The prevalence of postural deformities among children age 11 to 13 years in some Western Cape schools

[摘要] ENGLISH ABSTRACT:Postural deformities are a commonly encountered problem among children. Most of the achesand pains of adults are the result, not of injuries, but of the long-term effects of distortions inposture or alignment that have their origins in childhood or adolescence. Television, videoentertainment, motorized transportation, fast food and lack of regular physical activitycontribute to the poor physical condition of children. School screening for scoliosis ismandated in schools in 26 states of the United States (US) for children between 10 and 16years of age. Previous studies conducted in the US found that 160 out of 1000 people sufferfrom scoliosis. This means that scoliosis is as prevalent as hypertension or diabetes mellitus(Boachie-Adjei & Lonner, 1996). Identification of postural deformities at an early stage makesearly treatment possible, which may, in future, prevent serious postural abnormalities. TheAmerican Academy of Orthopedic Surgeons approved the implementation of screeningprograms in schools in 1974 (Lonstein, 1988).Few studies have included the entire musculoskeletal system. The purpose of this study wasto determine the prevalence of postural deformities among children aged 11 to 13 years inselected primary schools in the Western Cape. The study also proposes to investigatefactors that may influence the prevalence rate of postural deformities. These factors includedage, gender, school district, weight, height, BMI (Body Mass Index), fat%, waist-hip ratio, andphysical activity.Letters were sent to 15 primary schools within a 30km radius of Stellenbosch. This regionincluded Stellenbosch, Strand, and Kuilsrivier. Four schools replied, giving permission toconduct the study at their schools. The sample (N=288, mean age=12.36, SD=0.92)consisted of 78 scholars from grade five; 104 scholars form grade six; and 106 scholars fromgrade seven. Of the total number of scholars examined (288), 154 were boys, and 134 weregirls. Only children with parental consent were allowed to participate in the study.Anthropometric measures included stature, mass, skinfoids (two-site skinfoid), waist- and hipcircumferences and trochanterion leg length. Level of physical activity and family history ofdeformities were obtained by means of a questionnaire. The New York Posture Test wasused for postural evaluation (Bloomfield et aI., 1994:320; Reedeo Inc., 2001. This PostureTest was designed for the screening of 13 categories of deformities. Using a see-throughposture grid, lateral and posterior examinations were performed. The Adam's position(forward bending) was used for further scoliosis evaluation.Quantitative data was analyzed, using Statistica (Statsoft, 2001) and classification treemethodology (Breiman et aI., 1993). The anthropometric results indicated that the subjectshad a mean stature of 1.54m, mass of 47.48kg, BMI of 19.75, waist-hip ratio of 0.79 and fat%(Lohman, 1987) of 21.35%. The prevalence of postural deformities was as follows: Lordosis,70%; Kyphosis, 57%; Uneven shoulders, 55%; Inclined trunk, 43%; Winged scapulae, 42%;Pronated feet, 30%; Flat feet, 30%; Flat chest, 29%; Forward head, 28%; Protrudingabdomen, 28%; Uneven hips, 11%; Scoliosis, 10%; and Twisted head, 1%. Uneven hips,scoliosis and twisted head were not considered for statistical purposes, because of their lowincidence compared to the other deformities. The factors that influenced the prevalence rateof deformities the most were BMI and fat%. A higher BMI and fat% resulted in a higherprevalence rate in most deformities.The prevalence rate of postural deformities in this study was considerably high. Sedentarylifestyles of children (watching television, computer games, junk food and physical inactivity)were a contributing factor in the high prevalence rate of postural deformities. It is known thatoverweight and sedentary behavior of children is increasing and this could pose an alarmingconcern to the health of a child. Also, if a significant correlation does exist between theprevalence of postural deformities and conditions such as back pain, the high prevalence ratereported in this study is a matter of concern.

[发布机构] Stellenbosch University