{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:09Z","timestamp":1787027289012,"version":"build-2736575974"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical examinations are critical for early detection of spinal abnormalities and visual function issues in children. Spinal health has a significant impact on both physical and psychological well-being, while untreated abnormalities may lead to postural deformities. Despite evidence linking spinal posture and balance control to visual function, the relationship between these factors remains underexplored. This study investigates the association between spinal health and visual function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 875 children undergoing health examinations. Spinal parameters, including the thoracic kyphosis angle and the angle of trunk rotation, were measured alongside visual and perceptual examinations and refractive status. Statistical analyses were performed to assess their relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences were observed in the distribution of spinal parameters across three orders of stereopsis and spherical equivalent (SE). Specifically, the median angle of trunk rotation (ATR) was 2\u00b0 (IQR: 1\u00b0\u20133\u00b0) in participants with level 4 zero-order stereopsis, which was significantly lower than that in level 0 participants (median: 4\u00b0, IQR: 3\u00b0\u20135\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The median kyphosis angle (KA) was 27\u00b0 (IQR: 25\u00b0\u201329\u00b0) in those with pass-grade first-order stereopsis, significantly lower than the 35\u00b0 (IQR: 32\u00b0\u201338\u00b0) in non-passers (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Spearman\u2019s rank correlation analysis revealed a significant negative correlation between SE and both KA (rs\u202f=\u202f\u22120.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and ATR (rs\u202f=\u202f\u22120.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Additionally, gender differences were found in KA distribution, with females having a higher median KA (29\u00b0, IQR: 26\u00b0\u201331\u00b0) than males (27\u00b0, IQR: 25\u00b0\u201330\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest a potential link between spinal health and visual development. In this cross-sectional sample, poorer stereopsis and more myopic refractive error were associated with modestly higher kyphosis and trunk-rotation angles. These findings provide preliminary evidence for the link between visual function and spinal alignment in school-aged children. Incorporating spinal health assessments into pediatric visual screening programs could facilitate early intervention for both spinal and visual abnormalities, improving overall child health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1702548","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:44:14Z","timestamp":1768977854000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The association between spinal health and visual function in a pediatric population: insights from large-scale health examinations"],"prefix":"10.3389","volume":"13","author":[{"given":"Jun","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]},{"name":"Clinical Research Center for Pediatric Eye Diseases in Hunan Province","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linhui","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]},{"name":"Clinical Research Center for Pediatric Eye Diseases in Hunan Province","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]},{"name":"Clinical Research Center for Pediatric Eye Diseases in Hunan Province","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zili","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Children's Healthcare, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xilang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]},{"name":"Clinical Research Center for Pediatric Eye Diseases in Hunan Province","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Pediatrics Research Institute of Hunan Province, The Affiliated Children\u2019s Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Changsha Aier Eye Hospital","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]},{"name":"Clinical Research Center for Pediatric Eye Diseases in Hunan Province","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children\u2019s Hospital)","place":["Changsha, Hunan, China"]},{"name":"Clinical Research Center for Pediatric Eye Diseases in Hunan Province","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"212","DOI":"10.23736\/S1973-9087.23.07605-0","article-title":"Intensive bracing management combined with physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis patients with a major curve ranging from 40-60\u00b0 who refused surgery: a prospective cohort study","volume":"59","author":"Zhang","year":"2023","journal-title":"Eur J Phys Rehabil Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1016\/S0140-6736(08)60658-3","article-title":"Adolescent idiopathic scoliosis","volume":"371","author":"Weinstein","year":"2008","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13013-017-0145-8","article-title":"2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth","volume":"13","author":"Negrini","year":"2018","journal-title":"Scoliosis Spinal Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1016\/j.apmr.2024.04.011","article-title":"Effectiveness of physiotherapeutic scoliosis-specific exercises on 3-dimensional spinal deformities in patients with adolescent idiopathic scoliosis: a systematic review and meta-analysis","volume":"105","author":"You","year":"2024","journal-title":"Arch Phys Med Rehabil"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"755726","DOI":"10.3389\/fpubh.2021.755726","article-title":"The effect of parental social integration on the physical examination utilization for young migrant children: a national cross-sectional study in China","volume":"9","author":"Jing","year":"2021","journal-title":"Front Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1167\/iovs.04-0175","article-title":"The critical period for susceptibility of human stereopsis","volume":"46","author":"Fawcett","year":"2005","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1111\/cxo.12655","article-title":"Stereopsis: are we assessing it in enough depth?","volume":"101","author":"O'Connor","year":"2018","journal-title":"Clin Exp Optom"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1136\/bjo-2023-323688","article-title":"Prevalence of myopia among children and adolescents aged 6-16 during COVID-19 pandemic: a large-scale cross-sectional study in Tianjin, China","volume":"108","author":"Li","year":"2024","journal-title":"Br J Ophthalmol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"171","DOI":"10.3389\/fnins.2018.00171","article-title":"Human postural control","volume":"12","author":"Ivanenko","year":"2018","journal-title":"Front Neurosci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1213\/ANE.0000000000005742","article-title":"Effects of Sevoflurane-Propofol-balanced anesthesia on flash visual evoked potential monitoring in spine surgery: a randomized noninferiority trial","volume":"134","author":"Ma","year":"2022","journal-title":"Anesth Analg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1109\/OJEMB.2024.3399469","article-title":"EEG microstate as a marker of adolescent idiopathic scoliosis","volume":"5","author":"Rubega","year":"2024","journal-title":"IEEE Open J Eng Med Biol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e0303086","DOI":"10.1371\/journal.pone.0303086","article-title":"Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: a systematic review","volume":"19","author":"Paramento","year":"2024","journal-title":"PLoS One"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1089\/cyber.2018.0259","article-title":"Intermittent exotropia treatment with dichoptic visual training using a unique virtual reality platform","volume":"22","author":"Li","year":"2019","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12891-022-05021-5","article-title":"Sagittal imbalance of the spine is associated with poor sitting posture among primary and secondary school students in China: a cross-sectional study","volume":"23","author":"Li","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1016\/j.spinee.2013.03.044","article-title":"Assessing kyphosis with SpineScan: another attempt to reduce our dependence on radiography","volume":"13","author":"Finestone","year":"2013","journal-title":"Spine J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2502","DOI":"10.1242\/jeb.143883","article-title":"Stereopsis in animals: evolution, function and mechanisms","volume":"220","author":"Nityananda","year":"2017","journal-title":"J Exp Biol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/S0887-6185(00)00043-8","article-title":"Visual influences on balance","volume":"15","author":"Redfern","year":"2001","journal-title":"J Anxiety Disord"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/bs.irn.2019.07.005","article-title":"Exercise, spinogenesis and cognitive functions","volume":"147","author":"Zhang","year":"2019","journal-title":"Int Rev Neurobiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1186\/s13018-022-03366-0","article-title":"Postural habits and lifestyle factors associated with adolescent idiopathic scoliosis (AIS) in China: results from a big case-control study","volume":"17","author":"Yang","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1190285","DOI":"10.3389\/fpubh.2023.1190285","article-title":"Prevalence of anisometropia and influencing factors among school-age children in Nantong, China: a cross-sectional study","volume":"11","author":"Zhou","year":"2023","journal-title":"Front Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"71","DOI":"10.3390\/children8020071","article-title":"Secondary school pupils' mental wellbeing is associated with belonging to a perceived minority and experiencing discrimination","volume":"8","author":"Kokkonen","year":"2021","journal-title":"Children (Basel)"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"101227","DOI":"10.1016\/j.dcn.2023.101227","article-title":"Developmental brain changes during puberty and associations with mental health problems","volume":"60","author":"Dehestani","year":"2023","journal-title":"Dev Cogn Neurosci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1016\/j.jadohealth.2021.03.017","article-title":"Biologically universal yet ethnically diverse: puberty and its psychological effect on adolescent girls' mental health","volume":"68","author":"Natsuaki","year":"2021","journal-title":"J Adolesc Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0259862","DOI":"10.1371\/journal.pone.0259862","article-title":"Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson's disease","volume":"16","author":"Fransson","year":"2021","journal-title":"PLoS One"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1097\/CM9.0000000000000652","article-title":"Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis","volume":"133","author":"Peng","year":"2020","journal-title":"Chin Med J"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1111\/j.1442-9071.2012.02884.x","article-title":"Full correction and undercorrection of myopia evaluation trial: design and baseline data of a randomized, controlled, double-blind trial","volume":"41","author":"Li","year":"2013","journal-title":"Clin Experiment Ophthalmol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1007\/s40123-022-00628-2","article-title":"Effect of myopic Undercorrection on habitual Reading distance in schoolchildren: the Hong Kong children eye study","volume":"12","author":"Tang","year":"2023","journal-title":"Ophthalmol Ther"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"501","DOI":"10.3390\/jcm14020501","article-title":"Own typology of body posture based on research using the Diers Formetric III 4D system","volume":"14","author":"Wilczy\u0144ski","year":"2025","journal-title":"J Clin Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1016\/j.apmr.2014.02.027","article-title":"Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers","volume":"95","author":"Longworth","year":"2014","journal-title":"Arch Phys Med Rehabil"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1702548\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:40:28Z","timestamp":1771918828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1702548\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":29,"alternative-id":["10.3389\/fpubh.2025.1702548"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1702548","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"article-number":"1702548"}}