The prevalence and changes in postural abnormalities during the course of adolescence amongst a selected group of black children : the PAHL-study

Abstract

Evidence exists that during growth and development in children and adolescents’ various postural disorders may occur, especially in school-age children. Research regarding the changes in posture during the course of adolescents, especially in black children is, however, limited. Improper postures adopted by children and adolescents at home and at school cause body musculature imbalances that result in postural deviations that may last throughout adulthood. Modern lifestyle and the convenience of technology can be seen as a predictor of poor posture and postural adaptations in children, but most black South African children in rural areas do not have access to computers and electronic devices. These children usually have to travel long distances carrying school back by foot and their food intake is mostly unbalanced and inadequate, which may result in poor posture over time. Boys and girls do not go through similar postural changes during adolescence and therefore gender differences that exist in the postural stability and development of children should be taken into consideration. It is important for educators, parents, and healthcare individuals to understand normal growth patterns and be aware of significant changes in a child’s posture during normal growth and development in order to identify postural deviations. The aim of this study was therefore to determine the prevalence and changes of postural deformities during the course of adolescence amongst a selected group of black boys and girls in the Potchefstroom area of the North West Province, South Africa. A total of 100 African adolescents, aged 14 years in 2010 and 18 years in 2014, who were part of Physical Activity and Health Longitudinal Study (PAHLS), were participants in this current longitudinal study. Participants underwent measurements of stature and body mass, as well as the New-York Posture Test based on 13 categories of postural deformities. Each test item was scored on a 5-3-1 basis and the score of each item was based on the criteria and drawings located on the score sheet with: 5 = correct or normal posture; 3 = slight deviation or slightly abnormal; 1 = pronounced deviation or abnormal. The Adam’s Test (forward bending test) was used to evaluate further for scoliosis. Additionally, an inkpad (The Harris Mat Impression system, Step Forward Foot Correctors®) was used to obtain a walking footprint of each participant. The results show that in all 13 variables of postures, the prevalence of abnormal ranged from 0-35%, and slightly abnormal ranged from 16-73% for the total group across the measured points. The observed findings for the total group in the present study showed a high prevalence for forward head, forward shoulders, hip sway, lordosis and uneven shoulders in the abnormal and slightly abnormal category in 2014. Out of the 13 posture variables, boys showed more abnormal posture (forward head, p≤0.001; forward shoulders, p≤0.001 kyphosis, p=0.007 and hip sway, p=0.048) than the girls who were presented with three categories of significant changes in abnormal posture (forward head, p≤0.001; uneven shoulders, p=0.049 and lordosis, p=0.004) over a period of study. This study showed alarming results with regard to poor posture and postural deviations during adolescence. Implementing intervention programmes in schools to address these postural deviations at an early stage should be encouraged.