Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Health Care Centre for Primary and Secondary Schools of Zhongshan Municipality, Zhongshan, China.
J Orthop Surg Res. 2022 Oct 29;17(1):472. doi: 10.1186/s13018-022-03366-0.
Adolescent idiopathic scoliosis (AIS) is the most prevalent type of scoliosis affecting children between the ages of 10-16 years. However, risk factors for AIS, particularly the modifiable ones, are still largely unknown. This study aims to investigate the associations of lifestyle and social environment factors with AIS in Chinese schoolchildren.
This is a matched case-control study based on survey data collected from school-based scoliosis screening program. We used conditional logistic regression models to describe the relative risk of AIS incidence for each variable in the analyses. To examine the independent effect of each factor on developing AIS, a multivariate conditional logistic regression was conducted and odds ratios (ORs) were adjusted for age and other significant variables.
Overall, 2538 participants from 49 schools were included in this study, comprising 1269 AIS cases and 1269 controls. Mean age of the study population was 13.4 years ± 1.06 (range 10-18). One thousand five hundred and fifty (61.1%) of the study subjects were girls. After adjusting for other significant factors, inappropriate desk heights, either too low (OR = 1.40, 95% CI 1.04-1.90) or too high (OR = 1.61, 95% CI 1.09-2.38), standing with anterior pelvic tilt (OR = 2.73, 95% CI 1.41-5.28), and sleeping on the right side (OR = 1.38, 95% CI 1.00-1.91), remained associated with elevated AIS risks. In contrast, sitting normally and classroom sitting positions change regularly were associated with lower odds of AIS. The adjusted ORs were 0.69 (95% CI 0.50-0.96) for sitting normally, and 0.72 (95% CI 0.53-0.98) for sitting positions change.
This is the first study to address the associations between desk heights and AIS and showed inappropriate desk heights were related to increased AIS risks. To protect school children from developing AIS, stakeholders are advised to consider introducing height-adjustable desks in the class, changing students' sitting positions in the classroom on a regular basis, and implementing educational programs to help students maintain correct sitting postures.
青少年特发性脊柱侧凸（AIS）是最常见的脊柱侧凸类型，影响 10-16 岁儿童。然而，AIS 的风险因素，尤其是可改变的风险因素，仍知之甚少。本研究旨在探讨生活方式和社会环境因素与中国学童 AIS 的关系。
这是一项基于学校脊柱侧凸筛查计划收集的调查数据的匹配病例对照研究。我们使用条件逻辑回归模型来描述分析中每个变量的 AIS 发生率的相对风险。为了检查每个因素对发展 AIS 的独立影响，我们进行了多变量条件逻辑回归，并对年龄和其他显著变量进行了调整后的比值比（OR）。
总体而言，本研究共纳入 49 所学校的 2538 名参与者，包括 1269 例 AIS 病例和 1269 名对照。研究人群的平均年龄为 13.4 岁±1.06（10-18 岁）。1550 名（61.1%）研究对象为女性。在调整其他显著因素后，不合适的书桌高度，要么太低（OR=1.40，95%CI 1.04-1.90），要么太高（OR=1.61，95%CI 1.09-2.38），站立时骨盆前倾（OR=2.73，95%CI 1.41-5.28），以及右侧卧位睡眠（OR=1.38，95%CI 1.00-1.91），与 AIS 风险升高相关。相反，正常坐姿和定期改变教室坐姿与 AIS 发生的可能性较低相关。调整后的 OR 分别为 0.69（95%CI 0.50-0.96）和 0.72（95%CI 0.53-0.98）。
这是第一项研究探讨书桌高度与 AIS 之间的关系，结果表明不合适的书桌高度与 AIS 风险增加有关。为了保护学童免受 AIS 的影响，建议利益相关者考虑在课堂上引入可调节高度的书桌，定期在教室里改变学生的坐姿，并实施教育计划，帮助学生保持正确的坐姿。
