Lifestyle Behaviours Profile of Spanish Adolescents Who Actively Commute to School.

The aim of this study was to study different 'healthy profiles' through the impact of multiple lifestyle behaviours (sleep patterns, screen time and quality diet) on active commuting to school (ACS) in adolescents. Sixteen secondary schools from four Spanish cities were randomly selected. All participants filled in an "Ad-Hoc" questionnaire to measure their mode of commuting and distance from home to school and their lifestyle behaviours. A multivariate logistic regression model was performed to analyse the main predictor variables of ACS. The final sample was 301 adolescents (50.2% girls; mean age ± SD: 14.9 ± 0.48 years). The percentage of ACS was 64.5%. Multiple logistic regressions showed: boys were more active commuters than girls [OR = 2.28 (CI 95%: 1.12−4.64); p = 0.02]; adolescents who lived farther had lower probability to ACS [OR = 0.74 (CI 95%: 0.69−0.80); p < 0.001]; adolescents who met sleep duration recommendations were more likely to ACS [OR = 3.05 (CI 95%: 1.07−8.69); p = 0.04], while with each hour of sleep, the odds of ACS was reduced [OR = 0.51 (CI 95%: 0.30−0.89); p = 0.02]; higher odds were shown to ACS in adolescents who have more adherence to MD [OR = 1.16(CI 95%: 1.00−1.33); p = 0.05]; and habitual breakfast consumption was inversely associated with ACS [OR = 0.41 (CI: 95%: 0.18−0.96); p = 0.04]. ACS was associated with being a boy, living at a shorter distance to school, a daily sleep time ≥ 8 h and presented a higher adherence to MD.

Prevalence and Characteristics of Back Pain in Children and Adolescents from the Region of Murcia (Spain): ISQUIOS Programme.

Puberty is a vulnerable period for musculoskeletal disorders due to the existence of a wide inter-individual variation in growth and development. The main objective of the present study was to describe the prevalence of back pain (BP) in the past year and month in school-aged children according to sex, age, maturity status, body mass index (BMI) and pain characteristics. This study involved 513 students aged between 9 and 16 years. Anthropometric measures were recorded to calculate the maturity stage of the students using a regression equation comprising measures for age, body mass, body height, sitting height and leg length. An ad hoc questionnaire composed of eight questions was used to describe BP prevalence in school-aged children. The results showed that the prevalence of BP in school-aged children was observed in 35.1% over the last year (45% boys and 55% girls), and 17.3% (40.4% boys and 59.6% girls, with an association found between female sex and BP) in the last month. The prevalence of back pain in the past year and month was higher the older the students were, or the more pubertal development they had experienced. The prevalence of BP in the last year was also higher in those with overweight or obesity. After adjustment for sex, there was an association between BP and older age and higher BMI in boys and an association between BP and higher pubertal development in girls. In summary, the present study showed that the prevalence of BP was related to the maturity stage and weight of the participants, with different prevalence patterns found according to sex.

Reliability of five trunk flexion and extension endurance field-based tests in high school-aged adolescents: ISQUIOS programme.

This study aimed to explore the inter-session reliability of the measures obtained from 2 trunk extension (Biering-Sorensen and Dynamic Extensor Endurance (DEE) tests) and 3 trunk flexion (Ito, Side Bridge and Bench Trunk Curl-Up (BTC) tests) endurance field-based tests in adolescents. A total of 208 (males, n = 100; females, n = 108) adolescents performed all the field-based tests on 2 separate testing sessions, 7-days apart. The inter-session reliability scores were explored through relative reliability, inter-session differences and precision of measurements. Most of the trunk endurance measures demonstrated acceptable relative reliability (the intraclass correlation coefficients (ICC) ranged from 0.75 to 0.94). However, significant inter-session differences were identified for measures from the DEE and BTC tests. Likewise, the precision of the measurement of each field-based test was poor (the the standard error of measurement expressed as a percentage of the mean score (CVTE) ranged from 11.3 to 24.4%) with the minimal detectable change (MDC95) revealing that changes higher than 42% for trunk extension endurance tests and 31.4% for trunk flexion endurance tests after an intervention are required to indicate a significant change above measurement error. Therefore, the findings from this study indicate that only the BTC test demonstrates acceptable inter-session reliability (ICC > 0.9, CVTE ~ 10%, MDC95 ~ 30%) to monitor the changes in trunk endurance scores that may be expected in adolescents after performing an intervention programme.

Sagittal standing spinal alignment and back pain in 8 to 12-year-old children from the Region of Murcia, Spain: The ISQUIOS Program.

BACKGROUND: The child's spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP). OBJECTIVE: The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children. METHODS: This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children's parents or legal guardians filled in a questionnaire according to the children's responses about the BP suffered in the previous week and the preceding year. RESULTS: The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009-1.160, p= 0.028). CONCLUSIONS: To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.

Validity and Reliability of the New Basic Functional Assessment Protocol (BFA).

The global evaluation of motion patterns can examine the synchrony of neuromuscular control, range of motion, strength, resistance, balance and coordination needed to complete the movement. Visual assessments are commonly used to detect risk factors. However, it is essential to define standardized field-based tests that can evaluate with accuracy. The aims of the study were to design a protocol to evaluate fundamental motor patterns (FMP), and to analyze the validity and reliability of an instrument created to provide information about the quality of movement in FMP. Five tasks were selected: Overhead Squat (OHS); Hurdle Step (HS); Forward Step Down (FSD); Shoulder Mobility (SM); Active Stretching Leg Raise (ASLR). A list of variables was created for the evaluation of each task. Ten qualified judges assessed the validity of the instrument, while six external observers performed inter-intra reliability. The results show that the instrument is valid according to the experts' opinion; however, the reliability shows values below those established. Thus, the instrument was considered unreliable, so it is recommended to repeat the reliability process by performing more training sessions for the external observers. The present study creates the basic functional assessment (BFA), a new protocol which comprises five tasks and an instrument to evaluate FMP.

A Meta-Analysis of the Reliability of Four Field-Based Trunk Extension Endurance Tests.

This meta-analysis aimed to estimate the inter- and intra-tester reliability of endurance measures obtained through trunk extension field-based tests and to explore the influence of the moderators on the reliability estimates. The reliability induction rate of trunk extension endurance measures was also calculated. A systematic search was conducted using various databases, and subsequently 28 studies were selected that reported intraclass correlation coefficients for trunk extension endurance measures. Separate meta-analyses were conducted using a random-effects model. When possible, analyses of potential moderator variables were carried out. The inter-tester average reliability of the endurance measure obtained from the Biering-Sorensen test was intraclass correlation coefficient (ICC) = 0.94. The intra-session reliability estimates of the endurance measures recorded using the Biering-Sorensen test, the prone isometric chest raise test, and the prone double straight-leg test were ICC = 0.88, 0.90, and 0.86, respectively. The inter-session average reliability of the endurance measures from the Biering-Sorensen test, the prone isometric chest raise test, and the dynamic extensor endurance test were ICC = 0.88, 0.95, and 0.99, respectively. However, due to the limited evidence available, the reliability estimates of the measures obtained through the prone isometric chest raise, prone double straight-leg, and dynamic extensor endurance tests should be considered with a degree of caution. Position control instruments, tools, and familiarization session demonstrated a statistical association with the inter-session reliability of the Biering-Sorensen test. The reliability induction rate was 72.8%. Only the trunk extension endurance measure obtained through the Biering-Sorensen test presented sufficient scientific evidence in terms of reliability to justify its use for research and practical purposes.

Sitting Posture, Sagittal Spinal Curvatures and Back Pain in 8 to 12-Year-Old Children from the Region of Murcia (Spain): ISQUIOS Programme.

To explore sagittal spinal alignment and pelvic disposition of schoolchildren in a slump sitting position is needed in order to establish preventive educational postural programs. The purposes of this study were to describe sagittal spinal alignment and pelvic tilt (LSA) in a slump sitting position and to explore the association of sagittal spine and pelvic tilt with back pain (BP) among 8-12-year-old children. It was a cross-sectional study. Sagittal spinal curvatures, BP and pelvic tilt were assessed in 582 students from 14 elementary schools. It was found that 53.44% of children had slight thoracic hyperkyphosis and that 48.80% presented moderate lumbar hyperkyphosis and 38.66% presented slight lumbar hyperkyphosis. Those who did not suffer from BP in any part of the back had a higher lumbar kyphosis (24.64 ± 7.84) or a greater LSA (107.27 ± 5.38) than children who had some type of BP in the previous year or week (lumbar kyphosis: 23.08 ± 8.06; LSA: 105.52 ± 6.00), although with no clinically relevant differences. In fact, neither sufferers nor those who did not have BP presented normal mean values for lumbar kyphosis or LSA according to normality references. This study demonstrates the need to assess sagittal morphotype in childhood since schoolchildren remain incorrectly seated for many hours and it greatly affects their spinal curvatures.

Classification System of the Sagittal Integral Morphotype in Children from the ISQUIOS Programme (Spain).

The sagittal spinal morphology presents 4 physiological curvatures that increase endurance to axial compression forces and allow adequate postural balance. These curves must remain within normal ranges to achieve a static and dynamic balance, a correct functioning of the muscles and an adequate distribution of the loads, and thus minimize the injury risk. The purpose of this study was to categorize the sagittal spinal alignment according to the different morphotypes obtained for each curve in standing, slump sitting, and trunk forward bending positions in schoolchildren. It was a cross-sectional study. Sagittal spinal curvatures were assessed in 731 students from 16 elementary schools. In the sagittal standing position assessment, 70.45% and 89.06% of schoolchildren presented a "normal" morphotype for both dorsal and lumbar curves, respectively. After the application of the "Sagittal Integral Morphotype" protocol according to the morphotypes obtained in the three positions assessment (standing, slump sitting, and trunk forward bending), it was observed how the frequency of normal morphotypes for the dorsal and lumbar curve decreased considerably (only 32% and 6.6% of children obtained a "normal sagittal integral morphotype" for the thoracic and lumbar curvatures, respectively). These results show how it is necessary to include the slump sitting and trunk forward bending assessment as part of the protocol to define the "integral" sagittal alignment of the spine and establish a correct diagnosis. The use of the diagnostic classification presented in this study will allow early detection of misalignment not identified with the assessment of standing position.

Sagittal spinal morphotype assessment in 8 to 15 years old Inline Hockey players.

BACKGROUND: Physiological sagittal spinal curvatures play an important role in health and performance in sports. For that reason, several scientific studies have assessed spinal morphology in young athletes. However, to our knowledge, no study has assessed the implications of Inline Hockey (IH) practice on sagittal integrative spinal morphotype in adolescent players. OBJECTIVES: The aims of the present study were to describe habitual sagittal spinal posture in young federated IH players and its relationship with training load and to determine the sagittal integrative spinal morphotype in these players. METHODS: An observational analysis was developed to describe the sagittal spinal morphotype in young federated IH players. A total of 74 IH players from the Technification Plan organized by the Skating Federation of the Valencian Community (aged from 8 to 15 years) participated in the study. Thoracic and lumbar curvatures of the spine were measured in a relaxed standing position (SP), in a slump sitting position (SSP) and in maximum flexion of the trunk (MFT) to determine the "Sagittal Integrative Morphotype" of all players. An unilevel inclinometer was used to quantify the sagittal spinal curvatures. The Hip Joint Angle test was used to quantify the Lumbo-Horizontal angle in flexion (L-H fx) of all participants with a goniometer. RESULTS: When thoracic curvature was analyzed according to normality references, it was found that 64.9% of IH players had thoracic hyperkyphosis in a SSP, while 60.8% and 74.3% of players were classified as normal in a SP and in MFT, respectively. As for the lumbar curve, 89.2% in a SP and 55.4% in MFT were normal, whereas 68.9% of IH players presented lumbar hyperkyphosis in a SSP. Regarding the "Sagittal Integrative Morphotype," only 17.6% of players were classified as "Normal" in the three measured positions for the thoracic curve, while 37.8% had "Thoracic Hyperkyphosis" and 41.8% presented "Functional Thoracic Hyperkyphosis." As for the "Sagittal Integrative Lumbar Morphotype," only 23% of athletes had a normal curve in the three positions, whereas 66.2% presented "Functional Lumbar Hyperkyphosis." When the L-H fx was evaluated, the results showed that only 16.2% of the athletes were classified as normal. CONCLUSIONS: Federative IH practice seems to cause specific adaptations in spinal sagittal morphotype. Taking into account the "Sagittal Integrative Morphotype" only 17.6% IH players presented "Normal Morphotype" with a normal thoracic kyphosis in the three measured positions, while only 23% IH players presented "Normal Morphotype" with a normal lumbar curvature in the three assessed positions. Furthermore, only 16.2% of IH players showed normal pelvic tilt. Exercise programs to prevent or rehabilitate these imbalances in young IH players are needed.

Sagittal Spinal Morphotype Assessment in Dressage and Show Jumping Riders.

CONTEXT: Previous research has analyzed how the sport influences sagittal spinal curvatures in young athletes and has found that spinal curves may be modified as a consequence of repeated movement patterns and postures of each discipline. OBJECTIVE: To analyze sagittal spinal alignment by equestrian discipline and its relation to training load, and to describe "sagittal integrative morphotype" in young riders. DESIGN: Observational descriptive study. SETTING: Training room. PARTICIPANTS: A total of 23 riders (aged 9-17 y)-13 dressage riders (3 males and 10 females) and 10 show jumping riders (5 males and 5 females)-participated voluntarily. MAIN OUTCOME MEASURES: Mann-Whitney U test was applied to determine differences between riders' characteristics (gender, discipline, and training load) and spine variables. RESULTS: According to normality ranges for spinal curves, females showed an increase for lumbar curvature in standing position. It was found that show jumping riders manifested an increment in thoracic and lumbar curves while standing and an increase in the thoracic curvature in slump sitting. Statistically significant differences were found when lumbar curvature, "sit and reach" distance, and lumbo-horizontal angle in flexion were analyzed by gender in "sit and reach" test. No statistical significant differences were found when spinal curves in each position were analyzed depending on the training load. With regard to "sagittal integrative morphotype," all riders presented a hyperkyphotic dorsal morphotype no matter what their discipline. As for the lumbar curve, dressage and show jumping riders presented a functional hyperkyphotic morphotype. CONCLUSIONS: It is important to note that many riders presented a sagittal imbalance for the thoracic and lumbar curves. Therefore, as the sagittal spinal misalignments persist and worsen over time, exercise programs to prevent or rehabilitate these imbalances in young riders will be needed. The "sagittal integrative morphotype" assessment is an essential tool in order to identify the spinal misalignment.