Prevalence and risk factors for asymmetric posture in preschool children aged 6-7 years

Adult scoliosis can be a severe disease. Not much is known about its determinants and the predictive value of early trunk asymmetries. In Vilnius, Lithuania, a cohort study has been started among 6-7 year old children in 1994. The purpose of the present report was to estimate the prevalence of trunk asymmetry in 6-7 year old children, and the association between previous rachitis, frequent illness during childhood and reduced physical activity and trunk asymmetry.

The degree of asymmetry was established in 791 children in kindergartens by measuring with a ruler the distance from the seventh cervical vertebra to the lower angles of the left and the right scapulas. Rachitis and the number of illnesses were extracted from each child's medical card, whereas data on physical activity were based on questionnaires filled in by parents and kindergarten teachers.

In all, 46.9% of children were found to have trunk asymmetry. The odds ratio of asymmetric posture was 2.76 (95% confidence interval [CI]: 1.62-4.72) for children with rachitis degree II compared to non-rachitic children, 3.97 (95% CI: 2.48-6.36) for those who were ill 16-28 times (over the years) compared to those who reported fewer than nine illnesses and 2.44 (95% CI: 1.21-4.91) for children with low physical activity level (13-22 points) as compared to children with a high level (> 33 points).

These findings indicate the need for prophylactic measures to decrease the incidence of infantile rachitis, acute morbidity and to increase physical activity. The significance of the high frequency of asymmetric posture can only be assessed by a follow-up of this cohort.