Advertisement

Associations of Sedentary Behavior, Physical Activity, Cardiorespiratory Fitness, and Body Fat Content With Pain Conditions in Children: The Physical Activity and Nutrition in Children Study

  • Anu Vierola
    Correspondence
    Address reprint requests to Anu Vierola, DDS, Institute of Biomedicine/Physiology, University of Eastern Finland, PO Box 1627, Kuopio 70211, Finland.
    Affiliations
    Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
    Search for articles by this author
  • Anna Liisa Suominen
    Affiliations
    Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

    Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
    Search for articles by this author
  • Virpi Lindi
    Affiliations
    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
    Search for articles by this author
  • Anna Viitasalo
    Affiliations
    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
    Search for articles by this author
  • Tiina Ikävalko
    Affiliations
    Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

    Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
    Search for articles by this author
  • Niina Lintu
    Affiliations
    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
    Search for articles by this author
  • Juuso Väistö
    Affiliations
    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
    Search for articles by this author
  • Jari Kellokoski
    Affiliations
    Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

    Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
    Search for articles by this author
  • Matti Närhi
    Affiliations
    Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
    Search for articles by this author
  • Timo A. Lakka
    Affiliations
    Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

    Kuopio Research Institute of Exercise Medicine, Kuopio, Finland

    Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
    Search for articles by this author

      Highlights

      • Prepubertal children with high levels of sedentary behavior have an increased likelihood of various pain conditions.
      • Prepubertal children with low levels of cardiorespiratory fitness may be at increased risk of any pain and headache.
      • Prepubertal children with low body fat content may be at increased risk of any pain, multiple pain, and lower limb pain.

      Abstract

      We investigated the cross-sectional associations of sedentary behavior, physical activity, cardiorespiratory fitness, and body fat content with pain conditions in prepubertal children. The participants were a population sample of 439 children aged 6 to 8 years. Sedentary behavior, physical activity, and pain conditions were assessed using questionnaires, cardiorespiratory fitness using maximal cycle ergometer test, and body fat percentage using dual-energy X-ray absorptiometry. The associations of sedentary behavior, physical activity, cardiorespiratory fitness, and body fat percentage with the risk of pain conditions were analyzed using multivariate logistic regression. Children in the highest sex-specific third of sedentary behavior had 1.95 (95% confidence interval [CI], 1.20–3.17; P = .007 for trend across thirds) times higher odds of any pain than children in the lowest third. Children in the highest sex-specific third of cardiorespiratory fitness had 46% (odds ratio [OR] = .54; 95% CI, .32–.91; P = .019) lower odds of any pain and 50% (OR = .50; 95% CI, .28–.87; P = .015) lower odds of headache than children in the lowest third. Children in the highest sex-specific third of body fat percentage had 44% (OR = .56; 95% CI, .34–.93; P = .023) lower odds of any pain, 49% (OR = .51; 95% CI, .30–.86; P = .011) lower risk of multiple pain, and 48% (OR = .52; 95% CI, .31–.86; P = .010) lower odds of lower limb pain than children in the lowest third. Physical activity was not associated with pain conditions. These findings suggest that prepubertal children with high levels of sedentary behavior, low levels of cardiorespiratory fitness, and low body fat content have increased likelihood of various pain conditions. This information could be used to develop strategies to prevent chronic pain in childhood.

      Perspective

      Our findings suggest that low cardiorespiratory fitness, high levels of sedentary behavior, and low body fat content are associated with increased likelihood of various pain conditions among prepubertal children. This information could be used to develop strategies to prevent chronic pain in childhood.

      Key words

      To read this article in full you will need to make a payment
      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bell L.M.
        • Byrne S.
        • Thompson A.
        • Ratnam N.
        • Blair E.
        • Bulsara M.
        • Jones T.W.
        • Davis E.A.
        Increasing body mass index z-score is continuously associated with complications of overweight in children, even in healthy weight range.
        J Clin Endocrinol Metab. 2007; 92: 517-522
        • Cole T.J.
        • Bellizzi M.C.
        • Flegal K.M.
        • Dietz W.H.
        Establishing a standard definition for child overweight and obesity worldwide: International survey.
        BMJ. 2000; 320: 1240-1243
        • Daniels S.R.
        • Arnett D.K.
        • Eckel R.H.
        • Gidding S.S.
        • Hayman L.L.
        • Kumanyika S.
        • Robinson T.N.
        • Scott B.J.
        • St Jeor S.
        • Williams C.L.
        Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment.
        Circulation. 2005; 111: 1999-2012
        • Deere K.C.
        • Clinch J.
        • Holliday K.
        • McBeth J.
        • Crawley E.M.
        • Sayers A.
        • Palmer S.
        • Doerner R.
        • Clark E.M.
        • Tobias J.H.
        Obesity is a risk factor for musculoskeletal pain in adolescents: Findings from a population-based cohort.
        Pain. 2012; 153: 1932-1938
        • Engelbert R.H.
        • van Bergen M.
        • Henneken T.
        • Helders P.J.
        • Takken T.
        Exercise tolerance in children and adolescents with musculoskeletal pain in joint hypermobility and joint hypomobility syndrome.
        Pediatrics. 2006; 118: 690-696
        • Haapala E.A.
        • Poikkeus A.M.
        • Kukkonen-Harjula K.
        • Tompuri T.
        • Lintu N.
        • Väistö J.
        • Leppänen P.H.
        • Laaksonen D.E.
        • Lindi V.
        • Lakka T.A.
        Associations of physical activity and sedentary behavior with academic skills–a follow-up study among primary school children.
        PLoS One. 2014; 10: 9
        • Hakala P.
        • Rimpelä A.
        • Salminen J.J.
        • Virtanen S.M.
        • Rimpelä M.
        Back, neck, and shoulder pain in Finnish adolescents: National cross sectional surveys.
        BMJ. 2002; 325: 743
        • Hakala P.T.
        • Rimpelä A.H.
        • Saarni L.A.
        • Salminen J.J.
        Frequent computer-related activities increase the risk of neck-shoulder and low back pain in adolescents.
        Eur J Public Health. 2006; 16: 536-541
        • Hershey A.D.
        • Powers S.W.
        • Nelson T.D.
        • Kabbouche M.A.
        • Winner P.
        • Yonker M.
        • Linder S.L.
        • Bicknese A.
        • Sowel M.K.
        • McClintock W.
        Obesity in the paediatric headache population: A multicenter study.
        Headache. 2009; 49: 170-177
        • Holth H.S.
        • Werpen H.K.
        • Zwart J.A.
        • Hagen K.
        Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: Results from the Nord-Trondelag Health Study.
        BMC Musculoskel Disord. 2008; 9: 159
        • Jones G.T.
        • Silman A.J.
        • Macfarlane G.J.
        Predicting the onset of widespread body pain among children.
        Arthritis Rheum. 2003; 48: 2615-2621
        • Landry B.W.
        • Driscoll S.W.
        Physical activity in children and adolescents.
        PM R. 2012; 4: 826-832
        • Lintu N.
        • Tompuri T.
        • Viitasalo A.
        • Soininen S.
        • Laitinen T.
        • Savonen K.
        • Lindi V.
        • Lakka T.A.
        Cardiovascular fitness and haemodynamic responses to maximal cycle test in children 6-8 years of age.
        J Sports Sci. 2014; 32: 652-659
        • Marshall W.A.
        • Tanner J.M.
        Variations in pattern of pubertal changes in girls.
        Arch Dis Child. 1969; 44: 291-303
        • Marshall W.A.
        • Tanner J.M.
        Variations in the pattern of pubertal changes in boys.
        Arch Dis Child. 1970; 45: 13-23
        • Paananen M.V.
        • Auvinen J.P.
        • Taimela S.P.
        • Tammelin T.H.
        • Kantomaa M.T.
        • Ebeling H.E.
        • Taanila A.M.
        • Zitting P.J.
        • Karppinen J.I.
        Psychosocial, mechanical, and metabolic factors in adolescents’ musculoskeletal pain in multiple locations: A cross-sectional study.
        Eur J Pain. 2010; 14: 395-401
        • Pařízková J.
        • Hills A.
        Childhood Obesity: Prevention and Treatment.
        2nd ed. CRC Press, Boca Raton, London, New York, Washington DC2005
        • Pavone P.
        • Rizzo R.
        • Conti I.
        • Verrotti A.
        • Mistretta A.
        • Falsaperla R.
        • Pratico A.D.
        • Grosso G.
        • Pavone L.
        Primary headaches in children: Clinical findings on the association with other conditions.
        Int J Immunopathol Pharmacol. 2012; 14: 1083-1091
        • Perquin C.W.
        • Hazebroek-Kampschreur A.A.
        • Hunfeld J.A.
        • Bohnen A.M.
        • van Suijlekom-Smit L.W.
        • Passchier J.
        • van der Wouden J.C.
        Pain in children and adolescents: A common experience.
        Pain. 2000; 87: 51-58
        • Reilly J.J.
        Descriptive epidemiology and health consequences of childhood obesity.
        Best Pract Res Clin Endocrinol Metab. 2005; 19: 327-341
        • Roth-Isigkeit A.
        • Thyen U.
        • Stöven H.
        • Schwarzenberger J.
        • Schmucker P.
        Pain among children and adolescents: Restrictions in daily living and triggering factors.
        Pediatrics. 2005; 115: 152-162
        • Saari A.
        • Sankilampi U.
        • Hannila M.L.
        • Kiviniemi V.
        • Kesseli K.
        • Dunkel L.
        New Finnish growth references for children and adolescents aged 0 to 20 years: Length/height-for-age, weight-for-length/height, and body mass index-for-age.
        Ann Med. 2011; 43: 235-248
        • Sollerhed A.C.
        • Andersson I.
        • Ejlertsson G.
        Recurrent pain and discomfort in relation to fitness and physical activity among young school children.
        Eur J Sport Sci. 2013; 13: 591-598
        • Spinks A.B.
        • McClure R.J.
        • Bain C.
        • Macpherson A.K.
        Quantifying the association between physical activity and injury in primary school-aged children.
        Pediatrics. 2006; 118: 43-50
        • Stovitz S.D.
        • Pardee P.E.
        • Vazquez G.
        • Duval S.
        • Schwimmer J.B.
        Musculoskeletal pain in obese children and adolescents.
        Acta Paediatr. 2008; 97: 489-493
        • Swain M.S.
        • Henschke N.
        • Kamper S.J.
        • Gobina I.
        • Ottová-Jordan V.
        • Maher C.G.
        Pain and moderate to vigorous physical activity in adolescence: An international population-based survey.
        Pain Med. 2016; 17: 813-819
        • Tomkinson G.
        • Olds T.
        Secular changes in pediatric aerobic fitness test performance: The global picture.
        Med Sport Sci. 2007; 50: 46-66
        • Torsheim T.
        • Eriksson L.
        • Schnohr C.W.
        • Bjarnason T.
        • Välimaa R.
        Screen-based activities and physical complaints among adolescents from the Nordic countries.
        BMC Public Health. 2010; 10: 234
        • Tremblay M.S.
        • LeBlanc A.G.
        • Kho M.E.
        • Saunders T.J.
        • Larouche R.
        • Colley R.C.
        • Goldfield G.
        • Gorber S.C.
        Systematic review of sedentary behavior and health indicators in school-aged children and youth.
        Int J Behav Nutr Phys. 2011; 8: 98
        • Väistö J.
        • Eloranta A.M.
        • Viitasalo A.
        • Tompuri T.
        • Lintu N.
        • Karjalainen P.
        • Lampinen E.K.
        • Ågren J.
        • Laaksonen D.E.
        • Lakka H.M.
        • Lindi V.
        • Lakka T.A.
        Physical activity and sedentary behaviour in relation to cardiometabolic risk in children: Cross-sectional findings from the Physical Activity and Nutrition in Children (PANIC) study.
        Int J Behav Nutr Phys Act. 2014; 11: 55
        • Vierola A.
        • Suominen A.L.
        • Ikävalko T.
        • Lintu N.
        • Lindi V.
        • Lakka H.M.
        • Kellokoski J.
        • Närhi M.
        • Lakka T.A.
        Clinical signs of temporomandibular disorders and various pain conditions among children 6 to 8 years of age: The PANIC study.
        J Orofac Pain. 2012; 26: 17-25
        • Vuorela N.
        • Saha M.T.
        • Salo M.
        Prevalence of overweight and obesity in 5- and 12-year-old Finnish children in 1986 and 2006.
        Acta Paediatr. 2009; 98: 507-512
        • Wedderkopp N.
        • Kjaer P.
        • Hestbaek L.
        • Korsholm L.
        • Leboeuf-Yde C.
        High-level physical activity in childhood seems to protect against low back pain in early adolescence.
        Spine J. 2009; 9: 134-141
        • Wedderkopp N.
        • Leboeuf-Yde C.
        • Bo Andersen L.
        • Froberg K.
        • Steen Hansen H.
        Back pain in children: No association with objectively measured level of physical activity.
        Spine J. 2003; 28: 2019-2024
        • Wöber C.
        • Wöber-Bingöl C.
        Clinical management of young patients presenting with headache.
        Funct Neurol. 2000; 15: 89-105