Martínez-Romero María Teresa, De Ste Croix Mark, Sainz de Baranda Pilar
Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, 30720 Murcia, Spain.
Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, 30100 Murcia, Spain.
Children (Basel). 2025 Sep 17;12(9):1253. doi: 10.3390/children12091253.
BACKGROUND/OBJECTIVES: Back pain is increasingly prevalent during childhood and adolescence, often predicting adult spinal disorders. This study aimed to describe sex-specific anthropometric and "Postural Fitness" characteristics in school-aged children and adolescents and to introduce a standardized, field-based assessment protocol for early screening of postural and functional deficits.
This cross-sectional study included a total of 494 students (8-17 years; 50% girls) from 14 schools in Murcia (Spain). Exclusion criteria included diagnosed spinal pathology or major physical injury, lack of signed informed consent, absence on the testing day, and incomplete Postural Fitness assessment. The "Postural Fitness" protocol included assessments of sagittal spinal alignment (inclinometer), hip range of motion (ROM) (inclinometer with an extendable telescopic arm), pelvic tilt (goniometer with a spirit level system), and trunk muscle endurance (chronometer). Tests were conducted in physical education sessions by trained sports scientists.
Significant sex-based differences were observed. Boys exhibited greater thoracic kyphosis (40.3 ± 9.6° vs. 36.7 ± 9.2°), reduced hip ROM (passive hip extension (PHE): 16.8 ± 8.1°, passive hip flexion with knee extension (PHFKE): 68.9 ± 8.6°), and more posterior pelvic tilt (104.9 ± 8.4° vs. 99.7 ± 8.1°), whereas girls demonstrated increased lumbar lordosis (35.7 ± 8.6° vs. 31.5 ± 8.5°), greater hip ROM (PHE: 18.5 ± 9°, PHFKE: 77.9 ± 13°), and superior trunk extensor endurance (123.2 ± 74.7 s vs. 106.2 ± 69.8 s). Lateral trunk muscle endurance was higher in boys (48.7 ± 31 s vs. 41.4 ± 24.9 s).
The "Postural Fitness" protocol proved feasible in school settings and revealed key sex-based disparities in spinal and neuromuscular profiles. These findings highlight the need for individualized, sex-specific screening and preventive programs to enhance back health during growth. Implementing this protocol may support early identification of modifiable risk factors linked to spinal dysfunction and pain in youth.
背景/目的：背痛在儿童和青少年时期越来越普遍，常常预示着成人脊柱疾病。本研究旨在描述学龄儿童和青少年中特定性别的人体测量学和“姿势适应性”特征，并引入一种标准化的、基于现场的评估方案，用于早期筛查姿势和功能缺陷。
这项横断面研究共纳入了来自西班牙穆尔西亚14所学校的494名学生（8 - 17岁；50%为女孩）。排除标准包括已诊断的脊柱病理状况或重大身体损伤、缺乏签署的知情同意书、测试当天缺勤以及姿势适应性评估不完整。“姿势适应性”方案包括矢状面脊柱排列评估（倾角仪）、髋关节活动范围（ROM）评估（带可伸展伸缩臂的倾角仪）、骨盆倾斜评估（带气泡水平系统的量角器）以及躯干肌肉耐力评估（秒表）。测试由经过培训的运动科学家在体育课上进行。
观察到显著的性别差异。男孩表现出更大的胸椎后凸（40.３±9.6°对36.7±9.2°）、髋关节活动范围减小（被动髋关节伸展（PHE）：16.8±8.1°，膝关节伸展时被动髋关节屈曲（PHFKE）：68.9±8.6°）以及更向后的骨盆倾斜（104.9±8.4°对99.7±8.1°），而女孩则表现出腰椎前凸增加（35.7±8.6°对31.5±8.5°）、更大的髋关节活动范围（PHE：18.5±9°，PHFKE：77.9±13°）以及更好的躯干伸肌耐力（123.2±74.7秒对106.2±69.8秒）。男孩的侧躯干肌肉耐力更高（48.7±31秒对41.4±24.9秒）。
“姿势适应性”方案在学校环境中被证明是可行的，并揭示了脊柱和神经肌肉特征方面基于性别的关键差异。这些发现凸显了需要个性化的、针对性别的筛查和预防计划，以在成长过程中增强背部健康。实施该方案可能有助于早期识别与青少年脊柱功能障碍和疼痛相关的可改变风险因素。
