidence points to various physical and psychosocial exposures of non-specific back pain in adolescents. Reviewing and synthesizing this evidence will help identify modifiable and non-modifiable exposures that can inform appropriate interventions. This systematic review and meta-analysis aims to estimate the global pooled prevalence of back pain in the age group of 10\u201319 years and describe the exposure-outcome relationships between various risk factors and non-specific back pain. We also aim to establish the dose-response relationship, if possible, between factors such as screen time exposure, BMI, psychological assessment scores, and non-specific back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A robust search strategy will be employed to search PubMed, PMC, and Scopus databases for articles in English. Observational studies that estimate the prevalence and severity of non-specific back pain in adolescents (age 10\u201319 years) will be included. Studies that have looked at exposures such as, but not limited to, the mode of transport to school, school bag weight, BMI, screen time exposure duration, physical activity, participants\u2019 perceptions, and psychological, familial, and social factors will be eligible. Two authors will independently screen articles for suitability using the Rayyan software, extract data using the Review Manager 5 software, and assess the risk of bias using the JBI tool for critical appraisal of observational studies. The global pooled prevalence will be calculated using the Freeman-Tukey transformed proportions in the common effect inverse variance model. In case of low heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009&amp;lt;\u200950%), the fixed effect model will be used, and a random effects model, otherwise. Subgroup analyses will be employed for socioeconomic strata, geography, use of school bags, type of school, screen time exposure, frequency and duration of physical activity, and objective assessments on psychosocial evaluation. If data are available, dose-response relationships will be determined between school bag weight, screen time duration, and severity of back pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Identifying modifiable exposures of non-specific back pain can inform intervention strategies suitable for the individual or school setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42024572590.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1712074","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:51:59Z","timestamp":1768204319000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The exposure-outcome relationship between physical and psychosocial factors and non-specific back pain in adolescents: a systematic review and meta-analysis protocol"],"prefix":"10.3389","volume":"13","author":[{"given":"Gauri A.","family":"Oka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish S.","family":"Ranade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupeshkumar B.","family":"Deshmukh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayur K.","family":"Shinde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasad D.","family":"Pore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/S0140-6736(11)60610-7","article-title":"Non-specific low back pain","volume":"379","author":"Balagu\u00e9","year":"2012","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2630","DOI":"10.1097\/BRS.0b013e318158d70b","article-title":"Epidemiology of adolescent spinal pain: a systematic overview of the research literature","volume":"32","author":"Jeffries","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/1471-2474-15-187","article-title":"Spinal pain in adolescents: prevalence, incidence, and course: a school-based two-year prospective cohort study in 1,300 Danes aged 11\u201313","volume":"15","author":"Aartun","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"key":"B4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.ejpain.2003.08.001","article-title":"Do pain problems in young school children persist into early adulthood? A 13-year follow-up","volume":"8","author":"Brattberg","year":"2004","journal-title":"Eur J Pain"},{"key":"B5","doi-asserted-by":"publisher","first-page":"606","DOI":"10.2105\/AJPH.82.4.606","article-title":"The epidemiology of low back pain in an adolescent population","volume":"82","author":"Olsen","year":"1992","journal-title":"Am J Public Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/00007632-200201150-00014","article-title":"Backpacks on! schoolchildren\u2019s perceptions of load, associations with back pain and factors determining the load","volume":"27","author":"Negrini","year":"2002","journal-title":"Spine (Phila Pa 1976)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1097\/01.BRS.0000058725.18067.F7","article-title":"The association of backpack use and back pain in adolescents","volume":"28","author":"Sheir-Neiss","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1542\/peds.111.4.822","article-title":"Predictors of low back pain in British schoolchildren: a population-based prospective cohort study","volume":"111","author":"Jones","year":"2003","journal-title":"Pediatrics"},{"key":"B9","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1097\/01.BRS.0000058721.69053.EC","article-title":"The weight of schoolbags and the occurrence of neck, shoulder, and back pain in young adolescents","volume":"28","author":"van Gent","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"E713","DOI":"10.1097\/BRS.0b013e31815a5a44","article-title":"Low back pain in 15- to 16-year-old children in relation to school furniture and carrying of the school bag","volume":"32","author":"Skoffer","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"197","DOI":"10.3233\/WOR-162284","article-title":"Postural habits and weight of backpacks of Portuguese adolescents: are they associated with scoliosis and low back pain?","volume":"54","author":"Minghelli","year":"2016","journal-title":"Work"},{"key":"B12","doi-asserted-by":"publisher","first-page":"409","DOI":"10.3233\/WOR-2009-0941","article-title":"Ergonomics related to seating arrangements in the classroom: worst in South East Asia? The situation in Sri Lankan school children","volume":"34","author":"Jayaratne","year":"2009","journal-title":"Work"},{"key":"B13","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1080\/00140139.2010.547608","article-title":"Risk factors associated with back pain in New Zealand school children","volume":"54","author":"Trevelyan","year":"2011","journal-title":"Ergonomics"},{"key":"B14","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1097\/BPB.0000000000000602","article-title":"Back pain and school bag weight-a study on Indian children and review of literature","volume":"28","author":"Oka","year":"2019","journal-title":"J Pediatr Orthop Part B"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1111\/j.1651-2227.1996.tb13948.x","article-title":"Low back pain and its relationship to back strength and physical activity in children","volume":"85","author":"Newcomer","year":"1996","journal-title":"Acta Paediatr"},{"key":"B16","first-page":"e1","article-title":"Relationship between low back pain and screen time among school children","volume":"95","author":"Serrano-Munoz","year":"2021","journal-title":"Rev Esp Salud P\u00fablica"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1590\/1984-0462\/2023\/41\/2021342","article-title":"Screen time and low back pain in children and adolescents: a systematic review of Brazilian studies","volume":"41","author":"Guerra","year":"2023","journal-title":"Rev Paul Pediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1007\/BF00433372","article-title":"The incidence of back pain and headache among Swedish school children","volume":"3","author":"Brattberg","year":"1994","journal-title":"Qual Life Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/j.apergo.2006.09.003","article-title":"A cross-sectional study of self-reported back and neck pain among English schoolchildren and associated physical and psychological risk factors","volume":"38","author":"Murphy","year":"2007","journal-title":"Appl Ergon"},{"key":"B20","volume-title":"The Joanna Briggs Institute Critical Appraisal Tools for use in JBI Systematic Reviews: Checklist for Analytical Cross-Sectional Studies","author":"Moola","year":"2017"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1712074\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:52:01Z","timestamp":1768204321000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1712074\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":20,"alternative-id":["10.3389\/fped.2025.1712074"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1712074","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"article-number":"1712074"}}