The National Center for Spinal Disorders, an affiliate of the Buda Health Center, is the only hospital in Hungary covering virtually the entire diagnostic and treatment spectrum of all disorders of the spine.

Magyar

Primary Prevention at School

Primary physical education prevention program for the prevention of degenerative diseases of the spine

(Short Summary, 2003)
Annamária Somhegyi MD, Ph.D.
Budapest, Hungary

The prevention program of the Hungarian Spine Society started in 1995 and financed by the Ministry of Health was part of the Johan Béla National Public Health Program as well as the Bone and Joint Decade of WHO.

Background
In many countries 60-80-90 % of school children have poor posture, a predisposing factor for early discopathy of the cervical and lumbar spine. Degenerative diseases of the spine are one of the leading causes of sick-leave especially among workers between the ages of 25-40 years. Primary prevention starting in school is needed.

Goal
- Daily physical activity in schools.
- Special exercises, as part of regular physical education, for all children, for several years.

Why?
- Posture is an automatism, which can be modified by habits. Correct posture needs correct balance (correct strength and flexibility) of postural muscles.
- Too much sitting: muscle balance disappears, postural muscles get shortened and/or weakened, the use of spine becomes biomechanically incorrect.

Solution
- Stretching and strengthening of postural muscles regularly for several year, for all school children
- Special posture correcting exercises to be taught to teachers of physical education.

Result
Correct balance of postural muscles, correct posture as an automatism. Biomechanically correct use of spine. One element for preventing discopathy.

Working method of the prevention program of the Hungarian Spine Society
The prevention program means teaching the physical education teachers how to build special posture correcting exercise material into physical education classes for all school children. As of March, 2003, 5178 teachers of physical education and kindergartners from 3093 schools and kindergartens have learned the preventing exercise material, they were given the material in book form and in video casettes. 975 teachers sent 49,113 completed muscle test results of 31,705 children
to the center. Results of these muscle tests show, that only 12 % of tested children have correct muscle balance, all other have shortened and/or weak postural muscles.
The Ministry of Health, Social and Family Affairs, the Ministry of Children, Youth and Sport and the Ministry of Education have been supporting this prevention program since 1995.

Evidence of impact on health
Controlled prospective study was made in Békéscsaba (Hungary) in 2001/2002, with 200 index and 213 control school children aged 6-14 years. In the index group considerable, significant improvement of postural muscles was found, whereas postural muscles of the control group did not change or worsened significantly. (Evaluation was made using Student t-tests and non-parameter tests.)

Links

www.gnk.hu (website if the National Center of Spinal Disorders)

National Public Health Program: www.eum.hu (website of the Ministry of Health)

physioth@axelero.hu : e-mail adress of the Hungarian Association of Physiotherapist – here one can get informations on courses of the preventing material for physical education.

European Congress on Prevention of Diseases through Physiotherapy, Vienna, 27-30 Nov 2002: plenary lecture.

14th International Congress of the World Confederation for Physical Therapy, Barcelona, 7-12 June 2003: two plenary lectures.

Gardi Zs., Feszthammer A., Darabosné Tim I., Tóthné Steinhausz V., Somhegyi A., Varga P.: Primary prevention program of the Hungarian Spine Society I. – Scientific background of the exercise material. Ideggyógyászati Szemle (Clinical Neuroscience), 2005; 58(3-4):105-112. (English abstract)

Somhegyi A., Tóth J., Makszin I., Gardi Zs., Feszthammer A., Darabosné Tim I., Tóthné Steinhausz V., Tóthné Szabó K., Varga P.: Primary prevention program of the Hungarian Spine Society II – controlled prospective study of short term efficacy. Ideggyógyászati Szemle (Clinical Neuroscience) 2005; 58(5-6):177-182 (English abstract)