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Journal of Physical Education and Sport
®
(JPES), Vol 17 Supplement issue 1, Art 16, pp. 101 - 106, 2017
online ISSN: 2247 - 806X; p-ISSN: 2247 – 8051; ISSN - L = 2247 - 8051 © JPES
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Corresponding Author ŠTEFAN BALKÓ, E-mail:
stefan.balko@ujep.cz
Original Article
Influence of physical activities on the posture in 10-11 year old schoolchildren
ŠTEFAN BALKÓ
1
, IVA BALKÓ
2
, LADISLAV VALTER
3
, MAREK JELÍNEK
4
1,2,3
Department of Physical Education and Sport, Faculty of Education, J.E. Purkyně University in Ústí nad
Labem, CZECH REPUBLIC
4
Faculty of Health Studies, Laboratory for Human Motion Study, J.E. Purkyně University in Ústí nad Labem,
CZECH REPUBLIC
Published online: February 15, 2017
(Accepted for publication January 11, 2017)
DOI:10.7752/jpes.2017.s1016
Abstract:
Purpose and problem: the aim of the study is to monitor the actual state of posture of schoolchildren in the
Czech Republic. A large number of recent studies shows a declining trend of physical activity application in
children who attend primary schools all over the world. We can assume that the factors that attract the attention
of children more than everyday physical activity are significantly affecting the inactivity of children. Materials
and methods: in this study, 50 10–11-year-old schoolchildren (primary school) were tested (25 boys, 25 girls).
To determine the posture condition (position of individual body segments), the Jaroš and Lomíček test
(standardized) and a Saehan metallic goniometer (Saehan Corporation, South Korea; 180 degrees) were used.
Furthermore, a standardized questionnaire was used, which contained 9 questions that were focused on
realization of physical activity in the observed children during the week. Results: the results of our study clearly
indicate that basic schoolchildren do not have good posture. In obese children, a higher number of defective and
very defective posture was observed in comparison with the normal weight children. The children that performed
physical activity three times a week had a perfect posture. A defective or even very bad posture was detected in
almost 83% of children who did not do any sports or exercised only once a week.
The results of our study clearly
demonstrated that schoolchildren who were less physically active during the week fell into the poor posture
category (p = 0.0001, η
2
= 0.09). Furthermore, we determined that most schoolchildren, who applied 3 or more
hours per week of physical activity, most often had a good posture (p = 0.0001, η
2
= 0.12). Conclusions: the
prevention of this problem may be in a higher number of physical education lessons in schools or the interaction
of state institutions, schools, families and sport clubs, which would ensure a sufficient amount of physical
activity during the daily program of children.
Keywords: posture; obesity; physical activity; physical education; healthy physical education; primary school
Introduction
Postural stereotype is an integrated chain of reflexes that we observe as movement (Bautmans, Van
Arken, Van Mackelenberg, & Mets, 2010). Repetition of the movement during the lifetime activates the same
muscle groups and muscles between which a link is formed. Movement stereotypes of each person depend on the
prerequisites of the individual human being (body shape, fat distribution, etc.).
In the last few decades, a decreasing trend is observed in the application of physical activity in the lives of
people. In everyday human activities, for many people, physical activity is of the least importance in their daily
routine. Without a doubt, technological advancements, workload at work and fast food options affect the
physical activity of the population. These factors are very closely linked, and it is possible to say that they all
have a negative effect on the movement of the current generation. The increase in the poor posture incidence is
associated with changes in lifestyle, obesity and lack of exercise. Hodges and Tucker (2011) describe upright
posture maintenance as a postural function that involves all muscles.
With the entry of children into school, there is a change in the musculoskeletal system, which is
influenced by burdening the organism by sitting. Out of the total waking hours, children spend 1/3 of time at
school in a static position (Kolisko, 2003). This fact begins to manifest itself right after the entry of children into
school by weakening of the support motion system. This issue was addressed in a study by Murphy, Buckle, and
Stubbs (2004), who found that the sitting of children in classrooms can cause painful conditions in the back area.
The number of children, who keep upright stance without increased muscular effort, with the natural curvature of
the spine is declining. Unfortunately, the family, which is the basis for harmonious and optimal development of
children, is not always able to sufficiently engage children in physical activities during the day due to work
duties of the parents. Currently, school cannot compensate enough for this fact. In the Czech Republic, children
have only two physical education lessons a week. The degree of involvement of children in physical activities
during these lessons is relative. Therefore, many authors from other countries highlight that more and more
schoolchildren have back pain (Grimmer & Williams, 2000; Masiero, Carraro, Celia, Sarto, & Ermani, 2008;
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Watson, Papageorgiou, Jones, Taylor, Symmons, Silman, & Macfarlane, 2002). However, poor posture more
frequently happens in children of preschool age. By observing activities of children, Kolisko (1992) concluded
that on average children actively move 2 to 14 minutes during a physical education lesson. Children are
generally less physically active, and this leads to a more frequent occurrence of poor posture. Hercig (2005)
stated that the range and frequency of weakening posture leads to a situation where physical education teachers
need more knowledge of healthy physical education than of the sports. Kolář (2002) states that the incorrect use
of muscles during the growth period may be considered as one of the major causes for the occurrence of poor
posture. Kolisko (2003) states that the sources of poor posture are the static load at school, lack of physical
activity and premature unilateral sports specialization in childhood. Spontaneous physical activity of children in
preschool, when children enter the primary school, is significantly suppressed, and children spend most of the
day in a static position (school desks, free time, activities on the internet, computer games, etc.). Over time, there
has been an increase in the amount of static muscular work to the detriment of dynamic muscular work. In the
early 19th century, hard physical work was compensated by a passive resting lying position, while the current
young generation is used to relaxing in a sedentary position at a computer, tablet or television (Kučera, 1999). In
adulthood, this fact may cause neuropsychological problems and consequent increased spending of funds to
maintain health. It should be noted that back pain occurs in up to 80% of the adult population (Kopecký, 2014).
Given these facts, it is certainly desirable to pay extra attention to the posture of children. An alarming sign is
that some studies indicate that there is an increase in the number of children with bad posture (Dostálová, 2006,
2011). Pokorný (2003) even states that 95% of 6–8-year-old children have incorrect posture. This is also related
to the claims of Kubánek (1992), who states that 70–80% of 6–11-year-old children need special balancing
exercises for the weakened musculoskeletal system. In general, Kopecký (2014) states that in surveys dealing
with bad posture it was found that 50–60% of schoolchildren have poor posture and therefore should regularly
carry out special compensatory exercises during healthy physical education lessons. Healthy physical education
is a form of controlled exercises that were designed by the qualified medical physical training practitioners for
individuals who are included in the so-called III health group (Beránková, Grmela, Kopřivová, & Sebera, 2012).
Similarly, Zanovitová, Zanovit, and Bendíková (2011) in their study found that nearly 60% of girls and 55% of
boys have incorrect posture. During the long-term monitoring of children, Widhe (2001) determined that after 10
years of life, the body posture of children worsens. The author monitored the same children when they were 5-6
years of age and again when they were 15-16 years of age. These children had a larger inclination
(approximately 6 degrees) of the thoracic kyphosis and lumbar lordosis within 10 years. At the same time, this
study revealed a decrease in the mobility of the spine of the same observed children. The results of the survey
investigation showed that approximately one third of 15–16-year-old children have an occasional back pain.
Exercises for improving body posture are mentioned in the study of Torlaković, Muftić, Avdić, and Kebata
(2013). A series of studies examined the effect of physical activity on body posture (e.g., Bogdanović &
Marković, 2010).
It is evident that proper diet and ample physical activity can positively affect the health of children,
which is associated with the correct posture. The question is how much time they should devote to physical
activity per week for good posture.
The aim of this study was to determine whether the amount of applied physical activities during the
week correlates with the posture of schoolchildren in the Czech Republic.
Materials and methods
The first part of this study focuses on monitoring the impact of BMI (body mass index) on posture and
the influence of organized physical activity on posture. Next part monitors the results from a standardized
questionnaire.
Participants
The research sample consisted of 50 children from primary school (25 boys, 25 girls) who were 10-11
years old. The measurement was conducted during physical education classes. Parents of the children provided
their consent for the measurement of children. The authors have all informed consents on hand.
Procedure
The Jaroš and Lomíček test was used to diagnose poor posture. Five parameters are assessed in this test:
a) posture of the head and neck, b) chest evaluation, c) abdomen and pelvic tilt evaluation, d) back curvature
evaluation and e) posture in the frontal plane evaluation. Legs were evaluated separately. For each indicator
tested, the students can receive a maximum of 4 points (large deviation from the standard posture) and at least
one point (the posture does not show any deviation from the norm). With regard to the correct posture, it was
optimal to obtain the lowest score for each indicator. The individuals were divided into four groups based on the
score scale that was obtained from the results of the measurements. In group I (perfect posture), there were
individuals who received a total of 5 points (the sum of all indicators). In group II (good posture), there were
students who received 6-11 points. Group III (poor posture) consisted of individuals who received 11-15 points.
In group IV (very bad posture), there were students who received 16-20 points. When evaluating lower
extremities, the students can receive a minimum of one and a maximum of four points. A degree of flat and
standing knee (varus, valgus) was observed.
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The tested students stood upright in their underwear and without shoes. The arms were loosely
positioned at their sides. Using a plumb line dropped from the occipital bone and a calibrated meter, the
distances between the segments of the body were deducted using a vertical line that was represented by the
dropped plumb line.
The individuals were divided into BMI categories by transferring the values into percentile graphs according to
Vignerová and Bláha (2001), always with respect to gender and age of the monitored children.
Instruments
A calibrated goniometer (Saehan metallic goniometer, Saehan Corporation, South Korea, 180 degrees) was used
to monitor the inclination of individual parts of the body. Height measurements were carried out using a
calibrated measuring tool. The measurement of body weight was carried out using a calibrated digital scale with
an accuracy of 0.01 kg.
All monitored students were given a standardized questionnaire (Posture comparison of preschool and
schoolchildren). For this study, we only used the part that was designed for schoolchildren. The questionnaire
contains 9 questions. The parents answered these questions:
• How far is your child's school from the residence?
• How is your child transported to school?
• How many hours per week does your child engage in organized physical activities (e.g., hobby groups,
sports clubs)?
• How many times a week does your child attend these sports organizations?
• How does your child spend most afternoons outside the school?
• How many hours a week do you and your child perform a physical activity (prolonged)?
• How many hours a day does your child spend on a PC or watches TV?
• Does your child complain about pain (cervical spine, thoracic spine, lumbar spine)?
• Do you have a medically confirmed diagnosis of poor posture?
Data analysis
The measurements were conducted with the approval of the school director and parents who expressed
agreement with the measurement via their signatures. The individuals did not suffer any pain, and parents and
children were aware that the results were used for scientific purposes. The data were processed using the
Microsoft Excel 2010 and Statistica 6.1 software. The results were evaluated using the Chi-square test at the
level of statistical significance of p <0.05.
Results
This portion of the study is divided into two parts. The first part focuses on tracking the actual state of posture in
children. The second part detects relationships between the observed variables (i.e., BMI vs. posture, applied
physical activity vs. posture).
First part – posture
Table 1 Results of posture evaluation for boys and girls
Posture
Perfect Good Poor Very bad
Gender n % n % n % n %
Boys 1 4 12 48 11 44 1 4
Girls 2 8 7 28 11 44 5 20
N 3 6 19 38 22 44 6 12
From Table 1, it is clear that 56% of all measured students (boys and girls together) have a posture that is worse
than good. Most children with bad posture belong to group III. It is very interesting that a perfect posture was
identified in only 6% of 50 children.
Fig. 1 Results of BMI evaluation of boys and girls
ŠTEFAN BALKÓ, IVA BALKÓ, LADISLAV VALTER, MAREK JELÍNEK
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In Figure 1, it is evident that many children belong to the normal body weight group. Overweight and obesity
were observed more frequently in girls than in boys. A significantly larger proportion of individuals with low
weight was found in boys as compared with girls.
Fig. 2 Influence of physical activity on the posture category
Figure 2 shows that students who are less physically active during the week (do not do any sports even once a
week) belong to the bad posture category. The relationship between these variables is significant, based on the
Chi-square test (p = 0.0001, η
2
= 0.09).
Second part – Questionnaire
Based on the results of the survey in this study, there were only few answers that provided an overview of the
application of physical activities for the examined students.
Fig. 3 Organized physical activities vs. posture
Legend: no OPA – no organized physical activity, OP1 – organized physical activity up to 1 hour a week, OP2 – organized
physical activity up to 2 hours a week, OP3 – organized physical activity up to 3 hours a week, OP4 – organized physical activity
up to 3 hours a week, OP5 – organized physical activity up to 5 hours a week, OP5+ - more than 5 hours of organized physical
activity
From Figure 3, it is clear that 50% of children spend time doing organized physical activity less than
three hours per week. On closer observation of this fact, it was found that most children (36%) with a very bad
posture stated in the survey that they did not participate in organized physical activities. This clearly indicates the
importance of physical activity on body posture. On the contrary, most children who spent 3 or more hours per
week performing a physical activity most often had a good posture (30%). Therefore, it can be argued that the
more hours children spend doing an organized physical activity, the better their posture is. The difference proved
to be statistically significant (p = 0.0001, η
2
= 0.12).
Discussion
It is known that physical activities have a positive effect on human health. Dylevský, Korbelář, and
Kučera (1996) state that movement determines normal growth and physical, mental and social development.
Therefore, lack of physical activities can result in adaptation disorders and may affect the mental development of
a child. Cooper (1991) mentions that a sufficiently intense physical load increases physical fitness of children,
which has a positive influence on the work function of internal organs and muscular system. By intentionally
influencing the functionality of the muscle apparatus, poor posture and the subsequent development of
orthopedic problems can be prevented. To receive a positive effect from physical activity, it should be performed
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at 60–85% of the maximum heart rate for 15 to 20 minutes at least three times a week. However, the intensity of
activities during the physical education class does not meet this requirement (Mužík & Krejčí, 1997). Based on
the existing research that clearly indicates that preschool and school-age children often have poor posture, we
decided to investigate the relation between the physical activity and posture of 10–11-year-olds. Our results
(Table 1) show that 56% of all measured students have worse than good posture (boys and girls together). Most
children with poor posture belong to group III. Perfect posture was identified in only 6% of 50 children. This is
consistent with the research findings of Kopecký (2014), which state that 50-60% of children have bad posture.
Similarly, in their study, Zanovitová, Zanovit, and Bendíková (2011) found that nearly 60% of girls and 55% of
boys have incorrect posture. Additionally, the authors stated the difference in posture among children who do
sports and those who do not. Furthermore, using the diagnostic test and survey results, we concluded that
students who are less physically active during the week (no sport even once a week) fall into the poor posture
category (Figure 2). The relationship between these variables is significant, based on the Chi-square test (p =
0.0001, η
2
= 0.09).
In our investigation, we determined that the monitored children do not get enough organized physical
activity during the week. This fact is understood in the context of recommending to perform physical activities
with a necessary intensity at least 3 times a week. In this respect, an interesting finding was that 50% of children
did an organized physical activity less than three hours a week. Furthermore, it was found that most children
(36%), who have poor or a very bad posture, stated in a survey that they did not participate in organized physical
activities. This clearly indicates the importance of physical activity on body posture. On the contrary, most
children who applied 3 or more hours a week to a physical activity most often had a good posture (30%).
Therefore, it can be argued that the more hours children spend doing an organized physical activity, the better
their posture is. The difference proved to be statistically significant (p = 0.0001, η
2
= 0.12). Similar finding
appeared in the study of Bogdanović and Marković (2010) who determined that poor body posture is related to
the participation of children in organized sport activities. In the survey, the parents reported that 46% of children
spend their free time doing passive activities (on a PC or watching TV). We showed that children, who are
physically active outside of school, are more likely (42%) to have a good or a perfect posture compared with
children who are physically passive. Children, who are physically passive, have a poor or a very bad posture
(44%). To the question of how many hours per week the child spends on a PC or watching TV, 50% of
respondents stated that it was 1–2 hours. Only 8% of parents stated less than an hour. Up to three hours is spent
watching TV or on a PC (28% of children). In total, 16% of the monitored children watch television or a PC
screen for more than three hours. An interesting finding was that most children with poor or very bad posture
watch TV or PC screen for up to three hours a day. Most children, who were identified to have a poor posture,
spent three or more hours per week watching TV or a PC screen. This clearly testifies to the fact that passive
activities outside school have a negative effect on the posture. An interesting solution to this problem is
mentioned in the study of Robbins, Johnson, and Cunliffe (2009) who used computers to draw attention of
children to the importance of the correct body posture. Dvořáková (2012) states that the main effort of educators
should be to create a positive relationship between the children and the movement. We believe that family is the
most important part in this interaction. Valuable information about posture can be derived using a surface
electromyography signal from measured muscles such as in the study of Nosko, Razumeyko, Iermakov, and
Yermakova (2016). We can obtain an especially important information from the measurements in which the
relationship of one sided loads in children (e.g., school bags) and EMG signals from the selected (overloaded)
muscles is monitored.
Conclusion
From the abovementioned results, we determined that poor posture can be prevented either
spontaneously or in a controlled manner using physical activities during the school day by reducing the static
load in the classroom and by modifying physical schedule of children in their spare time. A larger number of
physical education hours and a focus on physical education would allow this negative trend to change, assuming
a close cooperation between parents, school, sports institutions, and physical training doctors. Regular and
adequate pursuit of physical activities by children and the prevention of poor posture associated with the use of
special compensatory exercises can be considered as a valuable investment in the future. By monitoring the
current state of posture and frequency of physical activity among children in primary schools, the prognosis of
the health status of the Czech Republic population can be characterized.
The study was realized with the support of SGS UJEP Ústí nad Labem.
References
Bautmans, I., Van Arken, J., Van Mackelenberg, M., & Mets, T. (2010). Rehabilitation using manual
mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. Journal of
Rehabilitation and Medicine, 42(2), 129-135.
Beránková, L., Grmela, R., Kopřivová, J., & Sebera, M. (2012). Zdravotní tělesná výchova. Brno: Masarykova
ŠTEFAN BALKÓ, IVA BALKÓ, LADISLAV VALTER, MAREK JELÍNEK
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106
univerzita, Elportál: Retrieved from http://is.muni.cz/ elportal/?id=990779
Bogdanović, Z, & Marković, Ž. (2010). Presence of lordotic poor posture resulted by absence of spot in primary
school children. Acta Kinesiologica, 4(1), 63-66.
Cooper, K.H. (1991). Kid fitness. New York: Bantam Books.
Dostálová, I. (2006). Tělovýchovné chvilky. [Physical education moments]. In L. Miklánková & V. Karásková
(Eds.), Sborník příspěvků semináře Tak to učím já…Náměty pro tělesnou výchovu na 1. stupni škol
[Proceedings of the seminar so that I teach ... Suggestions for physical education at the 1st grade
schools] (pp.5-7). Olomouc: Univerzita Palackého.
Dostálová, I. (2011). Teorie a praxe zdravotní tělesné výchovy. [Theory and practice of health physical
education]. Tělesná kultura, 34(2), 113-125.
Dvořáková, H. (2012). Školáci v pohybu: tělesná výchova v praxi. [Schoolchildren in movement: physical
education in practise]. Praha: Grada Publishing
Dylevský, I., Korbelář, P., & Kučera, M. (1996). Pohybový systém a zátěž.
[
Musculoskeletal system and load].
Praha: Grada.
Grimmer, K., & Williams, M. (2000). Gender-age environmental associates of adolescent LBP. Applied
Ergonomics, 31(4),343-360.
Hercig, S. (2005). O problému zdravotně oslabených žáků, který přerůstá učiteli přes hlavu. [The problem of
physically disordered students who grows teachers over their head]. Tělesná výchova a
sport mládeže, 71(3), s 11.
Hodges, P., & Tucker, K. (2011). Moving differently in pain: A new theory to explain the adaptation to pain.
Pain 152(3), 90-98.
Kolář, P. (2002). Vadné držení těla v posturální ontogenezi. [Poor posture on postural ontogenesis]. Pediatrie
pro praxi, 3, 106-109.
Kopecký, M. (2014). Didaktika zdravotní tělesné výchovy. [Didactics of health physical education]. Olomouc:
Univerzita Palackého.
Kubánek, B. (1992). Základy zdravotní tělesné výchovy pro žáky základních škol. Oslabení podpůrně
pohybového systému. [Basics of health physical education for elementary school students. impairment
of locomotor system]. Olomouc: Hanex.
Kučera M. (1999). Základní princip terapie pohybem v rané ontogenezi. In H.Válková & Z. Hanelová (Eds.),
Sborník referátů z mezinárodní konference Pohyb a zdraví [Proceedings of the International
Conference on Movement and Health] (pp. 44-46). Olomouc: Univerzita Palackého,
Fakulta tělesné kultury.
Masiero, S., Carraro, E., Celia, A., Sarto, D., & Ermani, M. (2008). Prevalence of nonspecific low back pain in
schoolchildren aged between 13 and 15 years. Acta Paediatrica, 97(2), 212-216.
Murphy, S., Buckle, P., & Stubbs, D. (2004). Classroom posture and self-reported back and neck pain in
schoolchildren. Applied Ergonomics, 35(2). 113-120.
Mužík, V., & Krejčí, M. (1997). Tělesná výchova a zdraví. [Physical education and health]. Olomouc: Hanex.
Nosko, M., Razumeyko, N., Iermakov, S., & Yermakova, T. (2016). Correction of 6 to 10-year-old
schoolchildren postures using muscular-tonic imbalance indicators. Journal of Physical Education and
Sport, 16(3), 988 – 999.
Pokorný I. (2003). Zdravotní tělesná výchova pro 1. Stupeň základní školy. [Health Physical Education for the
1st grade of Primary School]. Ústí nad Labem: Univerzita Jana Evangelisty Purkyně.
Robbins, M., Johnson, I.P., & Cunliffe, C. (2009). Encouraging good posture in school children using
computers. Clinical Chiropractic, 12(1), 35-44.
Torlaković, Muftić, Avdić, & Kebata (2013). Effects of the combined swimming, corrective and aqua
gymnastics programme on body posture of preschool age children. Journal of Health Sciences, 3(2),
103-108.
Vignerová, J., & Bláha, P. (2001). Sledování růstu českých dětí a dospívajících. [Tracking of the growth of
Czech children and adolescents]. Praha: Státní zdravotní ústav.
Watson, K.D., Papageorgiou, A.C., Jones, G.T., Taylor, S., Symmons, D.P.M., Silman, A.J., & Macfarlane, G.J.
(2002). LBP in schoolchildren: occurrence and characteristics. Pain, 97, 87-92.
Widhe, T. (2001). Spine: posture, mobility and pain. A longitudinal study from childhood to adolescence.
European Spine Journal, 10(2), 118-123.
Zanovitová, M., Zanovit, I., & Bendíková, E. (2011). Zdravie a stav oporno-pohybového systému u
adolescentov. [Health and condition of musculoskeletal system u adolescents]. Biomedicína 13(3), 356-
366.
