POSTURAL VALUATION IN CHILDREN AND ADOLESCENTS: POSTURE CLASSIFICATION

Giovanni Barassi, Maurizio Panunzio, Piero Galasso, Antonio Moccia, Antonio Colombo, Barbara Praitano, Marco Licameli, Giorgia Di Bussolo, Luciano D'Ambrosio, Roberta Maurelli, Giovanna Sticca
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Abstract

IntroductionAs well known, to this day, the figure of school doctor is absent and much less physical activity is carried out in primary schools. For this reason, the Italian National Fair Play Committee, a meritorious association legally recognized, founded in 1994, in full synergy with Sport and Health, with CONI, Federations and Sports Promotion Bodies, aware of its vocational role, since 2010 had proceeded to establish "Medici Fair Play", as a not just conceptual defense, to integrate the precious action carried out by sports medicine with the verification of suitability for the practice. Aim of the studyThrough a screening project focused on postural problems, named "IOCHIRON, POSTURE IS HEALTH", we prepared a real cornerstone for health prevention and for charitable and useful purposes for the Higher Institute of Health. The initiative provides for a national screening activity in the three-year period 2022-2024, through an assessment with non-invasive tests, to study the structural level posture of over 7 million children and adolescents. This educational path aims to prevent wrong postures in children and adolescents, between 6 and 15 years of age, who are at the peak of growth, with a huge benefit on possible pathologies that could be found when adult, thus saving high costs to the SSN (or NHS).MethodsThe presented observational study represents the first experience carried out by the CeFiRR Structure (Center for Physiotherapy, Rehabilitation and Rehabilitation) at Gemelli Molise S.p.A. 120 school-age subjects were evaluated through a BioPostural questionnaire and an observational form which provided for the evaluation of the asymmetries of: shoulders, scapula, pelvis, knees, hindfoot, trunk rotation (through a scoliosometer), posterior overhang (through the plumb line) and the plantar vault (through static barodopometry).The outcome measures were calculated on the basis of the number of "YES" responses of the BioPostural questionnaire, and on the basis of the number of "YES" evaluations of the observational form.From the interdisciplinary communication and the interpretation of the outcome measures, Posture was classified the in: Asymmetrical, Dysfunctional and Pathological.ResultsThe 42% of the examined subjects presented a shoulder asymmetry (bisacromial line) and a pelvis asymmetry (bisiliac line); the 33% presented a scapulae asymmetry (lower angle of the scapula); and the 9% of the examined subjects presented a flattening of the plantar vault.The BioPostural Questionnaire reflected what was subsequently observed with the observational form and in particular for the number of affirmative answers recorded, it did not suggest further insights into any subject through a Digitalized Biometric analysis, but it highlighted an important number of subjects in the sample who reported: low back pain (85), neck-pain while studying or reading (68). Conclusions The retrospective observational study showed the possibility of observing the adolescent subject in a very short time and with inexpensive instruments (e.g. plumb bob, Bunner's scoliometer, and stabulometric platform) with the collaboration of various health professionals.This experience allowed us to create a classification, in three degrees, of posture which encloses the objective and subjective characteristics of the subject evaluated for a better interpretation of the data, at a territorial and multi-specialist level.The points of weaknesses of the study are represented by the exiguity of the sample examined, and by the difficulty in exposing and finalizing the data collected at a multidisciplinary level, in a field that is still not so much known.For future experiences, it would be necessary to increase the number of subjects examined and standardize the finalization of the data so that they can be ready for use and vision by a greater number of health professionals and medical specialists
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儿童和青少年的姿势评价:姿势分类
众所周知,到目前为止,学校医生的身影已经缺失,小学的体育活动也少得多。因此,1994年成立的意大利国家公平竞赛委员会是一个得到法律承认的有价值的协会,它与体育和卫生、意大利奥委会、联合会和体育促进机构充分协同作用,意识到其职业作用,自2010年以来开始建立"美第奇公平竞赛",不仅作为概念上的辩护,而且将运动医学开展的宝贵行动与实践适用性的验证结合起来。研究目的通过一项名为“IOCHIRON,姿势就是健康”的以姿势问题为重点的筛查项目,我们为高等卫生研究所的健康预防、慈善和实用目的奠定了真正的基础。该倡议规定在2022-2024年三年期间开展全国筛查活动,通过非侵入性测试进行评估,研究700多万儿童和青少年的结构水平姿势。这种教育方式的目的是防止6至15岁的儿童和青少年的错误姿势,他们正处于生长的高峰期,对成年后可能发现的疾病有巨大的好处,从而节省了SSN(或NHS)的高额费用。本观察性研究代表了Gemelli Molise S.p.A的CeFiRR结构(物理治疗、康复和康复中心)开展的第一次经验。120名学龄受试者通过生物结构问卷和观察表格进行评估,该表格提供了以下方面的不对称性评估:肩膀,肩胛骨,骨盆,膝盖,后脚,躯干旋转(通过脊柱侧弯计),后悬垂(通过铅垂线)和足底拱顶(通过静态气压计)。结果测量是根据BioPostural问卷的“YES”回答数和观察表的“YES”评价数来计算的。从跨学科的交流和对结果测量的解释来看,姿势分为不对称、功能失调和病态。结果42%的受试者出现肩部不对称(双肩线)和骨盆不对称(双髂骨线);33%表现为肩胛骨不对称(肩胛骨下角);9%的受试者表现为足底弓变平。生物形态问卷反映了随后通过观察形式观察到的情况,特别是记录的肯定答案的数量,它没有通过数字化生物特征分析对任何主题提出进一步的见解,但它突出了样本中报告的重要数量的主题:腰痛(85),学习或阅读时颈部疼痛(68)。结论回顾性观察研究表明,在各种卫生专业人员的合作下,可以在很短的时间内使用便宜的仪器(如铅锤、Bunner's脊柱侧弯仪和稳定测量平台)对青少年受试者进行观察。这一经验使我们能够在地域和多专家水平上创建一个三度的姿势分类,该分类包含了被评估对象的客观和主观特征,以便更好地解释数据。该研究的弱点体现在样本检验的紧迫性,以及在多学科水平上暴露和最终确定收集的数据的困难,在一个仍然不太为人所知的领域。为了今后的经验,有必要增加审查的主题数量,并使数据的最后定稿标准化,以便可供更多的保健专业人员和医学专家使用和查阅
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