The prevalence of trunk asymmetries in the small island state of Malta

Abstract

Background: Malta, the smallest member state of the European Union is constituted of two inhabited islands Malta and Gozo. In the Maltese islands there has not been any large population size definitive study concerning the incidence of trunk asymmetries that may indicate Adolescent Idiopathic Scoliosis (AIS) amongst the general population. Scoliosis is one of the most deforming orthopaedic conditions confronting children. To confirm the orthopaedic condition of scoliosis one has to carry out a visual examination that usually consists of the Adam’s Forward Bend test, this is followed by the measurement of trunk rotation with the use of a Bunnell Scoliometer. Should the angle of trunk rotation be more than five degrees then the positively screened student be referred for x-Rays and a 10 degree Cobb angle taken as being required to confirm the diagnosis of Scoliosis. The lack of a full scale study together with the apparent lack of awareness regarding the condition has prompted the authors to research the situation on all Gozitan children aged between 13 and 15 years of age. It was decided to measure Trunk Asymmetry and the aim of the study was to obtain statistical data on the occurrence of trunk asymmetries amongst the Gozitan population, to further analyse the ratio of distribution of trunk asymmetries between female and male students and finally to refer the positively screened students to the relevant medical authorities for x-ray to confirm a scoliosis diagnosis.

Methods: This quantitative study design was carried out on all children aged between 13 to 15 years old over a five-month period. An Adam’s forward bend test and Scoliometer reading were taken for each participant consenting to this study. To minimse bias a qualified full time Physiotherapist graduated with a Bachelor of Science Honours degree in Physiotherapy since 2012, carried out these tests in the selected schools.

Results: The results of the study concluded that 5.3% of the adolescent population in Gozo suffer from trunk asymmetries (13 out of 245). Prevalence of trunk asymmetry was calculated using the 95% confidence interval and the Chi square tests had a significant p-value. Further analysis showed that 69% of these were female and 31% were male. These results demonstrate that the prevalence of trunk asymmetries in Gozitan adolescents is comparable to that stated within the current literature.

Conclusions: Results from the study confirms that trunk asymmetry is relatively common within the Maltese population. This might be indicative that a significant portion of the Maltese adolescent population might suffer from Adolescent Idiopathic Scoliosis. The intention of this research is to increase the general public’s awareness of the condition AIS, to make this condition more prominent to members of the allied professions, to reinforce the need for school screening projects and finally to ensure that the condition Trunk Asymmetry and Scoliosis is given the importance that it requires in the curriculum of study for physiotherapists.