Postural deficiencies prevalence and correlation with foot conditions, body 2 composition and coordination, in Romanian preadolescents children: 3 descriptive observational study

Silviu Vlad¹Doriana Ioana Ciobanu^2*Julia Fulop³Nicola Matei³Dana Ioana Cristea²Mariana Szabo-Alexi²Florin Nicolae Blaga^1,4Dorina Ianc²Alexandru Bogdan Ilies⁵

• ¹Department of Surgical Specialties, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
• ²Department of Physical Education, Sport and Physiotherapy, Human Performance Research Center,, University of Oradea, Oradea, Romania
• ³Help&Care Association, Oradea, Romania
• ⁴Orthopedics and Traumatology Department, Avram Iancu Military Hospital, Oradea, Romania
• ⁵Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy,, University of Oradea, Oradea, Romania

Background: Correct posture during preadolescence is crucial for harmonious physical 7 development and long-term musculoskeletal health. The examination of spinal and lower limb 8 deficiencies in this age group represents a highly relevant and underexplored topic. 9 Objective: To determine the prevalence of postural deficiencies among Romanian 10 preadolescents and to assess their correlations with body composition, coordination, and foot 11 morphology. 12 Methods: A total of 983 children aged 8–12 years (507 boys, 51.6%; 476 girls, 48.4%) were 13 recruited from six middle schools in Oradea, Bihor County, Romania. Postural assessment 14 followed Kendall et al.'s protocol using a plumb line and grid chart. Plantar pressure and center of 15 gravity displacement were evaluated through baropodometry, while general coordination was 16 assessed using the Matorin test. 17 Results: Forward head posture was the most prevalent deficiency (641/983, 65.2%). Boys 18 exhibited a higher prevalence of kyphosis (n=448, 52.3%) compared with girls (n=368,40.4%), 19 while scoliosis occurred more frequent in girls (n=306, 33.6%) versus (n=257, 26.1%). Significant 20 correlations were observed between ankle valgus and scoliosis (x2(1)=7.87,p=.005), flatfoot and 21 scoliosis (x2(1)=7.87,p=.005), and flatfoot and coordination deficits (x2(3)=22.96, p=.005). 22 Conclusions: Forward head posture emerged as the most common spinal deficiency. Notable 23 associations were identified between body composition and kyphosis, hyperlordosis, and ankle 24 valgus, as well as between flatfoot, scoliosis, and impaired coordination. These findings 25 underscore the importance of early detection and the implementation of targeted prevention 26 programs to address postural deficiencies during childhood.