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 spinal column of children and adolescents. METHODS: 59 students were evaluated through the self-reporting Back Pain and Body Posture Evaluation Instrument and spinal panoramic radiographic examination. Spine curvatures were classified based on Cobb angles, as normal or altered in the saggital plane and as normal or scoliotic in the frontal plane. Data were analyzed using SPSS 18.0, based on descriptive statistics and chi-square association test (a=0,05). RESULTS: The prevalence of postural changes was 79.7% (n=47), of which 47.5% (n=28) showed frontal plane changes and 61% (n=36) sagital plane changes. Significant association was found between the presence of thoracic kyphosis and female gender, practice of physical exercises only once or twice a week, sleep time greater than 10 hours, inadequate postures when sitting on a seat and sitting down to write, and how school supplies are carried. Lumbar lordosis was associated with the inadequate way of carrying the school backpack (asymmetric); and scoliosis was associated wuth the practice of competitive sports and sleep time greater than 10 hours. CONCLUSIONS: Lifestyle may be associated with postural changes. It is important to develop health policies in order to reduce the prevalence of postural changes, by decreasing the associated risk factors.

研究目的：探讨行为风险因素（尤其是姿势习惯）与儿童青少年脊柱结构性改变之间的关联。
研究方法：共纳入59名学生，采用自评式背痛与身体姿势评估工具（Back Pain and Body Posture Evaluation Instrument）以及脊柱全景X线摄影检查进行评估。基于Cobb角（Cobb angle）对脊柱曲度进行分类：矢状面分为正常与异常，冠状面分为正常与脊柱侧凸。采用SPSS 18.0软件进行数据分析，基于描述性统计及卡方关联检验（chi-square association test，检验水准α=0.05）。
研究结果：姿势异常的患病率为79.7%（n=47），其中47.5%（n=28）存在冠状面姿势异常，61.0%（n=36）存在矢状面姿势异常。研究发现胸椎后凸与女性性别、每周仅1~2次体育锻炼、睡眠时间超过10小时、坐位姿势不当、伏案书写姿势不当以及书包携带方式存在显著关联。腰椎前凸与书包背负方式不当（不对称背负）相关；脊柱侧凸则与竞技体育锻炼及睡眠时间超过10小时存在关联。
研究结论：生活方式可能与姿势异常相关。应制定健康政策以降低相关风险因素，从而减少姿势异常的患病率。