ﺑﺮرﺳﻲ ﺷﻴﻮع اﺳﻜﻮﻟﻴﻮزﻳﺲ در ﺑﻴﻦ داﻧﺶ آﻣﻮزان دﺧﺘﺮ 10 ﺳﺎﻟﻪ ﻣﺪارس ﺧﺮم آﺑﺎد در ﺳﺎل ﺗﺤﺼﻴﻠﻲ 83-1384

Investigation on the Prevalence of Scoliosis among Ten Years Old Female Students of Khorramabad Schools in 2004-2005

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﺍﺳﻜﻮﻟﻴﻮﺯﻳﺲ، ﺍﻧﺤﺮﺍﻑ ﺟﺎﻧﺒﻲ ﺳﺘﻮﻥ ﻓﻘﺮﺍﺕ ﺑﻮﺩﻩ، ﻛﻪ ﻳﺎ ﺳﺎﺧﺘﺎﺭﻱ ﺍﺳﺖ ﻭ ﺑﺎﻋﺚ ﺗﻐﻴﻴـﺮ ﺳﺎﺧﺘﻤﺎﻥ ﻣﻬﺮﻩ ﺷﺪﻩ ﻭ ﺑﺼﻮﺭﺕ ﺗﻐﻴﻴﺮﻱ ﺩﺍﺋﻤﻲ ﻣﻲ ﻣﺎﻧﺪ ﻭ ﻳﺎ ﺍﻳﻨﻜﻪ ﺗﻨﻬﺎ ﻳﻚ ﺍﺧﺘﻼﻝ ﻣﻮﻗﺘﻲ ﺑﻮﺩﻩ ﻛﻪ ﺩﺭ ﺍﺛﺮ ﻓﻌﺎﻟﻴﺖ ﻭﺿﻌﻴﺘﻲ ﻳﺎ ﺭﻓﻠﻜﺴﻲ ﻋﻀﻼﺕ ﺳﺘﻮﻥ ﻓﻘﺮﺍﺕ ﺑﻪ ﻭﺟﻮﺩ ﻣﻲ ﺁﻳﺪ. ﺍﻳﻦ ﺍﺧﺘﻼﻝ ﺍﺯ ﺟﻤﻠﻪ ﻣﻌﻀﻼﺕ ﻣﻬـﻢ ﺑﻬﺪﺍﺷﺘﻲ ﺩﺭ ﺳﻨﻴﻦ ﻣﺪﺭﺳﻪ ﺑﻮﺩﻩ ﻛﻪ ﺩﺭ ﺟﻨﺲ ﻣـﺆﻧﺚ ﺷﻴﻮﻉ ﺑﻴﺸﺘﺮﻱ ﺩﺍﺷﺘﻪ، ﻋﺪﻡ ﺗﺸﺨﻴﺺ ﺑﻪ ﻣﻮﻗﻊ ﻭ ﺩﺭ ﻧﺘﻴﺠﻪ ﭘﻴﺸﺮﻓﺖ ﺁﻥ ﺑﺎﻋﺚ ﺑﺮﻭﺯ ﻋـﻮﺍﺭﺽ ﺟﺴﻤﻲ ـ ﺭﻭﺣﻲ ﻭ ﻧﻬﺎﻳﺘﺎﹰ ﺍﻓﺖ ﺗﺤﺼﻴﻠﻲ ﺧﻮﺍﻫﺪ ﺷﺪ. ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪﻑ ﺗﻌﻴﻴﻦ ﺷﻴﻮﻉ ﺍﺳﻜﻮﻟﻴﻮﺯﻳﺲ ﺩﺭ ﺑﻴﻦ ﺩﺍﻧﺶ ﺁﻣﻮﺯﺍﻥ ﺩﺧﺘﺮ 10 ﺳﺎﻟﻪ ﺧﺮﻡ ﺁﺑﺎﺩ ﺻﻮﺭﺕ ﮔﺮﻓﺖ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻳﻚ ﻣﻄﺎﻟﻌﻪ ﻣﺸﺎﻫﺪﻩ ﺍﻱ ، ﺍﺯ ﻧﻮﻉ ﻣﻘﻄﻌﻲ ﺑﻮﺩ ﻛﻪ ﺑﺮ ﺭﻭﻱ 768 ﻧﻔﺮ ﺍﺯ ﺩﺍﻧﺶ ﺁﻣﻮﺯﺍﻥ ﺩﺧﺘﺮ 10 ﺳﺎﻟﻪ ﺧﺮﻡ ﺁﺑﺎﺩ ﻛﻪ ﺑﺼﻮﺭﺕ ﺧﻮﺷﻪ ﺍﻱ ﺍﻧﺘﺨﺎﺏ ﺷﺪﻩ ﺑﻮﺩﻧﺪ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ. ﭘﺲ ﺍﺯ ﮔﺮﻓﺘﻦ ﺗﺎﺭﻳﺨﭽﺔ ﭘﺰﺷﻜﻲ ﺍﺯ ﺁﻧﻬﺎ ﺩﺭ ﻗﺎﻟﺐ ﭘﺮﺳﺸﻨﺎﻣﻪ ، ﺍﺑﺘﺪﺍ ﺗﻤﺎﻡ ﺁﻧﻬﺎ ﺑﻪ ﻭﺳﻴﻠﻪ ﺷﺎﻗﻮﻝ ﻣﻌﺎﻳﻨﻪ ﺷﺪﻧﺪ ﻭ ﺩﺭ ﻣﻮﺍﺭﺩﻱ ﻛﻪ ﻓﺎﻗﺪ ﻋﻼﻣﺘﻲ ﺑﻪ ﻧﻔﻊ ﺍﻧﺤـﺮﺍﻑ ﺟﺎﻧﺒﻲ ﺑﻮﺩﻧﺪ، ﻣﻌﺎﻳﻨﻪ ﺩﺭ ﺣﺎﻟﺖ ﺧﻢ ﺷﺪﻩ ﺑﻪ ﺟﻠﻮ ﺻﻮﺭﺕ ﮔﺮﻓﺖ ﻭ ﻣﻮﺍﺭﺩ ﻣﺸﻜﻮﻙ ﺑﻪ ﺍﺳﻜﻮﻟﻴﻮﺯﻳﺲ ﺑﻪ ﻛﻠﻴﻨﻴﻚ ﺗﺨﺼﺼﻲ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺷﻬـﺪﺍﻱ ﻋﺸﺎﻳﺮ ﺍﺭﺟﺎﻉ ﺷﺪﻩ، ﺍﺯ ﺁﻧﻬﺎ ﺭﺍﺩﻳﻮﮔـﺮﺍﻓﯽ ﺳﺘﻮﻥ ﻓﻘﺮﺍﺕ ﺟﻬﺖ ﺗﺸﺨﻴﺺ ﻗﻄﻌﻲ ﺑﻪ ﻋﻤﻞ ﺁﻣﺪ ﻭ ﺯﺍﻭﻳﻪ ﺍﻧﺤﺮﺍﻑ ﺑﺎ ﺭﻭﺵ ﻛﺎﺏ ﻣﺤﺎﺳﺒﻪ ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺗﻌﺪﺍﺩ ﻣﻮﺍﺭﺩ ﻏﺮﺑﺎﻟﮕﺮﻱ ﺷﺪﻩ، 97 ﻧﻔﺮ 12/6 ﺩﺭﺻﺪ( ﺑﻮﺩﻧﺪ ﻛﻪ ﺑﺎ ﺍﻧﺠﺎﻡ ﭘﺮﺗـﻮﻧﮕﺎﺭﻱ ﺍﺯ ﺳﺘﻮﻥ ﻓﻘـﺮﺍﺕ، 30 ﻧﻔﺮ ﺍﺯ ﺁﻧﻬﺎ ﺑﻪ ﺍﺳﻜﻮﻟﻴﻮﺯﻳﺲ ﻣﺒﺘﻼ ﺑﻮﺩﻧﺪ. ﻧﺘﻴﺠﺘﺎﹰ، ﺷﻴﻮﻉ ﺍﺳﻜﻮﻟﻴﻮﺯﻳﺲ ﺩﺭ ﻧﻤﻮﻧﻪ ﻫﺎﻱ ﺗﺤﺖ ﻣﻄﺎﻟﻌﻪ، 3/9 ﺩﺭﺻﺪ ﺑﻮﺩ ﻛﻪ ﺍﻏﻠﺐ ﺁﻧﻬﺎ )3/25%(، ﺯﺍﻭﻳﻪ ﻛﺎﺏ ﺯﻳﺮ ﺩﻩ ﺩﺭﺟﻪ ﺩﺍﺷﺘﻪ ﻭ 5 ﻣﻮﺭﺩ )0/65 ﺯﺍﻭﻳﻪ ﺑﺎﻻﻱ ﺩﻩ ﺩﺭﺟﻪ ﺩﺍﺷﺘﻨﺪ. ﺷﻴـﻮﻉ ﺑﻴﻤﺎﺭﻱ ﺩﺭ ﺑﻴﻦ ﺩﺍﻧﺶ ﺁﻣﻮﺯﺍﻥ ﻛﻪ ﻭﺭﺯﺵ ﻫﻮﺍﺯﻱ ﻣﻨﻈﻢ ﺍﻧﺠﺎﻡ ﻣﻲ ﺩﺍﺩﻧﺪ ﻧﺴﺒﺖ ﺑﻪ ﺳﺎﻳﺮﻳﻦ، ﺍﺯ ﻧﻈﺮ ﺁﻣﺎﺭﻱ ﺗﻔﺎﻭﺕ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﺭﺍ ﻧﺸﺎﻥ ﻣﻲ ﺩﺍد .(P<0.05) ﻧﺘﻴﺠﻪ ﮔﻴـﺮﻱ: ﻧﺘﻴﺠﺔ ﻧﻬﺎﻳﻲ، ﻧﺸﺎﻧﮕﺮ ﺷﻴﻮﻉ ﻧﺴﺒﺘﹰﺎ ﺑﺎﻻﻱ ﺍﺳﻜﻮﻟﻴﻮﺯﻳﺲ ﺩﺭ ﺑﻴﻦ ﻧﻤـﻮﻧﻪ ﻫﺎﻱ ﺗﺤﺖ ﻣﻄﺎﻟﻌﺔ ﻣﺎ ﺑﻮﺩ ﻛﻪ ﺍﻳﻦ ﻣﺴﺌﻠﻪ ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﺍﻫﻤﻴﺖ ﻏﺮﺑﺎﻟﮕﺮﻱ ﻣﺪﺍﺭﺱ ﺟﻬﺖ ﺷﻨﺎﺳﺎﻳﻲ ﺩﺍﻧﺶ ﺁﻣﻮﺯﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺍﻳﻦ ﺑﻴﻤـﺎﺭﻱ ﻣﻲ ﺑﺎﺷﺪ، ﭼﺮﺍ ﻛﻪ ﺑﺎ ﺍﻳﻦ ﻛﺎﺭ ﻭ ﺗﺸﺨﻴﺺ ﺑﻴﻤﺎﺭﻱ، ﻣﻴﺘﻮﺍﻥ ﺑﺎ ﺩﺭﻣﺎﻥ ﻣﺤﺎﻓﻈﻪ ﻛﺎﺭﺍﻧﻪ ﺍﺯ ﭘﻴﺸﺮﻓﺖ ﺁﻥ ﻣﻤﺎﻧﻌﺖ ﺑﻪ ﻋﻤﻞ ﺁﻭﺭﺩ.

Introduction & Objective: The term «scoliosis» denotes lateral curvature of the spine. The deformity may be structural; implying a permanent change in the bones or soft tissues, or it may be no more than a temporary disturbance produced by reflex or postural activity of the spinal muscles. This skeletal disorder is one of the important health problems in school ages that are much more common in females gender. The aim of this study was to investigate the prevalence of scoliosis among 10 years old female students of Khorramabad schools. Materials & Methods: It was a cross – sectional study which evaluated 768 ten-year old female students of Khorramabad School who were selected by the random clustering sampling method. After determination of samples and obtaining medical history through a questionnaire, physical examination was performed by the plumb line and then in the cases that had no signs of deviation, in this portion of examination, the second stage of examination was performed by the adams test. Finally the screened cases were referred to shohada hospital clinic. an‎d thoracolumbar X-ray was obtained and the angle of deviation was measured using cobb's method. Results: The number of screened cases was 97(12.6%) and after radiology was done, 30 were identified as being afflicted with scoliosis. Finally the prevalence of scoliosis in this study was 3.9 percent of which (3.25%) had cobb's angle below ten degree and only five cases (0.65%) had cobb's angle above ten degree. In this study there was statistical significant difference between student that perform regular aerobic exercise against those who did not perform this exercise. Conclusions: According to this study a partly high prevalence of scoliosis existed among our female school children. This shows the necessity of school screening programs, because by early diagnosis of scoliosis and conservative treatment (by using brace), one may be prevent scoliosis's progression and finally the appearance of complication.