{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:08:47Z","timestamp":1764047327709,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,18]],"date-time":"2024-08-18T00:00:00Z","timestamp":1723939200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Care Science"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to investigate the potential variance in the prevalence of early\u2010onset scoliosis among children aged 4\u20137 years and analyze the influencing factors. The goal was to establish a crucial reference point for monitoring and evaluating spinal curvature development in preschoolers, ultimately to reduce the occurrence of adverse health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children aged 4\u20137 years within the main urban area of Nanjing were selected using a stratified random sampling method. A team of four senior therapists conducted screenings for spinal curvature among children using visual inspection, the Adams forward bending test, and an electronic scoliometer to measure the angle of trunk rotation (ATR) and identify children displaying signs of scoliosis. Children with suspected scoliosis in the initial screening underwent X\u2010ray Cobb angle assessment for confirmation. The prevalence of early\u2010onset scoliosis was then determined from the screening results. R version 4.2.0 software was used to analyze the factors associated with scoliosis among children using partial least squares structural equation modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2281 children were included in this study, consisting of 1211 boys and 1070 girls, with a mean age of 5.44\u2009\u00b1\u20090.81 years (ranging from 4 to 7 years). Among them, 7.58% exhibited positive signs of scoliosis, 5.87% had early\u2010onset scoliosis, and the positive predictive value was 77.5%. Significant differences in ATR were observed among children in different age groups (Kruskal\u2013Wallis\u2009=\u200915, <jats:italic>p<\/jats:italic>\u2009=\u20090.0104) and by sex (<jats:italic>t<\/jats:italic>\u2009=\u20093.17, <jats:italic>p<\/jats:italic>\u2009=\u20090.00153). Significant variations in ATR were noted in children with scoliosis (<jats:italic>t<\/jats:italic>\u2009=\u2009\u221222.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with a cutoff at ATR\u2009=\u20094.5\u00b0, and auxiliary values of 0.947 and 0.990. Children diagnosed with early\u2010onset scoliosis generally exhibited lower body mass index values, with a statistically significant difference (<jats:italic>t<\/jats:italic>\u2009=\u20092.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using visual inspection, the Adams test, and an electronic scoliometer to measure the ATR, the present triad method is more sensitive for early scoliosis screening in children with abnormal posture aged 4\u20137 years. A full spine X\u2010ray is advised in children with an ATR over 4.5\u00b0 and poor posture.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hcs2.111","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T04:33:47Z","timestamp":1724042027000},"page":"274-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early\u2010onset scoliosis in children aged 4\u20137 years in Nanjing, China: A cross\u2010sectional study"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8276-5566","authenticated-orcid":false,"given":"Jun","family":"Song","sequence":"first","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong\u2010xin","family":"Rui","sequence":"additional","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya\u2010chun","family":"Xie","sequence":"additional","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Li","sequence":"additional","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Chi","sequence":"additional","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei\u2010lin","family":"Tong","sequence":"additional","affiliation":[{"name":"Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital) Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu China"},{"name":"Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University Nanjing Jiangsu 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