Musculoskeletal Pain and Hip Muscle Length Among Undergraduates: A Longitudinal Study of 1 Year

Background and Objectives: Musculoskeletal pain (MSP) is highly prevalent among undergraduate students and may originate during early adulthood, increasing the risk of chronicity later in life. Modifiable factors such as reduced muscle flexibility and prolonged sedentary behavior have been proposed as contributors; however, longitudinal evidence among student populations remains scarce. This study aimed to prospectively examine changes in MSP prevalence and hip muscle length over one year and to identify independent predictors of MSP. Materials and Methods: A prospective longitudinal study was conducted among 62 first-year undergraduate students assessed at baseline and at one-year follow-up. MSP was evaluated using a modified Standardized Nordic Questionnaire, and demographic data including physical activity and sitting behavior were recorded. Hamstring and iliopsoas muscle length were measured by passive straight-leg raise and modified Thomas tests, respectively. Changes over time were analyzed using paired t-tests and McNemar tests. Multivariable logistic regression was also performed to identify predictors of MSP at follow-up. Results: Most participants were female (79%, n = 49), with a mean age of 25.8 ± 6.0 years and body mass index of 23.6 ± 4.4 kg/m². Significant reductions in hamstring (p < 0.001; d = -0.55 to -0.70) and iliopsoas muscle length (p < 0.001; d = -1.32 to -1.46) were observed over one year. Health science students manifested a significant decrease in hamstring length over time compared to their counterparts in other programs (p ≤ 0.002). MSP prevalence increased across all body regions, particularly in the low back (46.8% to 71.0%) and cervical spine (46.8% to 61.3%). Baseline MSP was the only independent predictor of MSP at follow-up (upper quadrant: OR = 12.89, 95% CI: 2.38-69.65, p = 0.003; lower quadrant: OR = 6.35, 95% CI: 1.39-28.90, p = 0.018). Conclusions: A significant increase in the prevalence of MSP was observed alongside a reduction in hip muscle length among undergraduate students over a one-year period. The findings suggest that students enrolled in health science programs are more susceptible to musculoskeletal alterations, whereas baseline MSP is a strong predictor of future symptoms.