Adams Forward Bending Test Research Articles

Assessment of Refractive Errors, Dental Caries, and Scoliosis in School Children Aged 6-14 Years: A Study in Durrës Schools

This study aims to assess the prevalence of refractive errors, dental caries, and scoliosis in children aged 6-14 years across several primary and secondary schools in the city of Durrës. The sample includes 370 students from "Vincenc Prendushi", "Nënë Tereza", "Vasil Ziu", "Abedin Dino", and "Bajram Curri" schools. Each school was selected randomly. From each school we have selected different classes and students for further evaluation. Each student underwent a clinical examination to evaluate vision, oral health, and postural status. Refractive errors were assessed using Snellen chart table placed in 6 meters. Dental caries was evaluated through clinical inspection of the teeth, using the DMFT index (Decayed, Missing, and Filled Teeth). Scoliosis was diagnosed through physical examination and the Adams forward bend test, done in physiotherapy lab of Aleksander Moisiu University. The results provide insight into the risk factors and the need for early interventions to improve the overall health of children in this age group. Out of the 370 students, 28% (104 students) were found to have refractive errors, with myopia being the most common condition, affecting 17% (63 students), followed by hyperopia in 9% (33 students), and astigmatism in 2% (8 students). A total of 42% (155 students) exhibited signs of dental caries, with an average DMFT score of 2.8, indicating a moderate level of oral health concerns. Additionally, 12% (45 students) were diagnosed with scoliosis, with mild curvature observed in 8% (30 students) and moderate to severe curvature in 4% (15 students). These findings suggest a significant need for vision correction, oral health education, and orthopedic monitoring in the student population. Early detection and preventive measures in schools are crucial to addressing these health issues effectively and ensuring the well-being of children during their developmental years.

Conservative treatment of adolescent idiopathic scoliosis (AIS): A narrative review of current evidence and implications for clinical practice

Introduction and purpose: Adolescent idiopathic scoliosis (AIS) is characterized by lateral curvature, vertebral rotation, and disruption of physiological curvature of the spine with the Cobb angle ≥10°. AIS affects 1-3% of children aged 10-16 years, representing the most common form of idiopathic scoliosis. Diagnosis of AIS is by exclusion and can be suspected based on Adams forward bend test and scoliometer. Untreated AIS can lead to serious consequences, such as progression of the deformity, back pain, reduced respiratory and cardiovascular function. The aim of this review is to update overview of conservative treatment options. Description of the state of knowledge: AIS treatment guidelines from the Scoliosis Research Society (SRS) and the Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) advocate for observation, bracing, or surgery depending on curve severity, with a focus on avoiding spinal fusion when possible. Additionally, SOSORT recommends scoliosis-specific physiotherapy exercises for smaller curves or as an adjunct to bracing. Conservative treatment aims to prevent curve progression, manage respiratory and spinal complications, and improve quality of life. Conclusions: AIS can significantly impair the physical and psychosocial well-being of young patients, with potential long-term consequences extending into adulthood Individualized treatment plans and patient/parent education are crucial for optimal outcomes. Schroth exercises are superior to Core Stabilization (CS) exercises in reducing Cobb angle, trunk rotation and improving spinal mobility, cosmetic trunk deformities and quality of life. CS exercises are more effective in increasing peripheral muscle strength, reducing pain and correcting vertebral rotation.

The Relationship between Incorrect Body Posture in Elementary School Children on Idiopathic Scoliosis

Idiopathic scoliosis is a condition of spinal deformity characterized by abnormal lateral curvature. The factor that is thought to play a role in the development of idiopathic scoliosis is incorrect body posture. This research is a correlation study which aims to determine the significant relationship between incorrect body posture and the incidence of idiopathic scoliosis in elementary school children. This research approach uses a quantitative approach with a descriptive quantitative research type with a correlational model. Research data was obtained through questionnaires, documentation and measurements using a scoliometer. The population in this study were all sixth grade students at SDIT Bangkinang Elementary School, totaling 35 students. Independent variable is a sitting position using the Questionnaire on Body Awareness of Postural Habits in Young People (Q BAPHYP) measurement tool. The dependent variable is scoliosis measured using the Adam's Forward bending test. Data analysis techniques are descriptive statistical analysis and inferential statistical analysis. After analyzing the research results, it shows that incorrect body posture has a significant relationship with the incidence of idiopathic scoliosis in elementary school children as proven by the results of data analysis, p= 0.000 or p< 0.05. The conclusion of this study is that there is a significant relationship between incorrect body posture and the incidence of idiopathic scoliosis in elementary school children.

Early-onset scoliosis in children aged 4-7 years in Nanjing, China: A cross-sectional study.

This study aimed to investigate the potential variance in the prevalence of early-onset scoliosis among children aged 4-7 years and analyze the influencing factors. The goal was to establish a crucial reference point for monitoring and evaluating spinal curvature development in preschoolers, ultimately to reduce the occurrence of adverse health outcomes. Children aged 4-7 years within the main urban area of Nanjing were selected using a stratified random sampling method. A team of four senior therapists conducted screenings for spinal curvature among children using visual inspection, the Adams forward bending test, and an electronic scoliometer to measure the angle of trunk rotation (ATR) and identify children displaying signs of scoliosis. Children with suspected scoliosis in the initial screening underwent X-ray Cobb angle assessment for confirmation. The prevalence of early-onset scoliosis was then determined from the screening results. R version 4.2.0 software was used to analyze the factors associated with scoliosis among children using partial least squares structural equation modeling. A total of 2281 children were included in this study, consisting of 1211 boys and 1070 girls, with a mean age of 5.44 ± 0.81 years (ranging from 4 to 7 years). Among them, 7.58% exhibited positive signs of scoliosis, 5.87% had early-onset scoliosis, and the positive predictive value was 77.5%. Significant differences in ATR were observed among children in different age groups (Kruskal-Wallis = 15, p = 0.0104) and by sex (t = 3.17, p = 0.00153). Significant variations in ATR were noted in children with scoliosis (t = -22.7, p < 0.001), with a cutoff at ATR = 4.5°, and auxiliary values of 0.947 and 0.990. Children diagnosed with early-onset scoliosis generally exhibited lower body mass index values, with a statistically significant difference (t = 2.99, p = 0.003). Using visual inspection, the Adams test, and an electronic scoliometer to measure the ATR, the present triad method is more sensitive for early scoliosis screening in children with abnormal posture aged 4-7 years. A full spine X-ray is advised in children with an ATR over 4.5° and poor posture.

Evaluation of the prevalence of adolescent scoliosis and its associated factors in Gansu Province, China: a cross-sectional study.

Gansu Province is situated in the northwest region of China, characterized by diverse and complex topography and a rich diversity of ethnic groups. This study aims to explore the prevalence and risk factors of adolescent suspected scoliosis in Gansu Province through a cross-sectional population study. From April 2022 to July 2022, a prospective cross-sectional study was conducted in Baiyin City, Jinchang City, Lanzhou City, Linxia Hui Autonomous Prefecture, and Gannan Tibetan Autonomous Prefecture in Gansu Province. The screening covered 3,118 middle and high school students across 24 institutions, including middle and high schools. Diagnosis of suspected scoliosis was established through visual inspection, the Adams forward bend test, and measurement of trunk rotation angle. Employing a custom-designed questionnaire, demographic data were collected, and the prevalence of suspected scoliosis was calculated. Univariate and multivariate logistic regression analyses were employed to assess factors associated with suspected scoliosis. A total of 3,044 participants were ultimately included in the analysis. The overall prevalence of suspected scoliosis was 5.68% in Gansu Province. The peak prevalence for boy is at 14 years (6.70%), while for girl, it is at 15 years (8.75%). Lanzhou City exhibits the highest prevalence rates (boy, 9.82%; girl, 10.16). The results of univariate logistic regression analysis presented that BMI (OR = 0.92, 95% CI: 0.88-0.96), altitude of habitation (1,600 m-2000 m) (OR = 0.50, 95% CI: 0.34-0.73), altitude of habitation (2000 m-3321 m) (OR = 0.58, 95% CI: 0.40-0.83), family medical history (OR = 1.56, 95% CI: 1.02-2.31), and shoulders of unequal height (OR = 1.49, 95% CI: 1.09-2.03) were significantly correlated with suspected scoliosis. The multivariate logistic regression analysis indicated that BMI (OR = 0.91, 95% CI: 0.86-0.95), altitude of habitation (1,600 m-2000 m) (OR = 0.35, 95% CI: 0.23-0.54), altitude of habitation (2000 m-3321 m) (OR = 0.39, 95% CI: 0.24-0.60), family medical history (OR = 1.66, 95% CI:1.08-2.49), and shoulders of unequal height (OR = 1.45, 95% CI:1.06-1.99) were independently associated with suspected scoliosis. Low BMI, residence at an altitude of 1,600 m-3321 m, family medical history, and shoulders of unequal height were independently associated with an increased prevalence of suspected scoliosis. It is recommended to promptly screen high-risk adolescents for suspected scoliosis, provide effective preventive and intervention measures.

Adolescent Idiopathic Scoliosis Minimum Data Set: Towards Standardization of Data Elements in History and Physical Examination.

Nonoperative care represents a cornerstone of adolescent idiopathic scoliosis (AIS) management, although no consensus exists for a minimal data set. We aimed to determine a consensus in critical data points to obtain during clinical AIS visits. A REDCap-based survey was distributed to Pediatric Orthopedic Society of America (POSNA), Pediatric Spine Study Group (PSSG), and International Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT). Respondents ranked the importance of data points in history, physical examination, and bracing during AIS visits. Results: One hundred eighty-one responses were received (26% response rate), of which 86% were physicians and 14% were allied health professionals. About 80% of respondents worked at pediatric hospitals or pediatric spaces within adult hospitals, and 82% were academic, with the majority (57%) seeing 150+ unique AIS patients annually. Most respondents recommended six-month follow-up for patients under observation (60%) and bracing (54%). Most respondents (75%) considered family history and pain important (69%), with the majority (69%) asking about pain at every visit. Across all time points, Adam's forward bend test, shoulder level, sagittal contour, trunk shift, and curve stiffness were all considered critically important (>60%). At the first visit, scapular prominence, leg lengths, motor and neurological examination, gait, and iliac crest height were also viewed as critical. At the preoperative visit, motor strength and scapular prominence should also be documented. About 39% of respondents use heat sensors to monitor bracing compliance, and average brace wear since the prior visit was considered the most important (85%) compliance data point. This study establishes recommendations for a 19-item minimum data set for clinical AIS evaluation, including history, physical exam, and bracing, to allow for future multicenter registry-based studies.

Assessment of idiopathic scoliosis among adolescents and associated factors in Palestine

PurposeThis study aimed to investigate adolescent idiopathic scoliosis (AIS) and its related risk factors, including body mass index (BMI), physical activity (PA), gender, time of the first menstrual cycle, transportation, backpack weight and the way of carrying a backpack. Design and methoda cross-sectional quantitative design was utilized. A convenient sample of adolescent students in grades seven through ten was included in the study. A self-reported questionnaire with three sections: demographic data; physical data including height, weight and PA; and Adam's forward bend test to determine each student's spine's Cobb angle by measuring the angle of trunk rotation using a scoliometer. The data were analyzed using SPSS version 25, with confidence intervals of 95%. ResultsA total of 820 schoolchildren participated in the study; 53.7% were female and 46.3% were male. Only 22% of these students engaged in vigorous exercise, compared to 36.7% who engaged in low PA; additionally, 10% of the adolescents had a low BMI. After the analysis, it was found that 5.4% of participants had AIS. Low PA (p = 0.001), being underweight (p = 0.038), and time of first menstrual period (p = 0.033) were significantly associated with AIS, while gender, backpack weight, and way of carrying were not statistically related to AIS. Binary logistic regression identified low PA as an independent predictor of AIS (OR = 7.22, 95%CI [1.64, 31.79]). ConclusionsThe frequency of AIS in Palestine was significant, which highlighted the importance of this issue at a national and global level. There was an association between AIS and BMI, PA, and the time of the first menstrual cycle, which signifies the importance of early detection of the problem to limit its burden later in life. Practice implicationsTeachers, teenagers, and their parents should be provided with programs that educate and clarify AIS, and a specific protocol should be established for scoliosis screening in schools.

Prevalence angle of trunk rotation in adolescents: a study from an idiopathic scoliosis school screening in Surabaya

Link of Video Abstract: https://youtu.be/GtRgpMD7tsM Background: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in early puberty, affects 1-3% of adolescents, and randomly affects young women. Scoliosis screening is still a hot topic discussed by various researchers, especially in the school child population, and it is still an important preventive program to reduce the progression of spinal deformity. This study aims to determine the prevalence rate angle of trunk rotation in idiopathic scoliosis school screening in Surabaya. Methods: This research is a cross-sectional study with a descriptive observational type using surveys and examinations. In this study, the sample used was 405 junior high school students in Surabaya. The sampling method is cluster random sampling, where each member of the population is divided into subclasses with the school as the cluster. Samples were randomly selected from each area of Surabaya. Data were analyzed using SPSS version 25.0 for Windows. Results: These data found that the age distribution of the scoliosis screening study was an average of 13.87 years and a median of 14 years. The gender distribution of the scoliosis screening study sample was more female, 211 samples (52.1%) compared to men, 194 samples (47.9%). The distribution was obtained from 405 total samples; 2 positive samples were obtained during the Adam's Forward Bend Test, both 14 years old and female. On examination with a scoliometer, both showed 9 and 11 degrees, respectively. The prevalence angle of trunk rotation in idiopathic scoliosis school screening in Surabaya was 0.49%. Conclusion: This figure is lower than several studies conducted in several other countries. This may be obtained due to differences in the number of research samples undertaken in each country.

Identification of Risk Factors for Scoliosis in Elementary School Children Using Machine Learning

Scoliosis is an abnormal curvature of the spine and often diagnosed in childhood or early adolescence. In this study, the risk factors for scoliosis in elementary school children is investigate based on age, backpack weight and gender. There are 260 children participated in this study from aged 7 up to 12 years old. Scoliometer is used to measure the angle of trunk rotation (ATR) on Adam Forward Bending Test. Statistical analysis of analysis of variance (ANOVA) is used to determine the characteristic difference of ATR readings on the risk factors for scoliosis. Significant results with P-value less than 0.001 are found among ATR readings on a linear combination of risk factors for scoliosis of age and backpack weight. Then, the risk factors for scoliosis are classified among elementary school children using Decision Tree and K-Nearest Neighbor. The classification results shown that both Decision Tree method produced highest classification percentage up to 98.08%. This finding indicates that age and backpack weight are significant as the risk factors for scoliosis.

Are Craniofacial Asymmetries Related to Trunk Asymmetries?

The aim of this study was to investigate whether craniofacial asymmetries could be a predictor of spine asymmetries or not. Female individuals aged between 18 and 25 years participated in this cross-sectional descriptive-analytic study. The angle of trunk rotation was measured by a scoliometer in conjunction with the Adams forward-bending test. Individuals in the control group (n = 57) had spinal curvature of 0 to 3 degrees, and individuals in the study group (n = 53) had spinal curvature of between 4 and 6 degrees. Facial anthropometric measurements of individuals were evaluated by referencing anatomical landmarks determined on the face with 2-dimensional photogrammetry using ImageJ (Version 1.53q) program. Both groups were similar in terms of facial measurements (P > 0.05). Axial trunk rotation values of the mid-thoracic and thoraco-lumbar regions were significantly higher on both sides of the asymmetry group (P < 0.05). The distances between facial landmarks are not associated with asymmetries of spine regions (P > 0.05). Although the sensitivity and predictive value of facial asymmetries in determining trunk asymmetries and sagittal spinal posture were low, it was concluded that comparative studies are needed, especially in individuals with asymmetry at the level of scoliosis, as the asymmetries of the individuals in our study were not at the level of scoliosis.

Frequency of Scoliosis among School Going Students Carrying Heavy Bags: A Cross-Sectional Study in Lahore, Pakistan

Objective: Scoliosis is structural change that occurs in a diversity of conditions. Development of the scoliosis during time periods of rapid child growth may consequence in severe abnormality. This survey had the purpose to find out the scoliosis frequency among school going students with age 11-16 years and determine possible associations among scoliosis and bodyweight and the bagpacks weight.&#x0D; Method: A Cross-Sectional study was conducted on 374 students with age of 11-16 years old boys and girls were having no abnormality or any MSK deformity was involved in the survey. All students were monitored by Adam's forward bend test and physical inspection test and for this purpose SRS-22r patient questionnaire was used. All data collected via a questionnaire which coded it into SPSS version 26. Data was constituted in configuration of bar charts, graphs and tables.&#x0D; Results: This inquiry contains 374 participants, and means weight of students 43.83±11.98, and mean weight of bags 5.21±1.99. The frequency of scoliosis among respondents was 48.66%, 103(27.54%) students were suffering from right Scoliotic hump, and 79(21.12%) have left Scoliotic hump. The frequency of shoulder &amp; scapular asymmetry 73%, uneven hips 19.7%, head deviation 50.8%, body overweight 1.9%, carrying immoderate heavy school bag packs material 4%.&#x0D; Conclusion: The scoliosis frequency among the sample of school going students was high. The statistical analysis showed that scoliosis was positively correlated with weight of students with statistically significant (p=0.000). No association was found among frequency of scoliosis and bags weigh.

Knowledge and Calcium Intake to the Risk of Scoliosis at Boarding School Students

Teenagers in the modern era often have improper sitting positions, which will affect posture abnormalities, namely scoliosis. Scoliosis occurs due to many factors, such as information obtained from knowledge. In addition, there are nutritional factors obtained from calcium intake because a deficiency will affect bone density. This study aims to understand the relationship between knowledge and calcium intake with the risk of scoliosis in adolescents. The method used was an analytic observational study and a cross-sectional study design. Thirty-five students were chosen by purposive sampling. The respondent checked using Adam Forward Bending Test Checklist and the Food Frequency Questionnaire (FFQ). All data were processed using SPSS. The results of the correlation test from the Spearman-rho test on the knowledge variable with a significance value of 0.309 (p0.05) and the calcium intake variable of 0.624 (p0.05) concluded that H1 was rejected and H0 was accepted, which means there is no relationship between knowledge and calcium intake on the risk of scoliosis in adolescents. This study concluded that there is no relationship between knowledge and calcium intake on the risk of scoliosis in adolescents. But the long-term effects of insufficient calcium intake need further investigation.

Higher prevalence of trunk rotation among Egyptian students in urban than in countryside areas

IntroductionThis study was conducted to compare the prevalence of trunk rotation in selected urban and countryside areas in Egypt.MethodsOverall, 840 male students aged 10–15 years were divided into 2 equal groups: group A, representing urban schools, and group B, representing countryside schools. Both groups were first screened with the Adams forward bend test; then, the Scoliometer HD application was used to determine the angle of trunk rotation. Children with a reading of 7° or more (≥ 20° Cobb angle) were referred to a medical facility and their parents were informed about the findings.ResultsIn group A, the Adams forward bend test showed a higher prevalence of trunk rotation (41.43%) than in group B (17.14%). The Scoliometer HD application readings (≥ 7°) indicated a significant difference between the 2 groups: group A result was 12.61% and group B result was 5%.ConclusionsMale students of urban schools exhibit a higher prevalence of trunk rotation than those of countryside schools.

Use of Single Shoulder Handling Bag: Scoliosis and Musculoskeletal Pain in School Going Children. “A Cross Sectional Study”

Objectives: The objectives of the study were to assess the Frequency of musculoskeletal pain, and to check whether single strapped bags are culprit of causing scoliosis in school going children or not as compared to other types of school bags i.e. double strapped and trolley type bags.Methodology: The study design was an observational cross-sectional. The process of data collection from the school going children (n=398) between the ages of 8 and 16 years was carried out in the government schools of the Faisalabad through a simple random sampling technique. Measurements of weight were taken through spring scale and subjective self-administered questionnaire was completed from each student along with cobb’s angle to measure the curvature and Adam forward bend test was also performed on each pupil.Results: Majority of the students used to carry single strapped bag with average value of 50.5% while double strapped bag with average percentage of 48.0%. Most of the students were used to carry bag on one side of shoulder with an average value of 68.3% and only 31.7% carried bag on both sides of shoulders. Most of the children reported pain in the neck and shoulder region with average percentage of 73.6% and in back/buttock were 105 with percentage of 26.4%. 92.5% of the children stated that their pain was relieved when they took off their bags and 51.3% were used to take medicine for pain reduction. On visual analogue rating scale, 57.8% of the children reported the moderate level of pain. Mean ± SD of students using single strapped and double strapped bags were 2.2438± 0.579 and 1.7958 and 0.64497. Adam forward test was also most frequently positive in students using single strapped bag as compared to other types of bags (p value = 0.000) reflecting scoliosisConclusion: Students majority who used to wear one side shoulder bag were prone to suffer scoliosis and pain in neck and shoulder region.

Is Shoulder Imbalance a Useful Parameter in the Screening of Idiopathic Scoliosis? A Preliminary Study.

Objective The present study aims to analyze the use of shoulder imbalance as a parameter for scoliosis screening as well as its relationship with other parameters of physical examination. Methods This study assesses a smartphone application that analyzes several parameters of the physical examination in adolescent idiopathic scoliosis. Medical and non-medical examiners applied the screening tool in students in a public school and in a private sports club. After data collection, interobserver correlation was done to verify shoulder imbalance and to compare shoulder imbalance with Adam's bending test and with trunk rotation. Results Eighty-nine participants were examined, 18 of whom were women and 71 of whom were men. Two subjects were excluded from the analysis. The mean age of subjects from the public school was 11.30 years and, for those from the sports club, it was 11.92 years. The examiners had poor-to-slight interobserver concordance on shoulder asymmetry in the anterior and posterior view. No significant statistical correlation was found between shoulder asymmetry and positive Adam's forward bending test. Conclusion Our preliminary study shows that the shoulder asymmetry has a poor correlation with the Adam's forward bending test and measuring trunk rotation using a scoliometer. Therefore, the use of shoulder imbalance might not be useful for idiopathic scoliosis screening. Level of Evidence III; Diagnostic Study.

Scoliosis among children in Qinghai-Tibetan Plateau of China: A cross-sectional epidemiological study.

BackgroundThe average altitude of Qinghai-Tibetan Plateau is 4,500 m and most of the residents are Tibetan ethnicity. The purpose of this study was to investigate the prevalence of scoliosis and associated factors among children in this region through a scoliosis screening program.MethodsA cross-sectional study was preformed between May 2020 and December 2020 in Qinghai-Tibetan Plateau. A total of 9,856 children aged 6–17 years from schools and nearby villages were screened using visual inspection, the Adams forward-bending test, the angle of trunk rotation, and radiography. A self-designed questionnaire was used to collect demographic data. The prevalence of scoliosis and associated factors were analyzed.ResultsThe overall prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%, with 5.38% for females and 2.11% for males. The prevalence of scoliosis was 3.50% in children resided below 4,500 m while 5.63% in those resided above 4,500 m (P = 0.001). The prevalence of congenital scoliosis (2.14 vs. 0.42%, P < 0.001) and neuromuscular scoliosis (0.34 vs. 0.07%, P = 0.041) were significantly higher in the altitude above 4,500 m. 50.00% of patients resided above 4,500 m were recommended for surgery while 16.24% in those resided below 4,500 m (P < 0.001). Independent associated factors were detected as female (OR = 2.217, 95 CI% 1.746–2.814, P < 0.001), BMI < 18.5 (OR = 1.767, 95 CI% 1.441–2.430, P = 0.005), altitude of residence ≥ 4,500 m (OR = 1.808, 95 CI% 1.325–2.483, P = 0.002), and sleep time < 8 h (OR = 2.264, 95 CI% 1.723–2.846, P = 0.001).ConclusionThe prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%. With increasing altitudes, the prevalence of scoliosis and its major type were different from that at lower altitudes. Female, BMI < 18.5, altitude of residence ≥ 4,500 m, and sleep time < 8 h were independently associated with the prevalence of this disease. Early screening should be carried out before the age of 7 years, especially in the high-altitude, underdeveloped, and rural areas.

An Integrated Comprehensive Tailor-Made Rehabilitation Conservative Treatment For Idiopathic Adolescent Scoliosis

Scoliosis is an abnormal lateral curvature of the spine associated with or without rotation of the vertebrae. Scoliosis is not just a cosmetic problem, but it has impact on many aspects of a person’s quality of life. One’s can experience pain, posture, respiratory, psychosocial problems. In This case report we would like to demonstrated an integrated comprehensive, tailor-made rehabilitation treatment for adolescent scoliosis. The patient is a 15-year-old female with complaints of scoliosis and back pain. Her first menarche was when she was 11 years old. No medical Problem was found. She loved to hang out with her friends and family but since her back hump getting worse, she ashamed of herself and sometimes refused to meet them or cover it with thick layer clothes. The pain in scale of 6 has been present for 1 year. She is unhappy with her body alignment and posture. From physical examination we found The Adam forward bend test was positive. From the x-ray before treatment showed the cobb angle was 20. Pelvic tilt (+), Risser sign 3-4, with Scoliosis C Curve. She can easily do her activities without feeling easily tired nor dyspnoea. She was prescribed a tailor-made Boston brace, physical exercise, heating modality, psychosocial intervention. After 12 weeks of therapy and bracing there was an improvement in posture, minimal pain (3-4), and she became more confidence and happy. The spine malalignment and the curvature can compress spinal disks, irritate nerve, strain joints, tighten muscles and it leads to pain. Because of this spine malalignment can affect posture it can leads to a psychosocial problem. Since the cobb angle was 20 degrees, no full maturation found, it is indicated for Brace prescription, to correct posture and prevent progressivity of curve angle. A proper exercise with heating modality can decrease muscle spasm and pain, maintain flexibility and strengthen spine/core muscle. The earlier diagnosis and treatment of an adolescent scoliosis can give so much different; it depends on the maturation and the cobb angle. In this comprehensive treatment needs a support not only from the patient but also from her society.

AGENESIS OF MEDIAL PATELLOFEMORAL LIGAMENT (MPFL) WITH HABITUAL PATELLAR DISLOCATION IN ADOLESCENT WOMAN WITH CEREBRAL PALSY – A CASE REPORT

Background: The current treatment for habitual dislocation and nonoperative treatment failure is surgical therapy. Therefore, this study describes chronic patella dislocation's comprehensive evaluation and management in an adolescent woman with cerebral palsy (CP).Case Report: A 15 years old female patient has suffered knee pain for almost three years. Furthermore, the physical examination revealed positive adam's forward bending test and left knee cap dislocation with positive patellar J-sign at 90°. Radiologic examination of the vertebrae and left knee shows scoliosis left thoracolumbar curved with 43 cobb angle and patellar shift. The patient was then diagnosed with habitual patellar dislocation, spastic diplegia type of CP, and neuromuscular scoliosis, consulted to the pediatric department, and then planned for medial patellofemoral ligament (MPFL) reconstruction. During the surgical examination, we discovered the MPFL Agenesis. Finally, lateral release and plication of the medial retinaculum were selected for surgery and planned to receive a Boston brace for scoliosis. After six weeks of follow up, the patient shows a reduction in pain.Discussion: Lateral release and MPFL reconstruction for patellar stabilization generate better results. However, in this case, the absence of the medial patellar facet and the medial femoral condyle enhances Lateral release and plication of the medial retinaculum more preferable to fixate the left patella and improve functional limitation.Conclusion: Comprehensive and immediate treatment for a patient with habitual patella dislocation and other predisposition diseases increases the chances of success.

Analysis of postural asymmetry on sagittal plane between right and left side views using photogrammetry

BackgroundPostural asymmetry is natural and expected during postural assessment. Besides, there are conditions that exacerbate the difference between right and left side views, such as Idiopathic Scoliosis (IS). However, the photogrammetric postural assessment on sagittal plane is usually performed using only one side view. This study aimed testing if there are differences between the right and the left-side views in photogrammetric postural assessment of adults on sagittal plane. MethodsPatients with and without scoliosis were assessed and were grouped into Control Group (CG) and Positive Adam's test Group (PAG) according to Adam's forward bending test. After screening, participants were assessed using the right and the left-side views according DIPA© protocol. Descriptive and inferential analysis were made using Paired t-Test and Independence Chi-square Test (χ2). ResultsSignificant differences were found between right and left side views to knee angle and head position angle to overall sample. The mean difference was low, about 1° on head position and 2.6° on knee angle and did not affect the classification of body segments. ConclusionWe conclude that the postural assessment on sagittal plane of adults without IS can be performed using only one side view, becoming the photogrammetric postural assessment an easy-to-use tool.

Prevalence of Back Pain and Idiopathic Scoliosis in Adolescents From the Semiarid Region of Brazil: A Cross-sectional Study

ObjectiveThe purpose of this study was to estimate the prevalence of adolescent idiopathic scoliosis (AIS), and back pain and its risk factors, in schoolchildren from the semiarid region of Brazil. MethodsA total of 520 adolescents aged 10 to 16 years old were assessed. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument questionnaire. The screening for AIS included measuring the angle of trunk rotation using a scoliometer in the Adams forward-bend test. Participants with an angle of trunk rotation ≥ 7° were referred for radiography. The prevalence ratio was estimated by multivariable analysis using a Poisson regression model (α = 0.05). ResultsAmong the participants, 3.1% (95% confidence interval, 3.2%-6.9%) had a confirmed AIS diagnosis: 1.9% girls and 1.1% boys. There was no difference between boys and girls in AIS prevalence. The prevalence of back pain in the previous 3 months was 63.7% (95% confidence interval, 59.5%-67.7%), at a moderate level (visual analog scale = 3.83; 95% confidence interval, 3.57-4.08). Multivariable analysis showed that back pain is associated with postural variables, sex, and age. ConclusionThe prevalence of AIS in the semiarid region of Brazil was 3.1%, and that of back pain was 63.7%. Only body mass index was different between adolescents with and without AIS, with those with AIS having a lower mean body mass index. Back pain was higher in girls and increased in older adolescents. Furthermore, behavioral and postural habits and hereditary factors were associated with an increased chance of back pain.