| Objective:Based on the demographic characteristics of primary and secondary school students in Anshan City,their posture of reading and writing on weekdays,and their sports at school,the current situation of scoliosis among primary and secondary school students in Anshan City and the population distribution characteristics were investigated to explore the factors influencing scoliosis in primary and secondary school students and to construct a regression model of risk factors for scoliosis in primary and secondary school students.Methods:In this study,a multistage whole-group sampling method was used to collect data through a combination of questionnaire and physical examination for a cross-sectional survey of students who attended fourth grade to third year of high school within Anshan City in 2019.The questionnaire survey was divided into two parts;the A questionnaire included basic information such as students’ screening point,date of birth and physical examination,grade,gender,height,weight,and the outcome indicators of this study.The B questionnaire part included students’ basic information situation,sports-related situation,injury-related behavior situation,learning-related situation,and reading and writing posture situation.The physical examination was mainly for scoliosis abnormalities.The physical examination was conducted by the professional staff of the testing team to distinguish the normal spine from other spinal curvature abnormalities in accordance with the Screening for Abnormal Spinal Curvature in Children and Adolescents(GB/T 161332014).After pre-processing the data of this study,the subsequent steps were analyzed mainly with the software SPSS 26 and SAS 9.4.The first part of the study was a descriptive analysis of the screening subjects and a test of variance for each independent variable and the distribution of scoliosis.The second part of the study used whether the screening subjects had scoliosis as the dependent variable to find the factors influencing scoliosis in the screening subjects and to establish a multifactorial model.Since there were many independent variables in this study and most of them were hierarchical variables,variables were screened by variance inflation factor and Spearman’s correlation coefficient before establishing the multifactor model in order to avoid multicollinearity,and the forward method was used for screening variables during model building in order to make the final model as parsimonious as possible.Results:A questionnaire retains 3699 observations after ID check and hyper-logical value cleaning,and B questionnaire retains 3372 observations after ID check and hyper-logical value cleaning;then the data of A questionnaire and B questionnaire are merged by ID coding,and the observations appearing in both A questionnaire and B questionnaire are retained,finally leaving 3361 observations for subsequent analysis.In the data of this study,the number of primary and secondary school students with scoliosis was 115,with a detectable rate of 3.42%.The number of male students with scoliosis was 59,with a detectable rate of 3.14%,and the number of female students with scoliosis was 56,with a detectable rate of 3.78%.In a population-wide univariate analysis,statistically significant factors for demographic characteristics were school band(χ~2=113.06,P<0.0001),height(t=-6.47,P<0.0001),weight(t=-2.49,P=0.0129),school residency(χ~2=27.79,P<0.0001),and age(χ~2=36.70,P<0.0001);statistically significant factors for exerciserelated conditions were the number of days per week of varying moderate-to-high intensity exercise(χ~2=11.07,P=0.0040);statistically significant factors for injury-related behaviors were whether or not they smoked(χ~2=13.07,P=0.0003);statistically significant factors in learning-related behaviors were whether the height of the desk and chair was adjusted according to height(χ~2=37.62,P<0.0001)and the daily sleep time(χ~2=17.70,P=0.0001);and statistically significant factors in reading and writing posture were whether the chest was more than one fist from the edge of the desk when reading and writing(χ~2=7.96,P=0.0468),whether the eyes were more than one foot away from the book when reading and writing(χ~2=13.62,P=0.0035),whether the fingers were about one inch away from the pen tip when reading and writing(χ~2=10.33,P=0.0159),whether the teacher reminded the incorrect reading and writing posture,and whether the parents reminded the incorrect reading and writing posture(χ~2=21.56,P<0.0001).The statistically significant influencing factors in the multifactorial analysis were weight,screening point,school section,and whether the desk and chair would adjust for height.The risk of scoliosis was greater for students who were lighter in weight,had a screening point in an urban area,had a higher school band,and had desks and chairs that did not adjust for height.In the subgroup analysis,the influential factors in the multifactor analysis for urban students were gender,school level,and whether the height of the desk and chair would be adjusted according to height,and the risk of scoliosis was higher for female students,higher school level,desk and chair height would not be adjusted according to height,and students younger than 13 years old;the influential factors in the multifactor analysis for suburban students were school level and whether they had been threatened or intimidated,and the risk of scoliosis was higher for students with higher school level and those who had been threatened or intimidated.In the subgroup analysis by school level,the influential factors in the multifactor analysis for middle school students were height and whether the desk and chair would adjust to height,and the lower the height,the greater the risk of scoliosis for students whose desks and chairs would not adjust to height;the influential factor in the multifactor analysis for high school students was BMI,and the lower the BMI the higher the risk of scoliosis for students.Conclusion:(1)The detectable rate of scoliosis among primary and secondary school students in Anshan was 3.42%,which was not much different from the detectable rate of scoliosis among primary and secondary school students reported in most screening tests.The detectable rate of scoliosis among male students was 3.14%;the detectable rate of scoliosis among female students was 3.78%.(2)The risk of scoliosis was greater among primary and secondary school students in Anshan who were lighter in weight,had screening sites in urban areas,had higher school grades,and had desks and chairs that did not adjust to their height.(3)The risk of scoliosis was higher among primary and secondary school students in urban areas of Anshan City who were female,in higher grades,in desks and chairs that did not adjust to their height,and in students younger than 13 years of age;the risk of scoliosis was higher among primary and secondary school students in suburban counties of Anshan City who were in higher grades and who had been threatened or intimidated.(4)The risk of scoliosis was greater among junior high school students in Anshan who were lower in height and whose desks and chairs did not adjust to their height,and among high school students in Anshan who had a lower BMI. |
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