There is a paucity of information regarding the development of body posture during adolescence. This three-year prospective study aimed to evaluate sitting and sleeping postures among adolescents, and to determine whether these postures are associated with age and sex. We assessed 525 adolescents aged 11–16 years from the fifth to eighth grades. These adolescents were reassessed three years later. The Back Pain and Body Posture Evaluation Instrument was used to evaluate the sleeping posture and three sitting positions: sitting to write, to use a computer, and during leisure activities. Our findings indicated a low prevalence of adequate sleeping and sitting postures at baseline, with a decrease in prevalence observed after three years for all postures. These changes were similar for both sexes. Moreover, we found a strong reduction of adequate posture prevalence for younger adolescents, but the oldest adolescents demonstrated no significant differences after three years. Early, rather than late, adolescence is a critical period for establishing inadequate sitting and sleeping postures. This has implications for posture throughout adulthood; hence, interventions targeted at this age group are needed.
A coluna vertebral é um segmento complexo e a sua flexibilidade é importante para o aumento da resistência às forças de pressão e para a manutenção da postura corporal. No entanto, ainda não está clara, na literatura, a relação entre a postura estática da coluna vertebral com a sua flexibilidade. Verificar se a postura estática da coluna vertebral está relacionada com a sua flexibilidade, bem como o comportamento dessas variáveis entre os sexos. Participaram deste estudo 36 sujeitos de 7 a 18 anos de idade, que realizaram raios-x panorâmicos da coluna vertebral na incidência perfil direito. Nas radiografias foram medidos os ângulos de Cobb, das curvaturas torácica e lombar. A flexibilidade da coluna vertebral foi verificada por meio do Flexicurva. A avaliação consistiu na demarcação dos pontos anatômicos T1, T6 e T12 para a cifose torácica e T12, L4 e S2 para lordose lombar. Após, o Flexicurva foi moldado no dorso dos indivíduos durante três momentos: (a) com coluna neutra, (b) com coluna flexionada e (c) com coluna estendida, tanto para a coluna lombar quanto torácica. Em seguida, o contorno do dorso foi transcrito para um papel milimetrado. A partir das medidas obtidas, foi possível obter a flexibilidade total da coluna, bem como de flexão e extensão, além dos índices de cifose torácica e lordose lombar. Foram utilizados os testes de Correlação Produto-Momento de Pearson, o Coeficiente Correlação de Spearman e MANOVA (α<0,05). Não foram encontradas correlações entre as ADMs da coluna vertebral com os ângulos de Cobb de cifose e lordose. No entanto, foram encontradas correlações variando de moderada a alta entre as ADMs torácicas e lombares com os índices dessas regiões. A comparação entre os sexos demonstrou que os meninos possuem maiores valores de ADM de flexão lombar enquanto as meninas possuem maiores valores de ADM de flexão torácica. Não é possível afirmar que o ângulo de Cobb de cifose e lordose está relacionado com a flexibilidade da coluna vertebral, no entanto, os índices dessas regiões parecem ser um bom indicativo da flexibilidade.
Introduction: Spine problems are common, and assessment of spine flexibility provides relevant information; however, alternative evaluation methods need to be validated. Objective: To evaluate the concurrent validity of the Flexicurve using 3D videogrammetry as a reference value to assess spinal flexion and extension in the lumbar and thoracic regions. Method: The consecutive sample consisted of 39 individuals aged between 18 and 50 years. Two consecutive evaluations were performed by the same rater on the same day and at the same location: (1) Flexicurve and (2) 3D videogrammetry. The assessments were performed with the spine in the neutral position, followed by maximum flexion and extension. The range of motion (ROM) in the maximum flexion and extension positions was calculated in MATLAB® and defined as the difference between the maximum flexion or extension angle and that of the neutral position. Statistical analyses used were the Pearson Product-Moment Correlation coefficient, RMS error and Bland-Altman plot (α < 0.05). Results: The ROM between instruments was similar, with high correlations for thoracic flexion (r = 0.751), extension (r = 0.814) and lumbar flexion (r = 0.853), and RMS errors under 8°. The correlation for lumbar extension was moderate (r = 0.613) and the RMS error was more than 10°. The limits of agreement varied between ± 10º and ± 21º. Conclusion: The Flexicurve is valid for assessing maximum flexion and extension of the thoracic spine, and maximum flexion of the lumbar spine. We suggest caution in evaluating the maximum extension of the lumbar spine.
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