Classification System of the Sagittal Integral Morphotype in Children from the ISQUIOS Programme (Spain)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Procedures
2.3.1. Sagittal Integral Morphotype Assessment
Standing Position Assessment (SP)
Slump Sitting Position Assessment (SSP)
Trunk Forward Bending Assessment (TFB) during “Sit and Reach Test”
2.3.2. References of Normality for Thoracic and Lumbar Curves
2.3.3. Diagnostic Classification of the “Sagittal Integral Morphotype”
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
- In the sagittal standing position assessment, 70.45% and 89.06% of schoolchildren (boys and girls) 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.
- It can be observed that only 32% and 6.6% of children obtained a “normal sagittal integral morphotype” for the thoracic and lumbar curvatures, respectively.
- For the thoracic spine, the most common morphotype was “functional thoracic hyperkyphosis” (36.8%), without differences by sex.
- For the lumbar spine, the most common morphotype was “functional lumbar hyperkyphosis” (82.3%). Sex differences were found, concretely, males presented higher cases of “functional lumbar hyperkyphosis” (86.9% vs. 78.1%), and females showed higher percentages of “lumbar hypermobility” (10.3% vs. 4.3%) and “hyperlordotic attitude” (2.4% vs. 0.9%).
Author Contributions
Funding
Conflicts of Interest
References
- Kapandji, I.A. Cuadernos de Fisiología Articular. Tronco y Raquis, 2nd ed.; Masson: Barcelona, Spain, 2002. [Google Scholar]
- Penha, P.; Casarotto, R.; Sacco, I.; Marques, A.; João, S. Qualitative postural analysis among boys and girls of seven to ten years of age. Rev. Bras. Fisioter. 2008, 12, 386–391. [Google Scholar] [CrossRef] [Green Version]
- Boseker, E.H.; Moe, J.H.; Winter, R.B.; Koop, S.E. Determination of “normal” thoracic kyphosis: A roentgenographic study of 121 “normal” children. J. Pediatr. Orthop. 2000, 20, 796–798. [Google Scholar] [CrossRef] [PubMed]
- Cil, A.; Yazici, M.; Uzumcugil, A.; Kandemir, U.; Alanay, A.; Alanay, Y.; Surat, A. The evolution of sagittal segmental alignment of the spine during childhood. Spine 2005, 30, 93–100. [Google Scholar] [CrossRef] [PubMed]
- Dolphens, M.; Cagnie, B.; Vleeming, A.; Vanderstraeten, G.; Coorevits, P.; Danneels, L. A clinical postural model of sagittal alignment in young adolescents before age at peak height velocity. Eur. Spine J. 2012, 21, 2188–2197. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Widhe, T. Spine: Posture, mobility and pain. A longitudinal study from childhood to adolescence. Eur. Spine J. 2001, 10, 118–123. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gardocki, R.J.; Watkins, R.G.; Williams, L.A. Measurements of lumbopelvic lordosis using the pelvic radius technique as it correlates with sagittal spinal balance and sacral translation. Spine J. 2002, 2, 421–429. [Google Scholar] [CrossRef]
- Mac-Thiong, J.M.; Labelle, H.; Berthonnaud, E.; Betz, R.R.; Roussouly, P. Sagittal spinopelvic balance in normal children and adolescents. Eur. Spine J. 2007, 16, 227–234. [Google Scholar] [CrossRef] [Green Version]
- Mellin, G.; Poussa, M. Spinal mobility and posture in 8-to 16-year-old children. J. Orthop. Res. 1992, 10, 211–216. [Google Scholar] [CrossRef]
- Vialle, R.; Levassor, N.; Rillardon, L.; Templier, A.; Skalli, W.; Guigui, P. Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. JBJS 2005, 87, 260–267. [Google Scholar] [CrossRef]
- Dolphens, M.; Cagnie, B.; Coorevits, P.; Vleeming, A.; Danneels, L. Classification system of the normal variation in sagittal standing plane alignment: A study among young adolescent boys. Spine 2013, 38, 1003–1012. [Google Scholar] [CrossRef]
- Dolphens, M.; Cagnie, B.; Coorevits, P.; Vleeming, A.; Vanderstraeten, G.; Danneels, L. Classification system of the sagittal standing alignment in young adolescent girls. Eur. Spine J. 2014, 23, 216–225. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Smith, A.; O’Sullivan, P.; Straker, L. Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain. Spine 2008, 33, 2101–2107. [Google Scholar] [CrossRef] [PubMed]
- Araújo, F.A.; Severo, M.; Alegrete, N.; Howe, L.D.; Lucas, R. Defining Patterns of Sagittal Standing Posture in School-Aged Girls and Boys. Phys. Ther. 2017, 97, 258–267. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Stagnara, P. Deformaciones del Raquis: Escoliosis, Cifosis, Lordosis; Masson: Barcelona, Spain, 1987. [Google Scholar]
- Bradford, D.S. Juvenile kyphosis. Clin. Orthop. Relat. Res. 1977, 128, 45–55. [Google Scholar] [CrossRef]
- Chopin, D.; David, T. Cyphoses pathologiques. Encycl. Med. Chir. Appar. Locomoteur 1989, 15872, A10. [Google Scholar]
- Bado, J.L. Dorso Curvo; Artecolor: Montevideo, Uruguay, 1977. [Google Scholar]
- Santonja, F.; Pastor, A. Cortedad isquiosural y actitud cifótica lumbar. Selección 2003, 12, 150–154. [Google Scholar]
- Somhegyi, A.; Ratko, I. Hamstring tightness and Scheuermann’s disease. Am. J. Phys. Med. Rehabil. 1993, 72, 44. [Google Scholar] [CrossRef]
- Scrutton, D. The causes of developmental deformity and their implication for seating. Prosthet. Orthot. Int. 1991, 15, 199–202. [Google Scholar] [CrossRef] [Green Version]
- Dolphens, M.; Cagnie, B.; Vleeming, A.; Vanderstraeten, G.; Danneels, L. Gender differences in sagittal standing alignment before pubertal peak growth: The importance of subclassification and implications for spinopelvic loading. J. Anat. 2013, 223, 629–640. [Google Scholar] [CrossRef] [Green Version]
- Bićanin, P.; Milenković, S.; Radovanović, D.; Gajević, A.; Ivanović, J. Postural disorders in preschool children in relation to gender. Facta Univ. Ser. 2017, 15, 1–10. [Google Scholar] [CrossRef]
- Santonja, F. Las desviaciones sagitales del raquis y su relación con la práctica deportiva. In Escolar: Medicina y Deporte; Ferrer, V., Martínez, L., Santonja, F., Eds.; Diputacion Provincial de Albacete: Albacete, Spain, 1996; pp. 251–268. [Google Scholar]
- López-Miñarro, P.A.; Alacid, F.; Rodríguez-García, P.L. Comparison of sagittal spinal curvatures and hamstring muscle extensibility among young elite paddlers and non-athletes. Int. Sport Med. J. 2010, 11, 301–312. [Google Scholar]
- López-Miñarro, P.A.; Muyor, J.; Belmonte, F.; Alacid, F. Acute effects of hamstring stretching on sagittal spinal curvatures and pelvic tilt. J. Hum. Kinet. 2012, 31, 69–78. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- López-Miñarro, P.; Alacid Cárceles, F. Cifosis funcional y actitud cifótica lumbar en piragüistas adolescentes. Retos Nuevas Tend. Educ. Física Deporte Recreación 2010, 17, 5–9. [Google Scholar]
- Vaquero-Cristobal, R.; Esparza-Ros, F.; Gómez-Durán, R.; Martínez-Ruiz, E.; Muyor, J.M.; Alacid, F.; López-Miñarro, P.A. Morfología de las curvaturas torácica y lumbar en bipedestación, sedentación y máxima flexión del tronco con rodillas extendidas en bailarinas. Arch. Med. Deport. 2015, 32, 87–93. [Google Scholar]
- Muyor, J.M.; Zemková, E.; Chren, M. Effects of Latin style professional dance on the spinal posture and pelvic tilt. J. Back Musculoskelet. Rehabil. 2017, 30, 791–800. [Google Scholar] [CrossRef] [PubMed]
- Muyor, J.M.; López-Miñarro, P.A.; Alacid, F. Spinal posture of thoracic and lumbar spine and pelvic tilt in highly trained cyclists. J. Sport Sci. Med. 2011, 10, 355–361. [Google Scholar]
- De Baranda, P.S.; Cejudo, A.; Moreno-Alcaraz, V.J.; Martinez-Romero, M.T.; Aparicio-Sarmiento, A.; Santonja-Medina, F. Sagittal spinal morphotype assessment in 8 to 15 years old Inline Hockey players. PeerJ 2020, 8, 1–31. [Google Scholar] [CrossRef] [Green Version]
- Beach, T.A.C.; Parkinson, R.J.; Stothart, J.P.; Callaghan, J.P. Effects of prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine. Spine J. 2005, 5, 145–154. [Google Scholar] [CrossRef]
- Polga, D.J.; Beaubien, B.P.; Kallemeier, P.M.; Schellhas, K.P.; Lew, W.D.; Buttermann, G.R.; Wood, K.B. Measurement of in vivo intradiscal pressure in healthy thoracic intervertebral discs. Spine 2004, 29, 1320–1324. [Google Scholar] [CrossRef]
- Wilke, H.; Neef, P.; Caimi, M.; Hoogland, T.; Claes, L. New In-vivo measurements of pressures in the intervertebral disc in daily life. Spine 1999, 24, 755–762. [Google Scholar] [CrossRef]
- Nachemson, A. The load on lumbar disks in different positions of the body. Clin. Orthop. Relat. Res. 1966, 45, 107–122. [Google Scholar] [CrossRef] [PubMed]
- Sato, K.; Kikuchi, S.; Yonezawa, T. In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine 1999, 24, 2468–2474. [Google Scholar] [CrossRef] [PubMed]
- Adams, M.A.; Hutton, W.C. The Joints Effect in of Posture on the Role of the Forces Resisting. JBJS 1980, 62, 358–362. [Google Scholar]
- Camargo, M.Z.; de Oliveira, M.R.; Fujisawa, D.S. Evolution of postural alignment in preschool and school phases: A longitudinal study. Mot. Rev. Educ. Física 2017, 23, 1–6. [Google Scholar] [CrossRef] [Green Version]
- Muyor, J.M.; Sánchez-Sánchez, E.; Sanz-Rivas, D.; López-Miñarro, P.A. Sagittal spinal morphology in highly trained adolescent tennis players. J. Sport Sci. Med. 2013, 12, 588–593. [Google Scholar]
- Czaprowski, D.; Pawłowska, P.; Gebicka, A.; Sitarski, D.; Kotwicki, T. Intra- and interobserver repeatability of the assessment of anteroposterior curvatures of the spine using saunders digital inclinometer. Ortop. Traumatol. Rehabil. 2012, 14, 145–153. [Google Scholar] [CrossRef]
- Czaprowski, D.; Pawłowska, P. The influence of generalized joint hypermobility on the sagittal profile of the spine in children aged 10–13 years. Ortop. Traumatol. Rehabil. 2013, 6, 545–553. [Google Scholar] [CrossRef]
- Walicka-Cupryś, K.; Wyszyńska, J.; Podgórska-Bednarz, J.; Drzał-Grabiec, J. Concurrent validity of photogrammetric and inclinometric techniques based on assessment of anteroposterior spinal curvatures. Eur. Spine J. 2018, 27, 497–507. [Google Scholar] [CrossRef] [Green Version]
- MacIntyre, N.J.J.; Lorbergs, A.L.L.; Adachi, J.D.D. Inclinometer-based measures of standing posture in older adults with low bone mass are reliable and associated with self-reported, but not performance-based, physical function. Osteoporos. Int. 2014, 25, 721–728. [Google Scholar] [CrossRef]
- Reese, N.; Bandy, W.D. Joint Range of Motion and Muscle Length Testing-E-Book, 3rd ed.; Elsevier Health Sciences: Amsterdam, The Netherland, 2016. [Google Scholar]
- Norkin, C.C.; White, D.J. Measurement of Joint Motion: A Guide to Goniometry, 5th ed.; Davis Company: Philadelphia, PA, USA, 2017. [Google Scholar]
- López-Miñarro, P.A.; de Baranda, P.S.; Rodriguez-Garcia, P.L.; Ortega, E. A comparison of the spine posture among several sit-and-reach test protocols. J. Sci. Med. Sport 2007, 10, 456–462. [Google Scholar] [CrossRef]
- Chen, S.; Samo, D.; Chen, E.; Crampton, A.; Conrad, K.; Egan, L.; Mitton, J. Reliability of three lumbar sagittal motion measurement methods: Surface inclinometers. J. Occup. Environ. Med. 1997, 39, 217–223. [Google Scholar] [CrossRef] [PubMed]
- Gerhardt, J.J. Documentation of Joint Motion. International Standard Neutral-Zero Measuring S.F.T.R Recording and Aplication of Goniometers, Inclinometers and Calipers, 4th ed.; Isomed: Portland, OR, USA, 1994. [Google Scholar]
- Ginés-Díaz, A.; Martínez-Romero, M.T.; Cejudo, A.; Aparicio-Sarmiento, A.; de Baranda, P.S. Sagittal Spinal Morphotype Assessment in Dressage and Show Jumping Riders. J. Sport Rehabil. 2019. Ahead of P. [Google Scholar] [CrossRef]
- De Baranda, P.S.; Santonja, F.; Rodriguez-Iniesta, M. Tiempo de entrenamiento y plano sagital del raquis en gimnastas de trampolin. Rev. Int. Med. Cienc. Act Física Deport. 2010, 10, 521–536. [Google Scholar]
- Sanz-Mengibar, J.M.; de Baranda, P.S.; Santonja, F. Training intensity and sagittal curvature of the spine in male and female artistic gymnasts. J. Sports Med. Phys. Fit. 2018, 58, 465–471. [Google Scholar] [CrossRef]
- De Oliveira, T.S.; Candotti, C.T.; La Torre, M.; Pelinson, P.P.T.; Furlanetto, T.S.; Kutchak, F.M.; Loss, J.F. Validity and Reproducibility of the Measurements Obtained Using the Flexicurve Instrument to Evaluate the Angles of Thoracic and Lumbar Curvatures of the Spine in the Sagittal Plane. Rehabil. Res. Pract. 2012, 2012, 1–9. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Briggs, A.M.; Wrigley, T.V.; Tully, E.A.; Adams, P.E.; Greig, A.M.; Bennell, K.L. Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles. Skelet. Radiol. 2007, 36, 761–767. [Google Scholar] [CrossRef]
- Teixeira, F.A.; Carvalho, G. Reliability and Validity of Thoracic Kyphosis Measurements Using the Flexicurve Method. Rev. Bras. Fisioter. 2007, 11, 173–177. [Google Scholar] [CrossRef]
- Rodriguez-Garcia, P.L.; Lopez-Minarro, P.A.; Yuste, J.L.; de Baranda, P.S. Comparison of hamstring criterion-related validity sagittal spinal curvatures, pelvic tilt and score between sit-and-reach and toe-touch tests in athletes. Med. Sport 2008, 61, 11–20. [Google Scholar]
- De Baranda, P.S.; Rodríguez-García, P.L.; Santonja, F. Efectos sobre la disposición sagital del raquis de un programa de Educación Postural en Educación Física de Primaria. Apunt. Educ. Física Deport. 2010, 4, 16–21. [Google Scholar]
- De Baranda, P.S.; Santonja, F. Valoración de la disposición sagital del raquis en gimnastas especialistas en trampolín. Int. J. Sport Sci. 2009, 5, 21–33. [Google Scholar] [CrossRef]
- Negrini, S.; Aulisa, L.; Ferraro, C.; Fraschini, P.; Masiero, S.; Simonazzi, P.; Venturin, A. Italian guidelines on rehabilitation treatment of adolescents with scoliosis or other spinal deformities. Eur. Medicophys. 2005, 41, 183–201. [Google Scholar]
- Roussouly, P.; Nnadi, C. Sagittal plane deformity: An overview of interpretation and management. Eur. Spine J. 2010, 19, 1824–1836. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Serna, L.; Santonja, F.; Pastor, A. Exploración clínica del plano sagital del raquis. Selección 1996, 5, 88–102. [Google Scholar]
- Santonja, F. Exploración clínica y radiográfica del raquis sagital: Sus correlaciones. Ph.D. Thesis, Universidad de Murcia, Murcia, Spain, 1993. [Google Scholar]
- Andújar-Ortuño, P. Prevalencia de las Desalineaciones Sagitales del Raquis en Edad Escolar en el Municipio de Murcia. Ph.D. Thesis, Universidad de Murcia, Murcia, Spain, 2010. [Google Scholar]
- Czaprowski, D.; Stoliński, Ł.; Tyrakowski, M.; Kozinoga, M.; Kotwicki, T. Non-structural misalignments of body posture in the sagittal plane. Scoliosis Spinal Disord. 2018, 13, 1–14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Araújo, F.A.; Martins, A.; Alegrete, N.; Howe, L.D.; Lucas, R. A shared biomechanical environment for bone and posture development in children. Spine J. 2017, 17, 1426–1434. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Araújo, F.; Lucas, R. What do we know about the determinants of sagittal standing posture? OA Musculoskelet. Med. 2014, 17, 1–6. [Google Scholar]
- Schlosser, T.P.C.; Vincken, K.L.; Rogers, K.; Castelein, R.M.; Shah, S.A. Natural sagittal spino-pelvic alignment in boys and girls before, at and after the adolescent growth spurt. Eur. Spine J. 2015, 24, 1158–1167. [Google Scholar] [CrossRef]
- Araújo, F.; Lucas, R.; Alegrete, N.; Azevedo, A.; Barros, H. Sagittal standing posture, back pain, and quality of life among adults from the general population: A sex-specific association. Spine 2014, 39, 782–794. [Google Scholar] [CrossRef]
- Chaléat-Valayer, E.; Mac-Thiong, J.M.; Paquet, J.; Berthonnaud, E.; Siani, F.; Roussouly, P. Sagittal spino-pelvic alignment in chronic low back pain. Eur. Spine J. 2011, 20, 634–640. [Google Scholar] [CrossRef] [Green Version]
- Roussouly, P.; Gollogly, S.; Berthonnaud, E.; Dimnet, J. Classification of the Normal Variation in the Sagittal Alignment of the Human Lumbar Spine and Pelvis in the Standing Position. Spine 2005, 30, 346–353. [Google Scholar] [CrossRef]
- Vrtovec, T.; Pernuš, F.; Likar, B. A review of methods for quantitative evaluation of spinal curvature. Eur. Spine J. 2009, 18, 593–607. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Stokes, I.A.F. Three-dimensional terminology of spinal deformity. Spine 1994, 19, 236–248. [Google Scholar] [CrossRef] [PubMed]
- Rusnák, R.; Kolarova, M.; Aštaryová, I.; Kutiš, P. Screening and Early Identification of Spinal Deformities and Posture in 311 Children: Results from 16 Districts in Slovakia. Rehabil. Res. Pract. 2019, 2019. [Google Scholar] [CrossRef] [Green Version]
- Barrett, E.; Lenehan, B.; O’sullivan, K.; Lewis, J.; McCreesh, K. Validation of the manual inclinometer and flexicurve for the measurement of thoracic kyphosis. Physiother. Theory Pract. 2018, 34, 301–308. [Google Scholar] [CrossRef]
Spinal Curve | SP 1 | SSP 2 | TFB 3 | |||
---|---|---|---|---|---|---|
Classification | Values | Classification | Values | Classification | Values | |
Thoracic | Hypokyphosis | <20° | Hypokyphosis | <20° | Hypokyphosis | <40° |
Normal | 20° to 40° | Normal | 20° to 40° | Normal | 40° to 65° | |
Hyperkyphosis | >40° | Hyperkyphosis | >40° | Hyperkyphosis | >65° | |
Lumbar | Hypolordosis | <−20° | Hyperlordosis | <-15° | Hypokyphosis | <10° |
Normal | −20° to −40° | Normal | −15 to 15° | Normal | 10° to 30° | |
Hyperlordosis | >−40° | Hyperkyphosis | >15° | Hyperkyphosis | >30° |
Classification | Subclassification | SP 1 | SSP 2 | TFB 3 |
---|---|---|---|---|
Normal kyphosis | Normal (20°–40°) | Normal (20°–40°) | Normal (40°–65°) | |
Functional Thoracic Hyperkyphosis | Static | Normal (20°–40°) | Hyperkyphosis (>40°) | Normal (40°–65°) |
Dynamic | Normal (20°–40°) | Normal (20°–40°) | Hyperkyphosis (>65°) | |
Total | Normal (20°–40°) | Hyperkyphosis (>40°) | Hyperkyphosis (>65°) | |
Hyperkyphosis | Total | Hyperkyphosis (>40°) | Hyperkyphosis (>40°) | Hyperkyphosis (>65°) |
Standing | Hyperkyphosis (>40°) | Normal (20°–40°) | Normal (40°–65°) | |
Static | Hyperkyphosis (>40°) | Hyperkyphosis (>40°) | Normal (40°–65°) | |
Dynamic | Hyperkyphosis (>40°) | Normal (20°–40°) | Hyperkyphosis (>65°) | |
Hypokyphosis/ Hypokyphotic attitude | Flat-back | Hypokyphosis (<20°) | Hypokyphosis (<20°) | Hypokyphosis (<40°) |
Standing | Hypokyphosis (<20°) | Normal (20°–40°) | Normal (40°–65°) | |
Static | Hypokyphosis (<20°) | Hypokyphosis (<20°) | Normal (40°–65°) | |
Dynamic | Hypokyphosis (<20°) | Normal (20°–40°) | Hypokyphosis (<40°) | |
Hypomobile kyphosis | Normal (20°–40°) | Normal (20°–40°) | Hypokyphosis (<40°) |
Classification | Subclassification | SP 1 | SSP 2 | TFB 3 |
---|---|---|---|---|
Normal lordosis | Normal (−20°/−40°) | Normal (0°±15°) | Normal (10°–30°) | |
Lumbar spine with reduced mobility | Functional lumbar lordosis // Hypomobile lordosis | Normal (−20°/−40°) | Normal (0°±15°) | Hypokyphosis or lordosis (<10°) |
Lumbar hypomobility | Hypolordosis (<−20°) | Normal (0°±15°) | Hypokyphosis (<10°) | |
Hyperlordotic attitude | Hyperlordosis (>−40°) | Normal (0°±15°) | Normal (10°–30°) | |
Functional lumbar hyperkyphosis | Static | Normal (−20°/−40°) | Hyperkyphosis (>15°) | Normal (10°–30°) |
Dynamic | Normal (−20°/−40°) | Normal (0°±15°) | Hyperkyphosis (>30°) | |
Total | Normal (−20°/−40°) | Hyperkyphosis (>15°) | Hyperkyphosis (>30°) | |
Lumbar Hypermobility | Hypermobility 1 | Hyperlordosis (>−40°) | Hyperkyphosis (>15°) | Hyperkyphosis (>30°) |
Hypermobility 2 | Hyperlordosis (>−40°) | Normal (0±15°) | Hyperkyphosis (>30°) | |
Hypermobility 3 | Hyperlordosis (>−40°) | Hyperkyphosis (>15°) | Normal (10°–30°) | |
Hypolordosis | Hypolordotic attitude | Hypolordosis (<−20°) | Normal (0±15°) | Normal (10°–30°) |
Lumbar kyphosis 1 | Hypolordosis (<−20°) | Hyperkyphosis (>15°) | Hyperkyphosis (>30°) | |
Lumbar kyphosis 2 | Hypolordosis (<−20°) | Hyperkyphosis (>15°) | Normal (10°–30°) | |
Lumbar kyphosis 3 | Hypolordosis (<−20°) | Normal (0°±15°) | Hyperkyphosis (>30°) | |
Structured Hyperlordosis | Hyperlordosis (>−40°) | Hyperlordosis (<−15°) or normal (0°±15°) | Lordosis or Hypokyphosis (<10°) | |
Structured lumbar kyphosis | Hypolordosis or kyphosis (<−20°) | Hyperkyphosis (>15°) | Hyperkyphosis (>30°) |
Curvature | Position | Classification | Mean ± SD | n | % |
---|---|---|---|---|---|
Thoracic curve | SP 1 | Rectification (<20°) | 15.75 ± 2.62° | 16 | 2.18 |
Normal (20° to 40°) | 32.6 ± 5.9° | 515 | 70.45 | ||
Hyperkyphosis (≥41°) | 46.85 ± 4.45° | 200 | 27.36 | ||
SSP 2 | Hypokyphosis (<20°) | 16.67 ± 2.31° | 3 | 0.41 | |
Normal (20° to 40°) | 35.29 ± 5.48° | 324 | 44.32 | ||
Hyperkyphosis (≥41°) | 49.15 ± 5.42° | 404 | 55.27 | ||
TFB 3 | Hypokyphosis (<40°) | 32.22 ± 6.71° | 18 | 2.46 | |
Normal (40° to 65°) | 53.88 ± 6.55° | 627 | 85.77 | ||
Hyperkyphosis (≥66°) | 70.56 ± 5.93° | 86 | 11.77 | ||
Lumbar curve | SP 1 | Rectification (<-20°) | −16.43 ± −1.78° | 14 | 1.89 |
Normal (−20° to −40°) | −31.05 ± −5.97° | 650 | 89.06 | ||
Hyperlordosis (≥−41°) | −45.94 ± −3.09° | 67 | 9.05 | ||
SSP 2 | Hyperlordosis (<−15°) | - | 0 | 0 | |
Normal (−15° to 15°) | 9.76 ± 3.7° | 93 | 12.72 | ||
Hyperkyphosis (≥16°) | 26.91 ± 6.47° | 638 | 87.27 | ||
TFB 3 | Hypokyphosis (<10°) | 9 ± 1.41° | 2 | 0.27 | |
Normal (10° to 30°) | 26.08 ± 4.23° | 277 | 38.43 | ||
Hyperkyphosis (≥31°) | 37.96 ± 5.03° | 452 | 61.83 |
Classification | Subclassification | Boys (n = 352) | Girls (n = 379) | Total (n = 731) |
---|---|---|---|---|
Normal Kyphosis | 112 (31.8%) | 122 (32.2%) | 234 (32%) | |
Functional Thoracic Hyperkyphosis | Static | 113 (32.1%) | 108 (28.5%) | 221 (30.2%) |
Dynamic | 6 (1.7%) | 13 (3.4%) | 19 (2.6%) | |
Total | 12 (3.4%) | 17 (4.5%) | 29 (4%) | |
Hyperkyphosis | Total | 12 (3.4%) | 20 (5.3%) | 32 (4.4%) |
Standing | 25 (7.1%) | 18 (4.7%) | 43 (5.9%) | |
Static | 53 (15.1%) | 66 (17.4%) | 119 (16.3%) | |
Dynamic | 3 (0.9%) | 3 (0.8%) | 6 (0.8%) | |
Hypokyphosis/Hypokyphotic attitude | Flat-Back | - | - | - |
Standing | 8 (2.3%) | 7 (1.8%) | 15 (2.1%) | |
Static | - | - | - | |
Dynamic | - | - | - | |
Hypomobile kyphosis | 8 (2.3%) | 5 (1.3%) | 13 (1.8%) |
Classification | Subclassification | Boys (n = 352) | Girls (n = 379) | Total (n = 731) |
---|---|---|---|---|
Normal lordosis | 19 (5.4%) | 29 (7.7%) | 48 (6.6%) | |
Lumbar spine with reduced mobility | Functional lumbar lordosis/Hypomobile lordosis | - | - | - |
Lumbar hypomobility | - | - | - | |
Hyperlordotic attitude | 3 (0.9%) | 9 (2.4%) | 12 (1.6%) | |
Functional lumbar hyperkyphosis | Static | 71 (20.2%) | 39 (10.3%) | 110 (15%) |
Dynamic | 5 (1.4%) | 25 (6.6%) | 30 (4.1%) | |
Total | 230 (65.3%) | 232 (61.2%) | 460 (63.2%) | |
Lumbar Hypermobility | Hypermobility 1 | 13 (3.7%) | 32 (8.4%) | 45 (6.2%) |
Hypermobility 2 | - | 1 (0.3%) | 1 (0.1%) | |
Hypermobility 3 | 2 (0.6%) | 6 (1.6%) | 8 (1.1%) | |
Hypolordosis | Hypolordotic attitude | - | - | - |
Lumbar kyphosis 1 | 7 (2%) | 4 (1.1%) | 11 (1.5%) | |
Lumbar kyphosis 2 | 2 (0.6%) | - | 2 (0.3%) | |
Lumbar kyphosis 3 | - | 1 (0.3%) | 1 (0.1%) | |
Structured Hyperlordosis | - | 1 (0.3%) | 1 (0.1%) | |
Structured lumbar kyphosis | - | - | - |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Santonja-Medina, F.; Collazo-Diéguez, M.; Martínez-Romero, M.T.; Rodríguez-Ferrán, O.; Aparicio-Sarmiento, A.; Cejudo, A.; Andújar, P.; Sainz de Baranda, P. Classification System of the Sagittal Integral Morphotype in Children from the ISQUIOS Programme (Spain). Int. J. Environ. Res. Public Health 2020, 17, 2467. https://doi.org/10.3390/ijerph17072467
Santonja-Medina F, Collazo-Diéguez M, Martínez-Romero MT, Rodríguez-Ferrán O, Aparicio-Sarmiento A, Cejudo A, Andújar P, Sainz de Baranda P. Classification System of the Sagittal Integral Morphotype in Children from the ISQUIOS Programme (Spain). International Journal of Environmental Research and Public Health. 2020; 17(7):2467. https://doi.org/10.3390/ijerph17072467
Chicago/Turabian StyleSantonja-Medina, Fernando, Mónica Collazo-Diéguez, María Teresa Martínez-Romero, Olga Rodríguez-Ferrán, Alba Aparicio-Sarmiento, Antonio Cejudo, Pilar Andújar, and Pilar Sainz de Baranda. 2020. "Classification System of the Sagittal Integral Morphotype in Children from the ISQUIOS Programme (Spain)" International Journal of Environmental Research and Public Health 17, no. 7: 2467. https://doi.org/10.3390/ijerph17072467