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Xu S, Li K, Jin L, Dong Y, Liang Y, Liu C, Wang P, Zhao Z, Wang Y, Guo C, Wang Z, Liu H. Distribution of scoliosis in 2.22 million adolescents in mainland China: A population-wide analysis. J Glob Health 2024; 14:04117. [PMID: 39026457 PMCID: PMC11258535 DOI: 10.7189/jogh.14.04117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background The characteristics of scoliosis afflicting school children and adolescents in mainland China are still unclear. Therefore, we conducted a systematic review to estimate scoliosis's prevalence and characterise its distribution in China. Methods We screened PubMed, Scopus, WanFang, China National Knowledge Infrastructure, National Science and Technology Library, and WeiPu databases for mainland China articles published between 1 January 1980 and 31 October 2022. Among them, we identified population-wide scoliosis studies in school children and adolescents. The main outcomes were the positive rate of primary screening and the prevalence of final screening. Primary screening mainly included general examination with/without the forward bending test in school. The final screening entailed clinical diagnosis by Röntgen radiation in a hospital (based on primary screening). A meta-analysis of scoliosis distribution by gender was performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Further, we analysed the distributions of scoliosis by age, region, aetiological type, and severity of curvature, in addition to the correlation between its prevalence and altitude or latitude. Results 77 studies with 2 224 320 participants were included. The positive rate through primary screening was 3.97%, whereas the prevalence of scoliosis at final screening was 1.20%. Analysing the data revealed a higher prevalence of scoliosis in girls (OR = 1.57; 95% CI = 1.38-1.81). The age-wise peak rate of scoliosis was 15-16 years (1.07%) in boys and 13-14 years (1.42%) in girls. The mean prevalence of scoliosis was 1.07% in the western region, 1.54% in the central, and 1.35% in the eastern. Scoliosis prevalence was not correlated with either altitude or latitude. The prevalence of idiopathic and congenital scoliosis was 1.18 and 0.03%. Among all subjects with scoliosis, 79.10 and 16.80% had mild and medium disease severity. Conclusions According to this comprehensive study using data sets of scoliosis in adolescents across mainland China, the mean prevalence of scoliosis is 1.20%, yet 1.57 times higher in girls than boys, and is most prevalent in the middle region. Overall, scoliosis in adolescents could pose a burden to public health in mainland China. Registration PROSPERO CRD42021231987.
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Affiliation(s)
- Shuai Xu
- Department of Spinal Surgery, Peking University People’s Hospital, Peking University, Beijing, China
| | - Kexin Li
- Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Linyu Jin
- Department of Spinal Surgery, Peking University People’s Hospital, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yan Liang
- Department of Spinal Surgery, Peking University People’s Hospital, Peking University, Beijing, China
| | - Chenjun Liu
- Department of Spinal Surgery, Peking University People’s Hospital, Peking University, Beijing, China
| | - Peihan Wang
- Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Zhuran Zhao
- Department of Paediatrics, Peking University People’s Hospital, Peking University, Beijing, China
| | - Yixuan Wang
- Department of Pain Medicine Centre, Peking University Third Hospital, Peking University, Beijing, China
| | - Chen Guo
- Department of Spinal Surgery, Peking University People’s Hospital, Peking University, Beijing, China
| | - Zhenbo Wang
- Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Haiying Liu
- Department of Spinal Surgery, Peking University People’s Hospital, Peking University, Beijing, China
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Cai J, Zhou Y, Chen X, Huang X, Li L, Zhu Y, Cai Q, Huang J, Sun Z. Is refractive error a factor affecting scoliosis? PLoS One 2024; 19:e0303324. [PMID: 38739623 PMCID: PMC11090344 DOI: 10.1371/journal.pone.0303324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Scoliosis is one of the most common surgical disorders of the pediatric spine. Refractive errors are commonly associated with vision impairment worldwide. However, it is currently unclear whether refractive error correlates directly with the development of scoliosis. METHODS A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was employed among school-aged students in Nantong City, China. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between scoliosis and related parameters; various types of refractive errors were also included in the study. RESULTS The prevalence of scoliosis among school-aged students was 2.2% in Nantong city. Multiple logistic regression analyses showed that myopia, hyperopia, astigmatism, and anisometropia were not correlated with the development of scoliosis (all, p≥0.05). Lower body mass index (BMI) [adjusted odds ratio (aOR) = 0.92; 95% confidence interval (CI): 0.88-0.95; p<0.001], living in rural areas (aOR = 1.40; 95% CI: 1.05-1.86; p = 0.020), and older age (aOR = 1.32; 95% CI: 1.25-1.38; p<0.001) had significantly higher risks of scoliosis. CONCLUSIONS Refractive errors did not correlate with the development of scoliosis. However, BMI, living in rural areas and older age did correlate with the development of scoliosis.
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Affiliation(s)
- Jianru Cai
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yue Zhou
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Xiaojuan Chen
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Xiaobo Huang
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Lele Li
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yan Zhu
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Qi Cai
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Jianping Huang
- Nantong Center for Disease Control and Prevention in Jiangsu Province, Jiangsu Province, China
| | - ZhiMin Sun
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
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Hu M, Cai Z, Yang Y, Hong X, Zhang Z, Wang C, Zhou X, Meng Y, Zhao J. Reliability and Validity of the Adapted Chinese Version of the Quality of Life Profile for Spine Deformities in Adolescents With Idiopathic Scoliosis. Global Spine J 2024; 14:1269-1276. [PMID: 36355378 DOI: 10.1177/21925682221139462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE To evaluate the cross-cultural adaptability and internal consistency of the Chinese version of the Quality-of-Life Profile for Spine Deformities (QLPSD) questionnaire in mainland China. METHODS The original QLPSD was translated from Spanish into Chinese with proper cross-cultural adaptation based on the American Academy of Orthopaedic Surgeons guidelines. A total of 129 AIS patients referring to our institution from February 2021 to January 2022 were enrolled in this study. The effects of ceiling and floor were evaluated and the reliability was verified by examining the internal consistency (the Cronbach's α coefficient). Interclass Correlation Coefficient (ICC) was used to test and retest reliability. The C-QLPSD dimensions were compared with the domains in Chinese version of 36-Item Short Form Health Survey (SF-36) and Scoliosis Research Society-22 (SRS-22) questionnaires using Pearson correlation coefficient to assess the concurrent validity. RESULTS No significant floor and ceiling effects in C-QLPSD was observed. The total Cronbach's α was estimated at .914, ranging from .768 in back pain dimensions to .862 in psychosocial function dimensions. The C-QLPSD dimensions indicated satisfactory test-retest reliability with ICC range of .784-.870. Construct validity analysis revealed that C-QLPSD was well correlated with SRS-22 and SF-36. The values of total correlation coefficient were calculated at -.924 and -.871, respectively, which were both statistically significant (P < .05). CONCLUSION The adapted Chinese version of QLPSD had good internal consistency and excellent test-retest reliability, which can be used to assess the outcome among Chinese-speaking patients with adolescent idiopathic scoliosis.
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Affiliation(s)
- Miao Hu
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Zhuyun Cai
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Yue Yang
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Xinjie Hong
- Department of Neurosurgery, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Zheng Zhang
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Ce Wang
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Xuhui Zhou
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Yichen Meng
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Jianquan Zhao
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
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Yuan P, Wang ZH, Jiang H, Wang YH, Yang JY, Li LM, Wang WT, Chen J, Li DH, Long SY, Zhang W, He F, Wang WZ. Prevalence and plasma exosome-derive microRNA diagnostic biomarker screening of adolescent idiopathic scoliosis in Yunnan Province, China. Front Pediatr 2024; 12:1308931. [PMID: 38720947 PMCID: PMC11076730 DOI: 10.3389/fped.2024.1308931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
Background Idiopathic scoliosis significantly affects the physical and mental health of children and adolescents, with varying prevalence rates in different regions. The occurrence of idiopathic scoliosis is associated with genetic regulation and biochemical factors, but the changes in exosome-derived miRNA profiles among idiopathic scoliosis patients remain unclear. This study aimed to determine the prevalence of idiopathic scoliosis in Yunnan Province, China, and identify key exosome-derived miRNAs in idiopathic scoliosis through a cohort study. Methods From January 2018 to December 2020, a cross-sectional study on idiopathic scoliosis in children and adolescents was conducted in Yunnan Province. A total of 84,460 students from 13 cities and counties in Yunnan Province participated in a scoliosis screening program, with ages ranging from 7 to 19 years. After confirmation through screening and imaging results, patients with severe idiopathic scoliosis and normal control individuals were selected using propensity matching. Subsequently, plasma exosome-derived miRNA sequencing and RT-qPCR validation were performed separately. Based on the validation results, diagnostic performance analysis and target gene prediction were conducted for differential plasma exosome-derived miRNAs. Results The overall prevalence of idiopathic scoliosis in children and adolescents in Yunnan Province was 1.10%, with a prevalence of 0.87% in males and 1.32% in females. The peak prevalence was observed at age 13. Among patients diagnosed with idiopathic scoliosis, approximately 12.8% had severe cases, and there were more cases of double curvature than of single curvature, with thoracolumbar curvature being the most common in the single-curvature group. Sequencing of plasma exosome-derived miRNAs associated with idiopathic scoliosis revealed 56 upregulated and 153 downregulated miRNAs. Further validation analysis confirmed that hsa-miR-27a-5p, hsa-miR-539-5p, and hsa-miR-1246 have potential diagnostic value. Conclusions We gained insights into the epidemiological characteristics of idiopathic scoliosis in Yunnan Province and conducted further analysis of plasma exosome-derived miRNA changes in patients with severe idiopathic scoliosis. This study has provided new insights for the prevention and diagnosis of idiopathic scoliosis, paving the way for exploring clinical biomarkers and molecular regulatory mechanisms. However, further validation and elucidation of the detailed biological mechanisms underlying these findings will be required in the future.
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Affiliation(s)
- Ping Yuan
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
| | - Zhi-Hua Wang
- Trauma Medicine Centre, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Hong Jiang
- Department of Medical Imaging, Kunming Children’s Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Yang-Hao Wang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
- Department of Pathology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jian-Yi Yang
- Department of Orthopaedics, Kunming Guandu District People’s Hospital, Kunming, Yunnan, China
| | - Lu-Ming Li
- Department of Orthopedics, Yunnan Sino-German Orthopedic Hospital, Kunming, Yunnan, China
| | - Wen-Tong Wang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
| | - Jing Chen
- Department of Pathology and Pathophysiology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Deng-Hui Li
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
| | - Sheng-Yu Long
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
- Department of Orthopedic, Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, China
| | - Wan Zhang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
| | - Fei He
- Department of Orthopedic, Qujing Affiliated Hospital of Kunming Medical University, Qujing, Yunnan, China
| | - Wei-Zhou Wang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- The First Clinical College, Kunming Medical University, Kunming, Yunnan, China
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Qi X, Peng C, Fu P, Zhu A, Jiao W. Correlation between physical activity and adolescent idiopathic scoliosis: a systematic review. BMC Musculoskelet Disord 2023; 24:978. [PMID: 38115016 PMCID: PMC10729348 DOI: 10.1186/s12891-023-07114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The multifactorial aetiology of scoliosis is well known. Physical activity is considered both a treatment and causative factor for idiopathic scoliosis; however, evidence for a causal relationship between physical activity levels and idiopathic scoliosis in adolescents is conflicting. Therefore, we aimed to summarise the current evidence regarding the association between adolescent idiopathic scoliosis and physical activity and further to assess whether the relationship is dose dependent. METHODS PubMed, Cochrane, Scopus, and Web of Science databases were searched from 1991 to July 2022 using the following main keywords: adolescent idiopathic scoliosis, physical activity, and risk factors, supplemented with manual searches, secondary citations, and reference searches. The quality of the included literature was evaluated using the Scale for Reporting Observational Studies in Enhanced Epidemiology guidelines. RESULTS Eight studies were included in this review, of which six reported an association between adolescent idiopathic scoliosis and physical activity levels and two reported no association. One British study reported reduced physical function early in life as a new risk factor for scoliosis onset. CONCLUSIONS Physical activity is strongly associated with adolescent idiopathic scoliosis. Physical activity should be encouraged as it plays an important role in the prevention of adolescent idiopathic scoliosis. Further research is needed to determine the dose-dependent relationship between physical activity and prevention of adolescent idiopathic scoliosis.
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Affiliation(s)
- Xiang Qi
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- School of Physical Education, Taizhou University, Taizhou, China
| | - Chao Peng
- Department of Rehabilitation, The First Affliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Pinting Fu
- Department of Rehabilitation, Shanxi Acupuncture Hospital, Taiyuan, China
| | - Aiyuan Zhu
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Wei Jiao
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
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Pan Y, Zhang H, Ye X, Li S, Li X, Li Z, Ying X. Study on the relationship between scoliosis and vision problems: A narrative review. Medicine (Baltimore) 2023; 102:e35178. [PMID: 37861544 PMCID: PMC10589577 DOI: 10.1097/md.0000000000035178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/21/2023] [Indexed: 10/21/2023] Open
Abstract
Adolescent scoliosis is one of the most common surgical disorders of the pediatric spine. With timely detection and early treatment, most scoliotic children can avoid major and expensive surgery. Vision problems are also frequently found at an early age and can take a toll on individuals quality of life. However, scoliosis, a severe health hazard to adolescents, is often accompanied by vision problems clinically, including myopia, astigmatism, strabismus, amblyopia, horizontal paralysis, and blindness. And people with genetic defects have a higher probability of suffering both spinal problems and vision problems than those with nongenetic defects. However, many individuals viewed scoliosis and vision problems as 2 irrelevant diseases. This review searched PubMed, China National Knowledge Infrastructure, and Web of Science for studies on adolescent, scoliosis, eye diseases, myopia, strabismus, spinal disorders, and vision problems for almost 3 decades, and thus confirmed the potential relationship between adolescent scoliosis and vision problems.
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Affiliation(s)
- Yingsen Pan
- The 3rd Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Haoyang Zhang
- The 3rd Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin Ye
- Tuina Department, The 3rd Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuailin Li
- Tuina Department, The 3rd Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoming Li
- Tuina Department, The 3rd Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zengtu Li
- Tuina Department, The 3rd Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoming Ying
- Tuina Department, The 3rd Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Malaquias LC, da Silva MCM, Menezes DYA, Magalhães MO. Measurement properties of the Spinal Appearance Questionnaire in adolescents with idiopathic scoliosis: a systematic review. BMC Musculoskelet Disord 2023; 24:587. [PMID: 37464253 DOI: 10.1186/s12891-023-06708-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Scoliosis is defined as a three-dimensional deformity of the spine characterized by lateral tilt and axial rotation of the vertebrae. Its magnitude in the frontal plane is identified by a Cobb angle greater than 10o. The aim of the study was to systematically examine the clinimetric properties of the Spinal Appearance Questionnaire (SAQ) in its cross-cultural adaptations in different languages. METHODS Medline (PubMed), CINAHL, EMBASE, Science Direct, PsycINFO and WorldWideScience.org databases were used for screening studies until July 16, 2022. In this study, records on the development, evaluation and translation of the SAQ instrument in adolescents with idiopathic scoliosis were included. In addition, two independent reviewers defined whether the studies were eligible and analyzed their psychometric properties of internal consistency, reliability, content validity, cross-cultural validity, construct validity and structural validity, according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The modified GRADE was applied for evidence synthesis. RESULTS A total of 95 articles were selected by title and abstract. After removing duplicates and reading and searching the references, a total of 13 studies were included in this review. The original version of the SAQ was described in English, and the instrument was translated into Polish, Canadian French, Simplified Chinese, Spanish (Europe), Danish, Traditional Chinese, Portuguese (Brazil), Korean, German, Turkish and Persian. The evidence was moderate for construct validity, low for internal consistency, and very low for reliability and cross-cultural validity; the content and structural validity properties did not present minimum data for classification. CONCLUSION The quality of the evidence regarding the clinimetric properties of the SAQ instrument in adolescents with idiopathic scoliosis was low due to the absence of clinimetric properties or dubious methodological quality. However, for clinical practice and research, we recommend the use of the instrument to assess the self-perception of the spine in adolescents. For future translations and adaptations, we recommend the use of the COSMIN guidelines.
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Affiliation(s)
- Lorenna Costa Malaquias
- Post Graduation Program in Human Movement Sciences, Federal University of Pará (UFPA), Belém, Pará, Brazil
| | - Maria Clara Monteiro da Silva
- Faculty of Physical and Occupational Therapy, Institute of Health Sciences, Federal University of Pará (UFPA), Belém, Pará, Brazil
| | - Dhara Yasmin Andrade Menezes
- Faculty of Physical and Occupational Therapy, Institute of Health Sciences, Federal University of Pará (UFPA), Belém, Pará, Brazil
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Zhu L, Ru S, Wang W, Dou Q, Li Y, Guo L, Chen X, Wang W, Li W, Zhu Z, Yang L, Lu C, Yan B. Associations of physical activity and screen time with adolescent idiopathic scoliosis. Environ Health Prev Med 2023; 28:55. [PMID: 37766541 PMCID: PMC10569969 DOI: 10.1265/ehpm.23-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 07/28/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is the most common type of idiopathic scoliosis, affecting approximately 0.61%-6.15% adolescents worldwide. To date, the results on the relationship between moderate-to-vigorous physical activity (MVPA) and AIS were inconsistent, and the association between screen time (ST) and AIS remained unclear. This study aimed to describe MVPA and ST among adolescents, and to explore the independent and joint associations between PA, ST, and AIS. METHODS A frequency-matched case-control study based on the 2021 Chinese School-based Scoliosis Screening Program in Shenzhen city, south China, was conducted. The research involved 494 AIS patients (aged 9-17 years) and 994 sex- and age-matched healthy controls. MVPA and ST were measured using a self-administered questionnaire. Logistic regression models estimated associations between PA, ST, and AIS. RESULTS Compared to subjects meeting the recommended 60-min daily of MVPA, adolescents reporting daily MVPA time less than 60 min had 1.76 times higher odds of experiencing AIS (95% CI: 1.32-2.35) and adolescents reporting daily MVPA in inactive status had 2.14 times higher odds of experiencing AIS (95% CI: 1.51-3.03). Moreover, participants reporting ST for 2 hours or more had 3.40 times higher odds of AIS compared with those reporting ST less than 2 hours (95% CI: 2.35-4.93). When compared with the adolescents reporting both ST and MVPA meeting the guidelines recommended times (ST < 2 h and MVPA ≥ 60 min/day), those reporting both ST ≥ 2 h and MVPA in inactive status are 8.84 times more likely to develop AIS (95% CI: 3.99-19.61). CONCLUSIONS This study reported that the insufficient MVPA, especially MVPA in inactive status, and excessive ST were risk factors for AIS. Additionally, the joint effects of insufficient MVPA and excessive ST probably increase the risk of AIS.
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Affiliation(s)
- Liwan Zhu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shouhang Ru
- Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Spine Surgery, the Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiufen Dou
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaosheng Chen
- Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Spine Surgery, the Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Weijun Wang
- Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Spine Surgery, the Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhixiang Zhu
- Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Spine Surgery, the Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Lei Yang
- Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Spine Surgery, the Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bin Yan
- Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Department of Spine Surgery, the Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
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Scaturro D, Balbo A, Vitagliani F, Stramazzo L, Camarda L, Letizia Mauro G. Is There a Relationship between Idiopathic Scoliosis and Body Mass? A Scoping Review. Nutrients 2022; 14:nu14194011. [PMID: 36235665 PMCID: PMC9572444 DOI: 10.3390/nu14194011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
The etiopathogenesis of idiopathic scoliosis remains unknown, although genetic or hereditary factors, neurological disorders, hormonal and metabolic dysfunctions, biomechanical factors, and environmental factors seem to be involved. Several studies have found that patients with scoliosis have common characteristics of taller stature, lower body mass index (BMI), and low systemic bone mass. We conducted a scoping review to analyze the association between idiopathic scoliosis and BMI. The search for articles was performed on PubMed and Cochrane, including the English language, full-text and free-full-text articles published from 31 December 2011 to 31 December 2021. Most of the results analyzed are in favor of a relationship between low BMI and scoliosis. Having a low BMI could be associated with the presence of scoliosis, although the reason for which is still doubtful. However, further large-scale epidemiological studies on different ethnicities and a comparison of BMI with the healthy population will be needed to better define the correlation between BMI and scoliosis.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Agnese Balbo
- Faculty of Medicine and Surgery, University of Catania, Via Santa Sofia 87, 95100 Catania, Italy
| | - Fabio Vitagliani
- Faculty of Medicine and Surgery, University of Catania, Via Santa Sofia 87, 95100 Catania, Italy
- Correspondence: ; Tel.: +39-3920677899
| | - Leonardo Stramazzo
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Lawrence Camarda
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
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Zhou L, Yang H, Hai Y, Hai JJ, Cheng Y, Yin P, Yang J, Zhang Y, Wang Y, Zhang Y, Han B. Scoliosis among children in Qinghai-Tibetan Plateau of China: A cross-sectional epidemiological study. Front Public Health 2022; 10:983095. [PMID: 36062094 PMCID: PMC9437421 DOI: 10.3389/fpubh.2022.983095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/01/2022] [Indexed: 01/25/2023] Open
Abstract
Background The average altitude of Qinghai-Tibetan Plateau is 4,500 m and most of the residents are Tibetan ethnicity. The purpose of this study was to investigate the prevalence of scoliosis and associated factors among children in this region through a scoliosis screening program. Methods A cross-sectional study was preformed between May 2020 and December 2020 in Qinghai-Tibetan Plateau. A total of 9,856 children aged 6-17 years from schools and nearby villages were screened using visual inspection, the Adams forward-bending test, the angle of trunk rotation, and radiography. A self-designed questionnaire was used to collect demographic data. The prevalence of scoliosis and associated factors were analyzed. Results The overall prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%, with 5.38% for females and 2.11% for males. The prevalence of scoliosis was 3.50% in children resided below 4,500 m while 5.63% in those resided above 4,500 m (P = 0.001). The prevalence of congenital scoliosis (2.14 vs. 0.42%, P < 0.001) and neuromuscular scoliosis (0.34 vs. 0.07%, P = 0.041) were significantly higher in the altitude above 4,500 m. 50.00% of patients resided above 4,500 m were recommended for surgery while 16.24% in those resided below 4,500 m (P < 0.001). Independent associated factors were detected as female (OR = 2.217, 95 CI% 1.746-2.814, P < 0.001), BMI < 18.5 (OR = 1.767, 95 CI% 1.441-2.430, P = 0.005), altitude of residence ≥ 4,500 m (OR = 1.808, 95 CI% 1.325-2.483, P = 0.002), and sleep time < 8 h (OR = 2.264, 95 CI% 1.723-2.846, P = 0.001). Conclusion The prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%. With increasing altitudes, the prevalence of scoliosis and its major type were different from that at lower altitudes. Female, BMI < 18.5, altitude of residence ≥ 4,500 m, and sleep time < 8 h were independently associated with the prevalence of this disease. Early screening should be carried out before the age of 7 years, especially in the high-altitude, underdeveloped, and rural areas.
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Affiliation(s)
- Lijin Zhou
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China,*Correspondence: Lijin Zhou
| | - Honghao Yang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China,Yong Hai
| | - Junrui Joanthan Hai
- Princeton International School of Mathematics and Science, Princeton, NJ, United States
| | - Yunzhong Cheng
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Peng Yin
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Jincai Yang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yangpu Zhang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yunsheng Wang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yiqi Zhang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Bo Han
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
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Computerized-Assisted Scoliosis Diagnosis Based on Faster R-CNN and ResNet for the Classification of Spine X-Ray Images. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3796202. [PMID: 35707041 PMCID: PMC9192275 DOI: 10.1155/2022/3796202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/22/2022] [Accepted: 04/06/2022] [Indexed: 01/01/2023]
Abstract
In order to reduce the subjectivity of preoperative diagnosis and achieve accurate and rapid classification of idiopathic scoliosis and thereby improving the standardization and automation of spinal surgery diagnosis, we implement the Faster R-CNN and ResNet to classify patient spine images. In this paper, the images are based on spine X-ray imaging obtained by our radiology department. We compared the results with the orthopedic surgeon's measurement results for verification and analysis and finally presented the grading results for performance evaluation. The final experimental results can meet the clinical needs, and a fast and robust deep learning-based scoliosis diagnosis algorithm for scoliosis can be achieved without manual intervention using the X-ray scans. This can give rise to a computerized-assisted scoliosis diagnosis based on X-ray imaging, which has strong potential in clinical utility applied to the field of orthopedics.
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