Violations of a bearing at children – the changes of physiological position of a backbone caused by structural and functional changes in the musculoskeletal device. Violations of a bearing at children can be shown by stoop, asymmetry of a backbone, thorax or back pains, headaches, an astenovegetativny syndrome. Diagnostics of violations of a bearing at children includes visual survey, a X-ray analysis (KT, MPT) of a backbone. Correction of violations of a bearing at children is carried out by means of physiotherapy exercises, massage, manual therapy; according to indications carrying corrective corsets is appointed.
Violations of a bearing at children
Violations of a bearing at children - different deformations of a backbone in the frontal and sagittalny plane. Violations of a bearing occur at 2,1% of children of early age; at 15-17% of preschool children; at 33% of pupils of high school and at 67% of the senior school students. At timely carrying out improving actions of violation of a bearing at children are reversible, however in the started cases can lead to restriction of mobility of a thorax and a diaphragm, decrease in depreciation function of a backbone, violation of activity respiratory, cardiovascular and the central nervous system. Violations of a bearing at children can be predecessors of such diseases of the musculoskeletal device as scoliosis, osteochondrosis, a hernia nuclei pulposi. For this reason questions of prevention of violations of a bearing at children are urgent for modern pediatrics.
The reasons of violations of a bearing at children
Postural defects at children can have the congenital or acquired character. Congenital violations of a bearing at children are connected with pre-natal violation of formation of a backbone (wedge-shaped deformation of vertebras, formation of additional vertebras), a dysplasia of connecting fabric, a miotonichesky syndrome, etc. At children can lead patrimonial injuries to violation of a bearing, first of all, an incomplete dislocation of the I cervical vertebra (a trauma of the Atlas), a wryneck.
The acquired violations of a bearing meet in 90-95% of cases and usually come to light at the children having an asthenic constitution. Adverse social and hygienic conditions can act as the immediate causes leading to violation of a bearing at children: insufficient physical activity (gipokineziya), discrepancy of educational furniture (a table, a chair) to growth of the child and low illumination of a workplace, carrying a portfolio in the same hand and so forth. All listed factors promote long wrong fixing of situation and development of skill of pathological installation of a body. Here it should be noted adverse influence on the formed children's bearing of such actions of adults as constant carrying the baby on one hand, attempts too early to put the child or to put it on legs, maintaining the child during walks by the same hand.
The acquired violations of a bearing at children can be formed owing to rickets, tuberculosis, poliomyelitis, spinal fractures, osteomyelitis, valgusny deformation of foot, flat-footedness, osteochondropathy, the deforming hems on a back, shortenings of one extremity, etc. Quite often the children having short-sightedness, an astigmatism, squint or relative deafness forcedly accept the wrong pose in operating time to compensate defect of visual or acoustical perception.
As the contributing moments for formation of violations of a bearing at children serve poor physical development, the wrong mode, a hypotrophy or obesity, somatic weakening of the child, a lack of receipt in an organism of minerals and vitamins.
Classification of violations of a bearing at children
In children's traumatology and orthopedics allocate violations of a bearing of two types: in the sagittalny and frontal plane.
Violations of a bearing in the sagittalny plane are characterized by the wrong ratio of physiological bends of a backbone:
- smoothing of all vertebral bends (a flat back at children);
- the increase in a lumbar lordoz which is poorly expressed by a cervical lordoz and a chest kifoz (a plano-concave back);
- increase in a chest kifoz with reduction of a lumbar lordoz (sutulovatost);
- increase in a chest kifoz along with almost full smoothing of a lumbar lordoz (a round back, a kifotichesky bearing);
- increase in all physiological bends of a backbone (round and concave back, kifolordotichesky bearing).
Asymmetry of the right and left half of a trunk at children is the defining sign of violations of a bearing in the frontal plane (a skoliotichesky bearing). Unlike scoliosis, at violation of a bearing in the frontal plane asymmetry of a backbone at children disappears in a prone position, there is no torsiya of vertebras that indicates the functional nature of deformation.
Children can have various extent of violation of a bearing. At the I degree minor changes of a bearing which can be eliminated by purposeful concentration of attention of the child are noted. The II extent of violations of a bearing at children is characterized by more expressed deformations which are possible for eliminating by means of unloading of a backbone in horizontal position or suspension of the child for axillary hollows. At violations of a bearing of the III degree at children deformations of a backbone which cannot be eliminated by unloading of a backbone are noted. At preschool children violations of a bearing of the I-II degree are usually observed; children of school age have II-III degrees.
Symptoms of violations of a bearing at children
Violations in itself of a bearing at children are not a disease yet, but create prerequisites for diseases of the musculoskeletal device and internals.
The main sign of violation of a bearing is appearance of the standing child. At a sutulovatost the head is inclined forward, shoulders also move forward, shovels act, buttocks are flattened. At children with a kifotichesky bearing (a round back) the ducking forward, omission of shoulders, a thorax zapadeniye, "wing-shaped" shovels, halfbent in leg knees, flattening of buttocks, a weak tone of muscles of all trunk is noted. Kifolordotichesky violation of a bearing at children (a round and concave back) is characterized by a ducking and the top humeral belt forward, protrusion and a svisaniye of a stomach (quite often vistseroptozy owing to weakness of muscles of an abdominal tension), a big tilt angle of a basin, the maximum extension or releg extention in knees. At children with a flat back the basin inclination is reduced, the thorax is displaced kpered, "wing-shaped shovels" act, the stomach droops. Violation of a bearing at children as a plano-concave back is followed by narrowness of a thorax, increase in a tilt angle of a basin, protrusion of a stomach and buttocks.
At an asymmetric bearing at children the arc-shaped deformation of a backbone with the top turned to the left or to the right is noted; ducking aside; raznourovnevy position of shoulders, shovels, nipples.
Violations of a bearing at children in no small measure promote change of functioning of lungs, hearts, digestive organs. So, the hollow flat breast and a round-shouldered back limit a full excursion of a thorax, do breath superficial that causes oxygen insufficiency and decrease in level of a metabolism. Children with violations of a bearing are sluggish, apathetic, suffer from bad memory, anemia, incidences of ORZ, bronchitis, pneumonia are subject, are predisposed to tuberculosis.
Owing to an excessive deflection in lumbar department of a backbone weakness of muscles of an abdominal tension and, as a result, omission of a stomach and intestines, locks develops. Children with violations of a bearing of various type can show complaints to pains in a back, bystry exhaustion, headaches, deterioration in sight. Violations of a bearing at children can lead to development of degenerate changes of a backbone (osteochondrosis), deformations of a thorax, hernias nuclei pulposi, scoliosis, the deforming osteoarthrosis over time.
Diagnostics of violations of a bearing at children
Inspection of the child is performed in a standing position in front, sideways and behind. Serve as the main visual criteria of violation of a bearing at children: acting back and located at the different levels and at different distance from a shovel backbone; a deviation of shoots of a backbone from the average line of a back; asymmetry of buttock folds, raznourovnevy arrangement of popliteal poles; concave or convex thorax; asymmetry of edges, assignment of shoulders forward, etc. Sometimes for best accuracy resort to measurement of various parameters (distance between the 7th cervical vertebra and bottom corners of shovels, distances between shovels, lengths of the lower extremities, to calculation of a humeral index, etc.).
At diagnostics of violations of a bearing at children Adams's test (a trunk inclination forward) is important by which the functional condition of bends of a backbone and existence of the rotational component which is a differential and diagnostic symptom of scoliosis is defined.
Tool methods of inspection are most exact as they allow to avoid the subjective mistakes connected with visual diagnostics of violations of a bearing at children. In case of need to the child the X-ray analysis, backbone KT or MPT is carried out.
Treatment of violations of a bearing at children
The medical complex at violations of a bearing at children has to be directed to formation of a full-fledged muscular corset, development of the correct functional stereotype.
The main role in correction of violations of a bearing at children belongs to physiotherapy exercises, massage (to the general, orthopedic, with the LFK elements, muscles of a stomach, a thorax, a back and a waist), manual therapy, hydrotherapy, medical swimming, a kinezioterapiya. At children of school age it is expedient to include occupations on the rowing exercise machine, the exercise bike, gymnastic complexes in a complex of medical and correctional actions. From physical therapy methods at violation of a bearing at children electrostimulation of muscles of a back, an induktotermiya, an electrophoresis, the general Ural federal district, a peloidoterapiya, thalassotherapy is used.
If necessary to the child carrying the special corset supporting back muscles is appointed.
The forecast and prevention of violations of a bearing at children
In most cases correctly organized medical and motive mode promotes full correction of violations of a bearing at children. At the available permanent deformations of a backbone surgical correction of scoliosis can be required.
The correct day regimen, good nutrition, dream on an orthopedic mattress and a pillow, exact selection of footwear, the correct organization of working space, etc. are extremely important for prevention of violations of a bearing at children. Full-fledged physical activity (walks, outdoor games, gymnastics, sports activities), a hardening, preventive massage is necessary for children for development of skill of a correct posture. Children with violations of a bearing have to stay on the dispensary registry at the children's orthopedist.