Date Published: January 26, 2012
Publisher: Hindawi Publishing Corporation
Author(s): Ragıba Zagyapan, Cihan Iyem, Ayla Kurkcuoglu, Can Pelin, Mustafa Agah Tekindal.
Posture can be defined as the form of the body when sitting, walking, or standing. There would be no problem if muscles interact in harmony with musculoskeletal system or nervous system. Posture analysis is crucial for clinical assessments in physical medicine and rehabilitation. However, studies into this issue are limited. In this study, the relationship between static standing balance and anthropomorphic features in healthy subjects was investigated. The study was carried out with a total of 240 students at Baskent University (116 females, 124 males) aged between 18 and 25 years. Type of balance of the subjects was determined with lateral posture analysis. Additionally, muscle shortness tests, subcutaneous fat thickness, and waist and thigh circumference were measured. As the results of lateral posture analysis, 107 subjects (71 males, 36 females) were detected to have anterior balance, 89 (41 males, 48 females) posterior balance, and 44 (12 males, 32 girls) neutral balance. Values of waist circumference, thigh circumference, and waist/thigh ratio were compared with all three balance types. A statistically significant difference was detected between these values in the subjects who had anterior balance (P < 0.05). In conclusion, a significant relationship was detected between muscle shortness, waist and thigh circumferences, and postural balance type.
Posture is one of the most important factors affecting physical and mental status of the individuals through their lives. Posture in humans is affected by different factors including familial factors, anatomical structural impairments, postural habits, and occupation . According to the definition of Posture Committee of American Academy of Orthopedics in 1947, posture is the regular and balanced arrangement of skeletal components so as to preserve supportive structures of the body from injury and progressive deformation [1, 2]. Cailliet stated that “posture may be in question if static spinal configuration does not lead to fatigue, pain in a certain period and is with acceptable ranges aesthetically” . Kapandji defined ideal posture as body’s being in balance with minimal stress and loading and stated that spinal movement segment is a mechanical system composed of two adjacent vertebrae, intervertebral disks, ligaments, and facet joints. Anterior and posterior structures share the load on this segment as two columns. Anterior column is the main supportive structure. Anterior column plays a static role, and posterior column plays a dynamic role . With a balanced posture, body and profund dorsal muscles may support the upper half of the body with the minimal muscle strength. When center of gravity slides forward due to impaired posture, dorsal muscles try to improve posture with more effort and provide a balanced position . Ligaments and muscles should be in balance for a proper posture. Imbalance of impaired posture leads to fatigue, skeletal asymmetry, and pain with nociceptive stimuli. Muscles extremely strain in order to maintain abnormal posture. Spasm and pain emerge in time. Weight is distributed to all body parts, shock is absorbed, range of movement is preserved, and thereby movements needed for stability and mobility are controlled independently with a correct posture [5, 6]. Posture analysis is crucial for clinical assessments in physical medicine and rehabilitation. It is important to establish the relation between postural balance and anthropometric measurements and determine the postural deviation in developing treatment programs in clinic (postural scoliosis, increasing lumbar lordosis, straight back posture, and others) and evaluating the different deformities that may have occurred . Comprehensive studies are limited incompatibly with the significance of the issue. Particularly, studies investigating the effectiveness of postural impairments and treatment modalities are severely limited.
In the study, type of balance in lateral posture analysis was investigated, and anthropometric measurements were conducted with 240 students (116 females, 124 males) of Baskent University aged between 18 and 25 years. This study was approved by Baskent University Institutional Review Board and Ethics Committee (Project no. KA 11/42) and supported by Baskent University Research Fund. Subjects who had any orthopedic problems or history of musculoskeletal system operations were excluded. A measure sensitive to 1 mm was used for anthropometric measurements, Holtain brand of skinfold caliper sensitive to 2 mm was used to measure fat, and a plumb-line was used for lateral static balance analysis .
Age, height, weight, and body mass indexes were also evaluated in addition to parameters above. t-test was used for two groups, and one-way variance analysis was used for 3 or more groups. Chi-square analysis was used for determination of presence of a relationship and degree of relationship for continuous and discontinuous variables. Spearman correlation coefficients were estimated as α = 0.05 for all tests.
Anterior balance was detected in 107 subjects (71 males, 36 females), posterior balance was detected in 89 subjects (41 males, 48 females), and neutral balance was detected in 44 subjects (12 males, 32 females) in lateral posture analyses. Three types of balance were compared in terms of mean values of waist circumference, thigh circumference, and waist circumference/thigh circumference ratio. A statistically significant difference was detected between them, mainly in anterior balance group (P < 0.05). Distribution between presence of shortness in hamstring group muscles and hip flexors and balance types was analysed. Shortness of these muscles showed statistically significant differences among all three balance types in the ones with anterior balance (P < 0.05). A statistically significant relationship could not be found between other parameters (lumbar extensors, supraspinal DKK, m. gastrocnemius, pectoral muscles) and balance types. Results of statistical analysis between body balance types and anthropomorphic features are shown in Table 1. Anterior balance was more frequent among the subjects who had shortness in hamstring group muscles and hip flexors. Contrary to the expectations, a significant relationship could not be found between lumbar extensor shortness and posterior balance. Anterior balance was detected more frequent among the subjects with higher waist circumference, thigh circumference, and waist/thigh circumference. This was a result of forward change of gravity center. No study was encountered in the literature on the relationship between postural balance and anthropometric properties. In the study by Keionen et al. investigating the relationship between body movements in postural balance and anthropometric factors in 100 adults, they concluded that changes in body balance in standing position could not be explained with only anthropometric features; however anthropometric features should be emphasized in balance studies . Study results indicate that height, weight, and emotional conditions could also be effective on balance. In a study of De Souza and Gil Coury conducted in Japan and Brazil, postural changes were investigated in 32 morbid obese patients and obesity was found to negatively affect anterior, posterior, and lateral balance and led to genu valgum deformity in 84.4% of the patients . Postural analysis is important in physical medicine and rehabilitation fields for detecting and correcting postural deformities. In addition, postural evaluation is indicative in the treatment of short muscles determined in anthropometric measurements in healthy individuals and the resulting pain. For instance, hyperlordosis developing in lumbar region in people with posterior balance type could result in pain around waist. Similarly, flexor position of body in individuals of anterior balance type could cause pain in thoracal region based on kyphotic appearance. In postural evaluation, a weak relationship was reported between balance types and anthropometric properties. Source: http://doi.org/10.1155/2012/146063