[Prevalence of idiopathic scoliosis and associated variables in schoolchildren of elementary public schools in Cuiabá, state of Mato Grosso, 2002]

Association between physical activity and body posture: a systematic review and meta-analysis

OBJECTIVE

To estimate the possible associations between posture and physical activity (PA).

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

The search was conducted in seven databases (PubMed, Web of Science, SportDiscus, EMBASE, Scopus, Cochrane Library, and CINAHL) for studies published from inception to January 2023.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were required to meet following criteria: (1) study design: cross-sectional, case control and cohort studies. (2) Participants: people of all ages without any diagnosed diseases. (3) Exposure and outcome: studies that examined the possible effect or correlations between PA, physical inactivity, physical exertion and human body posture.

RESULTS

Sixteen cross-sectional studies, two cohort studies and one case control study involving a total of 16772 participants aged from 6 to 79 years were included. Correlational studies showed that there was a significant relationship between PA and posture (C = 0.100, CI 95% = 0.012-0.186). However, regression studies demonstrated that there was not a significant association between PA and posture (C = 1.00, CI 95% = 0.998-1.002). Three studies investigated the association between PA and the lumbar lordosis and showed that there was not a significant association between the lordosis and PA (CI 95%: -0.253-0.048, P = 0.180). In addition, four studies showed that there were not any associations between scoliosis and PA (CI 95%: 0.819, 1.123, P = 0.607). The evidence of heterogeneity and publication bias was found among all analyzed data (P < 0.05). Also, meta regression was used for age and BMI and the results were not significant.

CONCLUSION

Although a weak correlation was shown to exist between PA and human posture, the odds ratio indicated that there was not a significant association between PA and human posture. The lack of a significant relationship may indicate that multiple biopsychosocial factors may be involved in human posture. In summary, our study highlights the need for caution when interpreting the results of meta-analyses, particularly when there is significant heterogeneity and publication bias in the included studies.

Associations Between Physical Activity and Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis

OBJECTIVE

To investigate the associations between adolescent idiopathic scoliosis (AIS) and physical activity (PA).

DATA SOURCES

MEDLINE, EMBASE, AMED, SPORTDiscus, Cochrane Library, and CINAHL electronic databases were searched from inception to August 2022/plus citation tracking.

STUDY SELECTION

Observational studies of participants with radiographically confirmed AIS with ≥10° lateral spinal curvature (Cobb method) and comparator groups without AIS that measured PA were selected by 2 reviewers.

DATA EXTRACTION

Data were extracted independently and cross-checked by 2 reviewers. Risk of bias was evaluated using Newcastle Ottawa Scales and overall confidence in the evidence using the GRADE approach.

DATA SYNTHESIS

Sixteen studies with 9627 participants (9162, 95% women) were included. A history of vigorous PA significantly reduced the odds of being newly diagnosed with AIS by 24% (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.65-0.89) (high certainty). Moderate PA reduced odds by 13% (moderate certainty) and light PA increased odds by 9% (low certainty), but neither analysis was statistically significant. Ballet or gymnastics (OR 1.47, 95% CI 3.08 (1.90, 5.00) were the only individual sports significantly associated with AIS diagnosis (moderate certainty). Case-control studies of people with and without AIS provided greater evidence that having AIS reduces vigorous PA and sports participation, and less evidence light PA and walking are affected.

CONCLUSION

Adolescents who participate in more vigorous PA are less likely to be diagnosed with AIS. Ballet and gymnastics are associated with AIS diagnosis, but the direction of this association is uncertain. People with AIS are likely to do less vigorous physical and sporting activity compared with those without AIS, which could negatively affect health and quality of life. Further research is warranted into the inter-relations between PA and AIS, studies need to be of sufficient size, include men, and evaluate vigorous including higher-impact PA compared with moderate or light PA.

Influence of physical activity and postural habits in schoolchildren with scoliosis

BACKGROUND

Scoliosis is considered one of the main musculoskeletal changes in childhood, and is characterized by three-dimensional changes in the spine. Schoolchildren is a group who are directly exposed to this condition because they go through a rapid growth phase in adolescence, added to other external factors such as school environment and daily living habits such as little physical activity. This study aimed to identify the risk factors associated with scoliosis in schoolchildren.

METHODS

An observational, retrospective case control study with a quantitative approach was carried out in the city of Santa Cruz/RN. The presence of scoliosis was assessed using the Adams test and physical activity by the Daily Physical Activity Index (IPAQ) and by a questionnaire on competitive sports practice, in addition to a questionnaire on postural habits in childhood and adolescence. Conditional multiple logistic regression was performed for statistical analysis, and the adjusted Odds Ratios (OR) and the respective confidence intervals (95%) of the outcome variable were estimated.

RESULTS

A total of 156 schoolchildren participated in the study, with an average age of 13.9 years, with 55.1% being female and 44.9% male, attending between the 6th grade of elementary school and the 3rd year of high school. Furthermore, 42.9% of these participants were considered irregularly active and only 33.3% practiced physical activity on a regular basis. After bivariate analysis and conditional logistic regression, little physical activity was shown to be a risk factor for scoliosis (p = 0.041; OR: 2.81; 95% CI: 1.04-7.57), while the postural habits evaluated in this study did not show a statistical association with scoliosis.

CONCLUSION

Low practice of physical activity and schoolchildren being classified as irregularly active were considered as risk factors for scoliosis, however postural habits do not seem to be associated with this condition.

Somatic determinants of changes in selected body posture parameters in younger school-age children

Background

The aim of this study was to describe changes in selected parameters of body posture in children between 5 and 9 years old with diversified somatic structures.

Methods

The study was carried out in 2015 and then repeated in 2018 among 67 participants who had previously been observed to have scoliotic posture. Basic body weight and height measurements were taken, which were then used to calculate the body mass index. Posture tests were conducted using the photogrammetric method.

Results

Girls and boys were not significantly different in body dimensions. With age, the number of overweight boys and children with normal growth-weight proportions increased. Temporary differences in posture variables indicating abnormalities were small.

Conclusions

There were no significant differences in somatic parameters between the girls and the boys. Those children with a slender body structure had the most abnormalities in the coronal plane. On the other hand, changes in spinal position in the sagittal plane were more frequent in overweight children. Relations were noted between the compensation index in the sagittal plane and deviation of the trunk inclination, the maximum deviation of the line of the spinous processes, and the angle of the shoulder line in the coronal plane and body mass index values were noted.

Relationship between postural changes and physical and functional variables in schoolchildren aged 6-12 years

Abstract The aim of this study was to evaluate the prevalence of postural changes and their relationship with BMI, pain, postures adopted in activities of the daily living (ADL), physical activity practice, gender and age (6 to 12 years). This study is characterized as cross-sectional, quantitative and descriptive. The convenience sample consisted of 840 schoolchildren. Regarding the sample characteristics, 477 (56.79%) were female aged 6-12 years (average=8.90±1.71years). Evaluations were carried out at the school premises and a questionnaire was used to collect data on gender, age, pain report, practice of out-of-school physical activities and postures adopted in ADLs. Body mass, height and posture were evaluated. Some schoolchildren (43.21%) reported not practicing physical activity outside of school, 544 (64.76%) correctly carried their backpack and 51.9% adopted correct postures to study and watch TV. Musculoskeletal pain was reported by 62.73%, and shoulders were the most affected. BMI indicated 55.6% of the sample with leanness/normal weight and 44.40% with overweight/obesity. Postural changes were present in 97.02% of students and the region with the highest number of alterations was the upper limbs. Girls presented greater number of trunk alterations (p=0.001), as well as those who did not practice physical activity (p=0.02) and alterations in the lower limbs for younger students (p=0.02) and female students (p=0.01). This study identified high prevalence of postural changes in schoolchildren.

EVALUATION OF QUALITY OF LIFE IN PATIENTS WITH SCOLIOSIS SUBMITTED TO CONSERVATIVE TREATMENT

ABSTRACT Objective To assess the level of quality of life (QOL) and the most affected dimensions in patients with scoliosis. Methods Original article about a descriptive, quantitative study of 20 individuals diagnosed with scoliosis and undergoing conservative treatment. Data were collected during consultations using two questionnaires, one containing social and demographic data and the Revised Scoliosis Research Society-22 (Brazilian version). The analysis was carried out in the Statistical Package for the Social Sciences (version 25), using descriptive statistics and the nonparametric Mann-Whitney test. The research was submitted to and approved by the Institutional Review Board of the Faculdades Integradas de Patos. Results The sample was composed mostly of female patients (70%), aged between 12 and 16 years (55%), whose most affected QOL domains were activity (10%) and mental health(55%). In addition, patients with moderate scoliosis had a lower quality of life when compared to those with mild scoliosis. Conclusion Scoliosis is an alteration of the spine that affects more female adolescents, negatively impacting their quality of life, and mainly affecting the domains of activity, mental health and appearance. Given this reality, a closer look is needed, seeking to create and encourage strategies that can improve the overall well-being of these patients. Level of Evidence II - Retrospective Study.

Prevalence of Adolescent Idiopathic Scoliosis in the State of São Paulo, Brazil

STUDY DESIGN

A cross-sectional study.

OBJECTIVE

To estimate the prevalence of adolescent idiopathic scoliosis (AIS) in cities in the state of São Paulo, Brazil, as well as to identify demographic, clinical, and lifestyle factors associated with AIS.

SUMMARY OF BACKGROUND DATA

AIS is a common three-dimensional spinal deformity. Epidemiological data about the condition in the southern hemisphere are scarce, and Brazil has no public health policies to implement school-based scoliosis screening programs.

METHODS

We assessed 2562 adolescents between 10 and 14 years of age. The screening procedure included measurement of the angle of trunk rotation using a scoliometer in the Adams forward bend test and the radiographic examination.

RESULTS

The overall prevalence of AIS was 1.5% (95% confidence interval [CI]: 1%-1.9%). The AIS prevalence was higher among the females than among the males-2.2% (95% CI: 1.4%-2.9%) and 0.5% (95% CI: 0.1%-0.9%), respectively. The following factors were associated with the development of AIS: being female (OR = 4.7, 95% CI: 1.8-12.2; P = 0.001) and being in the 13- to 14-year age group (OR = 2.2; 95% CI: 1.0-4.8; P = 0.035). Double curves and right laterality were more common (59.4% and 56.8%, respectively), although the curves were of low magnitude (75% of the curves having a Cobb angle ≤22°), as was the progression factor (≤1.2 in 75% of the cases).

CONCLUSION

The prevalence of AIS in cities within the state of São Paulo was similar to that reported in the literature, was higher among females, and was higher during puberty (13-14 years of age). Because puberty occurs later for males than for females, the recommendation to screen both sexes at 10 to 14 years of age should be reconsidered.

LEVEL OF EVIDENCE

3.

PREVALENCE OF SCOLIOSIS IN PUBLIC ELEMENTARY SCHOOL STUDENTS

OBJECTIVE

To evaluate the prevalence of scoliosis and the risk factors in elementary school students.

METHODS

A cross-sectional study was carried out in 954 students in 2015. The instrument involved was a questionnaire on postural habits, socioeconomic conditions, and demographic factors. The anthropometric measurements, including height and weight, a visual inspection of the deformity of the vertebral column, the leveling of shoulders, and the Adam's test were obtained. The sample was calculated in the expected frequency of 12.3%, acceptable error rate of 2.0% and confidence level of 95.0%. To compare the proportions, the chi-square test or Fisher's exact test was applied. The association between scoliosis and risk factors was evaluated by logistic regression, being significant p <0.05.

RESULTS

The prevalence of scoliosis was 24.3%, higher in obese patients and students who adopted a sitting position for a long period of time. Obese students showed a 1.8 times higher chance of testing positive Adam's Forward Bend Test when compared to normal-weight/lean and 2.1 times higher chance compared to overweight students. The sitting position for watching television increases the chance of testing positive Adam's test in 38.0%, when compared to the lying position. Obesity increases the risk of testing positive Adam's test in 74.0 and 98.0%, when compared, respectively, to the underweight/normal weight and overweight.

CONCLUSIONS

There was a high prevalence of scoliosis in students from public elementary schools in Santos. The most influential factors for this deviation of the spine were obesity and the position adopted by students to watch television.

Community Care Administration of Spinal Deformities in the Brazilian Public Health System

OBJECTIVE:

Underfunding of the surgical treatment of complex spinal deformities has been an important reason for the steadily growing waiting lists in publicly funded healthcare systems. The aim of this study is to characterize the management of the treatment of spinal deformities in the public healthcare system.

METHODS:

A cross-sectional study of 60 patients with complex pediatric spinal deformities waiting for treatment in December 2013 was performed. The evaluated parameters were place of origin, waiting time until first assessment at a specialized spine care center, waiting time for the surgical treatment, and need for implants not reimbursed by the healthcare system.

RESULTS:

Ninety-one percent of the patients lived in São Paulo State (33% from Ribeirão Preto - DRS XIII). Patients waited for 0.5 to 48.0 months for referral, and the waiting times for surgery ranged from 2 to 117 months. Forty-five percent of the patients required implants for the surgical procedure that were not available.

CONCLUSION:

The current management of patients with spinal deformities in the public healthcare system does not provide adequate treatment for these patients in our region. They experience long waiting periods for referral and prolonged waiting times to receive surgical treatment; additionally, many of the necessary procedures are not reimbursed by the public healthcare system.

Scoliosis epidemiology is not similar all over the world: a study from a scoliosis school screening on Chongming Island (China)

Background

School scoliosis screening has been carried out around the world. The screen program has never been performed on Chongming Island, the third largest island in China and characterized less population exchange with the rest of China. This study was designed to examine scoliotic parameters in children from Chongming Island and determine whether the parameters differed from those of the published data.

Methods

A total of 6824 children (3477 boys and 3347 girls) aged from 6 to 17 were recruited. The screen included Adam’s test and scoliometer measurements. Posteroanterior radiographic evaluation was performed if trunk rotation was 5° or more.

Results

One hundred seventy two were confirmed with Cobb angle of 10° or more; the prevalence was 2.52 %, higher in girls (3.11 %) than in boys (1.96 %) (p < 0.05). There was a weak positive correlation between prevalence and age. Majority curves were minor (from 10 to 19°). The most common thoracic curve was right curve (60.3 % of all thoracic curves), while the most common thoracolumbar (75.5 %) and lumbar curves (64.7 %) were left curves.

Conclusions

The prevalence of scoliosis on Chongming Island was 2.52 %. This study indicates that epidemiology of scoliosis has regional variation, and genetic differences may contribute such difference.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-016-1140-6) contains supplementary material, which is available to authorized users.

[Risk factors associated with structural postural changes in the spinal column of children and adolescents]

OBJECTIVE

To investigate the association between behavioral risk factors, specifically postural habits, with the presence of structural changes in the spine of children and adolescents.

METHODS

59 students were evaluated through the self-reporting Back Pain and Body Posture Evaluation Instrument e and the spine panoramic radiographic examination. The spine curvatures were classified, based on Cobb' angle, as normal or altered in the saggital plane and as normal or scoliotic in the frontal plane. Data were analyzed using SPSS 18.0, from descriptive statistics and chi-square association test (α=0,05).

RESULTS

The prevalence of postural alterations was 79.7% (n=47), of which 47.5% (n=28) showed frontal plane alterations and 61% (n=36) sagital plane alterations. Significant association was found between the presence of thoracic kyphosis and female gender, practice of physical exercise only once or twice a week, sleep time greater than 10 hours, inappropriate postures to sit on the bench and sit down to write, and transport of school supplies. Lumbar lordosis was associated with improperly transportation of school backpack (asymmetric); and scoliosis was associated with the practice of competitive sport and sleep time greater than 10 hours.

CONCLUSIONS

Lifestyle may be associated with postural alterations. It is important to develop health policies in order to reduce the prevalence of postural alterations with a reduction of associated risk factors.

Factors associated with scoliosis in schoolchildren: a cross-sectional population-based study

BACKGROUND

The present study aimed to investigate the prevalence of scoliosis and to analyze the factors associated with scoliosis in schoolchildren aged between 7 and 17 years.

METHODS

This is a cross-sectional and quantitative study with stratified random selection of public school students in the city of Santa Cruz, Brazil. The presence of scoliosis was examined, as well as the flexibility of the posterior muscle chain, socioeconomic characteristics, anthropometry, lifestyle habits, sexual maturation, and ergonomics of school furniture. In order to identify factors associated with scoliosis, the variables were divided in biological, socioeconomic, lifestyle, and ergonomic factors, and crude and adjusted prevalence ratios (PRs) were estimated by means of Poisson regression analysis.

RESULTS

Two hundred and twelve pupils participated in this study (mean age 11.61 years, 58% female). The prevalence of scoliosis was 58.1% (n = 123) and associated with female sex (PR 2.54; 95% CI, 1.33-4.86) and age between 13 and 15 years (PR 5.35; 95% CI, 2.17-13.21). Sleeping in a hammock was inversely associated with scoliosis (PR 0.44; 95% CI, 0.23-0.81).

CONCLUSIONS

Scoliosis seems to be positively associated with female sex and age between 13 and 15 years, whereas the habit of sleeping in a hammock is negatively associated with the onset of scoliosis.

Epidemiology of adolescent idiopathic scoliosis in students of the public schools in Goiânia-GO

OBJECTIVE:

To investigate the prevalence of adolescent idiopathic scoliosis in school children from 10 to 14 years in public schools in Goiânia, GO, Brazil.

METHODS:

In a cross-sectional study, 476 students were randomly selected from 5 public schools, from a total of 33,343 students distributed in 162 schools. These subjects received the informed consent prior, which was returned after being signed by parents on physical examination day. We evaluated the symmetry of the shoulders, the scapulae, the triangle-cut, the hip evenness and the Adams test. In suspected cases, students were referred to panoramic radiographs of the spine.

RESULTS:

418 students participated in the study (adjusted sampling error of 3.2%). Of this total, 31 students were suspected of scoliosis (17 males and 14 females). Twenty-eight students took radiographs, of which 18 were diagnosed with adolescent idiopathic scoliosis (11 female and 7 male), determining the prevalence of 4.3%. The chi-square test suggested no statistical difference in prevalence between the sexes. One student had congenital scoliosis.

CONCLUSION:

The prevalence of adolescent idiopathic scoliosis in the public schools of Goiânia is 4.3%. Level of Evidence III, Study of Nonconsecutive Patients.