Scoliotic posture and biological age measured by pubertal growth spurt in adolescent boys and girls.

Abstract

Puberty is a critical period in the development of children and adolescents. The muscular dystonia observed during this period and the environmental factors present at home and school promote the adoption of abnormal posture and impaired physical performance. Early detection of postural changes provides opportunities for prevention and treatment. The aim of this study was to compare the body posture and the size of the rotational deformation of the trunk in children aged 10-15 years, before and after pubertal growth spurt. The study included 40 subjects, 19 boys and 21 girls from Wroclaw, Poland, aged 10.3-15.6 years, who reported for the first time to the Postural Defects Outpatient Clinic with suspected rotational deformity of the trunk. Based on the equations, maturity offset (MO) was determined and the age of peak height velocity (APHV) was assessed. The posture was evaluated using a deflection of the plumb line, scapular asymmetry, finger-to-floor test, angle of trunk rotation ATR at 3 spinal levels: proximal thoracic, main thoracic, and lumbar and the Three Rotation Sum (TRS) parameter. These parameters are the earliest clinical signs of scoliosis. In the examined children and adolescents from Wrocław, irrespective of their calendar age, after the APHV, the characteristics describing lateral curvatures of the spine showed higher values, reaching especially for maximal ATR and for the TRS a highly statistically significant level. Post-pubertal children were also more often characterized by the so-called scoliotic posture - they had a significantly greater trunk deviation measured with the plumb line lowered from C7 (0.3 cm versus 0.9 cm; p = 0.01), a greater difference in the height of lower scapular anles, and a worse score on the finger-to-floor test. In conclusion, scoliometer testing should be permanently incorporated into periodic body measurements at school, especially among 10- to 12-year-old children who are at higher risk for scoliosis progression. Equations for assessing biological age, although associated with an error, appear to be easy to use and useful in screening for risk of developing scoliosis at peri-pubertal age.