Postura na infância prevalência de variações posturais e fatores associados avaliação de um programa de exercícios randomizado controlado

Abstract

Postural variations are common in childhood / adolescence and are corrected spontaneously. When maintained can cause overload. The objective of the first study was to evaluate the prevalence of postural variations in children / adolescents and to identify factors that explain these variations among age, gender, manual preference, body mass index (BMI) and physical activity, through multiple logistic regression analysis. 288 students were evaluated through postural observation. They were 59.4% female, mean age 10.6 (2.4) years, body mass 38.6 (12.7) kg and height 1.5 (0.1) m. Results show high prevalence of postural changes and their association with factors: age (forward head posture, shoulders and iliac crests asymmetry winged scapula), sex (winged scapula), BMI (forward head, iliac crest asymmetry, valgus knees and winged scapula) and not perform physical activity (valgus knees). Among the factors evaluated, obesity is a modifiable factor. Therefore, its association with the changes must be explored to facilitate the planning of preventive measures and more effective treatment. So, the objectives of the second study were to describe the prevalence of overweight in adolescents and identify differences in posture, (evaluated qualitatively and quantitatively) and the reporting of musculoskeletal pain (assessed by an adaptation of the Nordic Questionnaire) among normal weight and overweight in a large sample of students. 420 students were evaluated, 60% female, with mean age 11.1 (2.3) years, height 1.5 (0.1) m. body mass 44.5 (14.1) kg. Findings indicate that the prevalence of overweight was 36.2%. There was a higher prevalence of thoracic kyphosis, lumbar hyperlordosis and valgus knees with overweight students. There was no association between the presence of pain and weight excess. In childhood and adolescence, the posture lies in the development process. Therefore, any functional change to poor posture will reflect negatively in the future. So, the objective of the third study was to evaluate the effects of an exercise program of stretching and strengthening exercises in relation to posture, mobility of the spine and musculoskeletal pain in primary school children. Qualitative and quantitative postural evaluation of the trunk, pain and spine mobility (Whistance method) were collected before and after the intervention. The subjects were randomly assigned to groups. The exercise program was applied in groups, at school, twice weekly for eight weeks, for 50 minutes. The analysis included 78 subjects in the intervention group and 93 in the control, with mean age 11.6 (1.7) years, 1.5 (0.1) meters of height, 46.3 (14.1) kg of mass. It was also comprised of 67.3% female. The control group showed greater worsening percentage than intervention group to the posture of the shoulders. For the pain, the intervention group showed greater improvement percentage. These results show that the exercise program as described is effective in pain and posture of the shoulders. For other variables, adjustments in the duration of the program and individualized care may be recommended.