Background:
In Japan, in 2016, the School Health and Safety Act was revised
and examination of extremities in addition to scoliosis became mandatory. Musculoskeletal
examinations were subsequently started using a mark sheet-type questionnaire. In the
present study, we aimed to analyze the relationship between physical findings and
musculoskeletal problems and propose a preventive strategy for musculoskeletal
injuries.
Methods:
In 2017, a total of 4,073 elementary and middle school students
underwent direct musculoskeletal examination. In a direct examination, the following
elements were included: torticollis; scoliosis; stiffness of the shoulder, elbow, hip,
knee, and ankle; flexion and extension in standing position; flat foot; hallux valgus; and
alignment of the upper and lower extremities. Of the 4,073 students who underwent direct
examination in early 2017, only 3,754 were able to complete the mark sheet-type
questionnaires in early 2018. A prospective longitudinal analysis of the data gathered was
performed.
Results:
A total of 396 (11%) students had injuries. The ankle
sprain/non-ankle sprain group comprised 119 (3%)/3,635 (97%) students, while the
fracture/non-fracture group comprised 105 (2.8%)/3,650 (97.2%) students, respectively.
Comparing the sprain group with the non-sprain group, ankle stiffness significantly
correlated with ankle sprain in the univariable and multivariable analyses. Injuries
occurred more frequently among boys, older students, students with stiff bodies, and
students who were involved in sports activities of longer duration.
Conclusion:
Ankle stiffness was assumed to be a risk factor for ankle
sprain. Stretching of the ankle might be effective for preventing ankle sprain. However,
further interventional studies are needed to confirm this finding.