Postural Screening Program

1. Postural Screening Program

2. 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 grades5-9 • Covers the years in which adolescents experience the most rapid growth, and in which signs of curvature most often appear

3. 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

4. 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

5. 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

6. 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)

7. Evaluation Criteria • 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

8. Final Thoughts / Questions • 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

9. 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