No abstract

At five schools in the city of Bochum a serial study was carried out with regard to pathological posture of the spine. In total 2075 pupils from 10 to 17 years of age were examined and the degree of kyphosis was determined using Debrunner's kyphometer. An angle of 40 degrees or more was supposed to be a pathological kyphosis. The rate of this kyphosis was 12 p.c. in girls and 15.3 in boys. The children with pathological curvature were compared with a group of children inconspicuous with regard to posture and selected by random. The two groups were questioned using a halfstandardized questionnaire. This was designed to obtain details of general circumstances of life, attitude in sports and medical history either in orthopedics and diseases in the family. Thereby was seen that children with pathological kyphosis practised less sports and had more orthopedic diseases, and also in their families more orthopedic problems and back pain occurred.

Routine radiographs and PA dual x-ray absorptiometry (DXA) of the lumbar spine were performed in 253 patients. A T-score of -2SD (approximately 20% reduction from young normal bone mineral density (BMD)) as measured by DXA, was used as threshold for the diagnosis of osteopenia. A lumbar spine index (LSI) as proposed by Barnett and Nordin was assessed by one radiologist. The correlation between LSI and bone mineral density, measured by DXA, was poor, and our results indicate that osteopenic patients cannot be differentiated from non-osteopenic patients by LSI. 100 radiographs of the lumbar spine were evaluated by 9 observers in order to determine observer variation in the detection of osteopenia. A complete agreement between the readers for the diagnosis of osteopenia was achieved in 43 percent of all radiographs. DXA and observers agreed in 68 to 76 percent of all cases. For a decrease of BMD of more than 60 percent compared to young normal adults, as determined by DXA, all readers agreed in the diagnosis of osteopenia, whereas for higher BMD values the agreement between readers and DXA worsened. The inconsistency between DXA and observer agreement was greatest for patients with a BMD reduction between 10 and 20 percent. The mean values of the kappa-coefficients were 0.574 +/- 0.06 for interobserver variation and 0.437 +/- 0.06 for the agreement between readers and DXA-results. An only moderate kappa-coefficient of 0.573 for the intraobserver variation as determined in one reader was found.

During a period of 8 months 121 male and 99 female joggers were interviewed by a standardised questionnaire in respect of their running behaviour and problems caused by jogging. Only such runners were included who had jogged regularly on at least 2 days, regarding women on at least one day per week for at least 30 minutes during the last 2 years. Additionally a detailed orthopaedic examination was carried out in the ambulance of the Orthopaedic University clinic. The overwhelming majority of male and female joggers had a secondary education and practised easy physical activities. Only 4 per cent of the interviewed persons worked physically hard. In connection with jogging, 67 male and 44 female joggers developed signs at the locomotor system. Among the major problems with regard to running were Achilles tendinitis, calf muscle strain, shin splints and complaints referring to foot deformities. Injuries were seen only rarely. Jogging on forest grounds and cinder paths is less strenuous compared to asphalt tracks or tartan paths. Training errors were among the main causes of complaints occurring during running. Traumatic or posttraumatic influences as well as incorrect footwear were of secondary importance regarding the occurrence of complaints.