Dolphens Mieke, Cagnie Barbara, Coorevits Pascal, Vleeming Andry, Vanderstraeten Guy, Danneels Lieven
Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Artevelde University College, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium,
Eur Spine J. 2014 Jan;23(1):216-25. doi: 10.1007/s00586-013-2952-9. Epub 2013 Aug 18.
The purpose of this cohort study was to classify sagittal standing alignment of pre-peak height velocity (pre-PHV) girls, and to evaluate whether identified subgroups were associated with measures of spinal pain. This study further aimed at drawing attention to similarities and differences between the current postural classification and a previous system determined among pre-PHV boys.
557 pre-PHV girls [mean age, 10.6 years (SD, 0.47 years)] participated in the study. Three gross body segment orientation parameters and five specific lumbopelvic characteristics were quantified during habitual standing. Postural subgroups were determined by cluster analysis. Logistic regression was applied to assess the relationship between postural subgroups and spinal pain measures (pain and seeking care, assessed by self-administered questionnaire). Chi-square statistics, independent samples T test, and distribution-based methods were used for comparison with postural categorization in pre-PHV boys.
Among pre-PHV girls, clinically meaningful posture clusters emerged both on the gross body segment and specific lumbopelvic level. The postural subtypes identified among pre-PHV girls closely corresponded to those previously described in pre-PHV boys, thereby allowing the use of the same, working nomenclature. In contrast to previous findings among pre-PHV boys, no associations between posture clusters and spinal pain measures were significant in girls at pre-PHV age. When comparing discrete 'global' alignment scores across corresponding posture types, some intriguing differences were found between genders which might involve different biomechanical loading patterns. Whether habitual posture forms a risk factor for developing spinal pain up to adulthood needs evaluation in prospective multifactorial follow-up research.
本队列研究旨在对身高增长高峰前（pre-PHV）女孩的矢状面站立姿势进行分类，并评估所确定的亚组是否与脊柱疼痛指标相关。本研究还旨在关注当前姿势分类与先前在身高增长高峰前男孩中确定的系统之间的异同。
557名身高增长高峰前女孩[平均年龄10.6岁（标准差0.47岁）]参与了本研究。在习惯性站立期间，对三个总体身体节段定向参数和五个特定的腰骶部特征进行了量化。通过聚类分析确定姿势亚组。应用逻辑回归评估姿势亚组与脊柱疼痛指标（疼痛和寻求治疗，通过自填问卷评估）之间的关系。使用卡方统计、独立样本t检验和基于分布的方法与身高增长高峰前男孩的姿势分类进行比较。
在身高增长高峰前女孩中，在总体身体节段和特定的腰骶部水平上均出现了具有临床意义的姿势聚类。在身高增长高峰前女孩中确定的姿势亚型与先前在身高增长高峰前男孩中描述的亚型密切对应，因此可以使用相同的实用命名法。与先前在身高增长高峰前男孩中的发现相反，在身高增长高峰前的女孩中，姿势聚类与脊柱疼痛指标之间没有显著关联。在比较相应姿势类型的离散“整体”对线分数时，发现了一些有趣的性别差异，这可能涉及不同的生物力学负荷模式。习惯性姿势是否构成成年期脊柱疼痛发生的危险因素需要在前瞻性多因素随访研究中进行评估。
