Reading material on improving movement analysis and therapy

The process of examine postural defects in adolescents

The rehabilitation program should be carried out in consultation with the family and the adolescent’s teacher, and in consultation with the multidisciplinary team, taking into account the adolescent’s physical, mental and social condition.

Communication with adolescents can be problematic. Advances in neuroscience over the last 10 years have shown us that these challenges may, at least in part, derive from changes in the adolescent brain related to social communication, decision making and threat perception [7,8]. Healthcare organization also produces barriers to caring for adolescents effectively. Evidence from randomized controlled trials shows that effective communication with adolescents can not only be learnt but also sustained, and results in improved patient attendance, treatment concordance and overall health. Adults frequently attribute communication problems to the adolescent, yet adolescent’s themselves believe the responsibility lies with the adult to facilitate communication. Effective communication is essential to achieve concordant treatment plans, that is, shared decision making between adolescent and physiotherapist [9].

Sedentary behavior in adolescents is a rapidly developing area of research [10] . Operationally defined as “sitting time”, sedentary behavior can be high in the contexts of leisure time (eg, screen time), school and travel. Most of the evidence with adolescent people has centered on screen time, and TV viewing in particular. Although TV viewing remains the most prevalent sedentary behavior for youth, it is only one behavior and may not reflect wider patterns of excessive sitting. However, the development of attractive home-based or even mobile electronic entertainment has led to concerns about excessive sitting time in adolescents.  Low physical activity may cause musculoskeletal and mental disorders. Physical activity and exercise have many benefits in the adolescent group, as in other populations. In addition to correcting the spinal disorder with an exercise and rehabilitation program, maintaining the exercise habit will protect the adolescent both mentally and physically throughout life. Stress and mental health conditions, structural factors such as anatomical variations (cuneiform vertebrae) in vertebral structures, medical conditions such as Scheuermann’s disease and muscle imbalances are factors that are effective in the formation of postural defects in addition to sedentary lifestyle.

Differential diagnosis represents an important part of the evaluation of every adolescent addressed for the so-called poor posture. Despite the modern imaging techniques, including digital whole-body radiography, computed tomography, or nuclear magnetic resonance, the basic clinical examination retains its value. For instance, plurimeter, inclinometer or goniometer can often be used to evaluate posture in physiotherapy.

The correction of postural misalignments aimed at the restoration of a good sagittal alignment should start with detailed clinical examination followed by the application of specific corrective exercises directed to recover primary muscles’ function [4]. For the adolescent individual, the evaluation made in the sagittal plane and the suitability of the exercise program to be given thereafter are important.

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