Document Type : systematic review
Authors
- Negar Taleschian-Tabrizi 1
- Farbod Alinezhad 2
- Mohammad Zakaria Pezeshki 3
- Saeed Dastgiri 4
- Bina Eftekharsadat 5
- Neda Dolatkhah 6
1 Social Determinants of Health Research Center, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Bouvé College of Health Sciences; College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
3 Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
4 Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Faculty of Medicine, Tabriz, Iran
5 Physical Medicine and Rehabilitation Research Center, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
6 Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
Abstract
Background: Postural disorders and spinal deformities are one of the common conditions in children and adolescents. The aim of this systematic review and meta-analysis was to study the prevalence of spinal deformities among school age children in Iran.
Methods: The search strategy was developed using keywords relating to kyphosis, lordosis, scoliosis, child and Iran in the databases of Medline, Scopus, CINAHL, Psycinfo as well as Persian local databases up to January 2020. Articles were appraised by two reviewers using the checklist of Joanna Briggs Institute (JBI) and data was extracted in the designed tables and analyzed using R software with a random effects model. The heterogeneity and dispersion of data was presented in Forest plots.
Results: Eighteen studies were included in the meta-analysis. The total population included 84195 students consisting of 39202 boys and 45947 girls. The mean age of the participants was 12.71±1.18 years. The total prevalence of kyphosis was 13.06% [95% CI 0.07; 0.22], the total prevalence of scoliosis was 2.61% [95% CI 0.014; 0.045] and the total prevalence of lordosis was 32.59% [95% CI 0.23; 0.43]. The prevalence of deformities was higher in girls. Kyphosis and scoliosis was more frequent in elementary school children but lordosis was more frequent in middle school students. Confirmation of diagnosis with radiology as well as clinical examination yielded a lower prevalence compared to diagnosis only made by clinical examination.
Conclusion: The prevalence of spinal deformities in school age children in Iran is on the average level compared to the other countries and lordosis is more common in girls. Designing further studies to evaluate etiology and risk factors of this condition is recommended
Keywords
- Kim K, Kim YH. Role of trunk muscles in generating follower load in the lumbar spine of neutral standing posture. Journal of biomechanical engineering. 2008; 130(4):041005.
- Bogdanović Z, Marković Ž. Presence of lordotic poor posture resulted from absence of sport in primary school children. Acta Kinesiologica. 2010; 4(1):63-6.
- Mitova S, Popova D, Gramatikova M. Postural disorders and spinal deformities in children at primary school age. System for screening, examination, prevention and treatment. Activities in physical education and sport, 4 (2). 2014:172-7.
- Kratěnová J, ŽEjglicová K, Malý M, Filipová V. Prevalence and risk factors of poor posture in school children in the Czech Republic. Journal of School Health. 2007; 77(3):131-7.
- Mitova S. Frequency and prevalence of postural disorders and spinal deformities in children of primary school age. Research in Kinesiology. 2015; 43(1):21-4.
- Wiggins GC, Shaffrey CI, Abel MF, Menezes AH. Pediatric spinal deformities. Neurosurgical focus. 2003; 14(1):e3.
- Wu G, Siegler S, Allard P, Kirtley C, Leardini A, Rosenbaum D, Whittle M, D'Lima DD, Cristofolini L, Witte H, Schmid O, Stokes I, Standardization and Terminology Committee of the International Society of Biomechanics. ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion—part I: ankle, hip, and spine. Journal of biomechanics. 2002; 35(4):543-8.
- Rusnák R, Kolarová M, Aštaryová I, Kutiš P. Screening and early identification of spinal deformities and posture in 311 children: results from 16 districts in Slovakia. Rehabilitation Research and Practice. 2019; 2019.
- Institute JB. JBI critical appraisal checklist for studies reporting prevalence data. Adelaide: University of Adelaide. 2017.
- Moezzi A, Jalaei S, Vasaghi B. Prevalence of kyphosis and scoliosis among girl middle school students of Tehran city and evaluation of the effect of exercise activities and sitting positions on their incidence. Journal of the Medical Council of Iran. 2014; 32(4):310-9.
- Conti PBM, Sakano E, Ribeiro MÂGdO, Schivinski CIS, Ribeiro JD. Assessment of the body posture of mouth-breathing children and adolescents. Jornal de Pediatria. 2011; 87:357-63.
- McRoberts LB, Cloud RM, Black CM. Evaluation of the New York Posture Rating Chart for assessing changes in postural alignment in a garment study. Clothing and Textiles Research Journal. 2013; 31(2):81-96.
- Zakeri Y, Baraz S, Gheibizadeh M, Bijan Nejad D, Latifi SM. Prevalence of musculoskeletal disorders in primary school students in Abadan-Iran in 2014. International Journal of Pediatrics. 2016; 4(1):1215-23.
- Rajabi R, Seidi F, Mohamadi F. Which Method Is Accurate When Using the Flexible Ruler to Measure the Lumbar Curvature Angle? Deep Point or midPoint of Arch? World Appl Sci J. 2007; 4.
- Mendoza-Lattes S, Ries Z, Gao Y, Weinstein SL. Proximal junctional kyphosis in adult reconstructive spine surgery results from incomplete restoration of the lumbar lordosis relative to the magnitude of the thoracic kyphosis. The Iowa orthopedic journal. 2011; 31:199-206.
- Horne JP, Flannery R, Usman S. Adolescent idiopathic scoliosis: diagnosis and management. American family physician. 2014; 89(3):193-8.
- Phillips WA. Scoliosis Management for Primary Care Practitioners. Pediatrics in Review. 2021; 42(9):475-85.
- Moalej S, Asadabadi M, Hashemi R, Khedmat L, Tavakolizadeh R, Vahabi Z, Shariatpanahi G. screening of scoliosis in school children in Tehran: the prevalence rate of idiopathic scoliosis. Journal of Back and Musculoskeletal Rehabilitation. 2018; 31(4):767-74.
- Franko OI, Bray C, Newton PO. Validation of a scoliometer smartphone app to assess scoliosis. Journal of Pediatric Orthopaedics. 2012; 32(8):e72-e5.
- Furlanetto TS, Candotti CT, Comerlato T, Loss JF. Validating a postural evaluation method developed using a Digital Image-based Postural Assessment (DIPA) software. Computer methods and programs in biomedicine. 2012; 108(1):203-12.
- Ferreira EAG, Duarte M, Maldonado EP, Burke TN, Marques AP. Postural assessment software (PAS/SAPO): validation and reliability. Clinics. 2010; 65(7):675-81.
- Lasjouri G, Mirzaei B. The Prevalence of Postural Deformities in Pupils Aged 11-13 and Their Relationship with Age, Height and Weight Factors. Research on Sport Science. 2005; 3(6).
- Frontera WR, DeLisa JA, Gans BM, Robinson LR. DeLisa's physical medicine and rehabilitation: principles and practice: Lippincott Williams & Wilkins; 2019.
- Ochsmann EB, Pinzón CLE, Letzel S, Kraus T, Michaelis M, Muenster E. Prevalence of diagnosis and direct treatment costs of back disorders in 644,773 children and youths in Germany. BMC musculoskeletal disorders. 2010; 11(1):193.
- Bueno RdCdS, Rech RR. Postural deviations of students in Southern Brazil. Rev paul pediatr. 2013; 31(2):237-42.
- Daneshmandi H, Pourhosseini H, Sardar M. Comparison of spinal deformities between male and female students. Harekat. 2006,-(23):143-56.
- Mirzatolouei F, Aghazadeh J, Pourheidari B. Prevalence of scoliosis among 11-14 year old middle school students of Urmia. Medical journal of Tabriz University of medical sciences. 2004; 37(57):-.
- Karimian A, Rahmani N, Mohseni-Bandpei MA, Bassampour SA, Kiani A. Prevalence of Scoliosis and Associated Risk Factors in Children and Adolescents: A Systematic Review. Journal of Mazandaran University of Medical Sciences. 2015; 25(130):191-9.
- Zhang H, Guo C, Tang M, Liu S, Li J, Guo Q, et al. Prevalence of scoliosis among primary and middle school students in Mainland China: a systematic review and meta-analysis. Spine. 2015; 40(1):41-9.
- Suh S-W, Modi HN, Yang J-H, Hong J-Y. Idiopathic scoliosis in Korean schoolchildren: a prospective screening study of over 1 million children. European spine journal. 2011; 20(7):1087-94.
- Fathi M, Rezaei R. Evaluation and Comparison of postural anomalies in middle school and high school students. Tarbiyatbadani Roshdmag. 2011; 36(1):46-53.
- Rezaei S, Heidarian N, Saeb M, Gharagozlo F. Prevalence of Scoliosis in Secondary School Children in Kermanshah. Journal of Kermanshah University of Medical sciences. 2007; 11(1):32-43.
- Torkaman A. Prevalence of scoliosis in middle school students of Sanandaj. The Scientific Journal of Kurdistan University of Medical Sciences. 2003; 6(3):20-3.
- Homayouni K, Alavian M. The Relative Frequency of Idiopathic Scoliosis Among 14-16 Year-old Female Students in Shiraz (2000-2001). Journal of Medical Research. 2004; 2(1):13-8.
- Arti H, Abrishamkar S, Tavakoli A, Javdan M, Ganji F. Evaluation of scoliosis screening results in 10-14 year old students of shahrekord schools, 2003. Shahrekord University of Medical Sciences Journal. 2005; 7(3).
- Safikhani Z, Fakour M, Astaneh Me, Hejazian L. Determining types of scoliosis according to anatomy of apex of curvature in puberty ages 11-15 years in middle schools of Ahvaz. Yafteh Quarterly research journal. 2006; 8(2):3-6.
- Ghorbani L, Daneshjoo AH, Nazarian A, Domieh AM. Assessment of the prevalence of kyphosis disorders in students. British Journal of Sports Medicine. 2010; 44(Suppl 1):i13-i.
- Behruzi A, Hadi H, Ghandi A, Esmaili A. The prevalence of scoliosis in pupils aged 9-16 in Arak: 2011-2012. J of Arak Med Univ. 2013; 16(70):10-5.
- Siavashi B, Mansori M, Saki M, Heidari M. Investigation on the Prevalence of Scoliosis among Ten Years Old Female Students of Khorramabad Schools in 2004-2005. Iranian journal of surgery. 2008; 15(4).
- Eivazi Gh M, Alilou A, Ghafurinia S, Fereydounnia S. Prevalence of faulty posture in children and youth from a rural region in Iran. Biomedical Human Kinetics. 2012; 4(2012):121-6.
- Karimian R, Karimian M, Hadipour M, Heyat F, Janbozorgi A. The Prevalence of Children’s Postural Abnormalities and Its Association with Sport Activity. Journal of Fasa University of Medical Sciences. 2016; 6(1):106-12.
- Eslami S, Hemati J, editors. Prevalence lordosis and dorsal kyphosis deformity among girls 23- 11 years and its relationship to selected physical factors2013.
43. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine. 2009; 151(4):264-9.