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Children rehabilitation

The most common deformities of school and preschool children

The results of the general medical examination of children at primary and secondary schools show that the deformities of the spine are growing from year to year. The bone - muscle system of the children who are still in the development phase affected by the external and internal factors is a subject of deformities. Genetics and inappropriate holding of the body, the heavy schoolbags, the shortsightedness, inadequate school chairs and desks, insufficient physical activity, all lead to disrupted statics of the spine which later develops into kyphosis, scoliosis and lordosis. The fast growth of children in puberty unfavorably influences the development of the already existing deformations.

Kyphosis or humpback is enhanced curve of the spine at the thoracic part, but it could also appear at the other parts of the spine as well. It could mostly be noticed in a sitting position and it is followed by warping of the shoulders inwards. It is often caused by fast growth and inappropriate sitting of the children with weak stomach and back muscles.

Scoliosis is a curving of the spine on a side. It can be on one sided in the shape of the letter ‘ C ‘, or on two sided in a shape of an ‘ S ‘ and very rarely triple sided. There are no visible signs from the outside and very often these children hold their body perfectly so that the early diagnosing is obstructed. That is why it is recommendable for children at this age to be examined thoroughly more often and to pay a great attention if there is appearance of asymmetry of the body ( lowering of one of the shoulders opposed to the other, the thorax is more on one side than the other, the costal arch goes inwards, not even triangles on the figure… ). Unlike the other deformities where the cause is usually obvious, scoliosis is mostly with unknown etiology so it is difficult to predict how will it progress which complicates the healing and the prognosis. Unfortunately sometimes besides all the used effort for prevention and adequate treatment, there are some permanent outcomes to the bone – muscle system. That is why it is the early noticing of the deformity is so important, because the chances of successful curing are bigger.

Lordosis is overemphasized curve at the lumbar part of the spine ( sacrum ). Mainly it is a consequence of weak stomach muscles but also some deformities on the feet or knees which lead the legs and pelvis to irregular position which compensates with expressed curve in the lumbar part of the spine. When we observe the child from a side ( profile ) we can notice a big stomach eve with some very thin children who are skinny and usually with extended stomach muscles. Although it is not considered as a serious deformity of children and usually it is not treated, even passes as not noticed with plump children, still it passes into a more serious stage on elderly age because of the disrupted statics of the whole body which then leads to painful and degenerative diseases.

Thorax

The abnormities in the development of the chest can be manifested as pectus excavatum and pectus carinatum. Because of the incorrect position of the ribs a characteristic of this deformity is lowered ventilation of the lungs and is often accompanied with spine deformities.

Feet

The most common feet deformities are flat feet. Genetic predisposition has impact on them but also the physical inactivity, overweight or inadequate shoes. The outcome is difficulties in walking, running and standing, pain in the legs and sometimes even the sacrum.

Notice the deformity in time

In order to be successfully cured, the deformities on the feet, thorax and spine must be noticed on time during the general medical examination but also by the regular control from the parents and the school teachers. The signs of deformities can be seen by a thorough observation of the child in a straight standing position. First it should be seen if the body weight is evenly deployed to both legs, does the child have flat feet, what is the toes and ankle position. Then it should be observed if the knees touch or overlap or maybe they are gone far too back. The inappropriate position of the feet and knees leads to a bad position of the pelvis which can be slanting on one side or the lower part can be positioned inwards. The figure triangles ( the empty space which is formed by the body and the arms ) should be symmetrical. There are asymmetries of the ankles which can lead to unequal level of the scapulas and shoulders. The spine looked from behind should be in a straight line with sharply pointed endings.

Correction of the deformities

When these deformities are noticed the child is indicated to go to corrective gymnastics. That are therapeutic exercises which have as a goal to enhance the misbalance of the bone joint system as well as the muscles. If that is not completely possible, the continuous progress of the deformity should be stopped. The correction of spine deformities is a long process which requires a great engagement from the child and the parents as well as medical assistance. Only the good chosen and fully applied kinesiotherapy program of exercises can lead to an opportunity for stopping, correcting partially or complete correction of the deformity.