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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(04): e625-e631
DOI: 10.1055/s-0042-1749462
Artigo Original
Ombro e Cotovelo

Is Shoulder Imbalance a Useful Parameter in the Screening of Idiopathic Scoliosis? A Preliminary Study[*]

Article in several languages: português | English
Pedro Augusto Rocha Torres 
1   Ortopedista, Departamento de Ortopedia e Cirurgia de Coluna, Fundação Hospitalar São Francisco de Assis (FHFSA), Belo Horizonte, MG, Brasil
,
Andre Moreira Castilho 
2   Ortopedista, Cirurgião de Coluna, Departamento de Ortopedia e Cirurgia de Coluna, Hospital Mater Dei, Belo Horizonte, MG, Brasil
,
Kamila Rayane Campos Lopes 
3   Biomédica, Técnica de Enfermagem, Departamento de Biomedicina e Enfermagem, Hospital Unimed, Belo Horizonte, MG, Brasil
,
Leonardo Pellizzoni 
4   Especialista em Sistemas de Informação, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
,
Orlando Righesso 
5   Ortopedista, Cirurgião de Coluna, Docente de Ortopedia e Cirurgia de Coluna, Departamento de Ortopedia, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
,
Asdrubal Falavigna 
6   Neurocirurgião, Coordenador do Programa de Pós-Gradua÷ão em Ciências da Saúde, Departamento de Neurocirurgia, Universidade de Caxias do Sul (UCS), Caxias do Sul, RS, Brasil
› Author Affiliations Financial Support This study did not receive any financial support from public, commercial, or non-profit sources.
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Abstract

Objective The present study aims to analyze the use of shoulder imbalance as a parameter for scoliosis screening as well as its relationship with other parameters of physical examination.

Methods This study assesses a smartphone application that analyzes several parameters of the physical examination in adolescent idiopathic scoliosis. Medical and non-medical examiners applied the screening tool in students in a public school and in a private sports club. After data collection, interobserver correlation was done to verify shoulder imbalance and to compare shoulder imbalance with Adam's bending test and with trunk rotation.

Results Eighty-nine participants were examined, 18 of whom were women and 71 of whom were men. Two subjects were excluded from the analysis. The mean age of subjects from the public school was 11.30 years and, for those from the sports club, it was 11.92 years. The examiners had poor-to-slight interobserver concordance on shoulder asymmetry in the anterior and posterior view. No significant statistical correlation was found between shoulder asymmetry and positive Adam's forward bending test.

Conclusion Our preliminary study shows that the shoulder asymmetry has a poor correlation with the Adam's forward bending test and measuring trunk rotation using a scoliometer. Therefore, the use of shoulder imbalance might not be useful for idiopathic scoliosis screening.

Level of Evidence III; Diagnostic Study

Keywords

congenital abnormalities - public health - spine - scoliosis - mass screening

* Study conducted at the Hospital Mater Dei, Belo Horizonte, Minas Gerais, Brazil




Publication History

Received: 20 January 2022

Accepted: 18 April 2022

Article published online:
08 September 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet 2008; 371 (9623): 1527-1537
    CrossrefPubMedGoogle Scholar
  • 2 Cheng JC, Castelein RM, Chu WC. et al. Adolescent idiopathic scoliosis. Nat Rev Dis Primers 2015; 1: 15030
    CrossrefPubMedGoogle Scholar
  • 3 Hresko MT. Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med 2013; 368 (09) 834-841
    CrossrefPubMedGoogle Scholar
  • 4 Grivas TB, Wade MH, Negrini S. et al. SOSORT consensus paper: school screening for scoliosis. Where are we today?. Scoliosis 2007; 2: 17
    CrossrefPubMedGoogle Scholar
  • 5 Fong DY, Cheung KM, Wong YW. et al. A population-based cohort study of 394,401 children followed for 10 years exhibits sustained effectiveness of scoliosis screening. Spine J 2015; 15 (05) 825-833
    CrossrefPubMedGoogle Scholar
  • 6 Yang J, Zhang K, Fan H. et al. Development and validation of deep learning algorithms for scoliosis screening using back images. Commun Biol 2019; 2: 390
    CrossrefPubMedGoogle Scholar
  • 7 Grauers A, Einarsdottir E, Gerdhem P. Genetics and pathogenesis of idiopathic scoliosis. Scoliosis Spinal Disord 2016; 11: 45
    CrossrefPubMedGoogle Scholar
  • 8 Horne JP, Flannery R, Usman S. Adolescent idiopathic scoliosis: diagnosis and management. Am Fam Physician 2014; 89 (03) 193-198
    PubMedGoogle Scholar
  • 9 Bunge EM, Juttmann RE, de Koning HJ. Steering Committee of the NESCIO Group. Screening for scoliosis: do we have indications for effectiveness?. J Med Screen 2006; 13 (01) 29-33
    CrossrefPubMedGoogle Scholar
  • 10 Wong HK, Hui JH, Rajan U, Chia HP. Idiopathic scoliosis in Singapore schoolchildren: a prevalence study 15 years into the screening program. Spine (Phila Pa 1976) 2005; 30 (10) 1188-1196
    CrossrefPubMedGoogle Scholar
  • 11 Kuklo TR, Lenke LG, Graham EJ. et al. Correlation of radiographic, clinical, and patient assessment of shoulder balance following fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2002; 27 (18) 2013-2020
    CrossrefPubMedGoogle Scholar
  • 12 Bago J, Pizones J, Matamalas A, D'Agata E. Clinical photography in severe idiopathic scoliosis candidate for surgery: is it a useful tool to differentiate among Lenke patterns?. Eur Spine J 2019; 28 (12) 3018-3025
    CrossrefPubMedGoogle Scholar
  • 13 Akel I, Pekmezci M, Hayran M. et al. Evaluation of shoulder balance in the normal adolescent population and its correlation with radiological parameters. Eur Spine J 2008; 17 (03) 348-354
    CrossrefPubMedGoogle Scholar
  • 14 Gardner A, Berryman F, Pynsent P. What is the variability in shoulder, axillae and waist position in a group of adolescents?. J Anat 2017; 231 (02) 221-228
    CrossrefPubMedGoogle Scholar
  • 15 Dunn J, Henrikson NB, Morrison CC, Blasi PR, Nguyen M, Lin JS. Screening for Adolescent Idiopathic Scoliosis: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018; 319 (02) 173-187
    CrossrefPubMedGoogle Scholar