Preliminary Study On Epidemiological Investigation Of The Chidren With Growing Pains And Analysis With Related Factors

Objective:Growing pains is a kind of unknown causes body pains occurring in before children exuberant growth period.It very common in clinic,but easy to be oversights in diagnosis and misdiagnosis.The exact mechanism is still not clear,so far no satisfactory treatment.For futher research on the pathogenesis for GP among 3-7 years old children,prevention and control of GP,we carried out the series studies.This study include four parts:To survey the epidemic status of GP among 3-7 years old children.To analyze the risk factors of GP by case-control study.To preliminarily discuss the correlation of GP and the parameter of lower limb alignment.To analyze the surface electromyography in calf muscle of GP children by case-control study.Method:1.The random cluster sampling method was adopted from May,2014 to June,2014 to select young children and lower grade elementary school students with the age 3 ～ 7 years old from Changsha City for the cross-sectional survey.Two kindergartens and a elementary school were selected,a total of 1600 chidren.We designed a 《growing pains questionnarire for 3-7 years old children》.With the permission of each kindergarten and school for the students to participate this study,questionnaires were sent to each head teachers of selected class by the group of researchers and collected together by the head teachers two days later.The parameters of lower limb alignment were measured by researchers.After eliminating invalid questionnaire,the data base were prepared according to questionnaires, and statistical analyzed.2.The random cluster sampling method was adopted from May,2014 to October,2014 to select 48 GP and pronated foot posture (PFP) children as the case group,48 normal children as control group.All were taken surface electromyography (sEMG) measure, such as tibialis anterior, peroneus longus, medial gastrocnemius and tibialis posterior when standing and heel raising. The data were statistical analyzed.Result:1.The cross-sectional survey showed:①The prevalence of GP among 3～7 years old children in Changsha was 15.2%;②The difference of frequency of GP between boy and girl was statistically significant(P=0.003).The difference of nature of GP between boy and girl was statistically significant(P=0.001).The difference of duration of GP between boy and girl had no statistical significance(P=0.187).③25.8% chindren visited the doctor due to GP.The proportion of need medical service was significantly higher in boy than in the group of girl(P=0.006).2.(1)The risk factors result of case-control study by univariate analysis:①The difference of family history of GP between the case groupand the control groupwas statistically significant(P=0.000).② The proportion of playing ball games was significantly higher in the cases group than in the control group(P=0.043).③The proportion of doing dance was significantly higher in the cases group than in the control group (P=0.022).④The proportion of children doing gymnastics was significantly higher in the cases group than in the control group(P=0.018).⑤The proportion of normal gait was significant higher in the control group than in the cases group(P=0.034).⑥The proportion of time of sports activites was significant higher in the case group than in the control group(P=0.001).⑦The level of children fatigue after exercise was significant higher in the case group than in the control group(P=0.001).⑧The proportion of child fussy about his food was significant higher in the cases group than in the control group(P=0.027).(2)The risk factors result by multivariate logistic regression analysis:①The family history was a risk factor for GP.The prevalence of child with family history was higher than the child without family history (OR=2.116).②The child fussy about his food was a risk factor for GP. The prevalence of child fussy about his food was higher than the child without this habit(OR=2.745).③The child playing ball games was a risk factor for GP (OR=1.279). ④The gymnastics was a risk factor for GP(OR=2.354).⑤The normal gait was a protect factor for GP(OR=0.854).3.The correlation of GP and the parameter of lower limb alignment showed:①The difference of lower limb alignment between GP group and non-GP group was statistical significance(P=0.027).②The difference of lower limb torsion between GP group and non-GP group was statistical significance(P=0.041).③ The difference of foot shape between GP group and non-GP group was statistical significance(P=0.019).④ The difference of arthrochalasis between GP group and non-GP group was statistical significance(P=0.017).4.①The RMS values of peroneus longus in GP and PFP group increased significantly on standing (p=0.004).②The RMS values of medial gastrocnemius in GP and PFP group decreased significantly(p=0.04),and tibialis posterior increased significantly (p=0.001)when heel raising.③When the foot alignment of GP were abnormal, the change of the muscle activity may be the cause of GP.Conclusion:Chapter one:GP is a common disease of child in Changsha city.The frequency of GP,the nature of GP, the inpact on daily life and the need of medical service are all gender-related.Chapter two:There may be genetic factors in GP among child in Changsha.Early to start play ball games and gymnastics may increase the occurrence of GP.Children’s abnormal gait and fussy about his food were risk factor for GP.The time of sports activites and fatigue after exercise may associated with the happening of GP.Chapter three:The difference of lower limb alignment、lower limb torsion、foot shape and arthrochalasis may associated with the happening of GP.Chapter four:The RMS values of peroneus longus in GP and PFP group increased significantly on standing. The RMS values of medial gastrocnemius in GP and PFP group decreased significantly, and tibialis posterior increased significantlywhen heel raising.When the foot alignment of GP were abnormal, the change of the muscle activity may be the cause of GP.