The grade in physical education in adolescence as predictor for musculoskeletal pain diagnoses three decades later

Abstract 

We hypothesized that a low grade in physical education (PE) is associated with an increased risk of future musculoskeletal conditions, especially chronic pain. Using a historical cohort study design, we identified all students (mean age 16.0years), who in 1974–1976 graduated from compulsory school in a Swedish municipality and retrieved their PE grades. We ensured that persons were still alive and resident in the county in 2003–2007 and linked data to the Skåne Health Care Register covering all in- and outpatient care in the county. Diagnoses in focus were soft tissue pain, back pain, and osteoarthritis registered as ICD-10 codes. We used a logistic regression model adjusted for education and occupation to investigate the associations between the PE grade and a future musculoskeletal diagnosis. An average grade served as reference group. Of 2298 graduates born 1957–1962, 1712 (74.5%) were resident in the county at follow-up. Women with a low (bad) PE grade had an increased odds ratio (OR) for a musculoskeletal diagnosis OR=1.5 (95% CI=1.0–2.2) as well as for the subgroup “Other soft tissue disorders, not elsewhere classified” (M79) OR=1.9 (95% CI=1.0–3.3), containing mostly chronic soft tissue pain disorders. In men with a high (good) PE grade, we found a decreased risk for “Soft tissue disorders” (M60–M79) OR=0.54 (95% CI=0.33–0.86) as well as for the subgroup “Other enthesopathies” (M77) OR=0.29 (95% CI=0.11–0.78). This study indicates that adolescent girls with a low PE grade could be an important group to target with early interventions to reduce future musculoskeletal illness.

Keywords: Cohort studies, Registries, Physical education and training, Musculoskeletal disease, Adolescent, Middle aged

• 1 WHO Collaborating Centre for Evidence-Based Healthcare in Musculoskeletal Disorders.