INTRODUCTION:

Posture is the position in which we hold our bodies while standing, sitting, or lying down. Good posture is the correct alignment of body parts supported by the right amount of muscle tension against gravity.

A good posture is important because it helps us stand, walk, sit, and lie in positions that place the least strain on supporting muscles and ligaments during movement and weight-bearing activities. It helps us to keep our bones and joints in correct alignment so that our muscles are used correctly, decreasing the abnormal wearing of joint surfaces that could result in degenerative arthritis and joint pain. It also reduces the stress on the ligaments holding the spinal joints together, minimizing the likelihood of injury and allows muscles to work more efficiently, allowing the body to use less energy and, therefore, preventing muscle fatigue. Moreover, it prevents muscle strain, overuse disorders, and even back and muscular pain¹.

Many postural problems affecting the general population, especially those related to the spine, start during growth and body development-a period that coincides with the phase in which adolescents attend school. Identifying and understanding the postural habits of children and adolescents are important to prevent postural problems in adulthood. This information can guide both physical education and wider school policies.²Children of today are more stressed, weigh more and are either sedentary or over involved in physical activities when compared with past generations. Non-specific back pain, neck pain, shoulder pain and poor posture among school children are topics of increasing significance in the literature and were mostly related to overloaded caused by heavy school bags.³ Epidemiological study reported that the prevalence of back pain among children among youth aged 10-19 was 76.2%.⁹

Body postures adopted by school children during activities of daily life such as carrying school bag, sitting to write and use the computer, lifting objects from the floor and sleeping postures are considered by health professionals as the risk factor for occurrence of back pain.⁴ Some studies which evaluated the relationship between postural habits when watching television and using the computer and back pain confirmed that back pain is highly prevalent, has a significant impact on late adolescents and is associated with inappropriate home postural habits. Schools are considered to be appropriate places to perform activities that service proper physical and motor development in children⁵.

Good body postures are essential in maintaining good health and good health is important for carrying out our daily activities. To maintain proper posture, we need to have adequate muscle flexibility and strength, normal joint motion in the spine and other body regions, as well as efficient postural muscles that are balanced on both sides of the spine. In addition, we must recognize our postural habits at home and in the workplace and work to correct them, if necessary. The physical and intellectual development of an individual takes place mostly during the school period. So it is important for school children to maintain appropriate body postures during their day-to-day life activities⁶.

METHODS:

The research approach adopted for the study was quantitative approach and the design was descriptive analytical design. 250 school students were selected using convenient sampling technique which is a non-probability sampling method. Independent variable in the study was socio-personal variables and the dependent variable was postural habits among school students. Data was collected using 2 tools. Tool 1: Demographic proforma and Tool 2: Questionnaire on body awareness of postural habits among young people to assess the postural habits among school students. Validity of the tool was assessed by giving the tool to 3 experts in the nursing field. Modifications were done as per the suggestions given by the experts. Obtained permission from the principals of the schools and informed consent was taken from the students. Pilot study was conducted among 30 students to check the feasibility and practicability of the study. The study was found to be feasible. The data was tabulated and analysed using differential and inferential statistics like percentage, mean, standard deviation, Chi-square test and Fisher’s Exact test. The correlation was computed using Pearmans’s correlation coefficient.

RESULTS:

Section A: Description of demographic variables of school students:

Table 1 shows that out of 250 subjects majority, 71.6% belongs to the age group 15 to 17 years, 52% are males, 91.2% studies in 10^thstandard, 88.8% students are from rural area, 40.8% students are at a distance of 1 to 5km between home and school, 37.2% prefer transportation in private vehicle, 36.8% students have parent’s history of backache and 98.4% used bags with padded straps.

Table 1: Frequency and percentage distribution of socio-demographic variables (n=250)

Sl. No.

Variables

Frequency

Percentage (%)

Demographic variables

Age (in years)

9 – 11

12 – 14

15 – 17

17 and above

179

28.4

71.6

Gender

Male

Female

130

120

Class studying in

228

8.8

91.2

Place of residence

Rural

Urban

222

88.8

11.2

Place of school

Rural

Urban

250

100

Distance between home and school (km)

< 1

1 – 5

5 – 10

>10

102

9.6

40.8

27.6

Mode of transportation from home to school

Public transport

Private vehicle

School bus

Walking

24.4

37.2

31.6

6.8

Type of bag used

With padded straps

With non-padded straps

246

98.4

1.6

Health related variables

Method of studying at home

Lying down

Sitting

Standing or walking

161

10.4

64.4

25.2

Parent’s history of backache

Yes

Not known

36.8

29.2

Section B: Description of postural habits

Table 2 shows that out of 250 subjects 9.2% have good postural habits, 66% have fair postural habits and 24.8% have bad postural habits.

Table 2: Frequency and percentage distribution of postural habits (n = 250)

Postural Habit	Frequency	Percentage (%)
Bad	62	24.8
Fair	165	66
Good	23	9.2

Section C: Description related to association between postural habits and socio-personal variables:

Table 3 shows that Chi-square analyzed among collected data indicates a significant association between postural habits with place of residence at p < 0.001.

Table 3: Association between postural habits and socio-personal variables among school students (n = 250)

Sl. No.	Variables	Good	Fair	Bad	Chi-square/ Fisher's Exact	p value
A	Demographic variables
1.	Age in years
	a) 12 to 14	3	47	21	3.58	0.17
	b) 15 to 17	20	118	41
2.	Gender
	a) Male	16	86	29	3.5	0.17
	b) Female	7	79	33
3.	Class studying in
	a) 9th	1	16	5	0.77	0.67
	b) 10^th	22	149	57
4.	Place of residence
	a) Rural	23	152	47	15.25	< 0.001^*
	b) Urban	0	13	15
5.	Distance between home and school
	a) < 1 km	1	18	5	7.42	0.28
	b) 1 to 5 km	9	62	31
	c) 5 to 10	8	51	10
	d) > 10 km	5	34	16
6.	Mode of transportation from home to school
	a) Public transport	7	39	15	3.14	0.79
	b) Private vehicle	8	59	27
	c) School bus	6	54	18
	d) Walking	2	13	2
7.	Type of bag used
	a) Padded	23	164	59	5.54	0.06
	b) Non-padded	0	1	3
B	Health related variables
1.	Method of studying at home
	a) Sitting	12	111	38	7.34	0.11
	b) Standing or walking	9	41	13
	c) Lying down	2	13	11
2.	Parent's history of backache
	a) Yes	9	61	22	2.03	0.72
	b) No	8	44	21
	c) Not known	6	60	19

*Significance (p < 0.05)

Section D: Description related to correlation of postural habits with height and weight Table 4 shows that Pearson’s correlation coefficient analyzed among collected data showed negligible correlation between postural habits with height and weight.

Table 4: Correlation of postural habits with height and weight (n = 250)

Variables	Correlation	P Value
Postural habits and height	-0.058	0.36
Postural habits and weight	0.065	0.31

DISCUSSION:

The results show that out of 250 subjects majority, 71.6% belongs to the age group 15 to 17 years, 52% are males, 91.2% studies in 10^thstandard, 88.8% students are from rural area, 40.8% students are at a distance of 1 to 5 km between home and school, 37.2% prefer transportation in private vehicle, 36.8% students have parent’s history of backache 98.4% used bags with padded straps and 64.4% students preferred sitting posture while studying at home. The above findings were supported by a cross-sectional study conducted among 300 randomly selected normal healthy school going children (150 boys and 150 girls) aged 6-15 years of Amritsar, Punjab, India (2010) to observe the association between backpack weight and postural habits. The various parameters considered for the study were height, weight, backpack weight, percentage backpack weight, lumbar flexion, lumbar extension and lumbar lateral flexion. The results of the study indicated a statistically significant positive correlation between backpack weight and height (r=0.73), weight (r=0.57) and lumbar flexion (r=0.19) in boys and with height (r=0.65), weight (r=0.42) and lumbar extension (r=0.21) in girls. It was concluded that backpack weight has some strong association with postural habits in the studied samples. The backpack weight carried by the school children was reported to be between 7.48% - 16.83% of their body weight⁷.

The results show that out of 250 subjects 9.2% have good postural habits, 66% have fair postural habits and 24.8% have bad postural habits. The above findings were supported by a cross-sectional study comprising of 400 students of 14-17 years age group conducted in Pune city, India (2017) to identify awareness of correct sitting posture the source of information, if received, and problems experienced due to improper sitting posture. About 75% of the participants were aware about correct sitting posture, 81.5% had received information about correct sitting posture from parents, and 82% were aware of ill consequences of improper sitting posture. In conclusion, the knowledge about correct sitting posture among adolescents is present but it is still inadequate⁸.

Chi-square analyzed among collected data indicates a significant association between postural habits and place of residence. The above findings were supported by a three-year prospective study conducted among 726 adolescents aged 11–16 years from the fifth to eighth grades in Brazil (2017) to evaluate sitting and sleeping postures and to determine whether these postures were associated with age and sex. The Back Pain and Body Posture Evaluation Instrument was used to evaluate the sleeping posture and three sitting positions: sitting to write, to use a computer, and during leisure activities. The findings indicated a low prevalence of adequate sleeping and sitting postures at baseline, with a decrease in prevalence observed after three years for all postures.¹⁰

Pearson’s correlation coefficient analyzed among collected data showed negligible correlation between postural habits with height and weight.

CONCLUSION:

The conclusion drawn from the study has shown that that there is a significant association between postural habits and place of residence and there is no significant association between postural habits and socio-personal variables such as age, gender, class studying in, place of school, distance between home and school, mode of transportation from home to school, parents history of backache, method of studying at home and type of bag used. It is also found that there is no significant association between postural habits with height and weight.

REFERENCES:

1. Noll M, Candotti CT, Da Rosa BN, Do Valle MB, Antoniolli A, Vieira A, Loss JF. High prevalence of inadequate sitting and sleeping postures: a three-year prospective study of adolescents. Scientific Reports. 2017 Nov 2; 7(1):14929.

2. Robbins M, Johnson IP, Cunliffe C. Encouraging good posture in school children using computers. Clinical Chiropractic. 2009 Mar 1; 12(1):35-44.

3. Meziat Filho N, Coutinho ES, e Silva GA. Association between home posture habits and low back pain in high school adolescents. European Spine Journal. 2015 Mar 1; 24(3):425-33.

4. Noll M, Candotti CT, Rosa BN, Loss JF. Back pain prevalence and associated factors in children and adolescents: an epidemiological population study. Revista de Saude Publica. 2016 Jun 10; 50:31.

5. Kratěnová J, ŽEjglicová K, Malý M, Filipová V. Prevalence and risk factors of poor posture in school children in the Czech Republic. Journal of School Health. 2007 Mar; 77(3):131-7.

6. Tomar US, Gupta N. Prevalence of postural pain among school going children in Meerut, India-A cross sectional study. Indian Journal of Public Health Research & Development. 2013 Apr 1; 4(2):264.

7. Paranjape S, Ingole V. Prevalence of back pain in secondary school students in an urban population: cross-sectional study. Cureus. 2018 Jul; 10(7).

8. Noll M, Noll PR, Santos EM, NETO AS, Candotti CT. Inappropriate Postural Habits of High School Students from the Municipality of Ceres, Brazil. Indian pediatrics. 2016 Feb 1; 53(2).

9. Hewes GW. World distribution of certain postural habits. American Anthropologist. 1955 Apr 1; 57(2):231-44.

10. Alonso AC, Luna NM, Mochizuki L, Barbieri F, Santos S, Greve JM. The influence of anthropometric factors on postural balance: the relationship between body composition and posturographic measurements in young adults. Clinics. 2012 Dec; 67(12):1433-41.

Received on 25.04.2023 Modified on 14.06.2023

Int. J. of Advances in Nur. Management. 2023; 11(3):189-192.

DOI: 10.52711/2454-2652.2023.00043