Postural Screening Program

Background

• • The Massachusetts Department of Public Health has promoted postural screening in schools since 1971 In 1980, regulation changes required all school systems to begin providing screenings in grades 5-9 – Covers the years in which adolescents experience the most rapid growth, and in which signs of curvature most often appear

Program Goal

• Designed to detect possible early signs of spinal problems that require further medical evaluation – – Scoliosis (lateral curvature) Kyphosis (front to back curvature) • The Postural Screening program is intended as a supplement to primary health care – It does not provide a medical diagnosis

Postural Defects

• • • • • Scoliosis refers to a curvature of the spine Adolescent Idiopathic Scoliosis (AIP) is the most common type – First signs often appear in early adolescence – – Generally painless and may go unnoticed Causes unknown; thought to be multifactorial (age, gender, genetics) • Poor posture does not cause scoliosis/kyphosis or affect the progress of the curve In most cases, the curvature is mild and does not progress. Treatment will most likely include: – careful monitoring by a physician – exercises Severe curvature may require treatment with a brace or surgery If severe curvatures are untreated, may result in the following: – physical deformity – arthritic symptoms – heart and lung disorders – mobility issues

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Screening Process

Initial screenings will be conducted by the Physical Education staff – Location: Girls and Boys High School locker rooms – – – – – Girls and boys screened separately Students screened by staff of same gender Screened individually in private Observation ONLY Clothing considerations: • Girls should wear a bathing suit top or athletic bra • Boys will remove shirt Students with positive findings will be referred to the nurse for a second screening May recommend further medical evaluation – Parent/guardian notified – Does not mean the student has scoliosis – Screening is not intended to diagnose; designed to detect possible early signs of spinal problems

Postural Observation

• • • During the screening, posture is evaluated in 5 views Standing position: front, back, side Adams Forward Bending Test: front, side – Student bends forward until the back is parallel to the floor (bend to about knee level) • Feet together • • Knees straight Hands together (palm-to-palm) • Head down (tuck chin)

Evaluation Criteria

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Several things are evaluated:

– Head centered over the body – Shoulders/shoulder blades equal – Hips equal – Equal gaps between arms and torso when standing – Spine straight

Final Thoughts / Questions

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Don’t be embarrassed

– We are not looking at “you” – Compartmentalized evaluation

Humans are “Perfectly Imperfect”

– Positive findings do not necessarily mean there is a problem – Did you know? The dominant shoulder is typically lower than the non-dominant

Questions

Resources

Massachusetts Department of Public Health. (1996). Postural Screening Manual. Boston, MA.

 http://www.mass.gov/eohhs/docs/dph/com-health/school/psmanual04.pdf

Northeastern University. (2013). Postural Screening. School Based Screening and Referral Decision Making. Boston, MA: Denise Lotufo, PT, DPT, OCS, CSCI, CMT.

 http://neushi.org

Presentation prepared by Jennifer Greiner, RN February 2014