Trunk abnormalities in adolescence : a school health care based epidemiological cohort study

The rationale for the studies presented in this thesis was the whish to answer the question whether an extra scoliosis screening should be added to the two periodical medical examinations during adolescence. It was decided to use data collected in a prospective follow-up study conducted since 1984 to answer the following subquestions: 1. What is the prevalence of trunk abnormalities, including scoliosis and Scheuermann's disease? 2. What is the incidence of trunk abnormalities? 3. What ace the determinants of trunk abnormalities? 4. Are the current frequency of periodical medical examinations during adolescence, and the applied method of examining posture and back, adequate for early detection of adolescent idiopathic scoliosis? 5. Is it feasible to have scoliosis screening performed by school nurses? 6. What happens in the period between referral for scoliosis by the school physician and the onset of observation or treatment by the orthopedic surgeon

Two year cumulative incidence of trunk abnormalities in a schoolpopulation in Rotterdam, the Netherlands

We conducted a study of the 2 year cumulative incidence of trunk abnormalities in a cohort of 3,071 11 year old children (1,621 boys, 1,450 girls). The following data were recorded: height, weight, signs of puberty and menarche. Trunk abnormality was assessed in the erect child (asymmetry of shoulders and waistline, imbalance of the trunk, scoliosis, lordosis, kyphosis, swayback and flexibility) and by the forward bending test (FBT) (rib hump or lumbar prominence, persisting scoliosis, kyphosis and deviant lateral aspect). A normal FBT both at baseline and at follow-up was found in 84% of the boys and in 79% of the girls. The 2 year cumulative incidence of an abnormal FBT was 10% in boys and 13% in girls

A cognitive-behavioural program for adolescents with chronic pain - A pilot study

The purpose of this pilot study is to evaluate the feasibility of a cognitive-behavioural training program for adolescents with chronic pain irrespective of pain localisation. A secondary aim was to give an impression of the effect of the program on pain and quality of life. Eight adolescents (14-18 years) with chronic non-organic pain recruited from the general population (and their parents) participated in this pilot study. The intervention included five group meetings alternated with four telephone contacts (during the self-management weeks) over a period of 9 weeks. The training aimed to change pain behaviour through pain education, relaxation strategies, problem-solving techniques, assertiveness training, cognitive restructuring and by stimulating the adolescent's physical activity level. The training further addresses the social context of pain by inviting parents to attend two meetings for the parents only, and by asking the adolescents to bring a peer to one of the meetings. Adolescents and their parents were positive about the program. Adolescents felt they were more in control of their pain and parents valued the support they experienced in helping their children to master the pain. The training was considered to be feasible in daily life. Further, the preliminary data showed an effect on pain and quality of life in the expected direction. The results underline the need for a definitive study with a larger sample size and a random controlled design

Comparison between children and adolescents with and without chronic benign pain: consultation rate and pain characteristics

The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare services, suggesting that somatisation does not play a major role in children with chronic benign pain