Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading
The aim of this study was to analyze gender differences in sagittal standing alignment at pre‐peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and gir...
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Veröffentlicht in: | Journal of anatomy 2013-12, Vol.223 (6), p.629-640 |
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description | The aim of this study was to analyze gender differences in sagittal standing alignment at pre‐peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway‐back, or leaning‐forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway‐back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning‐forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning‐forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash‐out effect’ when pooled. When the classification system is applied, gender‐specificity in gravity line position is suggested, implying gender‐related differences in lever arms and thus load. Present findings may add to our understanding of gender‐specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal‐pelvic disorders. |
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The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway‐back, or leaning‐forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway‐back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning‐forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning‐forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash‐out effect’ when pooled. When the classification system is applied, gender‐specificity in gravity line position is suggested, implying gender‐related differences in lever arms and thus load. Present findings may add to our understanding of gender‐specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal‐pelvic disorders.</description><identifier>ISSN: 0021-8782</identifier><identifier>EISSN: 1469-7580</identifier><identifier>DOI: 10.1111/joa.12119</identifier><identifier>PMID: 24107185</identifier><identifier>CODEN: JOANAY</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Age Factors ; Biomechanical Phenomena - physiology ; biomechanics ; Child ; Confidence Intervals ; Female ; gender differences ; Growth ; Humans ; Leg - anatomy & histology ; Male ; Original ; Pelvis - anatomy & histology ; Postural Balance - physiology ; Posture ; posture types ; pubertal peak growth ; sagittal balance ; Sex Characteristics ; Sex Factors ; Spine - anatomy & histology</subject><ispartof>Journal of anatomy, 2013-12, Vol.223 (6), p.629-640</ispartof><rights>2013 Anatomical Society</rights><rights>2013 Anatomical Society.</rights><rights>Copyright © 2013 Anatomical Society</rights><rights>Copyright © 2013 Anatomical Society 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4439-f6c4a3e1959b75bbb64f328c924bde9e2b660395fdfb51aa6f5cacc4326113363</citedby><cites>FETCH-LOGICAL-c4439-f6c4a3e1959b75bbb64f328c924bde9e2b660395fdfb51aa6f5cacc4326113363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842204/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842204/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,1419,1435,27931,27932,45581,45582,46416,46840,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24107185$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dolphens, Mieke</creatorcontrib><creatorcontrib>Cagnie, Barbara</creatorcontrib><creatorcontrib>Vleeming, Andry</creatorcontrib><creatorcontrib>Vanderstraeten, Guy</creatorcontrib><creatorcontrib>Danneels, Lieven</creatorcontrib><title>Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading</title><title>Journal of anatomy</title><addtitle>J Anat</addtitle><description>The aim of this study was to analyze gender differences in sagittal standing alignment at pre‐peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway‐back, or leaning‐forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway‐back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning‐forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning‐forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash‐out effect’ when pooled. When the classification system is applied, gender‐specificity in gravity line position is suggested, implying gender‐related differences in lever arms and thus load. Present findings may add to our understanding of gender‐specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal‐pelvic disorders.</description><subject>Age Factors</subject><subject>Biomechanical Phenomena - physiology</subject><subject>biomechanics</subject><subject>Child</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>gender differences</subject><subject>Growth</subject><subject>Humans</subject><subject>Leg - anatomy & histology</subject><subject>Male</subject><subject>Original</subject><subject>Pelvis - anatomy & histology</subject><subject>Postural Balance - physiology</subject><subject>Posture</subject><subject>posture types</subject><subject>pubertal peak growth</subject><subject>sagittal balance</subject><subject>Sex Characteristics</subject><subject>Sex Factors</subject><subject>Spine - anatomy & histology</subject><issn>0021-8782</issn><issn>1469-7580</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9uFSEUh4nR2NvqwhcwJG7sYlpgmD-4aNI0WjVNutE1YZjDXK4MjDDTps_iy8p4r42ayIaQ8_Gdc_JD6BUlZzSf811QZ5RRKp6gDeW1KJqqJU_RhhBGi7Zp2RE6TmlHCC2J4M_REeOUNLStNujHNfgeIu6tMRDBa0jYepzUYOdZOZxm5XvrB6ycHfwIfsYdmBABT0sHcUUmUN_wEMP9vH2H5y1gO04hV7ILB4PT0mmnUrLGajXb4HE2row7vBPOPpwm68ME7s5q7IJae75Az4xyCV4e7hP09cP7L1cfi5vb609XlzeF5rwUhak1VyVQUYmuqbquq7kpWasF410PAlhX16QUlelNV1GlalNppTUvWU1pWdblCbrYe_NKI_Q6LxmVk1O0o4oPMigr_654u5VDuJNlyxkjPAveHgQxfF8gzXK0SYNzykNYkqS8IrQRragy-uYfdBeW6PN6meKiWSOjmTrdUzqGlCKYx2EokWvk-ZeSvyLP7Os_p38kf2ecgfM9cG8dPPzfJD_fXu6VPwHEXrpj</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Dolphens, Mieke</creator><creator>Cagnie, Barbara</creator><creator>Vleeming, Andry</creator><creator>Vanderstraeten, Guy</creator><creator>Danneels, Lieven</creator><general>Wiley Subscription Services, Inc</general><general>Blackwell Science Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7SS</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201312</creationdate><title>Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading</title><author>Dolphens, Mieke ; Cagnie, Barbara ; Vleeming, Andry ; Vanderstraeten, Guy ; Danneels, Lieven</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4439-f6c4a3e1959b75bbb64f328c924bde9e2b660395fdfb51aa6f5cacc4326113363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age Factors</topic><topic>Biomechanical Phenomena - physiology</topic><topic>biomechanics</topic><topic>Child</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>gender differences</topic><topic>Growth</topic><topic>Humans</topic><topic>Leg - anatomy & histology</topic><topic>Male</topic><topic>Original</topic><topic>Pelvis - anatomy & histology</topic><topic>Postural Balance - physiology</topic><topic>Posture</topic><topic>posture types</topic><topic>pubertal peak growth</topic><topic>sagittal balance</topic><topic>Sex Characteristics</topic><topic>Sex Factors</topic><topic>Spine - anatomy & histology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dolphens, Mieke</creatorcontrib><creatorcontrib>Cagnie, Barbara</creatorcontrib><creatorcontrib>Vleeming, Andry</creatorcontrib><creatorcontrib>Vanderstraeten, Guy</creatorcontrib><creatorcontrib>Danneels, Lieven</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of anatomy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dolphens, Mieke</au><au>Cagnie, Barbara</au><au>Vleeming, Andry</au><au>Vanderstraeten, Guy</au><au>Danneels, Lieven</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading</atitle><jtitle>Journal of anatomy</jtitle><addtitle>J Anat</addtitle><date>2013-12</date><risdate>2013</risdate><volume>223</volume><issue>6</issue><spage>629</spage><epage>640</epage><pages>629-640</pages><issn>0021-8782</issn><eissn>1469-7580</eissn><coden>JOANAY</coden><abstract>The aim of this study was to analyze gender differences in sagittal standing alignment at pre‐peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway‐back, or leaning‐forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway‐back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning‐forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning‐forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash‐out effect’ when pooled. When the classification system is applied, gender‐specificity in gravity line position is suggested, implying gender‐related differences in lever arms and thus load. Present findings may add to our understanding of gender‐specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal‐pelvic disorders.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>24107185</pmid><doi>10.1111/joa.12119</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Age Factors Biomechanical Phenomena - physiology biomechanics Child Confidence Intervals Female gender differences Growth Humans Leg - anatomy & histology Male Original Pelvis - anatomy & histology Postural Balance - physiology Posture posture types pubertal peak growth sagittal balance Sex Characteristics Sex Factors Spine - anatomy & histology |
title | Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading |
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