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A shared biomechanical environment for bone and posture development in children.

Fábio A Araújo1, Ana Martins1, Nuno Alegrete2

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The Spine Journal : Official Journal of the North American Spine Society
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Children with a flat posture have poorer bone properties, while rounded postures are linked to better bone health. This suggests bone and posture develop together in response to mechanical forces.

Keywords:
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Area of Science:

  • Pediatric Bone Health
  • Childhood Posture Development
  • Skeletal Biomechanics

Background:

  • Gravitational forces influence skeletal mechanical loading based on habitual standing posture.
  • Habitual mechanical stimulation is a key determinant of bone quality and resistance to stress.
  • The relationship between bone properties and sagittal posture in children remains understudied.

Purpose of the Study:

  • To investigate the association between bone physical properties and sagittal standing postural patterns in 7-year-old children.
  • To analyze the relationship between body composition (fat and fat-free mass) and postural patterns.

Main Methods:

  • Cross-sectional study of 2,398 children (1,138 girls, 1,260 boys) aged 7 years.
  • Sagittal standing posture quantified using photographs (trunk, lumbar, and sway angles).
  • Latent profile analysis used to identify postural patterns and assess associations with body composition and bone properties (dual-energy X-ray absorptiometry).

Main Results:

  • Identified postural patterns: Sway, Flat, Neutral to Hyperlordotic (girls); Sway to Neutral, Flat, Hyperlordotic (boys).
  • Flat posture associated with lower BMI; rounded posture with higher BMI.
  • Inverse association between bone properties and Flat posture; positive association between bone properties and rounded posture (especially Hyperlordotic).

Conclusions:

  • Inverse association exists between bone physical properties and Flat posture in children.
  • Bone properties and sagittal posture are positively linked in rounded postures.
  • Bone and posture maturation likely occur within a shared mechanical environment, influenced by anthropometrics and body composition.