Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, UK.
Nuffield Department of Orthopaedics, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
Int J Epidemiol. 2019 Aug 1;48(4):1152-1160. doi: 10.1093/ije/dyy268.
Little is understood about the causes of adolescent onset idiopathic scoliosis (AIS). No prospective studies assessing the association between physical activity and idiopathic adolescent scoliosis have been carried out. We aimed to carry out the first prospective population-based study of this association.
The Avon Longitudinal Study of Parents and Children (ALSPAC) collected self-reported measures of physical ability/activity at ages 18 months and 10 years. Objective measures of physical activity were collected by accelerometry at age 11 years. scoliosis was identified using the dxa scoliosis Method at age 15 years. Participants with scoliosis at age 10 years were excluded.
Of 4640 participants at age 15 years who had DXA scans, 267 (5.8%) had scoliosis. At age 18 months, those infants who were able to stand up without being supported were 66% less likely to have developed scoliosis by age 15 (P = 0.030) compared with infants who could not. Those children whose mothers reported they did most vigorous physical activity at age 10 years were 53% less likely to develop scoliosis (P = 0.027). Those children who did more objectively measured moderate/vigorous physical activity at age 11 were 30% less likely to have developed scoliosis (P < 0.001). Results were not affected by adjustment for age, gender, lean mass, fat mass or back pain.
We report reduced physical ability and activity as early as age 18 months in those who go on to develop scoliosis by age 15 years. Further research is justified to examine the mechanisms underlying this association.
青少年特发性脊柱侧凸（AIS）的病因知之甚少。尚未开展评估体力活动与特发性青少年脊柱侧凸之间关系的前瞻性研究。我们旨在进行这项关联的首次前瞻性基于人群的研究。
阿冯纵向研究父母和孩子（ALSPAC）在 18 个月和 10 岁时收集了体力/活动能力的自我报告测量值。在 11 岁时通过加速度计收集了体力活动的客观测量值。在 15 岁时使用 DXA 脊柱侧弯法确定脊柱侧弯。10 岁时患有脊柱侧弯的参与者被排除在外。
在 15 岁时有 DXA 扫描的 4640 名参与者中，有 267 名（5.8%）患有脊柱侧弯。在 18 个月时，那些无需支撑就能站立的婴儿在 15 岁时发生脊柱侧弯的可能性降低了 66%（P=0.030），而那些不能站立的婴儿则降低了 66%。那些母亲报告在 10 岁时进行最多剧烈体育活动的孩子发生脊柱侧弯的可能性降低了 53%（P=0.027）。那些在 11 岁时进行更多客观测量的中度/剧烈体育活动的孩子发生脊柱侧弯的可能性降低了 30%（P<0.001）。结果不受年龄、性别、瘦体重、体脂量或背痛调整的影响。
我们报告说，在 15 岁时患有脊柱侧弯的人群中，早在 18 个月时就表现出较低的身体能力和活动水平。有理由进一步研究该关联的潜在机制。
