Physical Therapy Treatment Once a Month versus Once a Week for Posture Improvement in Children and Adolescents Who Suffer from Posture Problem or LBP

Background: Lifetime prevalence of Low Back Pain (LBP) among children and adolescents ranges from 32% to 66%. LBP prevalence increases with age and among 17-year-olds it becomes equal to prevalence among adults (Hill and Keating 2010). Previous episodes of LBP predict future LBP attacks. Therefore, it is important to intervene at a young age, even prior the first attack. Poor posture is one of the risk factors for LBP in children. Interventions focused on knowledge have not been effective in changing posture behavior, hence it is preferable to focus on physical practice in order to improve and prevent LBP (Calvo-Munoz and Gomez-Conesa 2012).

Aim: To compare between physical therapy treatments once a week versus once a month, on postural behavior, thorax curve angle and LBP in children and adolescents with poor posture and LBP.

Methods: In this intervention trial 50 children and adolescents aged 10-18 years suffering from poor back posture, with or without LBP were divided to two groups. Both groups received once a month personal meetings in which a daily program home exercise was tailored. The treatment group received an additional group meeting once a week. The intervention program included physical awareness and practice for good posture, with additional flexibility, strength and muscle endurance exercises. We measured thorax curve angle using an Inclinometer smartphone application. Postural observation was conducted for measuring postural habits. Back pain and Posture Evaluation Instrument (BackPEI) assessed postural knowledge and behavioral habits. Parents completed a self-reported questionnaire assessing knowledge and ideas.

Results: Thorax curve angle improved in the intervention group from 39.18°±9.27° to 28.24°±6.81°p

Discussions and conclusions: Physical Therapy treatment using practice in exercise and postural awareness improves thorax curve angle, LBP and postural behavior. Comparing once a month face-to-face training versus once a month and an additional once a week meeting, the latter achieved larger and quicker improvement of postural behavior.