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Julián C, Ricardo DN, Rodrigo R, A TC, Lucas P, Eduardo G, Pablo AJ, Mariano N. Adolescent idiopathic scoliosis: is there a relationship between Risser staging and the proximal humerus ossification system? Spine Deform 2024; 12:629-633. [PMID: 38316729 DOI: 10.1007/s43390-023-00812-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/23/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE To evaluate whether there is a mismatch between Risser staging and the proximal humerus ossification system (PHOS); and to analyze the correlation in the skeletal maturity stages between the two humeral epiphyses. METHODS Data from patients aged 10 to 18 years with adolescent idiopathic scoliosis (AIS) seen between 2018 to 2021 were analyzed. In an anteroposterior (AP) spine radiograph the ossification process was evaluated using the Risser classification method and bilateral PHOS (if both humeral epiphyses were visualized). A mismatch between methods was defined as a Risser 0-1 (relatively skeletally immature) with a PHOS 4-5 (skeletally mature), or a Risser 2-5 (relatively skeletally mature) with a PHOS 1-3 (skeletally immature). The McNemar test was used to calculate the significance of the mismatch. RESULTS A mismatch between Risser and PHOS stages was observed in 28.5% of 105 patients, which was statistically significant (p < 0.001). Of the 49 patients with a Risser 0-1, 55.1% (n = 27) had a PHOS 4-5. None of the patients with a Risser 2-5 had a PHOS 1-3. In the 47 patients in whom both humeri were visualized, the absolute correlation between the left and right PHOS values was 95.7%. CONCLUSION Of AIS patients who are relatively skeletally immature according to Risser staging, more than half may be skeletally mature when measured with PHOS. In patients with a Risser 0-1, it is recommended to measure skeletal maturity in an AP spine radiograph using the PHOS method, which may more accurately guide treatment decision-making, without the need to visualize both humeral epiphyses in this radiographic projection. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Calcagni Julián
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina.
| | - Davies Néstor Ricardo
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
| | - Remondino Rodrigo
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
| | - Tello Carlos A
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
| | - Piantoni Lucas
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
| | - Galaretto Eduardo
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
| | - Arispe Juan Pablo
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
| | - Noel Mariano
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, CABA, Buenos Aires, Argentina
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Fernandez-Fernandez J, Canós-Portalés J, Martínez-Gallego R, Corbi F, Baiget E. Effects of different maturity status on change of direction performance of youth tennis players. Biol Sport 2023; 40:867-876. [PMID: 37398953 PMCID: PMC10286620 DOI: 10.5114/biolsport.2023.121324] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/16/2022] [Accepted: 10/08/2022] [Indexed: 09/05/2023] Open
Abstract
The aim of this study was to examine the maturational status (i.e., peak height velocity [PHV]) differences in neuromuscular performance (i.e., vertical jump, linear sprint, change of direction (COD) using different tests, and change of direction deficit [CODD]) of young tennis players. One hundred and two tennis players (70 boys and 52 girls; age 13.9 ± 2.0 years, body mass 53.3 ± 12.7 kg, height 163.1 ± 11.9 cm) participated in the study and were divided into Pre-PHV (n = 26), Circa-PHV (n = 33) and Post-PHV (n = 43) groups. Testing included speed (5, 10, and 20 m), COD tests (i.e., modified 5-0-5, pro-agility and hexagon), and bilateral/unilateral countermovement jump (CMJ). Pre- and Circa-PHV players presented lower levels of performance in jumping ability (i.e., both bilateral and unilateral CMJs; P < 0.001; ES: 0.85 to 0.98), linear sprints (5 to 20 m; P < 0.05 to < 0.001; ES: 0.67 to 1.19) and COD ability tests (modified 5-0-5 test, pro-agility and hexagon) compared to the Post-PHV players. Moreover, Pre-PHV players presented lower CODD% (p < 0.05; ES: 0.68-0.72) than Post-PHV for both forehand and backhand sides, and Circa-PHV showed lower values in the CODD of the rolling situation to the forehand side (p < 0.05; ES: 0.58). Among the COD tests, the pro-agility test seems to be a simple, easy-to-implement and reliable test, which can provide interesting information about the COD with higher entry speeds. Moreover, specific training strategies related to the PHV and focused not only on the neuromuscular training and COD workouts, but also on maximizing motor skill proficiency, should be recommended.
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Affiliation(s)
- Jaime Fernandez-Fernandez
- Department of Physical Activity and Sports Sciences, Universidad de León, Spain
- AMRED, Human Movement and Sports Performance Analysis, Universidad de León, Spain
| | - Jose Canós-Portalés
- National Institute of Physical Education of Catalonia, University of Barcelona, Barcelona, Spain
| | | | - Francisco Corbi
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Spain
| | - Ernest Baiget
- National Institute of Physical Education of Catalonia, University of Barcelona, Barcelona, Spain
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Tsutsui T, Iizuka S, Takei S, Sakamaki W, Maemichi T, Torii S. Growth pattern of lumbar maturity stage at L1 to L5 during adolescent growth spurt. Eur Spine J 2023:10.1007/s00586-023-07686-5. [PMID: 37014437 DOI: 10.1007/s00586-023-07686-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/23/2023] [Accepted: 03/25/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE This study aimed to clarify the order of the lumbar maturity stage, each at L1 to L5, and the relationships between age at peak height velocity (APHV) and the lumbar maturity stage. METHODS A total of 120 male first-grade junior high school soccer players were enrolled and followed for two years, and measurements were performed five times (T1 to T5). The lumbar maturity stage was assessed according to the degree of lesion of the epiphyseal from L1 to L5 using magnetic resonance imaging and classified into three stages: cartilaginous stage, apophyseal stage, and epiphyseal stage. The relationships between T1 and T5 temporal changes and developmental stages divided by 0.5 year increments based on APHV and the lumbar maturity stage at L1 to L5 were examined. For the apophyseal stage, developmental age calculated based on the difference between APHV and chronological age between each lumbar vertebra was compared. RESULTS We found that part of the cartilaginous stages decreased as time progressed, while that of the apophyseal and epiphyseal stages increased at L1 to L5 (chi-square test, p < 0.01). L5 matured earlier with the apophyseal stage than L1 to L4 (p < 0.05). The lumbar maturity stage was attained toward L1 from L5, comparing different lumbar levels. CONCLUSION The lumbar maturity stage progresses from L5 toward L1, and the apophyseal and epiphyseal stages would replace the cartilaginous stage at approximately 14 years of age or after APHV.
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Affiliation(s)
- Toshiharu Tsutsui
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Satoshi Iizuka
- Japan Institute of Sport Sciences, 3-15-1 Nishigaoka, Kita-Ku, Tokyo, Japan
| | - Seira Takei
- University of Tokyo Sports Science Initiative, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
- Institute of Human Growth and Development, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan
| | - Wataru Sakamaki
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan
| | - Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
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Chazono M, Inoue T, Obata S. Substantial mismatch of skeletal maturity assessment between Risser sign and Simplified Skeletal Maturity Scale/Thumb Ossification Composite Index in patients with adolescent idiopathic scoliosis. Spine Deform 2023:10.1007/s43390-023-00680-3. [PMID: 37004693 DOI: 10.1007/s43390-023-00680-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/11/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Recently, hand skeletal maturity systems such as the Simplified Skeletal Maturity Scale (SSMS) or Thumb Ossification Composite Index (TOCI) have been introduced to attempt to prospectively predict the occurrence of peak height velocity (PHV) in adolescents. This study aims to compare the frequency of the mismatch in estimation of HV between Risser sign (RS) and SSMS/TOCI stages in adolescent idiopathic scoliosis (AIS) patients. METHODS One hundred thirty-three female patients with AIS were included. The mean age of the patients was 13.1 years. A whole spine and hand X-rays were obtained to establish skeletal maturity stage according to RS, SSMS, and TOCI systems. A mismatch resulting in overestimation (MOE) with RS compared to SSMS/TOCI was defined as the combination of RS 3-4/SSMS 3-5 or RS 3-4/TOCI 4-6, whereas a mismatch resulting in underestimation (MUE) with RS and SSMS/TOCI was defined as RS 0-1/SSMS 6-8 or RS 0-1/TOCI 7-8. Height velocity (HV) was compared between MOE/non-MOE and MUE/non-MUE groups. RESULTS Between RS and SSMS, the rates of the MOE and MUE groups were 4.3% and 1.7%, respectively. Between RS and TOCI, rates were 2.8% and 1.7%, respectively. With the combination of RS and SSMS stages, an estimate of HV of 5.6 cm/year in the MOE group was significantly larger than that of 2.7 cm/year in the non-MOE group, and 3.7 cm/year in the MUE group was significantly smaller than 6.9 cm/year in the non-MUE group. Likewise, with the combination of RS and TOCI stages, an estimate of HV of 5.8 cm/year in the MOE group was significantly greater that of 2.7 cm/year in the non-MOE group, and 3.7 cm/year in the MUE group was significantly smaller than 6.9 cm/year in the non-MUE group. CONCLUSIONS These findings support the use of SSMS/TOCI as the standard for assessing HV and skeletal maturity in patients with AIS.
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Affiliation(s)
- Masaaki Chazono
- Department of Orthopaedic Surgery, NHO Utsunoimya Hospital, 2160, Shimo-okamoto, Utsunomiya, Tochigi, 329-1193, Japan.
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Takeshi Inoue
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shintaro Obata
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Costa E Silva L, Teles J, Fragoso I. Sports injuries patterns in children and adolescents according to their sports participation level, age and maturation. BMC Sports Sci Med Rehabil 2022; 14:35. [PMID: 35264218 PMCID: PMC8908692 DOI: 10.1186/s13102-022-00431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022]
Abstract
Background Growth can make young athletes more vulnerable to sports injuries. Increased knowledge about injury profile and its predictors is an important part of an overall risk management strategy but few studies have produced information. Methods Information about injury profile and sports participation (SP) level was obtained by LESADO and RAPIL II questionnaires. They were distributed to 651 participants aged between 10 and 18 years attending four schools. Maturity measures were evaluated through maturity offset (MO) and Tanner-Whitehouse III method. Bivariate analysis was used to identify the set of candidate predictors for multinomial logistic regression analysis that was used to determine significant predictors of injury type and body area injury location. Results Regarding injury type predictors recreative boys had more chances of having a sprain or a fracture than a strain. Also, recreative and scholar girls had more chances of having a sprain than a strain. As MO decreased, the chances of girls having a strain or a fracture when compared to sprains were higher. For body area location boys with 10–11 years were more likely to have upper limbs injuries than boys of other ages. This was also confirmed by MO. Spine and trunk injuries were more likely to occur in federate and no sports participation girls. Conclusions Injury type and body area injury location differed significantly by SP level, age group and MO.
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Affiliation(s)
- Lara Costa E Silva
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal. .,CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
| | - Júlia Teles
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,Mathematics Unit, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Isabel Fragoso
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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Yang KG, Lee WYW, Hung ALH, Hung VWY, Tang MF, Leung TF, Kong APS, Cheng JCY, Lam TP. Decreased cortical bone density and mechanical strength with associated elevated bone turnover markers at peri-pubertal peak height velocity: a cross-sectional and longitudinal cohort study of 396 girls with adolescent idiopathic scoliosis. Osteoporos Int 2022; 33:725-735. [PMID: 34643755 DOI: 10.1007/s00198-021-06200-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
UNLABELLED Decreased cortical bone density and bone strength at peak height velocity (PHV) were noted in girls with adolescent idiopathic scoliosis (AIS). These findings could provide the link to the previously reported observation that low bone mineral density (BMD) could contribute as one of the prognostic factors for curve progression that mostly occurs during PHV in AIS. INTRODUCTION As part of the studies related to aetiopathogenesis of AIS, we assessed bone qualities, bone mechanical strength and bone turnover markers (BTMs) focusing at the peri-pubertal period and PHV in AIS girls. METHODS 396 AIS girls in two separate cohorts were studied. Skeletal maturity was assessed using the validated thumb ossification composite index (TOCI). Bone qualities and strength were evaluated with high-resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA). RESULTS Cohort-A included 179 girls (11.95 ± 0.95 years old). Girls at TOCI-4 had numerically the highest height velocity (0.71 ± 0.24 cm/month) corresponding to the PHV. Subjects at TOCI-4 had lower cortical volumetric BMD (672.36 ± 39.07 mg/mm3), cortical thickness (0.68 ± 0.08 mm) and apparent modulus (1601.54 ± 243.75 N/mm2) than: (a) those at TOCI-1-3 (724.99 ± 32.09 mg/mm3 (p < 0.001), 0.79 ± 0.11 mm (p < 0.001) and 1910.88 ± 374.75 N/mm2 (p < 0.001), respectively) and (b) those at TOCI-8 (732.28 ± 53.75 mg/mm3 (p < 0.001), 0.84 ± 0.14 mm (p < 0.001), 1889.11 ± 419.37 N/mm2 (p < 0.001), respectively). Cohort-B included 217 girls (12.22 ± 0.89 years old). Subjects at TOCI-4 had higher levels of C-terminal telopeptide of type 1 collagen (1524.70 ± 271.10 pg/L) and procollagen type 1 N-terminal propeptide (941.12 ± 161.39 µg/L) than those at TOCI-8 (845.71 ± 478.55 pg/L (p < 0.001) and 370.08 ± 197.04 µg/L (p < 0.001), respectively). CONCLUSION AIS girls had decreased cortical bone density and bone mechanical strength with elevated BTMs at PHV. Coupling of PHV with decreased cortical and FEA parameters could provide the link to the previously reported observation that low BMD could contribute as one of the prognostic factors for curve progression that mostly occurs during PHV in AIS.
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Affiliation(s)
- K G Yang
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Y W Lee
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A L H Hung
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - V W Y Hung
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M F Tang
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - T F Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A P S Kong
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J C Y Cheng
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - T P Lam
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
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陈 曼, 杨 招, 苏 彬, 李 艳, 高 迪, 马 莹, 马 涛, 董 彦, 马 军. [Analysis on the law of height growth spurt in adolescence of children and adolescents in Zhongshan City]. Beijing Da Xue Xue Bao Yi Xue Ban 2021; 53:506-510. [PMID: 34145852 PMCID: PMC8220054 DOI: 10.19723/j.issn.1671-167x.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To analyze the characteristics of the age at peak height velocity and peak height velocity of primary and middle school students in Zhongshan City, Guangdong Province, and to explore the law of the sudden increase in adolescent height in this area, and to understand the law of height growth spurt in adolescence by longitudinal tracking of the height of children and adolescents in Zhong-shan City. METHODS Based on the physical examination database of primary and middle school students in Zhongshan City, Guangdong Province from 2005 to 2016, individuals who had been continuously tracked for more than 6 times were selected as research samples. SITAR model was used to fit the height data of the sample population, and the age at peak height velocity and peak height velocity were calcula-ted. RESULTS A total of 49 579 subjects were included in this study, including 26 524 boys and 26 008 urban students. The median follow-up ages of boys and girls were 7.74 and 7.72 years, respectively. The boy's height spurt peak age was (12.72±0.89) years, and later than the girls at the age of (10.98±0.95) years (t=207.639, P < 0.001), the boy's height spurt peak velocity of (10.12±1.49) cm/year, higher than the girls of (8.35±1.12) cm/year (t=150.826, P < 0.001). The gender differences of height spurt peak age and height spurt peak speed in urban and rural students were consistent with the whole sample. The height surge peak age of urban male students was earlier than that of rural male students, and the height surge peak speed of urban female students was lower than that of rural female students. CONCLUSION The peak age of the surge of girls was earlier than that of boys, but the peak rate of the surge of girls was lower than that of boys, the peak age of urban students was earlier than that of rural students, but the peak rate of urban boys was lower than that of rural boys in Guangdong Province.
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Affiliation(s)
- 曼曼 陈
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 招庚 杨
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 彬彬 苏
- 北京大学人口研究所,北京 100871Institute of Population Research, Peking University, Beijing 100871, China
| | - 艳辉 李
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 迪 高
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 莹 马
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 涛 马
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 彦会 董
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - 军 马
- 北京大学公共卫生学院,北京大学儿童青少年卫生研究所,北京 100191Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
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Chazono M, Obata S. A Simplified Skeletal Maturity Scale and Thumb Ossification Composite Index to Assess Skeletal Maturity and Predict Height Velocity in Japanese Females with Adolescent Idiopathic Scoliosis. Spine Surg Relat Res 2021; 5:244-251. [PMID: 34435148 PMCID: PMC8356234 DOI: 10.22603/ssrr.2020-0176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/30/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Since Little et al. first reported that peak height velocity (PHV) could be described as a reliable clinical marker for the prediction of remaining growth and curve progression of adolescent idiopathic scoliosis (AIS) in clinical practice, much attention has been paid to PHV as a possible predictor of curve progression in patients with AIS. However, PHV itself is only identified retrospectively, so its value is not available at the first outpatient clinic visit. Using the simplified skeletal maturity scale (SSMS) and the thumb ossification composite index (TOCI) staging systems, this study aims to assess skeletal maturity and predict height velocity (HV) in Japanese female patients with AIS. METHODS This study involved 95 female patients with AIS, ranging from 9 to 17 years old. A standing AP radiograph of the entire spine and a hand radiograph were retrospectively obtained to establish the skeletal maturity stage in accordance with the SSMS and TOCI systems. Height measurements were recorded at each visit; HV was calculated as the height change (cm) divided by the time interval (years). RESULTS The TOCI stage rating increased identically to the SSMS stage rating increase. The chi-square test showed that there was a significant correlation between the two scoring systems (χ2=720.4). The Cramer V correlation also demonstrated a very strong correlation (Cramer V=0.62). Regarding the relationship between HV and each SSMS and TOCI stage, HV decreased as SSMS and TOCI stages increased. η 2 equaled to 0.67 in both groups and displayed a strong correlation between HV and SSMS and TOCI stages. CONCLUSIONS These findings suggest that evaluation of the rate of HV using these radiological assessments is of supreme importance for determining the status of pubertal maturity and predicting the remaining amount of adolescent growth at the outpatient clinic visit.
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Affiliation(s)
- Masaaki Chazono
- Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shintaro Obata
- Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Zago M, Moorhead AP, Bertozzi F, Sforza C, Tarabini M, Galli M. Maturity offset affects standing postural control in youth male soccer players. J Biomech 2019; 99:109523. [PMID: 31767282 DOI: 10.1016/j.jbiomech.2019.109523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 10/25/2022]
Abstract
Quantifying the response of postural control in developmental athletes makes it possible to understand critical coordination and learning phases and to improve technical-physical interventions. However, the influence of maturation on postural control amongst young soccer players has neither been tested using quantitative methods, nor over a wide age range. In this study, we examined stabilometric parameters of 238 young male soccer players from 9 to 17 years old relative to maturity offset. Two 30-s tests (eyes open and eyes closed) were recorded on a baropodometric platform at 50 Hz. Participants were split into six groups according to their maturity offset, expressed as years from individual's peak height velocity. Dependent variables were: Sway Area, Center-of-Pressure velocity, standard deviation of the antero-posterior and medio-lateral Center-of-Pressure trajectory, Romberg Quotient. Sway Area was significantly higher in players with maturity offset <-1.5 than in groups with maturity offset > 0.5 years (p < 0.001, large effect). Center-of-Pressure velocity markedly dropped in players with maturity offset >-0.5 years (p < 0.001, very large effect). Antero-posterior standard deviation was higher before than after peak height velocity (p < 0.05, large effect) and significantly higher with closed eyes at some points. Medio-lateral standard deviation was higher in the youngest group of players (maturity offset <-2.5 years, large effect) than in those with maturity offset >-0.5 years. In sum, stabilometric parameters improved with age until zero maturity offset was achieved. Thereafter, variables describing postural control in developing soccer players were almost stable. No evidence of a changing role of vision in postural sway control during maturation was observed.
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Affiliation(s)
- Matteo Zago
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy; E4Sport Lab, Politecnico di Milano, Italy; Fondazione Istituto Farmacologico Filippo Serpero, Milano, Italy.
| | - Alex Patten Moorhead
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy; Dipartimento di Meccanica, Politecnico di Milano, Italy
| | - Filippo Bertozzi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | - Chiarella Sforza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | - Marco Tarabini
- E4Sport Lab, Politecnico di Milano, Italy; Dipartimento di Meccanica, Politecnico di Milano, Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy; E4Sport Lab, Politecnico di Milano, Italy
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Liu D, Xia SQ, Shi B, Shi BL, Liu Z, Sun X, Qiu Y, Zhu ZZ. [Value of thumb ossification composite index for predicting peripubertal growth potential in girls with adolescent idiopathic scoliosis]. Zhonghua Yi Xue Za Zhi 2018; 98:3315-9. [PMID: 30440119 DOI: 10.3760/cma.j.issn.0376-2491.2018.41.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the predictive value of thumb ossification composite index (TOCI) for growth potential in female adolescent idiopathic scoliosis (AIS) patients and to analyze its correlation with several other indicators of growth potential. Methods: A retrospective review was conducted on 45 girls with AIS who underwent standard bracing treatment between October 2006 and August 2013 in Nanjing Drum Tower Hospital. All patients were regularly followed up with an interval of 3-6 months until brace weaning. At each visit, the following data were collected and recorded: chronologic age, stage of menses, standing height, Cobb angle of main curve, TOCI score, digital skeletal age (DSA) score and radius, ulna and small bones (RUS) score. The height velocity (HV) at each visit were calculated. The correlations analysis between TOCI and other indicators including DSA scores and RUS scores were studied. Results: The average age at initial visit was (10.9±1.3) years. The mean age of menarche was (12.6±1.3) years. The mean peak height velocity (PHV) was (7.5±1.5) cm/year and the mean age of PHV was (12.0±0.9) years. A total of 71.8% AIS girls attained their PHV at TOCI 5. The Spearman correlation analysis showed that TOCI was highly correlated with the DSA and RUS scores (r=0.95 and 0.96, both P<0.001). Chi-square test showed that TOCI 5 accurately predicted the occurrence of PHV (Cramer V=0.531, P=0.007). Conclusion: The TOCI 5 indicates high HV and high growth potential in AIS patients with bracing treatment. TOCI can thus serve as a good indicator for growth potential in braced AIS girls.
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11
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Peña-González I, Fernández-Fernández J, Moya-Ramón M, Cervelló E. Relative Age Effect, Biological Maturation, and Coaches' Efficacy Expectations in Young Male Soccer Players. Res Q Exerc Sport 2018; 89:373-379. [PMID: 30015598 DOI: 10.1080/02701367.2018.1486003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The talent identification and selection process in young male soccer players is mainly focused on anthropometrics and physical performance, but social factors are also considered in this process. The purpose of this study was to test the existence of the relative age effect and its possible influence on anthropometrics and physical performance and to analyze coaches' efficacy expectations. METHOD Data for 564 young male soccer players (Mage = 13.7 ± 1.5 years; Mweight = 53.7 ± 11.6 kg; Mheight = 160.2 ± 11.6 cm) included their birth quartile, maturity status, anthropometrics, a physical test battery, and coaches' efficacy expectations. RESULTS Early-born players were overrepresented (p < .05). Early-born players were not statistically taller, heavier, or better at physical performance (p > .05) when maturation and chronological age were controlled as confounding factors. However, coaches expected more from early-born players (p < .05), and the inferential analysis showed likely to very likely worthwhile differences between the coaches' expectations for players born in the first quartile of the year and those born in the fourth quartile of the year. CONCLUSIONS Anthropometrical and physical performance variables were not affected by birth quartile, and coaches' efficacy expectations were related to the relative age effect.
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12
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Cao Z, Hui LL, Wong MY. New approaches to obtaining individual peak height velocity and age at peak height velocity from the SITAR model. Comput Methods Programs Biomed 2018; 163:79-85. [PMID: 30119859 DOI: 10.1016/j.cmpb.2018.05.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/30/2018] [Accepted: 05/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE We compared three methods for estimating the individual peak height velocity (PHV) and age at peak height velocity (APHV) from the SuperImposition by Translation and Rotation (SITAR) model. METHODS We fitted the SITAR model using simulated data and heights of 12 girls from the Chard Growth Study and obtained individual PHVs and APHVs from three methods: the model method, the quadratic function method and the numerical method, which are available in our newly developed R package"iapvbs". The mean, interquartile range, range of biases in estimated APHV and PHV as well as the rates of warning and unreasonable cases, i.e. estimated APHVs being outside the range of age measurements, from the three methods were presented and compared. RESULTS When the growth curves of all individuals were well fitted by the SITAR model, all three methods estimated individual APHVs with similarly small biases, with a few unreasonable cases (0.16%) observed when the model method was used while more computation time required for the numerical method. When the growth curves of some individuals were not very well fitted, the model method generated more unreasonable individual APHV (8.15%) and more bias in PHV and APHV, compared to those estimated by the numerical method and quadratic function method. In line with the observations from the simulated data, the real data analysis demonstrated that the numerical method generated more reliable PHV and APHV for individuals with growth curve not well fitted by the SITAR model. CONCLUSION The performance of different methods estimating individual APHV depends largely on how well the growth curves are fitted by the SITAR model. The quadratic function method is more superior when growth curves of all individuals are well fitted by the SITAR model; otherwise, the numerical method should be adopted for getting most robust estimates of PHV and APHV. The model method generates unreasonable APHV estimates, particularly when the growth curves are not well fitted.
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Affiliation(s)
- Zhiqiang Cao
- Department of Mathematics, The Hong Kong University of Science & Technology, Hong Kong SAR, China
| | - L L Hui
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - M Y Wong
- Department of Mathematics, The Hong Kong University of Science & Technology, Hong Kong SAR, China.
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Abstract
Aims Using 90% of final height as a benchmark, we sought to develop a quick, quantitative and reproducible method of estimating skeletal maturity based on topographical changes in the distal femoral physis. Patients and Methods Serial radiographs of the distal femoral physis three years prior to, during, and two years following the chronological age associated with 90% of final height were analyzed in 81 healthy children. The distance from the tip of the central peak of the distal femoral physis to a line drawn across the physis was normalized to the physeal width. Results A total of 389 radiographs of the distal femur with corresponding Greulich and Pyle bone ages and known chronological ages were measured. Children reached 90% of final height at a mean age of 11.3 years (sd 0.8) for girls and 13.2 years (sd 0.6) for boys. Linear regression analysis showed higher correlation coefficent in predicting the true age at 90% of final height using chronological age + gender + central peak value (R2 = 0.900) than chronological age + gender (R2 = 0.879) and Greulich and Pyle bone age + gender (R2 = 0.878). Conclusion Chronological age + gender + central peak value provides more accurate prediction of 90% of final height compared with chronological age + gender and Greulich and Pyle bone age + gender. Cite this article: Bone Joint J 2018;100-B:1106-11.
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Affiliation(s)
- D M Knapik
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA and Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio, USA
| | - J O Sanders
- University of Rochester, Rochester, New York, USA
| | - A Gilmore
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA and Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio, USA
| | - D R Weber
- Division of Endocrinology and Diabetes, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - D R Cooperman
- Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut, USA
| | - R W Liu
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA and Rainbow Babies and Children's Hospital at Case Western Reserve University, Cleveland, Ohio, USA
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14
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Mao SH, Sun X, Shi BL, Qiu Y, Qian BP, Cheng JCY. Association between braced curve behavior by pubertal growth peak and bracing effectiveness in female idiopathic scoliosis: a longitudinal cohort study. BMC Musculoskelet Disord 2018; 19:88. [PMID: 29580223 PMCID: PMC5870088 DOI: 10.1186/s12891-018-1987-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pre-pubertal idiopathic scoliosis (IS) is associated with high risk of bracing ineffectiveness. Integrated multidimensional maturity assessments are useful but complex to predict the high-risk occurrence of curve progression. This study is designed to provide a simple screening method for brace effectiveness by determining whether or not the braced curve behavior at growth spurt, being defined as variations in Cobb angle velocity (AV) at peak height velocity (PHV), can be a new factor predictive of brace outcome prescribed before PHV. METHODS This is a retrospective study of a series of 35 IS girls with simplified skeletal maturity score no more than 3 at initiation of bracing treatment and followed up through the growth spurt until brace weaning or surgery. Serial Cobb angle and maturity indicators involving height velocity, Risser sign, triradiate cartilage, simplified skeletal maturity score and distal radius and ulna classification were assessed and patients were stratified into either a positive or negative category based on a positive or negative value of AV at PHV. Comparisons were made between the positive and negative AV groups, as well as the failed and successful bracing groups, using independent sample T test and crosstab analysis. Logistic regression analysis was used to identify the predictive factors of failed brace treatment. RESULTS Brace treatment prescribed before PHV was found to have an overall failure rate of 57.1% and a surgical rate of 45.7%. Negative AV at PHV accounting for 54.3% of the recruited patients were associated with lower brace failure rate (36.8% vs. 81.2%, p = 0.016) and surgical rate (21.1% vs. 75.0%, p = 0.002). Patients in the failed bracing group showed higher ratio of thoracic curve (80.0% vs. 26.7%,p = 0.002) and higher AV at growth peak (2.3 ± 9.1 vs. -6.5 ± 11.4°/yrs., p = 0.016). The logistic regression analysis revealed that positive AV at PHV (OR = 9.268, 95% CI = 1.279-67.137, p = 0.028) and thoracic curve type (OR = 13.391, 95% CI = 2.006-89.412, p = 0.007) were strong predictive factors of ineffective brace treatment initiated before PHV. CONCLUSIONS Sustained curve correction following bracing despite early onset and rapid pubertal growth was strongly predictive of effective brace control of scoliosis.
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Affiliation(s)
- Sai-Hu Mao
- Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China
| | - Xu Sun
- Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China
| | - Ben-Long Shi
- Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China
| | - Yong Qiu
- Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.,Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China
| | - Bang-Ping Qian
- Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China. .,Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
| | - Jack C Y Cheng
- Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China
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15
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Garcia MR, Nicholson AD, Nduaguba AM, Sanders JO, Liu RW, Cooperman DR. Ossification of the phalanges of the foot and its relationship to peak height velocity and the calcaneal system. J Child Orthop 2018; 12:84-90. [PMID: 29456759 PMCID: PMC5813130 DOI: 10.1302/1863-2548.12.170164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE There are multiple skeletal maturity grading systems, but none of them utilizes the phalanges of the foot. To minimize radiation, it would be ideal if one could assess the skeletal maturity of a foot based on bones seen on routine foot radiographs, if guided growth is being considered as a treatment option. We developed a system that correlates changes of the appearance of the foot phalanges to peak height velocity (PHV) and the recently described calcaneal apophyseal ossification grading system. METHODS We selected 94 children from the Bolton-Brush study, each with consecutive radiographs from age ten to 15 years old. Using the anteroposterior view, we analyzed the ossification patterns of the phalanges and developed a six-stage system. We then determined the PHV for each subject and defined its relationship with our system. Our system was then compared with the previously established calcaneal system. RESULTS We calculated an Intraclass correlation coefficient (ICC) range of 0.957 to 0.985 with a mean of 0.975 and interclass reliability coefficient of 0.993 indicating that this method is reliable and consistent. Our system showed no significant difference between gender with respect to PHV, which makes it a reliable surrogate for determining bone age in paediatric and adolescent patients. CONCLUSIONS Our system has a strong association with the calcaneal system. It is a simple six-stage system that is reliable and correlated more strongly with PHV than chronological age. The system requires knowledge of the ossification markers used for each stage but is easily used in a clinical setting.
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Affiliation(s)
- M. R. Garcia
- Yale School of Medicine, New Haven, Connecticut, USA,
Correspondence should be sent to M. R. Garcia, BS, 123 York Street, Apt. 10G, New Haven, Connecticut 06511, United States. E-mail:
| | - A. D. Nicholson
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - A. M. Nduaguba
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - J. O. Sanders
- Department of Orthopaedics, University of Rochester School of Medicine, Rochester, New York, USA
| | - R. W. Liu
- Department of Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - D. R. Cooperman
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
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16
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Abstract
PURPOSE We investigate the thenar and plantar sesamoids as markers of skeletal maturity, and grade appearance using two scales, a binary system (absent or present), and an analogue system that relies upon judging regular changes in morphological appearance. METHODS We studied 94 healthy children (49 female and 45 male patients) between ages three and 18 years who had approximately 700 serially acquired sets of radiographs and physical examinations. The children had at least annual radiographs taken of the left hand and left foot. Velocity of growth was calculated and curves were fit to a cubic spline model to determine age of maximum height velocity, or peak height velocity (PHV). Appearance of the plantar and thenar sesamoids was recorded using a binary system classifying the sesamoids as absent or present and an analogue system classifying the sesamoid as absent, present as a small ossification centre or larger than a small ossification centre. RESULTS The plantar sesamoids appear 1.67 years before PHV and reach mature size 1.02 years after PHV. The thenar sesamoids appear 0.32 years before PHV and reach mature size 2.25 years after PHV. The plantar sesamoids are present and thenar sesamoids are absent at a mean 1.5 years prior to PHV. No patients had the thenar sesamoids present while the plantar sesamoids were absent. CONCLUSION As binary markers, when the plantar and thenar sesamoids are considered together it is possible to localize maturity. As analogue markers, they offer more information. The sesamoids also allow clarification of the calcaneal and Sanders stages. LEVEL OF EVIDENCE Not Applicable.
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Affiliation(s)
- A. D. Nicholson
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA,Correspondence should be sent to A. D. Nicholson, 123 York St., Apt.4G, New Haven, Connecticut, 06511, United States. E-mail:
| | - J. O. Sanders
- Department of Orthopaedics, University of Rochester School of Medicine, Rochester, New York, USA
| | - R. W. Liu
- Department of Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - D. R. Cooperman
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
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17
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Mogi Y, Torii S, Kawakami Y, Yanai T. A cross-sectional study on the mechanical properties of the Achilles tendon with growth. Eur J Appl Physiol 2018; 118:185-94. [PMID: 29177722 DOI: 10.1007/s00421-017-3760-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to elucidate growth pattern of mechanical properties of the Achilles tendon and to examine if imbalance between growth of bone and muscle-tendon unit occurs during adolescence. METHODS Fourteen elementary school boys, 30 junior high school boys, 20 high school boys and 15 male adults participated in this study. Based on estimated age at peak height velocity (PHV), junior high school boys were separated into two groups (before or after PHV). An ultrasonography technique was used to determine the length, cross-sectional area, stiffness and Young's modulus of Achilles tendon. In addition, the maximum strain in "toe region" (strainTP) was determined to describe the balance between growth of bone and muscle-tendon unit. RESULTS No group difference was observed in length, cross-sectional area and strainTP among the groups. However, stiffness and Young's modulus in after PHV groups were significantly higher than those of elementary school boys and before PHV groups (p ≤ 0.05). CONCLUSIONS These results indicate that mechanical properties of Achilles tendon change dramatically at and/or around PHV to increased stiffness. The widely believed assumption that muscle-tendon unit is passively stretched due to rapid bone growth in adolescence is not supported.
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18
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Holmgren A, Niklasson A, Gelander L, Aronson AS, Nierop AFM, Albertsson-Wikland K. Insight into human pubertal growth by applying the QEPS growth model. BMC Pediatr 2017; 17:107. [PMID: 28424059 PMCID: PMC5395895 DOI: 10.1186/s12887-017-0857-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/01/2017] [Indexed: 11/10/2022] Open
Abstract
Background Computerized mathematical models describing absolute and relative individual growth during puberty in both cm and standard deviation (SD)-scores are lacking. The present study aimed to fill this gap, by applying the QEPS-model that delineates mathematically the specific pubertal functions of the total growth curve. Methods Study population used was the individual growth curves of the longitudinally followed cohort GrowUp1974 Gothenburg (n = 2280). The QEPS-model describes total height as (T)otal-function: a combination of four shape-invariant growth functions, modified by time-scale and height-scale parameters: a (Q)uadratic-function for the continuous growth from fetal life to adulthood; a negative (E)xponential-function adds the rapid, declining fetal/infancy growth; a (P)ubertal-function the specific pubertal growth spurt; a (S)top-function the declining growth until adult height. A constructed variable, MathSelect, was developed for assessing data-quality. CIs and SD-scores for growth estimates were calculated for each individual. QEPS-model estimates used for pubertal growth; from the T-function: onset of puberty as minimal height velocity (AgeTONSET); mid-puberty as peak height velocity (AgeTPHV); end of puberty as height velocity decreased to 1 cm/year (AgeTEND); duration of different intervals and gain (AgeTONSET–END and Tpubgain); from the P-function: onset of puberty, estimated as growth at 1% or 5% (AgeP1,AgeP5); mid-puberty as 50% (AgeP50) and PHV (AgePPHV); end of pubertal growth at 95 or 99% (AgeP95, AgeP99); duration of different intervals and pubertal gain (Ppubgain; Pmax); from the QES-function: gain (QESpubgain). Results Application of these mathematical estimates for onset, middle and end of puberty of P-function, QES-function, and T-function during puberty showed: the later the onset of puberty, the greater the adult height; pubertal gain due to the P-function growth was independent of age at onset of puberty; boys had higher total gain during puberty due to P-function growth than to QES-function growth; for girls it was reversed. Conclusions QEPS is the first growth model to provide individualized estimates of both the specific pubertal growth function and the total growth during puberty, with accompanying SD-scores and Cis for each individual. These QEPS-derived estimates enable more in-depth analysis of different aspects of pubertal growth than previously possible. Electronic supplementary material The online version of this article (doi:10.1186/s12887-017-0857-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anton Holmgren
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-41685, Gothenburg, Sweden. .,Hallands Hospital Halmstad, Halmstad, Sweden.
| | - Aimon Niklasson
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-41685, Gothenburg, Sweden
| | - Lars Gelander
- Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-41685, Gothenburg, Sweden
| | | | - Andreas F M Nierop
- Muvara bv, Multivariate Analysis of Research Data, Leiderdorp, The Netherlands
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, SE-40530, Gothenburg, Sweden
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19
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Zhang Z, Lindstrom MJ, Lai HJ. Pubertal height velocity and associations with prepubertal and adult heights in cystic fibrosis. J Pediatr 2013; 163:376-82. [PMID: 23535012 PMCID: PMC3700583 DOI: 10.1016/j.jpeds.2013.02.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/11/2013] [Accepted: 02/11/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test the hypothesis that pubertal peak height velocity (PHV) in cystic fibrosis (CF) has improved and is influenced by prepubertal growth and genetic potential. STUDY DESIGN PHV from 1862 children born in 1984-87 and documented in the 1986-2008 US CF Foundation Registry was determined by statistical modeling and classified into normal, delayed (2-SD > average age), attenuated (magnitude <5th percentile), or both delayed and attenuated (D&A). Genetic potential for height was estimated by parental stature. RESULTS PHV averaged 8.4 cm/year at age 14.0 years in boys and 7.0 cm/year at age 12.1 years in girls, ∼6-month delay and ∼15% reduction compared with healthy children. PHV was normal in 60%, delayed in 9%, attenuated in 21%, and D&A in 5%. Patients with delayed PHV reached similar adult height percentile (boys: 34th, girls: 46th) to those with normal PHV (boys: 33rd, girls: 34th); both were significantly taller than the attenuated (boys: 11th, girls: 19th) and D&A PHV subgroups (boys: 8th, girls: 14th). Pancreatic-sufficient patients had taller prepubertal and adult heights but similar PHV compared with pancreatic-insufficient or meconium ileus patients. Adjusting for genetic potential reduced adult height percentiles more in boys (from 25th to 16th) than girls (from 28th to 24th). Height at age 7 years, PHV age and magnitude, and parental stature significantly predicted adult height. CONCLUSIONS Pubertal PHV has improved in children with CF born after mid-1980s compared with older cohorts but remains below normal. Suboptimal prepubertal and pubertal growth led to adult height below genetic potential in CF.
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Affiliation(s)
- Zhumin Zhang
- Department of Nutritional Sciences, University of Wisconsin – Madison, Madison, Wisconsin
| | - Mary J. Lindstrom
- Department of Biostatistics and Medical Informatics, University of Wisconsin – Madison, Madison, Wisconsin
| | - HuiChuan J. Lai
- Department of Nutritional Sciences, University of Wisconsin – Madison, Madison, Wisconsin,Department of Biostatistics and Medical Informatics, University of Wisconsin – Madison, Madison, Wisconsin,Department of Pediatrics, University of Wisconsin – Madison, Madison, Wisconsin
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