Objective: In 2016, Japan started conducting musculoskeletal examinations that included "limb status" of students as an essential item. Our institution implemented a unified musculoskeletal examination for all public elementary and junior high schools in Tcity. In this study, we aimed to report the progress in the past 4 years. Patients and Methods: The Tsukuba Childhood Locomotive-Organ Screening Sheet (T-CLOSS), which is a questionnaire that includes some nationwide-recommended questions, was prepared and distributed to students. Results of the questionnaires were analyzed, and the orthopedic surgeon conducted examinations for the extracted items. From these questionnaires, the ratio of each item, rate of advisory for screening, and content of the advisory were investigated. Results: During 2016-2019, musculoskeletal examinations were conducted in every public schools, with nearly 20,000 students in T-city. The consultation advisory rate was 6.7% in 2019. Of the 524 students who received the third screening recommendation, the actual consultation rate was 248 (40.8%). After the third screening, the proportion of students requiring treatment and outpatient visits was 46.7% (n=248), which accounted for 1.2% of all elementary and junior high school students in the city. Conclusion: We reported the results of 4-year musculoskeletal examinations in a city. In our screening, we distributed a uniform questionnaire throughout the city, and orthopedic surgeons performed secondary examinations of identified students in all schools. This appears to be an advanced effort to prevent musculoskeletal impairment in students. We hope to conduct more sophisticated musculoskeletal examinations using our results, aiming at early detection, early treatment, and improvement of musculoskeletal function in elementary and junior high school students.

The purpose of this study was to investigate the characteristics of musculoskeletal findings in elementary and junior high school children using 1-year prospective longitudinal data from a long-term survey. Data from 1209 (97.6%) of 1239 children were analyzed. The main results were as follows: "Limitation of standing forward flexion" was particularly frequent in the 4 th grade in all children and in the 5 th grade in boys and girls going on to the next grade. "Flat foot" was particularly frequent in boys in the 1 st , 6 th , and 8 th grades going on to the next grade. In girls, the frequency of "flat foot" was particularly high in the 1 st , 4 th , and 8 th grades going on to the next grade. Findings of scoliosis appeared more often in girls than in boys. Minor findings such as "asymmetrical height of the shoulder and scapula", first appearing in the 4 th and 5 th grades, may be linked to the increase in "Rib hump" in the stage entering junior high school; it is important to pay attention to such changes in the scoliosis findings. This 1-year prospective longitudinal analysis demonstrated that the frequency of some musculoskeletal findings was high. We suggest that an extended longitudinal study will contribute to a better understanding of the relationship between the appearance of musculoskeletal findings and growth and development in school children. Accordingly, further analysis of the various stages of growth and development are needed.

Objective: In 2020, coronavirus disease-2019 (COVID-19) became the cause of a pandemic. In response, the Japan Sports Agency issued warnings about secondary damage to health, such as the threat to physical and mental well-being due to the lack of exercise in this situation. In this study, we report on cross-sectional and longitudinal examinations of standing trunk flexion to evaluate how temporary long-term school closures affected musculoskeletal function in elementary school students. Patients and Methods: All children in one public elementary school in T-city during the school years 2019 and 2020 were included in this study. A digital forward flexion meter was used to measure standing trunk flexion. Results: In this study, 284 (284/289: 98.3%) and 266 (266/274: 97.1%) children in school years 2020 and 2019, respectively, were found to have valid data for cross-sectional analysis. The standing trunk flexion did not show significant differences between grades or sexes. In the longitudinal analysis, the results of the comparison of standing trunk flexion in children for two consecutive years revealed significant differences only between grades 3 and 4 ( P <0.05) and between girls in grades 3 and 4 ( P <0.01), but no significant differences in other grades or among boys or girls were observed. Conclusion: Initially, we expected that there would be a difference in the results of functional assessment using standing trunk flexion depending on the period of absence from school. However, the results of this study showed no significant changes in standing trunk flexion. Moreover, since children’s musculoskeletal functions may be affected by various factors during the COVID-19 pandemic, they should be carefully monitored in the future.

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