Effect of traditional rehabilitation programme versus telerehabilitation in adolescents with idiopathic scoliosis during the COVID-19 pandemic: a cohort study.

BACKGROUND: Telerehabilitation has become increasingly popular since the SARS-CoV-2 (COVID-19) outbreak. However, studies are needed to understand the effects of remote delivery of spine treatment approaches. OBJECTIVES: To verify and compare the effects of traditional rehabilitation programmes (in-person) and telerehabilitation (online) on the progression of scoliotic curvature in adolescents with idiopathic scoliosis during the COVID-19 pandemic, and to verify the acceptability, appropriateness, and feasibility among patients and physiotherapists regarding both treatments. METHODS: This is a cohort study (prospective analysis of 2 intervention groups: telerehabilitation (online) and traditional rehabilitation (in-person). A total of 66 adolescents with idiopathic scoliosis were included. Recruitment was conducted through the Clinical Center in Scoliosis Care (January-December 2020). Participants were divided into 2 intervention groups: telerehabilitation (online) (n = 33) and traditional rehabilitation programme (in-person) (n = 33). Both groups also were supplied with a spinal orthopaedic brace. Scoliosis was confirmed by a spine X-ray examination (Cobb angle). Radiographic parameters measured were: Cobb angles (thoracic and lumbar). The method of Nash and Moe (thoracic and lumbar) was also evaluated based on the relationship between the vertebral pedicles and the centre of the vertebral body in the X-rays. Assessments were performed at baseline (T0) and after 6 months of the intervention protocol (T6). Patient and physiotherapist reports were evaluated on the acceptability, appropriateness, and feasibility of the interventions. RESULTS: Adolescents with idiopathic scoliosis showed a significant decrease in the Cobb angle (main scoliotic curvature), with a 4.9° for the traditional rehabilitation programme and 2.4° for the telerehabilitation. Thoracic and lumbar Cobb angles did not show significant changes after the intervention in both groups or between groups. Thoracic and lumbar Nash and Moe scores scores also did not show significant differences after 6 months of in-person or telerehabilitation intervention, or between groups. The intervention by telerehabilitation was acceptable, appropriate, and feasible for patients and physiotherapists. CONCLUSION: Use of the rehabilitation programme for adolescents with idiopathic scoliosis, delivered via telerehabilitation during the COVID-19 pandemic, was encouraging for future applications due to the improved effect on reducing the Cobb angle, preventing progression of scoliosis. In addition, telerehabilitation showed good acceptability among patients and physiotherapists. Traditional rehabilitation programmes (in-person) in adolescents with idiopathic scoliosis also showed a reduction in the Cobb angle.

Educação postural em escolares: existe diferença na aprendizagem entre escolas públicas e privadas? / Educación postural en escolares: ¿hay alguna diferencia en el aprendizaje entre escuelas públicas y privadas? / Postural education in schoolchildren: is there a difference in learning between public and private schools?

Objetivo: Comparar o antes e o depois de uma ação de educação postural sobre o conhecimento relativo ao modo de transportar o material escolar, o modo de se sentar e a posição ao dormir de escolares da rede pública e privada do município de Santa Cruz (RN), Brasil. Métodos: A amostra foi composta por 200 escolares do 1º ao 5º ano, e a ação, de três atividades: palestra sobre hábitos posturais, peça teatral e paródia educativa. Para comparação antes e após as intervenções, foi aplicado um questionário com figuras ilustrativas das diversas posições que poderiam ser adotadas pelo escolar. Na análise estatística, utilizou-se o teste de Mcnemar (??0,05). Resultados: Apenas os alunos da escola privada obtiveram aumento significativo no número de respostas corretas em todas as variáveis observadas: 16% em relação ao transporte do material escolar [55 (67,9%) versus 68 (83,9%)]; 27,5% no modo de sentar [48 (60%) versus 70 (87,5%); ?2=1,905; p<0,001]; e aumento de 18,2% no número de acertos quanto à posição ao dormir [55 (71,4%) versus 69 (89,6%); ?2=0,349; p=0,007]. Conclusão: Esta intervenção de educação postural foi eficaz no aumento do conhecimento dos escolares da rede privada. Entretanto, para a rede pública, as abordagens educacionais utilizadas neste estudo parecem não ter produzido efeito.

Objetivo: Comparar el antes y el después de una acción de educación postural sobre el conocimiento relativo con el modo de cargar los útiles escolares, sentarse y posición de dormir de estudiantes de la red pública y privada en el municipio de Santa Cruz (RN). Métodos: la muestra fue compuesta por 200 estudiantes de 1º a 5º grado, y la acción de tres actividades: una palestra sobre hábitos posturales, obra de teatro y la parodia educativa. Para la comparación antes y después de la intervención, fue aplicado un cuestionario con figuras ilustrativas de las distintas posiciones que podrían ser adoptadas por los estudiantes. En el análisis estadístico, se utilizó el teste de McNemar (??0,05). Resultados: sólo los estudiantes de escuela privada tuvieron un aumento significativo en el número de respuestas correctas en todas las variables observadas: 16% en relación con el transporte del material escolar [55 (67,9%) frente a 68 (83,9%)]; 27 5%, para sentarse [48 (60%) frente a 70 (87,5%), ?2=1,905, p<0,001]; y el 18,2% de aumento en el número de aciertos en relación a la posición de dormir [55 (71,4%) frente a 69 (89,6%), ?2=0,349, p=0,007]. Conclusión: La presente intervención de educación postural fue eficaz para aumentar el conocimiento de los estudiantes de las escuelas privadas. Sin embargo, para las públicas, los abordajes educacionales utilizados parecen haber producido ningún efecto.

Objective: To compare a posture education measure on the knowledge related to the way students carry their school supplies, sit in the desk and their sleeping position at public and private schools in Santa Cruz/RN. Methods: The sample consisted of 200 students from the 1st to the 5th grades and three activities: a lecture on postural habits; a play and an educational parody. For a comparison before and after the interventions, we applied a questionnaire with illustrative figures of the various positions that could be adopted by the school. In the statistical analysis we used the McNemar test (??0.05). Results: Only private school students had a significant increase in the number of correct answers in all the observed variables: 16% regarding the way they carried school supplies [55 (67.9%) versus 68 (83.9%)], 27.5% concerned to the way they sit [48 (60%) versus 70 (87.5%), ?2=1.905, p<0.001] and an increase of 18.2% in the number of correct answers related to the sleeping position [55 (71.4%) versus 69 (89.6%), ?2=0.349, p=0.007]. Conclusion: This postural education intervention was effective in increasing the students? knowledge from private schools. However, for public school students, the educational approaches used in this study did not seem to have produced effects.