Forward Bending Test Research Articles

PREVALENCE OF SCOLIOSIS IN PUBLIC ELEMENTARY SCHOOL STUDENTS.

ABSTRACTObjective: To evaluate the prevalence of scoliosis and the risk factors in elementary school students.Methods: A cross-sectional study was carried out in 954 students in 2015. The instrument involved was a questionnaire on postural habits, socioeconomic conditions, and demographic factors. The anthropometric measurements, including height and weight, a visual inspection of the deformity of the vertebral column, the leveling of shoulders, and the Adam’s test were obtained. The sample was calculated in the expected frequency of 12.3%, acceptable error rate of 2.0% and confidence level of 95.0%. To compare the proportions, the chi-square test or Fisher’s exact test was applied. The association between scoliosis and risk factors was evaluated by logistic regression, being significant p <0.05.Results: The prevalence of scoliosis was 24.3%, higher in obese patients and students who adopted a sitting position for a long period of time. Obese students showed a 1.8 times higher chance of testing positive Adam’s Forward Bend Test when compared to normal-weight/lean and 2.1 times higher chance compared to overweight students. The sitting position for watching television increases the chance of testing positive Adam’s test in 38.0%, when compared to the lying position. Obesity increases the risk of testing positive Adam’s test in 74.0 and 98.0%, when compared, respectively, to the underweight/normal weight and overweight. Conclusions: There was a high prevalence of scoliosis in students from public elementary schools in Santos. The most influential factors for this deviation of the spine were obesity and the position adopted by students to watch television.

A study on screening for scoliosis among school children in the age group of 10-14 using a cost effective and an innovative technique

Background: Scoliosis refers to a sideways curvature of the spine. Early detection of scoliosis prevents progress into severe scoliosis. In a resource constrained setting like India, there is a need for cost effective solutions for the purpose of screening. Objective of this study is to identify scoliosis among school children, determine risk factors associated with scoliosis and to compare the readings of the Scoliometer device to those obtained from Scoliometer smartphone app.Methods: The present cross sectional study was conducted in students aged 10-14 years studying in private schools of Hyderabad. All willing students (n=1000) were screened for scoliosis during June-August 2015. They were screened using physical examination (Adams forward bend test), Scoliometer device and Scoliometer App.Results: A total of 3.3% of the students had positive scoliosis findings when physically examined in standing position and 3.4% were positive for Adam’s forward bend test. Around 0.7% of students had a reading &gt;7o when screened using the Scoliometer device and 1% had a reading &gt;7o when screened using the App i.e. similar results were obtained. The risk factors associated with scoliosis found by this study includes prematurity of foetus during delivery and carrying school bag on one shoulder which had statistically significant association with positive scoliotic findings with O.R of 3.6 and 4.3 at 95% CI respectively.Conclusions: Scoliometer app can replace the expensive Scoliometer device for screening of scoliosis. This can be included in school health programmes.

Low hospital referral rates of school scoliosis screening positives in an urban district of mainland China.

Significant prevalence rates of adolescent scoliosis in China were suggested in previous studies. However, school screenings for adolescent scoliosis have been suspended due to low rates of positive detection under the past screening system in China. The present study was undertaken to screen for adolescent scoliosis in middle school students under a modern assessment system in a district of Shanghai. We performed a population-based, cross-sectional study of a middle school scoliosis screening program in the Jingan district. In 2015, schoolchildren were initially screened by visual inspection of clinical signs and the forward-bending test. Suspected cases were referred for radiography in hospital for scoliosis diagnosis. A total of 5327 middle school students (grades 6–8) were screened with 520 (9.76%) positives (the positive rates of girls and boys at 15.28% and 4.59%, respectively) and no statistically significant difference among grades. Only 301 positives (57.9%) followed the referral for hospital radiography. There were 102 cases (33.9%) that were diagnosed with scoliosis by radiography criteria (Cobb angle ≥10°) including mild scoliosis (Cobb 10–25) for 94 cases and moderate scoliosis (Cobb 25–40) for 8 cases, and false-positives (Cobb 0) for 39 cases. The putative prevalence rate was estimated as 1.9% from the referred students. Under an accurate and modern assessment system, school screenings can detect scoliosis at a significant rate, but awareness of scoliosis risks is needed for residents in China to take up referrals for hospital diagnosis after school screenings.

The Clinical Effectiveness of School Screening Programme for Idiopathic Scoliosis in Malaysia

IntroductionThere is no large population size study on school screening for scoliosis in Malaysia. This study is aimed to determine the prevalence rate and positive predictive value (PPV) of screening programme for adolescent idiopathic scoliosis.Materials and MethodsA total of 8966 voluntary school students aged 13-15 years old were recruited for scoliosis screening. Screening was done by measuring the angle of trunk rotation (ATR) on forward bending test (FBT) using a scoliometer. ATR of 5 degrees or more was considered positive. Positively screened students had standard radiographs done for measurement of the Cobb angle. Cobb angle of >10° was used to diagnose scoliosis. The percentage of radiological assessment referral, prevalence rate and PPV of scoliosis were then calculated.ResultsPercentage of radiological assessment referral (ATR >5°) was 4.2% (182/4381) for male and 5.0% (228/4585) for female. Only 38.0% of those with ATR >5° presented for further radiological assessment. The adjusted prevalence rate was 2.55% for Cobb angle >10°, 0.59% for >20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle >10°, 12.8% for >20° and 2.6% for > 40°.ConclusionsThis is the largest study of school scoliosis screening in Malaysia. The prevalence rate of scoliosis was 2.55%. The positive predictive value was 55.8%, which is adequate to suggest that the school scoliosis screening programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.

Discrepancy between self-awareness and actual diagnosis and treatment of the conditions among adolescent with scoliosis in middle-school age.

[Purpose] The purpose of this research was to determine the awareness of the actual conditions of the diagnosis and treatment of scoliosis by focusing on middle-school students in order to provide a basis for active education and treatment of scoliosis. [Subjects and Methods] The survey was conducted among 4,782 students. The students performed Adam’s forward bend test, and some of the students who showed predictive features of scoliosis were further examined for the spine structure with rasterstereography. [Results] The proportion of students with awareness about scoliosis appeared to be 71.47%. Among the students, 50.84% knew the definition of scoliosis and 4.37% were diagnosed as having scoliosis, of whom 46.37% underwent treatment. It was a significant difference between to get a diagnosis and the predictive scoliosis or the scoliosis. [Conclusion] The results showed that the students in the second grade of middle school had high awareness levels, but about 50% of them did not know the definition of scoliosis. More than 50% of them did not receive treatment after diagnosed as having scoliosis. Therefore, active education and school screening for scoliosis should be provided to adolescent students.

Epidemiological study of adolescent idiopathic scoliosis in Eastern China.

Previous epidemiological studies of adole-scent idiopathic scoliosis in mainland China have had diverse results. The aim of this cross-sectional study was to determine the epidemiology of adolescent idiopathic scoliosis based on a representative sample city, Wuxi, in eastern China. Primary and secondary school students aged 10-16 years were enrolled in the study. Physical examination and Adam's forward bending test, combined with scoliometer measurements were performed at school-based screening. Students with an angle of trunk inclination of 5° or more were referred for whole-spine X-ray. The threshold for confirmed diagnosis was a Cobb angle of 10° or more. A total of 79,122 students were screened. The overall prevalence of adolescent idiopathic scoliosis in Wuxi City was estimated as 2.4%. Girls had a higher prevalence in each age subgroup compared with boys. Higher prevalence was found in individuals with lower body mass index. Mild and moderate curves were the most common types in our study. The prevalence of adolescent idiopathic scoliosis in this region was slightly higher. Medical resources should be considered for children with lower body mass index and high risk of scoliotic progression. Measurement with a scoliometer would be suitable for mild-to-moderate scoliotic deformities, while alternative methods should be developed for those with severe deformities or higher body mass index.

Differences in erect sitting and natural sitting spinal alignment—insights into a new paradigm and implications in deformity correction

Background ContextSitting spinal alignment is increasingly recognized as a factor influencing strategy for deformity correction. Considering that most individuals sit for longer hours in a “slumped” rather than in an erect posture, greater understanding of the natural sitting posture is warranted. PurposeThis study aimed to investigate the differences in sagittal spinal alignment between two common sitting postures: a natural, patient-preferred posture; and an erect, investigator-controlled posture that is commonly used in alignment studies. Design/SettingThis is a randomized, prospective study of 28 young, healthy patients seen in a tertiary hospital over a 6-month period. Patient SampleTwenty-eight patients (24 men, 4 women), with a mean age of 24 years (range 19–38), were recruited for this study. All patients with first episode of lower back pain of less than 3 months' duration were included. The exclusion criteria consisted of previous spinal surgery, radicular symptoms, red flag symptoms, previous spinal trauma, obvious spinal deformity on forward bending test, significant personal or family history of malignancy, and current pregnancy. Outcome MeasuresRadiographic measurements included sagittal vertical axis (SVA), lumbar lordosis (LL), thoracolumbar angle (TL), thoracic kyphosis (TK), and cervical lordosis (CL). Standard spinopelvic parameters (pelvic incidence, pelvic tilt [PT], and sacral slope) and sagittal apex and end vertebrae were also measured. MethodsBasic patient demographics (age, gender, ethnicity) were recorded. Lateral sitting whole spine radiographs were obtained using a slot scanner in the imposed erect and the natural sitting posture. Statistical analyses of the radiographical parameters were performed comparing the two sitting postures using chi-squared tests for categorical variables and paired t tests for continuous variables. ResultsThere was forward SVA shift between the two sitting postures by a mean of 2.9 cm (p<.001). There was a significant increase in CL by a mean of 11.62° (p<.001), and TL kyphosis by a mean of 11.48° (p<.001), as well as a loss of LL by a mean of 21.26° (p<.001). The mean PT increased by 17.68° (p<.001). The entire thoracic and lumbar spine has the tendency to form a single C-shaped curve with the apex moving to L1 (p=.002) vertebra in the majority of patients. ConclusionsIn a natural sitting posture, the lumbar spine becomes kyphotic and contributes to a single C-shaped sagittal profile comprising the thoracic and the lumbar spine. This is associated with an increase in CL and PT, as well as a constant SVA. These findings lend insight into the body's natural way of energy conservation using the posterior ligamentous tension band while achieving sitting spinal sagittal balance. It also provides information on one of the possible causes of proximal junctional kyphosis or proximal junctional failure.

Posture disorders and their causes in rural schools pupils

The aim of the research is to identify the particularities of pupils’ body posture in the rural schools of Šiauliai region. Particularities of pupils’ body posture were screened using Adams forward bend test. It was found out that faulty body posture (lesion of skeleton-muscle system and asymmetry of innervations) is common to the largest part of different age pupils in rural schools. Faulty body posture of asymmetry of innervations has a tendency to normalize during child’s development, and faulty body posture of lesion of skeleton-muscle system might change to serious pathology of bone system.

Effect of MELT method on thoracolumbar connective tissue: The full study

Altered connective tissue structure has been identified in adults with chronic low back pain (LBP). A self-care treatment for managing LBP is the MELT method. The MELT method is a hands-off, self-treatment that is said to alleviate chronic pain, release tension and restore mobility, utilizing specialized soft treatments balls, soft body roller and techniques mimicking manual therapy. The objective of this study was to determine whether thickness of thoracolumbar connective tissue and biomechanical and viscoelastic properties of myofascial tissue in the low back region change in subjects with chronic LBP as a result of MELT. This study was designed using a quasi experimental pre-post- design that analyzed data from subjects who performed MELT. Using ultrasound imaging and an algorithm developed in MATLAB, thickness of thoracolumbar connective tissue was analyzed in 22 subjects. A hand-held digital palpation device, called the MyotonPRO, was used to assess biomechanical properties such as stiffness, elasticity, tone and mechanical stress relaxation time of the thoracolumbar myofascial tissue. A forward bending test assessing flexibility and pain scale was added to see if MELT affected subjects with chronic LBP. A significant decrease in connective tissue thickness and pain was observed in participants. Significant increase in flexibility was also recorded.

How the spine differs in standing and in sitting—important considerations for correction of spinal deformity

Background ContextThe current prevailing school of thought in spinal deformity surgery is to restore sagittal balance with reference to the alignment of the spine when the patient is standing. This strategy, however, likely accounts for increased rates of proximal junctional failure. PurposeThe purpose of this study was to investigate the differences between the spine in standing and sitting positions as these may elucidate reasons for deformity correction failure. Study Design/SettingA prospective, comparative study of 58 healthy patients presenting to a tertiary hospital over a 6-month period was carried out. Patient SampleAll patients presenting with a less than 3-month history of first episode lower back pain were included. Patients who had radicular symptoms, red flag symptoms, previous spine surgery, or visible spinal deformity during forward bending test were excluded. Pregnant patients were also excluded. Outcome MeasuresRadiographic measurements including sagittal vertical axis (SVA), lumbar lordosis (LL), thoracolumbar angle (TL), thoracic kyphosis (TK), cervical lordosis (CL), pelvic incidence (PI), and pelvic tilt (PT) were collected. The sagittal apex and end vertebrae of all radiographs were also recorded. MethodsBasic demographic data (age, gender, and ethnicity) was recorded. Lateral standing and sitting radiographs were obtained using EOS technology. Statistical analysis was performed to compare standing and sitting parameters using chi-square tests for categorical variables and paired t tests for continuous variables. ResultsTaking the standing position as the reference point, forward displacement of the SVA occurred during sitting by a mean of 6.39±3.87 cm (p<.001). This was accompanied by a reduction of LL and TK by a mean of 24.63±12.70° (p<.001) and 8.56±7.21°(p<.001), respectively. The TL became more lordotic by a mean of 3.25±7.30° (p<.001). The CL only reached borderline significance (p=.047) for increased lordosis by a mean of 3.45±12.92°. The PT also increased by 50% (p<.001). Despite relatively constant end vertebrae, the apex vertebra moved inferiorly for the thoracic curve (p<.006) and superiorly for the lumbar curve (p<.001) by approximately one vertebral level each. ConclusionsSagittal spinal alignment changes significantly between standing and sitting positions. Understanding these differences is crucial to avoid overcorrection of LL, which may occur if deformity correction is based solely on the spine's standing sagittal profile.

Prevalence of Idiopathic Scoliosis in Chinese Schoolchildren: A Large, Population-Based Study.

This is a population-based, cross-sectional study of school scoliosis screening program in mainland China. The aim of this study was to assess current prevalence and distribution of idiopathic scoliosis (IS) in schoolchildren and to compare with the results of previous studies. The feasibility and predictive values of scoliosis screening programs for school-age children remains controversial and many of these programs have recently been discontinued in different countries. Due to different race and medical model in China, it is not feasible to introduce these data without further study. Therefore, a reliable retrospective cohort study with a large sample size to ensure proper evaluation of school scoliosis screening is needed. Schoolchildren were initially screened by visual inspection of clinical signs, the forward-bending test, and the measurement of the angle of trunk rotation (ATR). Students suspected were rescreened, and then were referred for radiography or dismissed. The diagnosis and treatment were based on the Cobb angle. The personal information, demographic information, and results of tests performed were recorded and analyzed. A total of 99,695 children were screened, with a female-to-male ratio of 1:1.03. Around 6.56% of children screened were referred for radiography, and 5125 of them had confirmed diagnosis. The overall scoliosis prevalence rate was 5.14%. According to age and gender, 14- to 15-year-old girls had the highest prevalence rates (13.81%). And, the prevalence of IS in need of treatment was 0.64%. A prevalence rate of 13.1% was observed in girls with BMI less than 18 kg/m². The prevalence rate of IS was 5.14% in our study. Screening of 13- to 14- and 14- to 15-year-old girls identified a significant number who could benefit from preventive treatment. Low BMI may be a risk factor for IS. We present this study as a guide for studying the prevalence of IS and modifying our further research. 3.

Prevalence and determinants of idiopathic scoliosis in primary school children in Beitang district, Wuxi, China.

To study the prevalence of idiopathic scoliosis in children aged 6-13 years and the corresponding predictors in China, based on a representative sample from Beitang District, Wuxi. A total of 11,024 primary school students aged 6-13 years were enrolled. Students who had an angle of trunk inclination (ATI) ≥ 5° (determined by the forward bending test (FBT) combined with a scoliometer) were referred to our clinic for X-ray examination. Their diagnosis was confirmed by Cobb angles of ≥ 10°. Data reflecting demographics (e.g. age, sex, etc.) and clinical characteristics (i.e. Cobb angle) were collected. Approximately 2.6% of the children were screened positive (determined by ATI). Four boys and 7 girls had a definite positive diagnosis, suggesting an idiopathic scoliosis prevalence of 0.22%. The mean Cobb angle of those diagnosed was 13.2 ± 5.9°. The highest prevalence was found in girls aged 12-13 years. Predictors identified in weighted and unweighted bivariate logistic regression were being female, use of single-shoulder bags, and more time using a computer. A relatively low overall prevalence of idiopathic scoliosis was found in primary school children of Beitang District, Wuxi, China. In future screening more attention should be paid to females, those who use single-shoulder bags, and those who spend more time using a computer.

Comparison of the body build and physical abilities of the students of sports classes and ordinary classes

The aim of the current study was to analyse and compare the peculiarities of physical abilities and body build of the students of the primary school classes (Year 1–4) of ordinary classes and sports classes at Tallinn Lillekula Secondary School. The sample consisted of 170 primary school students – 93 boys and 77 girls. It involved 56 boys and 29 girls in sports classes and 37 boys and 48 girls in ordinary classes. The body height and weight of all the students were measured and their BMI was calculated. All the students also performed four physical abilities tests, which were standing long jump test, forward bending test, 4 × 10m shuttle run test ja 3 minute endurance run test. The reliability and validity of these tests have been checked earlier. Arithmetic means and standard deviations were calculated. To find the differences between the groups and assess the results, Student’s paired t-test was used; the lowest level of significance was set at p<0.05. The study revealed that, comparing the test results of boys’ and girls’ physical abilities, differences appear with an increase in age. In most cases, boys of Year 4 outdo girls statistically significantly. Girls are better than boys only in flexibility. Physical abilities tests showed that in nine cases statistically significant differences in physical abilities appeared between the students of the ordinary class and the sports class. In eight cases, the mean result in physical abilities was better in the sports classes than in the ordinary classes. In their stature and physical abilities the students of primary school classes of Tallinn Lillekula Secondary School are similar to their peers Estonia.

Effect of symmetric mobilization exercises applied sagittale plane on spine flexibility and angle of trunk rotation in scoliosis

Thoracic and lumber flatback has been assumed to be the triggerring factor for idiopathic scoliosis. It is belived that rotation and lateral deviation are secondary patterns of deformity in the development of idiopathic scoliosis, and it should be possible to improve scoliosis by forces in sagittal plane. It is suggested that Physio-logic® exercises stabilize the spine posture and correct scoliosis in 3-D. The aim of this study was to assess the effect of symmetric mobilization exercise which was defined in Physio-logic®exercises on spine flexibility and angle of trunk rotation. Thirty four patients (30 female, 4 male) with adolescent idiopathic scoliosis (AIS) were included in this study. King classification was used to classify of scoliosis types. “Symmetric mobilization” exercise was done 20 repetitions, 15 sessions in supin position under physiotherapist supervision. Spine flexibility was evaluated with forward and lateral bending test and angle of trunk rotation was measured with scoliometer. Evaluations were performed before and after every session. The mean age of patients was 13.5years (range; 10-17). The mean Cobb angle was 31.64° (range; 12°- 60°) and angle of trunk rotation was 9.86° (range; 3°-16°). Statistically significant improvements were observed for all assessed measurements after the treatment (p<0.05). Our results showed that spine flexibility can be improved and angle of trunk rotation can be decreased by sagittal forces. Increasing of spine flexibility and decreasing angle of trunk rotation may prevent progression of scoliosis. We suggest that symmetric mobilisation exercises should take place in the rehabilitation programme of AIS.

To screen or not to screen for adolescent idiopathic scoliosis? A review of the literature

ObjectivesOver the years, there has been much debate about the desirability and efficacy of screening for adolescent idiopathic scoliosis. To analyse the current evidence from a public health point of view a renewed evaluation of the literature was performed. Study designLiterature review. MethodsWe performed two literature searches: from January 2000 to April 2015 for systematic reviews or guidelines on screening for adolescent idiopathic scoliosis and from January 2009 to April 2015 for all studies on adolescent idiopathic scoliosis and screening methods. We evaluated if screening for adolescent idiopathic scoliosis fulfils the criteria of the UK National Screenings Committee for appraising a screening programme. ResultsAdolescent idiopathic scoliosis is a condition with an unpredictable natural history. The optimal age and frequency of screening are unknown; it is not possible to predict which patients will need (conservative or surgical) treatment. The Forward Bending Test has a positive predictive value of 2.6% and a sensitivity of 56% (95% CI 23–88%) for (conservative or surgical) treatment, and is therefore not valid enough for use in a screening programme. There seems to be sufficient evidence that brace treatment is effective for preventing progression of adolescent idiopathic scoliosis. It is not clear if screening is cost effective. ConclusionsDespite evidence that brace treatment is effective for preventing progression of adolescent idiopathic scoliosis, the benefits from the screening programme do not outweigh the harms. From a Public Health point of view, there is not enough evidence to support a screening programme for adolescent idiopathic scoliosis.

Comparison of pulmonary function and back muscle strength according to the degree of spinal curvature of healthy adults.

[Purpose] Degree of curvature on the spine is known to affect respiratory function and back muscle activation. We compared pulmonary function and back muscle strength according to the degree of curvature of the spine of healthy adults. [Subjects and Methods] Twenty-three healthy volunteers were enrolled. They were divided into two groups according to the degree of curvature of the spine: the below 2° group, and the above 2° group. The degree of curvature was assessed using the Adams forward bending test and a scoliometer. A pulmonary function test (PFT) was conducted, and back muscle strength was measured. [Results] No significant differences in PFT were found between the below 2° group and the above 2° group, in terms of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), or peak expiratory flow (PEF). However, back muscle strength in the below 2 group was significantly higher than that of the above 2 group. [Conclusion] Our findings indicate that the degree of curvature of the spine is associated with back muscle strength in subjects who have spinal curvature within the normal range. Therefore, evaluation and treatment of back muscle strength might be helpful for preventing the progress of curvature of the spine in adolescents with potential scoliosis.

The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.

[Purpose] This study aimed to provide a predictable evaluation method for the progression of scoliosis in adolescents based on quick and reliable measurements using the naked eye, such as the calcaneal valgus angle of the foot, which can be performed at public facilities such as schools. [Subjects and Methods] Idiopathic scoliosis patients with a Cobb’s angle of 10° or more (96 females, 22 males) were included in this study. To identify relationships between factors, Pearson’s product-moment correlation coefficient was computed. The degree of scoliosis was set as a dependent variable to predict thoracic and lumbar scoliosis using ankle angle and physique factors. Height, weight, and left and right calcaneal valgus angles were set as independent variables; thereafter, multiple regression analysis was performed. This study extracted variables at a significance level (α) of 0.05 by applying a stepwise method, and calculated a regression equation. [Results] Negative correlation (R=−0.266) was shown between lumbar lordosis and asymmetrical lumbar rotation angles. A correlation (R=0.281) was also demonstrated between left calcaneal valgus angles and asymmetrical thoracic rotation angles. [Conclusion] Prediction of scoliosis progress was revealed to be possible through ocular inspection of the calcaneus and Adams forward bending test and the use of a scoliometer.

Scoliosis epidemiology is not the same all over the world: a study from a scoliosis school screening in the island of Chongming, China

Methods A total of 6824 children (3477 boys and 3347girls) aged from 6 to 17 years old recruited from 352 classes of primary schools, and junior and senior high schools were screened for scoliosis. 442 children showed physical signs of potential scoliosis (Angle of Trunk Rotation at Adam’s forward bending test of five degrees or more) and were referred for posteroanterior radiographic evaluation. Radiographic evaluation included the Cobb angle, curve type, and curve side of scoliosis. The differences in the prevalence rate, the distribution of curve parameters and the variables of age and gender were analyzed by SPSS.

AUTOMATIC DETECTION OF SPINAL DEFORMITY BASED ON STATISTICAL FEATURES FROM THE MOIRE TOPOGRAPHIC IMAGES

Spinal deformity is one of a disease mainly suffered by teenagers during their growth stage particularly from element school to middle school. There are many different causes of abnormal spinal curves, but all of them are unknown. To find the spinal deformity in early stage, orthopedists have traditionally performed on children a painless examination called a forward bending test in mass screening of school. But this test is neither objective nor reproductive, and the inspection takes much time when applied to medical examination in schools. To solve this problem, a moire method has been proposed which takes moire topographic images of human backs and checks symmetry/asymmetry of their moire patterns. In this paper, we propose a method for automatic judgment of spinal deformity which is obtained moire topographic images based on statistical features on the moire image. Statistical feature of asymmetry degrees are applied to train employing the classifier such as Artificial Neural Network, Support Vector Machine, Self-Organization Map and AdaBoost.

181 Spinal deformities (SD) in young CF patients: two years experience of screening and follow up

Background: Increased survival in CF patients (pts) requires assessment of extrapulmonary morbidities, as SD. Scoliosis (S) is more frequent in CF than in general population; it causes functional spinal disorders and restrictive pulmonary disease and may be influenced by CF musculoskeletal involvement. Aims: To describe: • SD distribution in a group of CF pts • SD and clinical status relationship • 2 years follow up in a subgroup Methods: Respiratory therapist measured the angle of trunk rotation (ATR) with scoliometer in the Adams forward bending test position in CF pts, 6−19 years old (yrs). Results: 58 pts (M 46.55%, aged 12.45±3.61 yrs, median %ile for weight 39.22 and for height 49.12, mean FEV1 91.79±16.94%pred) were enrolled. No difference at baseline existed between males and females. Pts were divided in: (1) Negative group (N): ATR 0−4o (n = 48); (2) Positive group (P): ATR 5o (n = 10). Pts in P were older (p = 0.001); N had greater FVC%pred (p = 0.008). 6 thoracic (60%), 3 lumbar (30%) and 1 thoracolumbar (10%) curves (70% with right convexity) were found. Specialized physician prescribed 10 spine x-ray diagnosing S (>10o Cobb) in 3 pts (5.17%) with indication of brace. ATR correlated with height %ile (r = 0.7; p = 0.02) in P; no relationship with lung function was found. 36 pts were reassessed 2 years after the 1st evaluation. ATR was the same in 52.78% of pts, while it increased in 25%. Changes in ATR didn’t correlate with respiratory and nutritional status. Conclusion: Our data justify SD early screening and at least yearly reassessment because of their possible progression and lack of correlation with clinical data. A study to assess S and back pain prevalence in adult CF pts is ongoing. 183 Mycobacterium abscessus: stand alone hospital admission for agressive physiotherapy and nutritional review can extend periods between toxic IV antibiotic treatments J. Tame1, A. Turnbull1, J. Forton1,2. 1Noah’s Ark Children’s Hospital for Wales, University Hospital of Wales, Department of Paediatric Respiratory Medicine, Cardiff, United Kingdom; 2Cardiff University, Department of Child Health, Cardiff, United Kingdom