{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:06:03Z","timestamp":1767650763686},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sagittal postural patterns are associated with back pain in adolescents and adults. However, whether postural patterns are already observable during childhood is unknown. Such a finding would confirm childhood as a key period for posture differentiation and thus for chronic pain etiology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aims of this study were to identify and describe postural patterns in girls and boys of school age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This was a cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Eligible children were evaluated at age 7 in the population-based birth cohort Generation XXI in Portugal. Posture was assessed through right-side photographs during habitual standing with retroreflective markers placed on body landmarks. Postural patterns were defined from trunk, lumbar, and sway angles with model-based clusters, and associations with anthropometric measures were assessed by multinomial logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Posture was evaluated in 1,147 girls and 1,266 boys. Three postural patterns were identified: sway (26.9%), flat (20.9%), and neutral to hyperlordotic (52.1%) in girls and sway to neutral (58.8%), flat (36.3%), and hyperlordotic (4.9%) in boys. In girls, a higher body mass index was associated with a sway pattern (versus a flat pattern: odds ratio = 1.21; 95% CI = 1.12, 1.29), whereas in boys, a higher body mass index was associated with a hyperlordotic pattern (versus a flat pattern: odds ratio = 1.30; 95% CI = 1.17, 1.44).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Photogrammetry as a noninvasive method for posture assessment may have introduced some postural misclassifications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Postural patterns in 7-year-old children were consistent with those previously found in adults, suggesting that childhood is a sensitive period for posture differentiation. Sagittal morphology differed between girls and boys, emphasizing sex-specific biomechanical loads during a habitual upright position even in prepubertal ages.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2522\/ptj.20150712","type":"journal-article","created":{"date-parts":[[2016,10,7]],"date-time":"2016-10-07T01:39:35Z","timestamp":1475804375000},"page":"258-267","source":"Crossref","is-referenced-by-count":13,"title":["Defining Patterns of Sagittal Standing Posture in Girls and Boys of School Age"],"prefix":"10.1093","volume":"97","author":[{"given":"F\u00e1bio Azevedo","family":"Ara\u00fajo","sequence":"first","affiliation":[{"name":"F.A. Ara\u00fajo, MSc, EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, 135\u2013139, 4050\u2013600 Porto, Portugal, and Department of Clinical Epidemiology, Predictive Medicine, and Public Health, University of Porto Medical School, Porto, Portugal. Address all correspondence to Mr Ara\u00fajo at: fabio.araujo@ispup.up.pt."}]},{"given":"Milton","family":"Severo","sequence":"additional","affiliation":[{"name":"M. Severo, PhD, EPIUnit, Institute of Public Health, University of Porto, and Department of Clinical Epidemiology, Predictive Medicine, and Public Health, University of Porto Medical School."}]},{"given":"Nuno","family":"Alegrete","sequence":"additional","affiliation":[{"name":"N. Alegrete, MD, Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal, and Department of Surgery, University of Porto Medical School."}]},{"given":"Laura D.","family":"Howe","sequence":"additional","affiliation":[{"name":"L.D. Howe, PhD, MRC Integrative Epidemiology Unit, Bristol, United Kingdom, and School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom."}]},{"given":"Raquel","family":"Lucas","sequence":"additional","affiliation":[{"name":"R. Lucas, PhD, EPIUnit, Institute of Public Health, University of Porto, and Department of Clinical Epidemiology, Predictive Medicine, and Public Health, University of Porto Medical School."}]}],"member":"286","published-online":{"date-parts":[[2016,10,6]]},"reference":[{"key":"2023011704370316200_bib1","doi-asserted-by":"crossref","first-page":"E599","DOI":"10.1097\/BRS.0b013e3181aad219","article-title":"Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity","volume":"34","author":"Lafage","year":"2009","journal-title":"Spine (Phila Pa 1976)"},{"key":"2023011704370316200_bib2","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1097\/01.brs.0000179086.30449.96","article-title":"The impact of positive sagittal balance in adult spinal deformity","volume":"30","author":"Glassman","year":"2005","journal-title":"Spine (Phila Pa 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