Background
Postural disorders are prevalent in children and can lead to various chronic conditions in adulthood. Environmental, socioeconomic, and intrinsic factors influence postural development during puberty. Despite the potential benefits, school-based postural screenings are controversial due to concerns about costs, overreferrals, and unnecessary diagnostic procedures.
Objective
This study aims to evaluate the prevalence of postural deviations among schoolchildren aged 7-13 in the german-polish border region and to assess the influence of demographic and anthropometric factors on these deviations to optimize future screening programs.
Study Design
A retrospective analysis of anonymised data from the screening program conducted between 2018 and 2019. The study is based on the results a comprehensive clinical examination of postural features conducted by a team of seven experienced physiotherapists.
Methods
The study sampled the examiniation data of 800 children (male: 367, female: 433) ages between 7 and 13, assessing 14 postural features including spinal alignment in various planes, pelvic static, body alignment, foot anatomy, and muscle functionality. Statistical analyses were conducted to identify significant correlations between postural deviations and factors such as sex, age, Body Mass Index (BMI),
and Body Fat Percentage (BFP). The subjects were categorized into quartiles based on these anthropometric measurements to explore significant trends.
Results
The data shows that 80.6 % of all participants had at least one postural deviation. Overall 23.8 % of children were referred to a specialist for further consultation. The five most common postural deviations resulting in a referral are in body alignment (56.8 %), foot anatomy (53.1 %), spinal transverse plane (48.4 %) followed by muscle weakness (44.7 %) and spinal sagittal plane plane (42.6 %). Among all
children complex spinal deformities like scoliosis (7.1 %) are less prevalent. The obesity rate is 24.6 %. Significant findings include an increase in muscle shortening with age and a higher prevalence of pelvic static issues and hyperkyphosis with lower BMI. High BFP was correlated with foot anomalies. No significant sex-based differences were noted after adjustments for multiple comparisons. Scoliosis, flat back and hyperlordosis showed no significant change in prevalence with age, sex, BMI or BFP.
Conclusion(s)
The study provides clinical evidence for targeted postural screening programs that focus on children at high risk due to specific anthropometric profiles, potentially reducing the financial burden and incidence of overreferrals in school-based screenings. The results highlighted that the substantial referral rate was
primarily influenced by BMI and BFP deviations from the normative values of the World Health Organization. However, for scoliosis no simple anthropometric risk factor screening was identified that justifies a more targeted screening approach.