Risk Factors, Lifestyle and Prevention among Adolescents with Idiopathic Juvenile Scoliosis: A Cross Sectional Study in Eleven First-Grade Secondary Schools of Palermo Province, Italy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
- The first section included 9 questions regarding socio-demographic and general characteristics of pre-adolescents (age, sex, height, weight, number of family members, parents’ educational level, parents’ occupation);
- The second section consisted of 8 questions concerning the daily personal habit and attitudes of the study sample (physical activity duration and type, use of backpack and daily meters traveled, daily time spent sitting, personal smartphone or tablet and daily usage); and
- The third section included 12 items regarding clinical characteristic, attitudes and habits associated with scoliosis of the adolescents (visual, hearing, dental or posture disorders and type, back pain and daily duration, familiarity with scoliosis, talking about scoliosis with a physician).
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Guan, T.; Zhang, Y.; Anwar, A.; Zhang, Y.; Wang, L. Determination of three-dimensional corrective force in adolescent idiopathic scoliosis and biomechanical finite element analysis. Front. Bioeng. Biotechnol. 2020, 8, 963. [Google Scholar] [CrossRef]
- Shahidi, B.; Yoo, A.; Farnsworth, C.; Newton, P.O.; Ward, S.R. Paraspinal muscle morphology and composition in adolescent idiopathic scoliosis: A histological analysis. JOR Spine 2021, 4, e1169. [Google Scholar] [CrossRef]
- Illés, T.S.; Lavaste, F.; Dubousset, J.F. The third dimension of scoliosis: The forgotten axial plane. Orthop. Traumatol. Surg. Res. 2019, 105, 351–359. [Google Scholar] [CrossRef]
- Konieczny, M.R.; Senyurt, H.; Krauspe, R. Epidemiology of adolescent idiopathic scoliosis. J. Child. Orthop. 2013, 7, 3–9. [Google Scholar] [CrossRef] [Green Version]
- Pérez-Machado, G.; Berenguer-Pascual, E.; Bovea-Marco, M.; Rubio-Belmar, P.A.; García-López, E.; Garzón, M.J.; Mena-Mollá, S.; Pallardó, F.V.; Bas, T.; Viña, J.R.; et al. From genetics to epigenetics to unravel the etiology of adolescent idiopathic scoliosis. Bone 2020, 140, 115563. [Google Scholar] [CrossRef]
- Latalski, M.; Danielewicz-Bromberek, A.; Fatyga, M.; Latalska, M.; Kröber, M.; Zwolak, P. Current insights into the aetiology of adolescent idiopathic scoliosis. Arch. Orthop. Trauma Surg. 2017, 137, 1327–1333. [Google Scholar] [CrossRef] [Green Version]
- Watanabe, K.; Michikawa, T.; Yonezawa, I.; Takaso, M.; Minami, S.; Soshi, S.; Tsuji, T.; Okada, E.; Abe, K.; Takahashi, M.; et al. Physical activities and lifestyle factors related to adolescent idiopathic scoliosis. J. Bone Joint Surg. Am. 2017, 99, 284–294. [Google Scholar] [CrossRef]
- Kim, S.; Uhm, J.Y.; Chae, D.H.; Park, Y. Low body mass index for early screening of adolescent idiopathic scoliosis: A comparison based on standardized body mass index classifications. Asian Nurs. Res. 2020, 14, 24–29. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Minghelli, B.; Oliveira, R.; Nunes, C. Postural habits and weight of backpacks of Portuguese Adolescents: Are they associated with scoliosis and low back pain? Work 2016, 54, 197–208. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alves, M.E.; Marinho, D.A.; Carneiro, D.N.; Alves, J.; Forte, P.; Nevill, A.M.; Morais, J.E. A visual scan analysis protocol for postural assessment at school in young students. Int. J. Environ. Res. Public Health 2020, 17, 2915. [Google Scholar] [CrossRef] [Green Version]
- Pan, X.X.; Huang, C.A.; Lin, J.L.; Zhang, Z.J.; Shi, Y.F.; Chen, B.D.; Zhang, H.W.; Dai, Z.Y.; Yu, X.P.; Wang, X.Y. Prevalence of the thoracic scoliosis in children and adolescents candidates for strabismus surgery: Results from a 1935-patient cross-sectional study in China. Eur. Spine J. 2020, 29, 786–793. [Google Scholar] [CrossRef] [PubMed]
- Scaturro, D.; de Sire, A.; Terrana, P.; Costantino, C.; Lauricella, L.; Sannasardo, C.E.; Vitale, F.; Mauro, G.L. Adolescent idiopathic scoliosis screening: Could a school-based assessment protocol be useful for an early diagnosis? J. Back Musculoskelet. Rehabil. 2021, 34, 301–306. [Google Scholar] [CrossRef]
- Adamczewska, K.; Wiernicka, M.; Malchrowicz-Mośko, E.; Małecka, J.; Lewandowski, J. The angle of trunkrotation in school children: A study from an idiopathic scoliosis screening. prevalence and optimal age screening value. Int. J. Environ. Res. Public Health 2019, 16, 3426. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ciaccia, M.C.C.; Castro, J.S.; Rahal, M.A.; Penatti, B.S.; Selegatto, I.B.; Giampietro, J.L.M.; Rullo, V.E.V. Prevalence of scoliosis in public elementary school students. Rev. Paul. Pediatr. 2017, 35, 191–198. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tahirbegolli, B.; Obertinca, R.; Bytyqi, A.; Kryeziu, B.; Hyseni, B.; Taganoviq, B.; Shabani, B. Factors affecting the prevalence of idiopathic scoliosis among children aged 8–15 years in Prishtina, Kosovo. Sci. Rep. 2021, 11, 16786. [Google Scholar] [CrossRef] [PubMed]
- Rrecaj-Malaj, S.; Beqaj, S.; Krasniqi, V.; Qorolli, M.; Tufekcievski, A. Outcome of 24 weeks of combined Schroth and Pilates exercises on cobb angle, angle of trunk rotation, chest expansion, flexibility and quality of life in adolescents with idiopathic scoliosis. Med. Sci. Monit. Basic Res. 2020, 26, e920449. [Google Scholar] [CrossRef]
- McMaster, M.E.; Lee, A.J.; Burwell, R.G. Physical activities of patients with adolescent idiopathic scoliosis (AIS): Preliminary longitudinal case-control study historical evaluation of possible risk factors. Scoliosis 2015, 10, 6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hong, J.Y.; Suh, S.W.; Park, H.J.; Kim, Y.H.; Park, J.H.; Park, S.Y. Correlations of adolescent idiopathic scoliosis and pectus excavatum. J. Pediatr. Orthop. 2011, 31, 870–874. [Google Scholar] [CrossRef] [PubMed]
- Talmage, M.S.; Nielson, A.N.; Heflin, J.A.; D’Astous, J.L.; Fedorak, G.T. Prevalence of hip dysplasia and associated conditions in children treated for idiopathic early-onset scoliosis-don’t just look at the spine. J. Pediatr. Orthop. 2020, 40, e49–e52. [Google Scholar] [CrossRef] [PubMed]
- Théroux, J.; Stomski, N.; Hodgetts, C.J.; Ballard, A.; Khadra, C.; Le May, S.; Labelle, H. Prevalence of low back pain in adolescents with idiopathic scoliosis: A systematic review. Chiropr. Man. Therap. 2017, 25, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Teles, A.R.; St-Georges, M.; Abduljabbar, F.; Simões, L.; Jiang, F.; Saran, N.; Ouellet, J.A.; Ferland, C.E. Back pain in adolescents with idiopathic scoliosis: The contribution of morphological and psychological factors. Eur. Spine J. 2020, 29, 1959–1971. [Google Scholar] [CrossRef] [PubMed]
- Strikovic, V.; Krasnik, R.; Zvekic-Svorcan, J.; Drljan, C.D.; Kuhajda, D.; Ivanicì, J.; Vuklis, D. Potential risk factors for back pain in children. J. Back Musculoskelet. Rehabil. 2019, 32, 749–754. [Google Scholar] [CrossRef] [PubMed]
Variables | Yes n = 66, n (%) | No n = 362, n (%) | p-Value | |
---|---|---|---|---|
Age in years (mean) | - Mean ± SD | 11.74 ± 0.83 | 11.77 ± 0.85 | 0.84 |
Gender | - Male | 32 (14) | 196 (86) | 0.23 |
- Female | 34 (17) | 166 (83) | ||
Height | - ≤140 cm | 10 (13.5) | 64 (86.5) | 0.3 |
- >140 cm | 56 (15.8) | 298 (84.2) | ||
Weight | - ≤40 kg | 23 (13.7) | 145 (86.3) | 0.25 |
- >40 kg | 43 (16.5) | 217 (83.5) | ||
BMI (kg/m2) | - Underweight | 24 (12.9) | 162 (87.1) | 0.17 |
- Healthy weight | 38 (16.6) | 191 (83.4) | ||
- Overweight/Obese | 4 (30.8) | 9 (69.2) | ||
Physical activity | - Yes | 43 (17) | 209 (83) | 0.16 |
- No | 23 (13) | 153 (87) | ||
If yes, it is a high risk sport (dance or artistic gymnastics)? | - Yes | 11 (28) | 28 (72) | 0.04 |
- No | 32 (15) | 181 (85) | ||
Weekly duration of physical activity | - ≤3 h | 41 (18.9) | 176 (81.1) | 0.03 |
- >3 h | 2 (5.7) | 33 (94.3) | ||
Use of backpack | - Yes | 64 (16) | 337 (84) | 0.18 |
- No (use bag with wheels) | 2 (7.4) | 25 (92.6) | ||
Daily meters traveled with a backpack | - <300 mt | 52 (15.2) | 292 (84.8) | 0.41 |
- >300 mt | 14 (16.7) | 70 (83.3) | ||
Daily time spent sitting | - <8 h | 47 (15) | 266 (85) | 0.40 |
- >8 h | 19 (16.5) | 96 (83.5) |
Variables | Yes n = 66, n (%) | No n = 362, n (%) | p-Value | |
---|---|---|---|---|
Visual disorders | - Yes | 28 (16.8) | 139 (83.2) | 0.31 |
- No | 38 (14.5) | 223 (85.5) | ||
If yes, what kind of disorders | - Astigmatism/hypermetropia | 8 (12.3) | 57 (87.7) | 0.15 |
- Myopia | 20 (19.6) | 82 (80.4) | ||
Dental disorders | - Yes | 14 (22.2) | 49 (77.8) | 0.08 |
- No | 52 (14.2) | 313 (85.8) | ||
If yes, what kind of disorders | - Dental malocclusion | 5 (38.5) | 8 (61.5) | 0.11 |
- Dental device | 9 (18) | 41 (82) | ||
Back pain | - Yes | 15 (14) | 92 (86) | 0.38 |
- No | 51 (15.9) | 270 (84.1) | ||
Daily duration of back pain | - <3 h | 9 (9.4) | 87 (90.6) | <0.001 |
- >3 h | 6 (54.5) | 5 (45.5) | ||
Posture disorders | - Yes | 12 (34.3) | 23 (65.7) | <0.01 |
- No | 54 (13.7) | 339 (86.3) | ||
If yes, what kind of disorders | - Deformity of the spinal column | 4 (36.4) | 7 (63.6) | 0.8 |
- Height difference of the basin | 6 (40) | 9 (60) | ||
- Difference in shoulder blades | 2 (22.2) | 7 (77.8) | ||
Familiarity with scoliosis | - Yes | 16 (18.4) | 71 (81.6) | 0.24 |
- No | 50 (14.7) | 291 (85.3) | ||
Talking about scoliosis with physician | - Yes | 22 (23.6) | 71 (76.3) | <0.01 |
- No | 44 (13.2) | 290 (86.8) |
Variables | Crude OR | CI 95% | p-Value | AdjOR | CI 95% | p-Value |
---|---|---|---|---|---|---|
Gender | ||||||
- Male | ref | 0.21 | ||||
- Female | 1.47 | (0.80–2.70) | ||||
Age in years (continuous variable) | 1.09 | (0.77 1.55) | 0.61 | |||
BMI (kg/m2) | ||||||
- underweight | ref | 0.09 | ref | 0.07 | ||
- overweight/healthy weight | 1.60 | (0.92–2.68) | 1.68 | (0.97–2.95) | ||
Physical activity | ||||||
- Yes | ref | 0.91 | ||||
- No | 1.03 | (0.55–1.91) | ||||
Physical activity (high risk sports) | ||||||
- No | ref | <0.05 | ref | <0.05 | ||
- Yes | 1.78 | (1.06–5.06) | 1.83 | (1.11–4.76) | ||
Weekly duration of physical activity | ||||||
- ≤3 h | ref | 0.28 | ||||
- >3 h | 0.44 | (0.1–1.96) | ||||
Daily meters traveled with a backpack | ||||||
- <300 mt | ref | 0.49 | ||||
- >300 mt | 1.29 | (0.63–2.65) | ||||
Daily time spent sitting | ||||||
- <8 h | ref | 0.83 | ||||
- >8 h | 0.92 | (0.46–1.85) | ||||
Visual disorder | ||||||
- No | ref | 0.40 | ||||
- Yes | 1.30 | (0.70–2.40) | ||||
Dental disorders | ||||||
- No | ref | 0.18 | ref | 0.49 | ||
- Yes | 1.67 | (0.78–3.56) | 0.99 | (0.34–2.80) | ||
Back pain | ||||||
- No | ref | 0.79 | ||||
- Yes | 0.90 | (0.44–1.85) | ||||
Posture disorders | ||||||
- No | ref | <0.05 | ref | <0.05 | ||
- Yes | 2.69 | (1.14–6.23) | 1.67 | (1.12–3.60) | ||
Familiarity with scoliosis | ||||||
- No | ref | 0.35 | ||||
- Yes | 1.39 | (0.69–2.32) | ||||
Talking about scoliosis with physician | ||||||
- No | ref | 0.08 | ref | 0.24 | ||
- Yes | 1.81 | (0.93–3.51) | 1.55 | (0.74–3.23) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Scaturro, D.; Costantino, C.; Terrana, P.; Vitagliani, F.; Falco, V.; Cuntrera, D.; Sannasardo, C.E.; Vitale, F.; Letizia Mauro, G. Risk Factors, Lifestyle and Prevention among Adolescents with Idiopathic Juvenile Scoliosis: A Cross Sectional Study in Eleven First-Grade Secondary Schools of Palermo Province, Italy. Int. J. Environ. Res. Public Health 2021, 18, 12335. https://doi.org/10.3390/ijerph182312335
Scaturro D, Costantino C, Terrana P, Vitagliani F, Falco V, Cuntrera D, Sannasardo CE, Vitale F, Letizia Mauro G. Risk Factors, Lifestyle and Prevention among Adolescents with Idiopathic Juvenile Scoliosis: A Cross Sectional Study in Eleven First-Grade Secondary Schools of Palermo Province, Italy. International Journal of Environmental Research and Public Health. 2021; 18(23):12335. https://doi.org/10.3390/ijerph182312335
Chicago/Turabian StyleScaturro, Dalila, Claudio Costantino, Pietro Terrana, Fabio Vitagliani, Vincenzo Falco, Daniele Cuntrera, Claudia Emilia Sannasardo, Francesco Vitale, and Giulia Letizia Mauro. 2021. "Risk Factors, Lifestyle and Prevention among Adolescents with Idiopathic Juvenile Scoliosis: A Cross Sectional Study in Eleven First-Grade Secondary Schools of Palermo Province, Italy" International Journal of Environmental Research and Public Health 18, no. 23: 12335. https://doi.org/10.3390/ijerph182312335