Age, Sex, Body Mass Index, and Laterality in the Foot Posture of Adolescents: A Cross Sectional Study.

OBJECTIVE: To investigate the relationship between the right and left foot posture in terms of body mass index (BMI), sex, and age in adolescents aged 10 to 14. METHODS: A total of 1400 adolescents were included. For assessment, the Foot Posture Index (FPI-6) was used. Each foot was assessed and ranked as supinated, normal, or pronated by the sum of the FPI-6 criteria. Each criterion was scored on a scale of -2 to +2, with negative for supinated and positive for pronated posture. A linear mixed model with repeated measures was used for statistical analysis. RESULTS: Sex, BMI, and right and left foot are associated with FPI-6. The total score attributed for male sex (ß = 0.29, P = .04) and the left foot (ß = 0.73, P < .001) was higher (male right foot: mean ± standard deviation [SD], 3.09 ± 2.84, male left foot: 3.76 ± 2.80; female right foot: mean ± SD, 2.28 ± 2.61, female left foot: 3.45 ± 2.66; laterality for left foot: mean ± SD, 3.55 ± 2.71, laterality for right foot: mean ± SD, 2.82 ± 2.7). On the other hand, the correlation coefficient for the BMI was negative (ß = -0.08, P = < .001), which means that the higher the BMI the lower the score attributed to the FPI-6. CONCLUSIONS: The FPI-6 is positively related to the male sex and the left foot-that is, the predicted score is higher, so the feet tend to present with a tendency to pronation. Although BMI is associated with FPI-6, it was not possible to establish a relationship between high BMI and pronation of the feet.

Posture Alignment of Adolescent Idiopathic Scoliosis: Photogrammetry in Scoliosis School Screening.

OBJECTIVE: The objective of this study was to describe the posture patterns of adolescents diagnosed with adolescent idiopathic scoliosis (AIS) in a scoliosis school screening (SSS). METHODS: Two-dimensional photogrammetry was used to assess the posture of 37 adolescents diagnosed with scoliosis (scoliosis group, SG) (Cobb angle ≥10°) and 76 adolescents with a false positive diagnosis (false positive group, FPG) (Cobb angle <10°, angle of trunk rotation ≥7°). In total, 2562 10- to 14-year-old adolescents were enrolled in the SSS, which was performed in public schools in the cities of Amparo, Pedreira, and Mogi Mirim in the state of São Paulo, Brazil. Their posture was analyzed using Postural Analysis Software. Continuous variables were tested using Student t test, and categorical variables were tested using a χ2 test. The SG, FPG, simple curve group, and double curve group were all compared. Bivariate analysis was used to identify associations between postural deviations and scoliosis. The adopted significance level was α = .05. RESULTS: The SG (2.7 ± 1.9°) had greater shoulder obliquity than the FPG (1.9 ± 1.4°) (P = .010), and this deviation was associated with scoliosis (odds ratio [95% CI] P = 1.4 [1.1-1.8] 0.011). The SG had asymmetry between the right- and left-side lower limb frontal angle, shoulder sagittal alignment, and knee angle. The double curve group (3 ± 1.7°) presented a greater value of the vertical alignment of the torso than the simple curve group did (1.9 ± 1°; P = .032). CONCLUSIONS: Adolescents diagnosed with AIS in an SSS had greater shoulder obliquity and asymmetry between the right and left sides. Shoulder obliquity was the only postural deviation associated with AIS.

The Impact of Training Time on Understanding the Treatment of Adolescent Idiopathic Scoliosis According to SOSORT International Guidelines: An Online Survey Study.

The lack of knowledge by health professionals in the management of scoliosis can lead to an erroneous diagnosis. The aim of the current study was to understand the influence of length of professional experience on the knowledge of Brazilian physical therapists regarding international guidelines for the treatment of adolescent idiopathic scoliosis. The study was conducted using an online questionnaire consisting of 23 questions, divided into 8 questions on sociodemographic data and 15 questions based on information provided by the guidelines in the SOSORT 2016. In total, 506 physiotherapists were interviewed, and they comprised the study sample. The results showed that professionals who have been working for more than 6 years in the field have greater knowledge of AIS, seek to become more professional, and with that, have an understanding of AIS that is more aligned with the SOSORT. Length of experience made a difference when considering knowledge of the treatment of idiopathic scoliosis. The present study showed that a time since graduation of 6 years or more was satisfactory.

Posture of Adolescent and the Relationship with Body Mass Index, Sex, and Physical Activity.

Background: The increase in overweight and the physical inactivity in children and adolescents in the last years have been causing constant concerns. The comprehension of the postural patterns contributes to the prevention of postural deviations that could predispose to future pain and disabilities. The aim of this study was to assess the association between posture, sex, body mass index (BMI), and physical activity to understand the relationship of these factors with the posture of adolescents. Methods: We evaluated 217 adolescents of both sexes between 11 and 15 years of age who were students in municipal schools in São Paulo. The posture was assessed by photogrammetry, Foot Posture Index, Flexicurve, and the Scoliometer®. Physical activity was evaluated by the Physical Activity Questionnaire for Children and Adolescent. Results: The group of adolescents with obesity presented a higher angle of lumbar lordosis and the overweight group showed greater anteriorization of the head when compared with the group with normal weight. The females presented greater head anteriorization, Q angle and lumbar lordosis, and the males presented greater projection of the trunk and body forward. The group with sedentary habits showed greater abduction of the scapulae. Conclusions: We concluded that BMI and sex had the highest relationship with the posture of adolescents. Further studies are needed to clarify the association between physical activity and posture. Our results may assist future studies and support preventive and therapeutic actions in the treatment of adolescents' postural changes.

Prevalence of Back Pain and Idiopathic Scoliosis in Adolescents From the Semiarid Region of Brazil: A Cross-sectional Study.

Objective: The purpose of this study was to estimate the prevalence of adolescent idiopathic scoliosis (AIS), and back pain and its risk factors, in schoolchildren from the semiarid region of Brazil. Methods: A total of 520 adolescents aged 10 to 16 years old were assessed. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument questionnaire. The screening for AIS included measuring the angle of trunk rotation using a scoliometer in the Adams forward-bend test. Participants with an angle of trunk rotation ≥ 7° were referred for radiography. The prevalence ratio was estimated by multivariable analysis using a Poisson regression model (α = 0.05). Results: Among the participants, 3.1% (95% confidence interval, 3.2%-6.9%) had a confirmed AIS diagnosis: 1.9% girls and 1.1% boys. There was no difference between boys and girls in AIS prevalence. The prevalence of back pain in the previous 3 months was 63.7% (95% confidence interval, 59.5%-67.7%), at a moderate level (visual analog scale = 3.83; 95% confidence interval, 3.57-4.08). Multivariable analysis showed that back pain is associated with postural variables, sex, and age. Conclusion: The prevalence of AIS in the semiarid region of Brazil was 3.1%, and that of back pain was 63.7%. Only body mass index was different between adolescents with and without AIS, with those with AIS having a lower mean body mass index. Back pain was higher in girls and increased in older adolescents. Furthermore, behavioral and postural habits and hereditary factors were associated with an increased chance of back pain.

Spinal postural alignment variance according to sex and age in 7- and 8-year-old children.

PURPOSE: Children's postural alignment undergoes many adjustments due to the changes in body proportions during the stages of growth. The objective of this study was to quantitatively characterize and analyze spinal postural standards in 7- and 8-year-old children to verify which of the differences found were correlated to age and sex. METHODS: Two hundred thirty public school students (Amparo, São Paulo, Brazil) aged 7 to 8 years were divided into groups according to postural alignment, which were further subdivided by sex and age, for comparison. Digital photos of upright subjects were analyzed to evaluate posture. Lumbar and thoracic curvature, pelvic inclination, head posture, and lateral spine deviation were measured using CorelDraw (Ottawa, Canada) software guidelines and bone landmarks. Descriptive statistics and analysis of variance data analysis were utilized to verify differences among the groups. This was a cross-sectional, descriptive study. RESULTS: Mean values for the variables analyzed were calculated. For lumbar lordosis, 7-year-old boys showed 38.49 degrees +/- 15.32 degrees in comparison to all other groups (42.29 degrees +/- 7.13 degrees ). For thoracic kyphosis, the 7-year-old children presented 28.07 degrees +/- 7.73 degrees , and the 8-year-olds 30.32 degrees +/- 7.73 degrees . Pelvic inclination presented a mean value of 15.82 degrees +/- 5.46 degrees and single lateral spine deviation mean value of 3.48 degrees +/- 2.12 degrees . CONCLUSION: For the sample studied, differences based on sex and age were found for some of the body segments analyzed. The values found in this study may contribute to improved physiotherapeutic treatment when associated with other aspects of the clinical assessment and symptomatology.

Prevalence of Adolescent Idiopathic Scoliosis in the State of São Paulo, Brazil.

STUDY DESIGN: A cross-sectional study. OBJECTIVE: To estimate the prevalence of adolescent idiopathic scoliosis (AIS) in cities in the state of São Paulo, Brazil, as well as to identify demographic, clinical, and lifestyle factors associated with AIS. SUMMARY OF BACKGROUND DATA: AIS is a common three-dimensional spinal deformity. Epidemiological data about the condition in the southern hemisphere are scarce, and Brazil has no public health policies to implement school-based scoliosis screening programs. METHODS: We assessed 2562 adolescents between 10 and 14 years of age. The screening procedure included measurement of the angle of trunk rotation using a scoliometer in the Adams forward bend test and the radiographic examination. RESULTS: The overall prevalence of AIS was 1.5% (95% confidence interval [CI]: 1%-1.9%). The AIS prevalence was higher among the females than among the males-2.2% (95% CI: 1.4%-2.9%) and 0.5% (95% CI: 0.1%-0.9%), respectively. The following factors were associated with the development of AIS: being female (OR = 4.7, 95% CI: 1.8-12.2; P = 0.001) and being in the 13- to 14-year age group (OR = 2.2; 95% CI: 1.0-4.8; P = 0.035). Double curves and right laterality were more common (59.4% and 56.8%, respectively), although the curves were of low magnitude (75% of the curves having a Cobb angle ≤22°), as was the progression factor (≤1.2 in 75% of the cases). CONCLUSION: The prevalence of AIS in cities within the state of São Paulo was similar to that reported in the literature, was higher among females, and was higher during puberty (13-14 years of age). Because puberty occurs later for males than for females, the recommendation to screen both sexes at 10 to 14 years of age should be reconsidered. LEVEL OF EVIDENCE: 3.

The influence of gender and body mass index on the FPI-6 evaluated foot posture of 10- to 14-year-old school children in São Paulo, Brazil: a cross-sectional study.

BACKGROUND: Adolescence is marked by changes to the body, including the feet. The Foot Posture Index (FPI-6) stands out from other foot type classification methods as valid, reliable, and multidimensional. However, the current literature differs according to age group, with little consolidation of normative data in school children, largely due to the influence of such factors as sex, age and body mass index (BMI). Thus, this study assesses foot posture in adolescents according to age, sex and BMI. METHODS: The study evaluated 1.394 adolescents from Amparo and Pedreira regions in São Paulo, Brazil. Subjects were positioned barefoot on a wooden base and each foot was assessed by FPI-6 criteria. Each criterion was scored on a scale of -2 to +2, negative for supinated and positive for pronated posture. Initially the data were assessed for normality using the Shapiro-Wilk test and descriptive statistics were calculated. To investigate and compare the scores of FPI-6 with regards to age and body mass index, analysis of variance (ANOVA) was used, followed by post hoc Tukey. To compare the FPI-6 with regard to gender, an independent student t test was used. All data were analyzed using SPSS version 21.0 and the 5% significance level. RESULTS: Boys had higher scores than girls (p = 0.037) for the right foot, and the group with normal BMI values scored higher than the obese group (p = 0.001). For the left foot, 11- and 13-year-olds differed (p = 0.024) with respect to age in general. The overweight and obese group scored lower than the normal BMI group (p = 0.039; p = 0.001, respectively). CONCLUSIONS: Overall, the feet in this study were classified as normal, with a tendency to pronation, particularly in boys. There were differences between the 11 and 13 year groups and, with regard to BMI, there were higher scores for the group with normal BMI. Therefore, a higher BMI in adolescence is not indicative of a pronated foot type.

Postural assessment of girls between 7 and 10 years of age.

UNLABELLED: Postural alterations are often found in children and teenagers. In this stage of development, the posture undergoes many adjustments and adaptations due to changes of the body and to demanding psychosocial factors. PURPOSE: To identify which postural alterations occur most often in students between 7 and 10 years of age, to identify preventive measures, and to provide information to parents and teachers about the problem of bad posture. METHODS: Thirty three girls in each of 4 age groups between 7 and 10 years of age were assessed, resulting in a sample of 132 subjects. Photos of each girl in the sagittal and frontal planes were examined for postural deviations. RESULTS: The main postural deviations found were knock-knee, medial rotation of the hip, antepulsion, pelvic anteversion, knee hyperextension, lumbar hyperlordosis, valgus ankle, imbalanced shoulders, lateral pelvic inclination, scoliosis, trunk rotation, thoracic hyperkyphosis, winged scapula, shoulder protraction, abducted scapula, medial rotation of shoulders, and head tilt. CONCLUSION: High incidences of postural alterations occur in children of school age. Some of these reflect normal postural development, and get corrected during the child's growth. On the other hand, some alterations are asymmetries that can be caused by daily demands on the body and can result in negative impacts on the quality of life during childhood and adulthood. We emphasize the importance of providing information to parents and teachers about the problem of bad posture.

Professores universitários: descrição de características vocais e posturais / University professor: description of vocal and postural characteristics

O objetivo do presente estudo é descrever as características de voz e postura de professores universitários. Participaram do estudo quatro professores universitários, submetidos à avaliação de voz e postura. As gravações foram feitas de maneira controlada e em seguida submetidas à análise perceptivo-auditivada voz por dois juízes experientes. A avaliação da postura foi realizada por um fisioterapeuta com utilização do Software de Avaliação Postural (Sapo). Quanto à queixa de sintomas vocais os de mais idade e com mais tempo de profissão fizeram autorreferência. Na avaliação perceptivo-auditiva da voz, nenhum dos sujeitos apresentou alteração de voz. Na auto-avaliação nenhum dos sujeitos fez referência à desvantagem vocal, dado compatível com a avaliação perceptivo-auditiva. Na avaliação de postura, todos os sujeitos apresentaram inclinação de cabeça, desnivelamento dos ombros e das escápulas e protração de cabeça. Os casos descritos não permitem afirmar que as alterações posturais associadas ao tempo de profissão e ao envelhecimento podem potencializar o surgimento de alteração de voz em professores universitários. Contudo, percebe-se a relação entre voz e postura, sendo necessários mais estudos com um número maior de sujeitos, para conclusões mais assertivas.

The purpose of this study was to describe characteristics of voice and posture of University professors. The subjects were four professors submitted to voice and posture evaluation. The voice and speech samples were analyzed by two experienced judges. The posture evaluation was carried out by a physiotherapist by using the Postural Assessment Software (Sapo). Regarding the complaints of vocal symptoms the oldest and with longer careers were the ones who self-referred the symptoms. The auditory voice-perception analysis revealed that none of the subjects presented voice disorder. In the self-evaluation questionnaire none of the subjects referred voice handicap. In the posture evaluation, all subjects showed head tilt inclination, protraction head and the unevenness of the shoulders and scapulae. The cases described do not allow us to associate time of service with posture and vocal problems. However we find the relation between voice and posture suggesting more researchers with a larger number of subjects for more assertive conclusions.

El objetivo del presente estudio es describir las características de la voz y la postura profesores universitarios. En el estudio participaron cuatro profesores universitários, que se sometieron a la evaluación de voz y postura. Las grabaciones fueron hechas en una forma controlada y luego sometidos a un análisis perceptual-auditivo de la voz por dos jueces con experiencia. La evaluación de la postura se llevó a cabo por un fisioterapeuta con el software de Evaluación Postural (Sapo). En cuanto a las quejas de los síntomas vocales, los de mas edad y con mas tiempo de profesión han hecho auto-referencia. En la evaluación perceptivo-auditiva de la voz, ninguno de los sujetos tenía alteración de la voz. En la autoevaluación ninguno de los sujetos hizo referencia a la desventaja vocal, dato compatible con la evaluación perceptivo-auditiva. En la evaluación de la postura, todos los sujetos presentaron inclinación de la cabeza, desnivel de los hombros y de los omóplatos y protracción de la cabeza. Los casos descritos no permiten afirmar que los cambios posturales asociados al tiempo de servicio y al envejecimiento pueden aumentar la aparición de alteraciones vocales en profesores universitarios. Sin embargo, se nota la relación entre voz y postura, siendo que se necesita más investigaciónes con un mayor número de sujetos para llegar a conclusiones más firmes.

Avaliação da flexibilidade muscular entre meninos e meninas de 7 e 8 anos / Muscle flexibility assessment among boys and girls aged 7 and 8 years old

A flexibilidade muscular tem importante papel na prevenção de algumas patologias musculoesqueléticas, além de influenciar a postura. A criança em desenvolvimento apresenta maior flexibilidade. O objetivo deste foi avaliar a flexibilidade de crianças de 7 e 8 anos e a existência de diferença entre sexo e idade para essa variável...

Muscle flexibility has an important role in preventing musculoskeletal pathologies, besides influencing posture. Developing children present more flexibility. The purpose was to assess flexibility in 7 and 8 year olds, inquiring whether there are age or sex diferences...

Postural assessment of girls between 7 and 10 years of age

Alterações posturais são freqüentemente encontradas em crianças e adolescentes. Nessa fase, a postura sofre uma série de ajustes e adaptações às mudanças no próprio corpo e à demanda psicossocial que lhe é apresentada, ocorrendo uma grande transformação na busca de um equilíbrio compatível com suas condições. OBJETIVO: Identificar quais as alterações posturais mais freqüentes em escolares, de 7 a 10 anos, com intuito de fundamentar medidas preventivas e, secundariamente, alertar pais e professores para o problema da má postura. MÉTODOS: Foram avaliadas 33 meninas para cada idade entre 7 a 10 anos, totalizando uma amostra de 132 sujeitos. Cada estudante foi observado através de fotos nos planos frontal e sagital. RESULTADOS: Os principais desvios posturais encontrados foram: joelho valgo, rotação medial de quadril, antepulsão, anteversão pélvica, hiperextensão de joelho, hiperlordose lombar, tornozelo valgo, desnível de ombro, inclinação pélvica lateral, escoliose, rotação de tronco, hipercifose torácica, escápula alada, protração de ombros, abdução escapular, rotação medial de ombro e inclinação de cabeça. CONCLUSÃO: Este estudo alcançou seu objetivo de descrever os padrões posturais mais freqüentes entre meninas de 07 a 10 anos. Algumas das alterações posturais descritas são próprias do desenvolvimento postural normal da criança e tendem a serem incorporadas com seu crescimento ù como o valgismo de joelho, a rotação medial de quadril e a hiperlordose lombar. Outras, no entanto, caracterizam assimetrias que podem ser geradas por demandas diárias como, por exemplo, a escoliose.