[Lumbar hyperlordosis in children and adolescents at a privative school in southern Brazil: occurrence and associated factors]

Effects of Pilates in children and adolescents - A systematic review and meta-analysis

BACKGROUND

Pilates can be performed by children as a form of exercise to promote healthy growth and development. The increasing use of Pilates as a type of exercise for children or as an adjunct tool in pediatric rehabilitation should be supported by evidence of its benefits. The aim of this systematic review and meta-analysis was to assess the effects of Pilates as an exercise prescription for children and adolescents.

METHODS

Five electronic databases were searched to identify trials (randomized controlled clinical trials or quasi-experimental studies) with a population of children or adolescents in which Pilates (mat or equipment) was performed as a form of exercise. Studies that investigated outcomes related to health and physical performance was analyzed. Individual trial effects were extracted and pooled for meta-analysis whenever possible. To evaluate the external and internal validity of the studies, we assessed their risk of bias.

RESULTS

Fifteen studies (from 945 records), including 1235 participants, met the eligibility criteria, and were included. The reported outcomes were heterogeneous, so only the effect on flexibility could be included in the meta-analysis (n = 4 studies). A significant positive trend toward improved flexibility for the control group compared with the Pilates group was found (Std. mean difference, 0.54; 95%CI: 0,18, 0.91; p = 0.003).

CONCLUSION

Few studies have assessed the effect of Pilates on children and adolescents. The lack of appropriate methodological descriptions/controls made it impossible to determine if all of the included studies were of good quality.

Influence of Sex and Body Mass Index on the Thoracic Kyphosis and Lumbar Lordosis

OBJECTIVES

The purpose of this study was to assess the influence of sex and body mass index (BMI) on the thoracic kyphosis and lumbar lordosis of adolescents and to assess the reliability and agreement of the flexicurve method for these measurements.

METHODS

The study included 217 adolescents of both sexes, aged between 11 and 15 years, who were students from municipal schools in the city of São José dos Campos in São Paulo. The measurement of thoracic kyphosis and lumbar lordosis angles was performed using the flexicurve method. Descriptive analysis of the data, analysis of covariance for comparison between groups (by BMI and sex), assessment of reliability, and intrarater agreement were analyzed.

RESULTS

There was a significant difference between the groups by BMI and sex only for lumbar lordosis. The obese group had greater lumbar angles for both sexes (female sex: 32.6° ± 7.8° [eutrophic]; 37.7° ± 7.3° [obese]; male sex: 25.3° ± 7.3° [eutrophic]; 32.2° ± 7.3° [obese]). In the comparison between the sexes, the greatest lumbar angles were found in the female sex (female sex: 32.6° ± 7.8°; male sex: 25.3° ± 7.3°) among the eutrophic. Excellent intrarater reliability was found for thoracic kyphosis (intraclass correlation coefficient, 0.86) and moderate for lumbar lordosis (intraclass correlation coefficient, 0.72).

CONCLUSION

Sex and BMI were associated with lumbar lordosis in adolescents and were greater in individuals with obesity and female individuals. The flexicurve method was reliable and accurate for the assessment of thoracic kyphosis and lumbar lordosis in adolescents.

How does the activity level of the parents influence their children's activity? The contemporary life in a world ruled by electronic devices

INTRODUCTION

Apart from many positive changes associated with technical civilization, there are also - from the health point of view - some threats. The reduction in the level of physical activity is one of them. The aim of the study was to investigate whether there are any relationships between children's physical activity and behaviors, and to assess the impact of the adults' activity on their children's habits.

MATERIAL AND METHODS

The study involved a group of 340 children aged 7-12 years (mean age: 9.81 ±1.7) and their parents. In order to evaluate children's physical activity and the amount of time that they spend with electronic devices, an original questionnaire and the IPAQ questionnaire were used.

RESULTS

Children usually use electronic devices between 2 and 7 days per week (mean: 4.74 ±0.86), regardless of sex (p > 0.09) and spend between 5 and 1620 min per week (mean: 459.46 ±308.1) with their mobile phone, tablet, PCs and TVs. 67.92% of boys and 69.61% of girls lead an active lifestyle. The children's activity level depends on their parents' level of activity (p < 0.000001). Parents of semi-active children lead a lifestyle with a moderate level of physical activity.

CONCLUSIONS

The level of physical activity in younger children depends on the children's relationship with their parents and their level of activity. Children spend a lot of free time with their electronic devices. It is necessary to develop and implement activities intended to raise awareness of children and their families about the effects of hypokinesis.

The weight of pupils' schoolbags in early school age and its influence on body posture

BACKGROUND

Postural development progresses through a series of stages (growth spurts, development of balance and coordination, postural stability) which occur when children are at school age. The reduction in the level of physical activity, increased body weight, overloaded school bags, asymmetry of the backpack straps, the method of putting on and taking off the backpacks and increased usage of electronic devices have negative side effects such as bad body posture habits.

METHODS

A prospective cohort study in the group of 155 pupils at early school age 7-9 years old has been conducted. Examinations have been conducted twice: first, at the beginning of the school year (initial examination) and second - after 10-11 months (final examination). Age, gender, BMI, weight of school bag carried to school and the length of straps have been assessed. Body posture measurement (using Adams' test), the evaluation of the plumb line deflection from the gluteal cleft, the angle values of kyphosis and lordosis (according to Dobosiewicz methodology) and the pelvis and shoulder blades position (using a ruler and pediscoliometer) have been also measured.

RESULTS

The mean weight of a school bag in the initial study was 6.3 ± 0.8 (range between 4,7 and 9 kg). A tendency to carry slightly heavier school bags was noted in boys (6.7 vs. 5.9 kg; p = 0,00001). This tendency has linearly changed with age (R = 0.68; p < 0,001). In 3.2% of all school bags of children, weights exceeded norms with regard to the weight of the pupil. The increase of torso rotation exceeding norms was observed in 35.3% of girls (mean 2.7 ± 1.2) and in 60.9% of boys (mean 2.3 ± 1.3). The increase of kyphosis angle was noted in 48.5% of girls and in 36.8% of boys. The difference of straps length had a significant influence on the increase of rotation in upper thoracic spine, thoracolumbar junction and it also had influence on the decrease of lumbar lordosis in the group of girls.

CONCLUSIONS

Differences in the weight of school bags after one school year have influenced changes in body posture abnormalities, especially in rotation parameters. Backpack straps asymmetry was noticeably stronger in the group of girls and the difference between braces may have an impact on some posturometric parameters. Lack of proper backpack lifting skills tends to create programs and training systems in this regard.

Body posture and pulmonary function in mouth and nose breathing children: cross-sectional study

Abstract Introduction: Mouth breathing can lead to changes in body posture and pulmonary function. However, the consequences are still inconclusive and a number of studies are controversial. Objective: Evaluate and correlate spirometric parameters and postural measures in mouth breathing children, and compare them to nose breathers. Methods: two groups of 6 to 12 year-old children were evaluated: mouth breathers (MB, n = 55) and nose breathers (NB, n = 45). Spirometry and body posture analysis using photogrammetry (SAPo 0.68® v) were carried out. The following spirometric measures were evaluated: peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio (%) and forced expiratory flow between 25% and 75% of FVC (FEF 25-75%). Biophotogrammetric measures analyzed were: horizontal alignment of acromions (HAA) and anterior superior iliac spine (HAASIS), Charpy angle, horizontal alignment of the head (HAH), cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), cervical distance (CD) and lumbar distance (LD). Results: There were no intergroup differences in spirometric and postural variables. Positive and moderate correlations were found between CL and CD measures with PEF, FEV1, FVC and FEF 25-75%, while weak correlations were observed between lumbar lordosis and PEF, FEV1 and FVC. Conclusion: The breathing mode had no influence on postural and respiratory measures. However, greater forward head posture, with smaller cervical lordosis, was related to higher lung volumes and flows in both groups.

Monitoring the prevalence of postural changes in schoolchildren

[Purpose] The aim of this study was to identify whether postural changes are prevalent with advancing age using a photogrammetric method performing one-year follow-up study. [Subjects and Methods] Thirty-eight schoolchildren were evaluated in 2011 and 2012 in this cohort study. The subjects underwent a postural evaluation, which involved palpation of reference anatomic points, placement of reflexive markers over the anatomic points, image acquisition, and point digitalization using the Digital Image-based Postural Assessment evaluation software. For data analysis, descriptive statistics and inferential statistics were analyzed by McNemar’s test. [Results] The results showed a significant increase in postural change prevalence for the lumbar spine in the sagittal plane (from 42.2% to 81.6%) and the knees in the frontal plane (from 39.5% to 63.2%) and a significant decrease in the prevalence of scoliosis (from 68.5% to 42.2%). [Conclusion] The findings indicate an increase in the prevalence of postural changes in schoolchildren from Teutônia, RS, Brazil, in 2012 compared with 2011. The development of longitudinal investigations for long-term monitoring of the evolution of posture and of schoolchildren habits’s representing a viable alternative to subsidize health actions.

[Risk factors associated with structural postural changes in the spinal column of children and adolescents]

OBJECTIVE

To investigate the association between behavioral risk factors, specifically postural habits, with the presence of structural changes in the spine of children and adolescents.

METHODS

59 students were evaluated through the self-reporting Back Pain and Body Posture Evaluation Instrument e and the spine panoramic radiographic examination. The spine curvatures were classified, based on Cobb' angle, as normal or altered in the saggital plane and as normal or scoliotic in the frontal plane. Data were analyzed using SPSS 18.0, from descriptive statistics and chi-square association test (α=0,05).

RESULTS

The prevalence of postural alterations was 79.7% (n=47), of which 47.5% (n=28) showed frontal plane alterations and 61% (n=36) sagital plane alterations. Significant association was found between the presence of thoracic kyphosis and female gender, practice of physical exercise only once or twice a week, sleep time greater than 10 hours, inappropriate postures to sit on the bench and sit down to write, and transport of school supplies. Lumbar lordosis was associated with improperly transportation of school backpack (asymmetric); and scoliosis was associated with the practice of competitive sport and sleep time greater than 10 hours.

CONCLUSIONS

Lifestyle may be associated with postural alterations. It is important to develop health policies in order to reduce the prevalence of postural alterations with a reduction of associated risk factors.

[Influence of flexibility and gender on the posture of school children]

Objective:

To evaluate whether flexibility and gender influence students' posture.

Method:

Evaluation of 60 female and male students, aged 5 to 14 years, divided into two groups: normal flexibility (n=21) and reduced flexibility (n=39). Flexibility and posture were assessed by photogrammetry and by the elevation of the lower limbs in extension, considering the leg angle and the postural evaluation. Descriptive statistics (mean and standard deviation) were used for data analysis. Analysis of variance (ANOVA) was applied to assess the joint influence of flexibility and gender on the posture-dependent variables. After verifying an interactive effect between the variables of gender and flexibility, multiple comparisons using the t test were applied.

Results:

Flexibility influenced the symmetry angle of the knee (p<0.05) and anteroposterior body tilt (p<0.05). Gender did not influence postural angles (p>0.05). There was an interactive effect between the variables of gender and flexibility on the knee symmetry angle (p<0.02). Male students with reduced flexibility had greater asymmetry of the knee when compared to the other subgroups.

Conclusion:

Posture was influenced by an isolated effect of the variable of flexibility and by an interactive effect between gender and flexibility.