Scoliosis and Postural Deformity Evaluation in Famagusta Region Secondary Schools
Condition: Scoliosis Idiopathic Adolescent
MeSH terms: Scoliosis
Study type: Observational

Summary: 
      The aim of the study is to evaluate scoliosis and postural deformities in secondary school
      students in Famagusta region. Secondary school students who meet the inclusion criteria will
      be included in the study, which will be conducted in the form of screening in public and
      private schools in the Famagusta region of the Turkish Republic of Northern Cyprus.
      Sociodemographic information of the individuals will be obtained first. Then, Adam's forward
      bending test, trunk rotation angle with scoliometer, foot posture index and New York posture
      index will be evaluated. Evaluations will be made within a single day.
    

Detailed description: 
      The term scoliosis originates from the ancient Greek word "scolios" (curvature) and was first
      used by Galen around AD 130-201. Scoliosis is a common three-dimensional deformity that
      causes severe postural impairment in advanced stages. It is generally defined as a curvature
      of the spine towards lateral flexion in the frontal plane and towards rotation in the
      transverse plane. Scoliosis is divided into idiopathic and non-idiopathic. Although the
      etiology of idiopathic scoliosis is not known exactly, it is thought that secondary causes
      such as genetic, hormonal and biomechanical factors and neuromuscular problems contribute to
      the development of scoliosis. Scoliosis; It is divided into different classes according to
      the age of onset, etiology, type and severity of the curvature. The most common type of
      scoliosis in the community is Adolescent Idiopathic Scoliosis (AIS). The Scoliosis Research
      Society defines adolescent idiopathic scoliosis (AIS) as a curve of Cobb angle ≥10°.

      The incidence of adolescent idiopathic scoliosis (AIS) in healthy children is 2 - 4%. In
      Turkey, the prevalence of AIS has been reported as 2.3% in children aged 10-15 years. AIS
      begins in early puberty. The prevalence and severity of curvature are higher in girls than
      boys. While the prevalence of AIS aged 10-15 years in Turkey is 3.07% in girls, it is 1.49%
      in boys. Likewise, women are 8 times more prone to development of prognosis in curvature than
      men.

      School screenings in scoliosis are very important in terms of early diagnosis, prevention or
      protection of deformity progression without surgical intervention. Scoliosis Research Society
      states that it is appropriate to perform annual routine screenings at the age of 10-14 years.
      Studies have been carried out in terms of early diagnosis of scoliosis worldwide and the
      importance of school screening as an early diagnosis method has been emphasized. According to
      recent literature studies, the prevalence of Adolescent Idiopathic Scoliosis (AIS) in school
      surveys has been shown within wide limits such as 0.47%-5.2%.

      The aim of this study is that many school screening studies for scoliosis have been conducted
      in the literature both in the world and in Turkey, but there is no scoliosis and postural
      disorder screening data in TRNC. It is aimed to create an epidemiological database by
      calculating the prevalence of scoliosis in the 10-15 age group in secondary schools in the
      Famagusta region of the Turkish Republic of Northern Cyprus, as well as to evaluate postural
      deformities. It is expected that the data obtained will increase awareness about the
      incidence of scoliosis and contribute to the early diagnosis and treatment of curvature.
      Thus, in the long term, the development of severe spinal deformities and the medical problems
      caused by these deformities will be prevented.

      Research Questions:

      Research question 1: What is the incidence of scoliosis in secondary school students in
      Famagusta? Research question 2. What is the incidence of postural deformity in secondary
      school students in Famagusta?

      Material and Method:

      Secondary school students who meet the inclusion criteria will be included in the study,
      which will be conducted in the form of screening in public and private schools in the
      Famagusta region of the Turkish Republic of Northern Cyprus. Sociodemographic information of
      the individuals will be obtained first. Then, Adam's forward bending test, trunk rotation
      angle with scoliometer, foot posture index and New York posture index will be evaluated.
      Evaluations will be made within a single day. The sample size of the study was calculated
      using Epi InfoTM version 7. The initial sample size was calculated as 386 people in order to
      make an estimation in the 95% confidence interval under the assumptions that the population
      size of the study would be 2500, the expected prevalence rate would be 5%, the margin of
      error +/- 2%, and the pattern effect would be 1. Considering that there may be those who did
      not accept to participate in the study, this sample size was increased by 20% and the final
      sample size was calculated as 463 people.

      Evaluations to be applied to the Subject:

      Socio-demographic Form: In the first evaluation, socio-demographic informationof subjects
      such as age, height, body weight will be obtained through a form.

      Adam's Forward Bend Test: This test is also known as the forward bend test. The test will be
      applied in a way that the boys are completely naked on the top and the girls are only
      athletes. With the shoes taken off, the feet together and the knee extended, the children
      will be asked to bend forward with their hips at a 90 degree angle, the arms will swing down
      freely and the palms will be facing each other. In case of scoliosis, it will be checked
      whether there is a rotational protrusion or asymmetry in the back as a result of the
      deformity of the spine in the ribs.

      Body Rotation Angle Assessment: The person measuring with the scoliometer should sit in a
      chair behind the person to be evaluated. The person to be examined should keep his arms at
      head level and lean forward until the shoulders and hips are at the same level, and in this
      position, deviations in the scoliometer will be checked in the thoracic (T7 level),
      thoracolumbar (T12 level) and lumbar (L3 level) regions. Studies have shown that 7° deviation
      in the scoliometer corresponds to approximately 20° in the scoliosis Cobb angle of the spine.
      In the evaluations, students with scoliometer measurements of 7° and above will be informed
      about the suspicion of scoliosis and directed to the physician.

      New York Posture Assessment Scale: In this evaluation system, postural changes that may occur
      in 13 different parts of the body are scored observationally.

      Evaluation of Foot Postures: Foot posture will be assessed by the Foot PostureIndex (FPI).
    

Observational model: Other
Time perspective: Other
Sampling method: Probability Sample
Study population: 
        Students between the ages of 10-15 studying at secondary schools in the Famagusta region
        will be included in the study.
      
Keywords: Scoliosis Idiopathic Adolescent; School screening; Prevalence; Scoliometer; Adams test