Association Between Incorrect Posture and Adolescent Idiopathic Scoliosis Among Chinese Adolescents: Findings From a Large-Scale Population-Based Study

Abstract

Objectives: Adolescent idiopathic scoliosis (AIS) affects between 1 and 4% of adolescents, and severe curvature may be related to their adverse long-term outcomes. However, whether the change in body appearance is related to AIS remains largely unclear. We aimed to explore the association between incorrect posture and AIS among Chinese adolescents. Methods: Data were collected from a population-based (595,057) school scoliosis screening program in China. A sample of 3,871 adolescents was classified as cases with a diagnosed radiological lateral Cobb angle ≥10 • , and 3,987 control subjects with a Cobb angle <10 • were randomly selected from the screening system. Adolescents were accessed with demographic information and incorrect posture measured by visual inspection of physical signs, Adam's forward bending test (FBT), and the angle of trunk rotation (ATR). Logistic regression (LR) models were used to examine the associations. Results: Multivariate LR showed that shoulder-height difference, scapula tilt, lumbar concave, and pelvic tilt were associated with AIS. Adolescents with angle of thoracic rotation ≥5 • [adjusted odds ratio (AOR) = 5.33-14.67, P < 0.001], thoracolumbar rotation ≥5 • (AOR = 4.61-5.79, P < 0.001), or lumbar rotation ≥5 • (AOR = 7.49-7.85, P < 0.001) were at especially higher risk for AIS than those with ATR <5 •. Conclusions: Incorrect posture may be the potential risk factor for developing AIS, and ATR ≥5 • was an important indicator for predicting the occurrence of scoliosis. Early monitoring of incorrect posture for school adolescents should be considered as a routine intervention to effectively identify the progress of scoliosis.

Increased Computer Use is Associated with Trunk Asymmetry That Negatively Impacts Health-Related Quality of Life in Early Adolescents

“…The findings are in line with previous research that investigated the negative associations between posture abnormalities, musculoskeletal symptoms and disorders, [11][12][13][14] and a range of physical health problems and psychosocial difficulties that are commonly reported among children and adolescents with posture abnormalities. 5,7,[23][24][25]27 Given that the average daily duration of computer use was significantly longer for early adolescents with trunk asymmetry than for those without trunk asymmetry, it could be argued that the differences in the health-related quality of life may be due to the difference in the daily duration of computer use between these two groups. To rule out this possibility, another study was carried out to explore the influence of computer use on the health-related quality of life in early adolescents.…”

“…3,4 However, early adolescents who are undergoing a period of dynamic development and pubertal growth spurts are highly prone to incorrect or poor posture, 5 which means that the body is not in an upright position such that musculoskeletal balance and normal morphological functions cannot be maintained. [6][7][8] In fact, previous studies have shown that incorrect or poor posture is more common among early adolescents than among children, and this trend has been growing over the past decades. For instance, in 2003 in Czech Republic, the prevalence of poor posture was significantly higher, at 40.6%, in 1190 early adolescents aged 11 years, compared with 33% in 1097 children aged 7 years.…”

“…In view of the rising popularity of computers and smartphones in this population, it is worthwhile to explore whether prolonged use of computers and smartphones contributes to the increasing prevalence of posture abnormalities among early adolescents. Indeed, postural problem is a potential risk factor for developing musculoskeletal disorders, such as scoliosis, during adolescence, 7,23,24 and adolescents with scoliosis, compared to those without it, tend to experience more physical health problems, higher levels of pain, poorer psychosocial functioning, lower selfimage and poorer quality of life. [25][26][27] Therefore, given these significant effects of postural abnormalities on various health-related aspects, we aimed to explore the influence of postural abnormalities on the health-related quality of life in early adolescents.…”

Association of Trunk Muscle Strength and Scoliosis among Korean Children

“…Radiologically, scoliosis refers to a form of spinal deformity with a Cobb's angle of at least 10° ( 1 ). Particularly, idiopathic scoliosis is one of the most common spinal diseases in children and is highly prevalent.…”

Validation of Scolioscan Air-Portable Radiation-Free Three-Dimensional Ultrasound Imaging Assessment System for Scoliosis

“…It also reported that only 17% of diagnosed patients with AIS have curve progression that require medical intervention [ 14 ]. To find out those progressed cases for applying medical treatment, frequent monitoring for detecting spine curvature progression is needed for AIS patients until skeletal maturity [ 15 , 16 ].…”