Relation between Photogrammetry and Spinal Mouse for Sagittal Imbalance Assessment in Adolescents with Thoracic Kyphosis.

The evaluation of postural alignment in childhood and adolescence is fundamental for sports, health, and daily life activities. Spinal Mouse (SM) and photogrammetry (PG) are two of the most debated tools in postural evaluation because choosing the proper instrument is also important to avoid false or misleading data. This research aims to find out the best linear regression models that could relate the analytic kyphosis measurements of the SM with one or more PG parameters of body posture in adolescents with kyphotic posture. Thirty-four adolescents with structural and non-structural kyphosis were analyzed (13.1 ± 1.8 years; 1.59 ± 0.13 m; 47.0 ± 12.2 kg) using SM and PG on the sagittal plane in a standing and forward-bending position, allowing us to measure body vertical inclination, trunk flexion, and sacral inclination and hip position during bending. The stepwise backward procedure was assessed to estimate the variability of the grade of inclination of the spine and thoracic spine curvature with fixed upper and lower limits, evaluated with SM during flexion. In both models, the PG angle between the horizontal line and a line connecting the sacral endplate-C7 spinous process and the PG hip position were the best regressors (adjusted-R2 SM bend = 0.804, p < 0.001; adjusted-R2 SM fixed bending = 0.488, p < 0.001). Several Spinal Mouse and photogrammetry parameters showed significant correlations, especially when the Spinal Mouse measurements were taken when the adolescents were in the forward-bending position. Physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction.

Skeletal changes of the axial axis and lower limbs in overweight children and adolescents / Alterações esqueléticas do eixo axial e de membros inferiores em crianças e adolescentes com excesso de peso

Abstract Objective: To evaluate the presence of axial skeletal deviations in children and adolescents and to relate them to body mass index (BMI), age and sex. Methods: 101 patients aged 7 to 17 years old were included in this study; exclusion criteria were primary orthopedic diseases and syndromes or treatments that affect growth. Patients were grouped according to their BMI Z-score: eutrophic (n=29), overweight (n=18) and obese (n=54). They underwent static clinical inspection was made by simetrographic technique. Intermaleolar distance was obtained, Adam's forward bend and tiptoe tests were performed. Results: When comparing obese and eutrophic patients, changes in the cervical spine (p<0.01), spine (p<0.001), hip (p<0.01) and shoulders (p<0.001) were present in more than half of the obese patients (62.5%, 62.2%, 79.9% and 55.4%, respectively). Changes in the knees were more frequent among obese (p<0.001) when compared to eutrophic patients. There was no variation regarding age or sex (p>0.05). Conclusions: being overweight influences skeletal deviations in children and adolescents.

RESUMO Objetivo: Avaliar a presença de desvios do esqueleto axial em crianças e adolescentes e relacioná-los com índice de massa corpórea, idade e sexo. Métodos: Fizeram parte deste estudo 101 pacientes de sete a 17 anos, os quais não possuíam doenças ortopédicas primárias, síndromes ou tratamentos que afetassem o crescimento. Os pacientes foram agrupados conforme os escores Z do índice de massa corpórea em: eutróficos (n=29), com sobrepeso (n=18) e obesos (n=54). Foram avaliados por meio da inspeção clínica estática, com simetrógrafo de parede, medida da distância intermaleolar, manobra de Adams e teste da ponta dos pés. Resultados: Quando comparados os pacientes obesos com os eutróficos, alterações de coluna cervical (p<0,01), coluna (p<0,001), quadril (p<0,01) e ombros (p<0,001) ocorreram em mais da metade dos obesos (62,5, 62,2, 79,9 e 55,4%, respectivamente). Alterações nos joelhos foram mais frequentes entre os obesos (p<0,001) quando comparados aos eutróficos. Não houve variação com a idade ou o sexo (p>0,05). Conclusões: Conclui-se que o excesso de peso exerce influência sobre desvios do esqueleto em crianças e adolescentes.

Posture and Health: Are the Biomechanical Postural Evaluation and the Postural Evaluation Questionnaire Comparable to and Predictive of the Digitized Biometrics Examination?

BACKGROUND: Postural tone alterations are expressions of myofascial and, therefore, of structural, visceral, and emotional disorders. To prevent these disorders, this study proposes a quantitative investigation method which administers a postural evaluation questionnaire and a postural biomechanical evaluation to 100 healthy subjects. METHODS: The reliability of the method is studied by comparing both assessments with digitized biometrics. In addition, 50 subjects undergo the biomechanical evaluation form twice, by four different operators, to study the intraoperative repeatability. RESULTS: The results show a satisfactory overlap between the results obtained with the postural evaluation questionnaire and the postural biomechanical evaluation compared to computerized biometrics. Furthermore, intraoperative repeatability in the use of the biomechanical evaluation form is demonstrated thanks to a minimal margin of error. CONCLUSIONS: This experience suggests the importance of undertaking this path in both the curative and the preventive sphere on a large scale and on different types of people who easily, and even unknowingly, may face dysfunctional syndromes, not only structural and myofascial but also consequently of the entire body's homeostasis.

Association between lung function, physical activity level and postural evaluation variables in adult patients with cystic fibrosis.

INTRODUCTION: With the evolution of the cystic fibrosis (CF) disease, the decline of lung function associated with metabolic disorders and malnutrition, causes alterations in respiratory mechanics, musculoskeletal disorders and thoracic deformities, bringing injury to the individual's quality of life. OBJECTIVE: To verify the association between lung function, physical activity level and postural evaluation variables in adults with CF. METHODS: All patients underwent clinical evaluation and spirometry. The International Physical Activity Questionnaire (IPAQ) and an accelerometer were used to verify the physical activity level (PA). Photogrammetry was used with the aid of the Software of postural evaluation (SAPO) and, for complementary comparisons, the 6-minute walk test (6MWT) was used. RESULTS: Twenty-eight adult subjects with CF, mean age of 25.1 ± 6.3 years and mean expiratory volume in the first second (FEV1 ) of 47.1 ± 20.9% of the predicted group participated in the study. The FEV1 correlated with the parameters obtained by the accelerometer (r = 0.723, P = .000), postural evaluation (r = -0.483, P = .005) and 6MWT (r = 0.439, P = .019), but there was no correlation with the data obtained by IPAQ (r = -0.282; P = .073). The time in which each individual remained in moderate to vigorous physical activity correlated with parameters of postural evaluation (thoracic kyphosis r = -0.484, P = .031, cervical lordosis r = 0.531, P = .016), 6MWT (r = 0.564; P = .010) and with the total METS obtained by IPAQ (r = 0.451, P = .046). CONCLUSIONS: Lung function in patients with CF disease is associated with higher thoracic kyphosis, shorter time in moderate and vigorous PA, and shorter distance covered in 6MWT. The accelerometer has been shown to be the best instrument for assessing PA in this public.

Agreement between a test based on a qualitative analysis of filmed actions and one based on a questionnaires for assessing student body posture / Questionários e filmagens fornencem resultados semelhantes sobre a postura corporal dinâmica de escolares? / Cuestionarios y grabaciones proporcionan resultados similares sobre la postura corporal dinámica escolar?

This article aims to verify if the instruments Back Pain and Body Posture Evaluation Instrument (BackPEI) and Layout for Assessing Dynamic Posture (LADy), which evaluate the dynamic posture of schoolchildren using questionnaires and qualitative analysis of filming, respectively, provide similar concordance on activities, such as sitting down to write, sitting down to use the computer, picking up an object from the ground, and carrying a backpack. The sample was composed by 58 schoolchildren of both sexes (age = 12.94 ± 1.22 years, body mass = 52.34 ± 12.24 kilograms, and height = 1.64 ± 0.07 meters). The children were evaluated using both instruments. The instruments show similar levels of concordance (84.5% to 98.3%) and significant association (p<0.05) in the daily activities studied.

Este estudo teve como objetivo verificar se os instrumentos Back Painand Body Posture Evaluation Instrument (BackPEI) e Lay-out for Assessing Dynamic Posture (LADy), que consistem em questionário e análise qualitativa de filmagem, respectivamente, para avaliar a postura corporal dinâmica, Fornecem informações concordantes nas atividades de sentar para escrever, sentar para utilizar o computador, pegar objeto do solo e transportar mochila. A amostra foi composta por 58 escolares de ambos os sexos (idade = 12,94 + 1,22 anos, massa corporal = 52,34 + 12,24 quilos e estatura = 1,64 + 0,07 metros), que foram avaliados por ambos os instrumentos. Os instrumentos apresentam níveis similares de concordância (84,5% a 98,3%) e associação significativa (p<0,05) nas atividades de vida diária avaliadas.

El estudio tuvo como objetivo comprobar si los instrumentos Back Pain and Body Posture Evaluation Instrument (BackPEI) y Lay-out for Assessing Dynamic Posture(LADy), que se utilizan de cuestionario y análisis cualitativo de grabación, respectivamente, para evaluar la postura corporal dinámica. Proporcionan informaciones similares en actividades tales como sentarse a escribir, sentarse a usar la computadora, recoger objetos del suelo y transportar transpórtela mochila. La muestra fue compuesta de 58 escolares de ambos sexos (edad = 12,94 + 1,22 años, masa corporal = 52,34 + 12,24 kilogramos e la altura = 1,64 + 0,07 metros), que fueron evaluados por ambos instrumentos. Los instrumentos presentan niveles similares de concordancia (98,3% al 84,5%) y asociación significativa (p<0,05) en las actividades de la vida diaria estudiadas.

Moiré topography: an alternative to scoliosis evaluation in student's health

Moire's Topography (MT) is a method that detects scoliosis through shadows assymetry arised in the back. Few studies have discussed time of application, interpretation and operating cost. The aim of this study was to analyze operating aspescts of MT in students and to verify postural alterations by MT in the same group. 58 boys were analyzed in this study and through MT, the presence of shadow (fringes) in the back were evaluated where each assymetry corresponds to about 10º in Cobb's angle. MT marks were used to determine possible deviation. Data of interest received descriptive statistic analysis in variables such as total body mass, body mass index (BMI), weight, scoliosis, average time of analysis and diagnostic, and also the operation cost evaluation of equipment. Subjects (9,91 ± 0,79 years) showed total body mass of 37,83 ± 10,45kg, stature 1,42 ± 0,11m and BDI 18,53 ± 4,15 kg/m². The average time of analysis was 3,25 ± 0,29min. Among subjects 75% had deviation of one fringe in toracolumbar region that shows a scoliosis less than 10º. MT represented a fast method and of low operation cost that could be an important instrument in the screening of scoliosis. We concluded that MS confirmed to be practical and of easy handling where 94,6% subjects showed scoliosis. Our data suggests that the MSP insertion in the students' health care program of scoliosis identification is possible...(AU)

A Estereofotografia de Moiré (EFM) é um método que através da assimetria das sombras formadas no dorso detecta escoliose. Poucos os estudos tem discutido o tempo de análise, interpretação e custo operacional desta técnica. Os objetivos deste trabalho foram analisar os aspectos operacionais da (EFM) em escolares e; verificar desvios posturais pela EFM nesse mesmo grupo. Neste estudo foram analisadas 58 meninos e através da EFM, foram avaliadas a presença de sombras (franjas) no dorso, onde cada assimetria corresponde cerca de 10º no ângulo de Cobb. As marcações do EFM foram utilizadas para determinar os possíveis desvios. Os dados interesse receberam tratamento estatístico descritivo nas variáveis massa corporal total, índice de massa corporal (IMC), estatura, escoliose, tempo médio de análise e diagnóstico e, uma avaliação do custo operacional do equipamento. Os sujeitos (9,91 ± 0,79 anos) apresentaram uma massa corporal total de 37,83 ± 10,45kg, estatura 1,42 ± 0,11m e o IMC de 18,53 ± 4,15 kg/m². O tempo médio para análise foi de 3,25 ± 0,29min. Na amostra, 75% tiveram um desvio de até uma franja na região toracolombar o que indica uma escoliose menor que 10º. A EFM constituiu um método rápido e de baixo custo operacional podendo ser um instrumento importante no rastreamento de escoliose. Concluímos que a EFM de confirmou ser prático e de fácil manuseio que 94,6% dos sujeitos apresentaram escoliose. Os nossos dados sugerem que a é viável a inserção da EFM nos programas de saúde em escolares de detecção das escolioses...(AU)

Moiré topography: an alternative to scoliosis evaluation in student's health

Moire's Topography (MT) is a method that detects scoliosis through shadows assymetry arised in the back. Few studies have discussed time of application, interpretation and operating cost. The aim of this study was to analyze operating aspescts of MT in students and to verify postural alterations by MT in the same group. 58 boys were analyzed in this study and through MT, the presence of shadow (fringes) in the back were evaluated where each assymetry corresponds to about 10º in Cobb's angle. MT marks were used to determine possible deviation. Data of interest received descriptive statistic analysis in variables such as total body mass, body mass index (BMI), weight, scoliosis, average time of analysis and diagnostic, and also the operation cost evaluation of equipment. Subjects (9,91 ± 0,79 years) showed total body mass of 37,83 ± 10,45kg, stature 1,42 ± 0,11m and BDI 18,53 ± 4,15 kg/m². The average time of analysis was 3,25 ± 0,29min. Among subjects 75% had deviation of one fringe in toracolumbar region that shows a scoliosis less than 10º. MT represented a fast method and of low operation cost that could be an important instrument in the screening of scoliosis. We concluded that MS confirmed to be practical and of easy handling where 94,6% subjects showed scoliosis. Our data suggests that the MSP insertion in the students' health care program of scoliosis identification is possible...

A Estereofotografia de Moiré (EFM) é um método que através da assimetria das sombras formadas no dorso detecta escoliose. Poucos os estudos tem discutido o tempo de análise, interpretação e custo operacional desta técnica. Os objetivos deste trabalho foram analisar os aspectos operacionais da (EFM) em escolares e; verificar desvios posturais pela EFM nesse mesmo grupo. Neste estudo foram analisadas 58 meninos e através da EFM, foram avaliadas a presença de sombras (franjas) no dorso, onde cada assimetria corresponde cerca de 10º no ângulo de Cobb. As marcações do EFM foram utilizadas para determinar os possíveis desvios. Os dados interesse receberam tratamento estatístico descritivo nas variáveis massa corporal total, índice de massa corporal (IMC), estatura, escoliose, tempo médio de análise e diagnóstico e, uma avaliação do custo operacional do equipamento. Os sujeitos (9,91 ± 0,79 anos) apresentaram uma massa corporal total de 37,83 ± 10,45kg, estatura 1,42 ± 0,11m e o IMC de 18,53 ± 4,15 kg/m². O tempo médio para análise foi de 3,25 ± 0,29min. Na amostra, 75% tiveram um desvio de até uma franja na região toracolombar o que indica uma escoliose menor que 10º. A EFM constituiu um método rápido e de baixo custo operacional podendo ser um instrumento importante no rastreamento de escoliose. Concluímos que a EFM de confirmou ser prático e de fácil manuseio que 94,6% dos sujeitos apresentaram escoliose. Os nossos dados sugerem que a é viável a inserção da EFM nos programas de saúde em escolares de detecção das escolioses...

Prevalence of postural deviations in school of educationand professional practice of physical education

This study aimed to verify through postural assessment proposed by Kendall, McCreary and Provance (1990),the prevalence of postural alignment of elementary school students of both sexes, aged between seven andten years. For the definition of the survey, was chosen a private school in the city of Hortolandia - SP wereevaluated in 201 schools. The methodology was the demarcation of the spinous processes of the cervical,thoracic and lumbar vertebrae of the students were evaluated after posterior and lateral views. Data weretabulated and treated statistically. The results showed a high incidence in postural deviations and asymmetriescompared to existing research. It was observed that boys showed an incidence of kyphosis and lordosis higherthan girls and that scoliosis is present in more girls.

A Influência da postura sobre as capacidades motoras: agilidade, força e velocidade / Posture’s influence on motor capacities: agility, strength and speed

A procura por bons resultados no desempenho físico em modalidades esportivas faz com que os indivíduos se preocupem com seus hábitos diários, especialmente aqueles que podem comprometer a sua performance. Fatores como hábitos alimentares, hábitos posturais e vida estressante são exemplos que podem afetar esse desempenho. Deste modo, com o propósito de compreender de forma mais abrangente a relação entre postura e desempenho físico, o presente estudo pretende verificar a relação existente entre alterações da postura estática com o desempenho físico das capacidades motoras: força, agilidade e velocidade, em adolescentes. Foram avaliados trinta alunos de uma escola de Porto Alegre – RS, entre quinze e dezessete anos. A avaliação postural consistiu em palpação e marcação de pontos anatômicos, colocação de marcadores reflexivos sobre os pontos anatômicos e registros fotográficos da postura ereta no plano sagital (perfil direito). Para a análise da postura foram digitalizados os pontos reflexivos utilizando o Software APPID (Avaliação postural por Imagem Digital). A avaliação física consistiu na realização de testes físicos propostos pelo Projeto Esporte Brasil: (1) agilidade, (2) força explosiva de membros inferiores, (3) força explosiva de membros superiores e (4) velocidade. Os dados dos testes físicos e posturais foram submetidos a tratamento estatístico, através de testes de correlação, sendo o nível de significância adotado de 0,05. Os resultados demonstraram que os adolescentes possuem uma postura característica de dorso curvo, determinada pela grande freqüência das alterações da cervical e ombros (anteriorizados), da dorsal (aumentada), da pelve (retroversão), da lombar (diminuída) e dos joelhos (genuflexum)...

The search for satisfactory outcomes of physical performance in sportive modalities makes people concern about their daily habits, especially those which may compromise their performance. Some factors like alimentary and postural habits, beyond stressing life are examples that may affect this performance. In order to comprehend the relation between posture and physical performance in a broader sense, this study intends to verify the relation existent between static posture’s alterations and physical performance of motor capacities: strength, agility and speed of teenagers. Thirty students from a school of Porto Alegre-RS were evaluated. They were between fifteen and seventeen years old. The postural evaluation consisted of palpation and marking of anatomical points, collocation of reflexive markers on anatomical points, and photographic registers of erect posture in the sagittal plane (right profile). For the posture’s analysis, the reflexive points were digitalized by the software APPID (Avaliação postural por Imagem Digital). The physical evaluation consisted of physical tests accomplishment proposed by the Project Esporte Brasil: (1) agility, (2) explosive strength of inferior members, (3) explosive strength of superior members and (4) dislocation’s speed. The data of the physical and postural tests were submitted by statistical treatment through correlation tests, considering the significance level 0,05. The results demonstrated that the teenagers have a characteristic posture of curved back, which is determined by great frequency of alterations in cervical and shoulder (anterior transposition), dorsal (increased), pelvis (retroversion), low back (diminished), and knees (genuflexum)...

Avaliação da escoliose e seu risco evolutivo em três crianças com síndrome de Marfan / Evaluation of scoliosis and its evolutionary risk in three brothers with Marfan?s syndrome

Síndrome de Marfan (SM) é uma alteração genética, autossômica dominante, envolvendo necessariamente os derivados do tecido conjuntivo, com repercussão multissistêmica, em três sistemas principais: ocular, músculo-esquelético e cardiovascular. Dentre as alterações músculo-esqueléticas se evidencia a escoliose, que se caracteriza por um desvio tridimensional da coluna, apresentando deformidades estruturais e limitações funcionais. O objetivo deste estudo foi avaliar as alterações posturais, em especial a escoliose, bem como seu risco evolutivo em três irmãos com síndrome de Marfan, com idades entre 7 e 8 anos, submetidos a anamnese, avaliação postural por meio da biofotogrametria computadorizada, avaliação radiológica, avaliação pôndero-estatural e presença de caracteres sexuais secundários. As três crianças com SM avaliadas neste estudo apresentam alterações posturais, em que se destaca uma escoliose com risco evolutivo, definido pela correlação com os dados da anamnese, da avaliação radiológica, as características da síndrome e o potencial de crescimento evidenciado, pela avaliação pôndero-estatural e ausência de sinais de amadurecimento sexual.