Postural Disorders Research Articles

Risk Factors Involved in Postural Disorders in Children and Adolescents

Postural disorders in children and adolescents have an increasing incidence. The aim of this study was to identify the type of postural defects in school-age and preschool children, as well as the external risk factors determined by an inadequate lifestyle. The research included 134 children aged between 5 and 18 years, in whom postural defects were identified. The project involved an examination of the children’s body posture, a survey of the parents to determine the children’s lifestyle, blood tests, and spinal X-rays. A significant percentage (76%) of the children included in the study were underweight. The examination of postural defects in the students revealed scoliosis in 21% of the patients, kyphosis in 7.5%, and lordosis in 1.5%, while 70% of the patients presented an association between at least two postural defects. As far as risk factors are concerned, we identified the presence of rickets sequelae in 70% of the patients, the presence of pectus excavatum in 43% of the patients, genu varum in 15%, and flat foot in 12%. Additionally, 90% of the children had an incorrect posture at the desk, while 42% incorrectly carried their backpack on one shoulder only. In terms of diet quality, associations between an inadequate diet and postural disorders were found for kyphosis, scoliosis, and other deformities. In conclusion, postural abnormalities in children have an increased incidence from an early age and are a result of the change in lifestyle in recent years, represented by sedentarism, a lack of physical activity, the excessive use of electronic devices, stress, and an inadequate diet.

One-Side Weight Sports and the Impact of Their Load on the Feet and the Occurrence of Posture Disorders in Professional Football and Handball Players

The aim of this study was to evaluate center of pressure (CoP) changes in unilateral sports and examine how these changes affect the athlete’s feet, ankles, knees or posture. The study sample consisted of 40 professional male players (age: 19.4 ± 2.08 years; height: 165.78 ± 4.92 cm; weight: 59.04 ± 4.02 kg; BMI: 21.57 ± 2.22; foot size: 40.9 ± 1.6), divided by type of sport into group H—handball (n: 20) and group F—football (n: 20). To evaluate the monitored parameters, we used the instrumental diagnostic techniques: 3D laser footscan, baropodometric platform FreeStep and 2D Videography. We found no significant differences between the groups in the loading of the right and left foot (F: 8.3 ± 4.22; H: 7.7 ± 6.1) (p = 0.410). We found a significant difference in the load on the front and back of the left (p = 0.0079) and right foot (p = 0.0210) depending on the type of sport performed. Maximum and mean values of CoP (g/cm2) showed statistically significant differences depending on the sport performed (p < 0.0001). The shift in CoP (mm) from the norm depending on the sport performed was confirmed in the latero-lateral direction (p = 0.003), but not in the antero-posterior direction (p = 0.320). We found a difference in the angulation of the knees and heels depending on the sport played. Handball players showed higher knee varosity/valgosity (p = 0.015) and heel values than football players (p = 0.002). The handball players also confirmed a worse postural load and initial forward posture. The one-sided sports, handball and football, showed negative effects on the athlete’s movement system. These changes were more pronounced in handball players. Proper training programs should be applied in athletes’ daily routine to improve the negative effects of unilateral sports.

The relationship between cardiovagal baroreflex and cerebral autoregulation in postural orthostatic tachycardia disorder using advanced cross-correlation function

Postural orthostatic tachycardia syndrome (POTS) presents excessive orthostatic tachycardia and orthostatic intolerance. POTS is a common and therapeutically challenging condition affecting numerous people worldwide. As many disease entities can be confused with POTS, it becomes critical to identify this syndrome. Moreover, unbalanced autonomic nervous activity can induce cardiovascular diseases and influence the bio-feedback mechanism: Baroreflex (BR) and cerebral autoregulation (CA). BR and CA are important bio-mechanisms that maintain a stable circulatory system via the autonomic nervous system. Therefore, an impaired autonomic nervous system would lead to imbalanced BRS and CA. Consequently, we propose an advanced cross-correlation function (ACCF) time-domain approach to analyze baroreflex and cerebral autoregulation using physiological signals. This study assesses relation changes in BR and CA using ACCF in POTS for early clinical detection and diagnosis. The ACCF analysis results has thresholds that reveal that the BR of healthy and POTS groups present significantly different maximum CCF values (p < 0.05). The complete CCF index shows that the BR phase changes significantly into phase lag in the POTS group. Although CA analysis using the maximum CCF index was mildly weak, it did not differ in the POTS group. Thus, POTS only affects BR. An increasing sympathetic activity might induce an unbalanced baroreflex effect and increase cerebral vasomotor tone with CA. Maximum CCF value correlation coefficients between BR and CA indicated positive in POTS groups and negative in the healthy group. It could be speculated that the sympathetic nervous system compensates to improve BR function, which remains CA function. The advantage of this ACCF algorithm is that it helps observe BR and CA for early detection.

Dear DrDr Omid Massah Thank you very much for submitting your manuscript to Physical Treatments Journal. Your Manuscript with the code "A-10-263-1" and entitled " Is Opium Smoking A Cause of Sway Back Posture and Spinal Musculoskeletal Disorders? What is the Relation?", has been reviewed by PTJ international reviewers and their comments are included at the bottom of this letter

Cultural care in nursing is an essential component of holistic healthcare that recognizes the importance of cultural diversity in patient care. As societies become increasingly multicultural, the healthcare system must adapt to meet the diverse needs of its patient population [1]. Nurses, often at the frontline of patient care, play a critical role in providing culturally competent care that respects and responds to their patients' cultural backgrounds. This article explores cultural care's significance in nursing, its challenges, and strategies for effective implementation [2].

Indicators of support-spring properties of the foot of schoolchildren with sensory deprivation in the process of adaptive physical education

Based on the data of scientific and methodological work, it was determined that the musculoskeletal system of a person has many functions, the starting points of which are the provision of support, protection and body movements. The foot is the source of upright walking of human organs. In the conditions of natural locomotion, it is the foot that performs not only the function of support, but also organizes the interaction of the human body with the support surface. It is known that the process of development of the musculoskeletal system of schoolchildren occurs under the influence of various factors, including pathogenic ones. As a result, the musculoskeletal system undergoes certain changes, including pathological ones. The purpose of the article is to analyze the morphological features of 7- year-old schoolchildren with sensory deprivation in the process of adaptive physical education, as a prerequisite for the development of a technology for the formation of statodynamic stability. The study found an increase in the number of schoolchildren with sensory deprivation who were diagnosed with postural disorders. It is possible to note the prevalence of stooping in this contingent. In the formation of the support-spring function of the foot of schoolchildren, there is a complex dynamic of the formation of their lower limbs.

Disentangling gray matter atrophy and its neurotransmitter architecture in drug-naïve Parkinson's disease: an atlas-based correlation analysis.

Parkinson's disease is characterized by multiple neurotransmitter systems beyond the traditional dopaminergic pathway, yet their influence on volumetric alterations is not well comprehended. We included 72 de novo, drug-naïve Parkinson's disease patients and 61 healthy controls. Voxel-wise gray matter volume was evaluated between Parkinson's disease and healthy controls, as well as among Parkinson's disease subgroups categorized by clinical manifestations. The Juspace toolbox was utilized to explore the spatial relationship between gray matter atrophy and neurotransmitter distribution. Parkinson's disease patients exhibited widespread GM atrophy in the cerebral and cerebellar regions, with spatial correlations with various neurotransmitter receptors (FDR-P < 0.05). Cognitively impaired Parkinson's disease patients showed gray matter atrophy in the left middle temporal atrophy, which is associated with serotoninergic, dopaminergic, cholinergic, and glutamatergic receptors (FDR-P < 0.05). Postural and gait disorder patients showed atrophy in the right precuneus, which is correlated with serotoninergic, dopaminergic, gamma-aminobutyric acid, and opioid receptors (FDR-P < 0.05). Patients with anxiety showed atrophy in the right superior orbital frontal region; those with depression showed atrophy in the left lingual and right inferior occipital regions. Both conditions were linked to serotoninergic and dopaminergic receptors (FDR-P < 0.05). Parkinson's disease patients exhibited regional gray matter atrophy with a significant distribution of specific neurotransmitters, which might provide insights into the underlying pathophysiology of clinical manifestations and develop targeted intervention strategies.

Functional classification systems in Brazilian children with cerebral palsy: Reliability and associations between functional levels

ABSTRACT Children with Cerebral palsy (CP) present movement and posture disorders. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), Eating and Drinking Ability Classification System (EDACS), and Visual Function Classification System (VFCS) enhance the understanding of their performance. We verified inter-rater reliability and associations between the classification levels. Physical therapists classified 100 Brazilian children with CP (3–17 years) according to GMFCS, MACS, CFCS, EDACS, and VFCS. To evaluate inter-rater reliability (Intraclass Correlation Coefficient-ICC) two independent examiners concurrently assessed a subset of 60 participants. According to Spearman’s correlation coefficients, there were associations between GMFCS/MACS (r = 0.81), GMFCS/CFCS (r = 0.70), MACS/CFCS (r = 0.73), GMFCS/VFCS (r = 0.61), MACS/VFCS (r = 0.61), CFCS/EDACS (r = 0.58), CFCS/VFCS (r = 0.50), and EDACS/VFCS (r = 0.45) (p < .05). The inter-rater reliability ranged from excellent (ICC = 0.93-0.99) to good (ICC = 0.89), p < .05. The classification systems are reliable, and the levels associated with each other in Brazilian children, especially the GMFCS, MACS, and CFCS.

Efficient diagnostic classification of diverse pathologies through contextual eye movement data analysis with a novel hybrid architecture

The analysis of eye movements has proven valuable for understanding brain function and the neuropathology of various disorders. This research aims to utilize eye movement data analysis as a screening tool for differentiation between eight different groups of pathologies, including scholar, neurologic, and postural disorders. Leveraging a dataset from 20 clinical centers, all employing AIDEAL and REMOBI eye movement technologies this study extends prior research by considering a multi-annotation setting, incorporating information from recordings from saccade and vergence eye movement tests, and using contextual information (e.g. target signals and latency of the eye movement relative to the target and confidence level of the quality of eye movement recording) to improve accuracy while reducing noise interference. Additionally, we introduce a novel hybrid architecture that combines the weight-sharing feature of convolution layers with the long-range capabilities of the transformer architecture to improve model efficiency and reduce the computation cost by a factor of 3.36, while still being competitive in terms of macro F1 score. Evaluated on two diverse datasets, our method demonstrates promising results, the most powerful discrimination being Attention & Neurologic; with a macro F1 score of up to 78.8%; disorder. The results indicate the effectiveness of our approach in classifying eye movement data from different pathologies and different clinical centers accurately, thus enabling the creation of an assistant tool in the future.

A Mobile based Decision Support System for Postural Evaluation of Agricultural Activities with Rapid Entire Body Assessment (REBA)

Agriculture is an unorganized sector and it is a very high drudgery prone profession due to the absence of awareness and entry of advanced agricultural technologies. Many farming activities and operations are carried out by farm workers in the agriculture sector, where they are subject to very poor working conditions which can lead to physical and mental stress. Workers in agriculture experience musculoskeletal disorders in various body parts throughout various agricultural operations. These problems are caused by heavy work loads, repetitive movements, uncomfortable postures, prolonged periods of time spent in neutral or unsupported positions and the use of conventional equipment and implements that are not ergonomically built. The ergonomic risk factors present in the workplace can be examined using various evaluation instruments to ascertain the workers abilities and drawbacks. The work-related risks are measured using the scientifically validated posture assessment instruments. Rapid entire body assessment (REBA) is a technique that assess a person’s complete body including wrists, fore arms, elbows, shoulders, neck, trunk, back, legs and knees. It uses a systematic process to find the postural musculoskeletal disorders and risks associated with the job tasks. A mobile application is developed to assess the agricultural activities on the basis of physiological analysis and postural analysis using REBA ergonomics technique. The application evaluates the drudgery involved in the agricultural work by using physical assessment followed by postural ergonomics methods and provide recommendation of correct posture to avoid developing musculoskeletal disorders.

Pierre-Marie Gagey and the Evolution of Posturology: Unraveling the Complexity of the Fine Postural Control System.

The subtle sway of human standing posture began to be studied in the 19th century. Since then, numerous approaches - from the early statokinesiometers to the more advanced force platforms or 3D-posture recording systems - have been developed to understand human postural control physiology and its clinical implications. French physician Pierre-Marie Gagey made significant contributions to the field of posturology, a discipline focused on the intricacies of human postural control. From the 1950s, he advanced the field through observation and experimentation, particularly exploring the relationship between postural muscle tone and the fine postural control system. Gagey's collaboration with researchers of that time led to the refinement of stabilometry, a technique for measuring body sway in standing positions. Throughout his career, Gagey worked across multiple disciplines, including ophthalmology, podiatry, psychology, and the study of the vestibular and stomatognathic systems, to develop a comprehensive approach to postural assessment and treatment. His efforts culminated in the standardization of stabilometry, ensuring consistent and accurate measurements across different platforms. Gagey's work emphasized the complexity of postural control, highlighting the integration of peripheral and central nervous system inputs in maintaining balance. His research has left an enduring impact on the field of posturology, providing a framework for understanding and treating postural disorders. Pierre-Marie Gagey passed away in 2023, but his pioneering contributions continue to influence the study and clinical practice of human postural control. This narrative review aims to pay tribute to Dr. Gagey's career and research activity.

High-dose Vitamin-B6 reduces sensory over-responsivity.

Sensory reactivity differences are experienced by between 5% and 15% of the population, often taking the form of sensory over-responsivity (SOR), in which sensory stimuli are experienced as unusually intense and everyday function is affected. A potential mechanism underlying over-responsivity is an imbalance between neural excitation and inhibition in which inhibitory influences are relatively weakened. Therefore, interventions that boost neural inhibition or reduce neural excitation may reduce SOR; Vitamin-B6 is the coenzyme for the conversion of excitatory glutamate to inhibitory gamma-aminobutyric acid (GABA), and in animal models, it both increases the concentration of GABA and reduces glutamate. To discover whether taking a high dose of Vitamin-B6 reduces SOR and other aspects of sensory reactivity. We recruited 300 adults (249 females) from the general population who completed the Sensory Processing 3-Dimensions Scale (SP-3D) first at baseline, and again following randomisation to either 1 month's supplementation with 100 mg Vitamin-B6, or one of two control conditions (1000 µg Vitamin-B12 or placebo). To focus on individuals who experience SOR, we analysed the effects of supplementation only on individuals with high baseline SOR scores (above the 87th percentile). In individuals with SOR at baseline, Vitamin-B6 selectively reduced SOR compared to both placebo and Vitamin-B12. We also found that Vitamin-B6 selectively reduced postural disorder in individuals with high scores on this subscale at baseline, but there were no effects on the four remaining SP-3D subscales. Clinical trials and mechanistic studies should now be conducted in autism, attention deficit hyperactivity disorder and other groups with SOR.

Justification of the need to search and use pre-nosological markers of functional deviations of posture of children 6-7 years at the stage of formation of student skills

The problem of forming a healthy posture of schoolchildren is in dire need of an effective solution over the past decades. So according to K.I. Khodatskaya, A.A. Kuts, 2020 and others, posture disorders in children of primary school age are 62.8%, and among adolescents 11-15 years old they reach 80-90% of the total number of students. Purpose: theoretically and experimentally substantiate the feasibility of finding and using pre-nosological markers of posture disorders of students 6-7 years old at the stage of adaptation of the musculoskeletal system for school educational loads. The methodological basis of the study was the component analysis of the second variant of the Romberg test, on the basis of which the indicators of stability coefficients of the equilibrium function (EMF) and asymmetry of the equilibrium function (EDF) were calculated. Research methods: theoretical analysis of scientific and methodological literature, dynamic pedagogical observation, Romberg functional test (second option), goniometry of the spine according to V. A. Hamburtsev, stating experiment, statistical methods. Contingent of subjects: the study involved 12 boys 6-7 years old, first grade students of secondary schools of the city, who were assigned to the main group for health reasons. Scientific novelty: for the first time developed a complex of pre-nosological markers of posture for students 6-7 years old, who start school load; A preventive approach to the formation of posture of students 6-7 years old at the stage of adaptation to educational loads is substantiated, criteria that determine the risk group regarding the predicted occurrence of certain functional deviations in the posture state are worked out. The effectiveness of the goniometry method for studying the dynamics of indicators of the morphofunctional state of the spine of students 6-7 years old during the first year of school has been confirmed. The practical significance of the results obtained is that primary school teachers and parents will receive a ready-made toolkit based on innovative technologies for carrying out specific health-saving work in the direction of forming the posture of children 6-7 years old during the first year of schooling and the entire period of schooling.

POSTURE CORRECTION IN MIDDLE SCHOOL STUDENTS USING APPLIED KINESIOLOGY

The purpose of the study was to evaluate the effectiveness and feasibility of using applied kinesiology in a posture correction program for middle school children. The study involved 20 children aged 14-15 years (10 girls and 10 boys) who had postural disorders in the frontal plane. Three methods were used to assess posture: visual diagnosis, diagnosis by plumb line, and scoliosis measurement. Visual diagnosis included the evaluation of posture symmetry by shoulder height, scapula angles, and waist triangles symmetry. Diagnosis by plumb line assessed the alignment of spinous processes along a vertical line. Scoliometry was used to measure the degree of spinal curvature. The posture correction program included manual muscle testing, kinesio taping, manual techniques (ischemic pressure of trigger points, fascial release using a vibration gun, deep point massage), and special corrective exercises. The results showed a significant decrease in scoliosis measurements in all students, from 8.6 to 4 degrees. This indicates the effectiveness of applied kinesiology in correcting postural disorders in middle school children. Performing the exercises helped inhibit old and establish new connections in the cerebral cortex by building new motor pathways. Additionally, it fostered an understanding and habit of maintaining correct posture in children. Overall, the study demonstrated that applied kinesiology is an effective method for correcting postural disorders in middle school-aged children, leading to better posture habits and improved spinal alignment.

Socioeconomic disparities in children's posture defects: a comparison between private and public educational institutions

The topic of risk factors for posture pathology in Polish children is relevant at present, as it is insufficiently studied and reflects the need to investigate the relationship between family socioeconomic status and the occurrence of posture defects, to develop relevant prevention and treatment strategies in the context of current socioeconomic conditions in Poland. The research aims to study posture defects in children depending on their socioeconomic status in the example of private and public schools. A comparison of the prevalence of deformities and posture disorders of participants in private and public educational institutions from 2017 to 2020 is presented. Theoretical research methods (literature analysis, generalisation); empirical methods (study of other researchers' experience), statistical analysis, and graphical presentation of data were used. More than 1300 Polish schoolchildren from private and public schools took part in this cross-sectional study. The most common problems were flat feet (54.73%), calf muscle contracture (44.30%), and valgus deformity (21.22%). The least common problems were funnel chest (0.37%), cavus foot (0.10%), and hammer toe deformity (0.04%). The general trend shows that problems with flat feet and calf muscle contracture were more common among participants in both types of educational institutions. There was a general trend of increasing the number of nosological forms per patient in both private and public institutions over a period of three years. Private institutions had significantly fewer cases of one patient having more than one nosological form as compared to public institutions.

The Impact of Postural and Anthropometric Properties of Foot and Ankle on Physical Performance and Ambulation of Patients with Duchenne Muscular Dystrophy.

Abnormal foot anthropometry and posture of patients with Duchenne Muscular Dystrophy (DMD) can be considered as possible risk factors for performance and ambulation. It was aimed to examine the effects of foot posture and anthropometric characteristics, which deteriorated from the early period, on ambulation and performance of patients with DMD. The foot arch height (FAH), the metatarsal width (MW), subtalar pronation angle, and ankle limitation degree (ALD) were evaluated to determine the foot anthropometric characteristics of the patients. Foot Posture Index-6 (FPI-6) was used to evaluate foot posture. The performance of the patients was determined by the 6-minute walk test (6MWT), the 10-meter walk test (10MWT), and ascend/descend a standard 4-step test, and the ambulation was determined by the North Star Ambulatory Assessment (NSAA). Spearman's correlation coefficient was calculated to assess the relationship between foot anthropometric characteristics and posture, and performance and ambulation. The sample consisted of 48 patients with DMD aged 5.5 to 12 years. Both of the right and left foot FPI-6 scores were associated with all parameters, except descending 4-step. The left FAH was associated with 6MWT and NSAA, and the left MW was associated with 6MWT. The ALD of right foot was associated with 6MWT, ascending/descending 4 steps, and NSAA, and left ankle limitation was associated with NSAA (p<0.05). There was no relationship between other parameters. These findings suggest that postural disorders in the foot and ankle may contribute to the decrease in performance and ambulation in patients with DMD.

ANALYSIS OF THE RELATIONSHIP BETWEEN BODY POSTURE AND TEMPOROMANDIBULAR DISORDERS

The temporomandibular joint (TMJ) is one of the most complex joints in the human body, being responsible for the movement of opening and closing the mouth. Dysfunctions that affect the temporomandibular joint have a multifactorial etiology that includes: the joint itself, the chewing muscles and other structures of the stomatognathic system. In this sense, postural movements can be associated as a predisposing factor for temporomandibular disorder (TMD), when analyzing the negative repercussions of body movements reflected in the TMJ. In this way, it is clear that a better understanding of such conditions would therefore contribute to more accurate diagnoses and more comprehensive, coherent and, consequently, more effective therapeutic approaches. A systematic review of the literature was carried out, with the aim of searching for works that support the impact between craniocervical posture and temporomandibular disorders, using references from scientific articles from the last five years in Portuguese and English. Therefore, it is clear that a better understanding of these conditions would therefore contribute to more accurate diagnoses and more comprehensive, coherent and, consequently, more effective therapeutic approaches.

The state of the biogeometric profile of the posture of young athletes specializing in hand-to-hand combat as a prerequisite for the development of corrective and preventive measures

Purpose: The purpose of the presented scientific research was, on the basis of somatoscopic indicators, to substantiate the biological prerequisites for the introduction of corrective and preventive measures into the educational and training process of young athletes specializing in hand-to-hand combat. Material and Methods: The scientific study involved 150 athletes specializing in hand-to-hand combat, aged 8–14 years. The problems identified during the study were solved using generally accepted methods: theoretical analysis of scientific literature on the chosen research topic; the Torso program was used to determine the types of posture, visual screening of the state of the biogeometric profile of the posture of young athletes specializing in hand-to-hand combat included a focus on the tribal system and the use of a method for comparing individual posture on a photogram and methods of mathematical statistics. Results: It has been established that poor posture of various types is common among athletes aged 8-14 years, specializing in hand-to-hand combat, covering a contingent of 46.7 to 60% in different age groups. Based on the results of screening the biogeometric profile of posture of an experimental contingent of young athletes specializing in hand-to-hand combat, a general tendency was traced to a decrease in the average values of the number of points at high and medium levels of the state of the biogeometric profile of posture of martial arts athletes with normal posture, and at low and medium levels - the state of the biogeometric profile of the posture of athletes with a stooped back, flat back, round back and scoliotic posture. In addition, a generalized examination of these results showed that some of the tested athletes who had a normal type of posture received the same scores (from 19 to 21 points) as those who had a certain type of posture disorder. We define the risk zone as the zone of overlap of assessments of the level of the biogeometric profile of posture, although theoretically it may appear wider if it is determined by values below the center of the distribution for athletes with normal posture. Since the distribution of all three indicators according to the test data in the group of athletes with normal posture and with various types of musculoskeletal disorders does not correspond to Gauss’s law, its center was determined by the median, which in this case was equal to 22 points. Conclusions: Understanding the findings and results of a wide range of scientific studies reveals the recent intensification of the dynamics of the occurrence of deviations in the state of posture of young athletes. Scientists are convinced that monitoring the state of athletes’ posture will make it possible to control the effect of physical exercise on the musculoskeletal system of young athletes and minimize the risk of injury. In the course of the study, the features of the biomechanics of posture of young athletes specializing in hand-to-hand combat were determined. Differences (at the level of trends) between athletes of all ages have been identified, which indicate a certain deterioration in the state of the biogeometric profile of posture with increasing age, but such differences have not received statistical confirmation. The theoretical and practical aspects of the scientific work presented above will be the basis for the theoretical substantiation of the biological prerequisites for the introduction of corrective and preventive measures into the educational and training process of young athletes specializing in hand-to-hand combat.

Shear wave elastography characteristics of the gastrocnemius muscle in postural instability gait disorder vs tremor dominant Parkinson's disease patients.

This study explored the characteristics of muscle stiffness of lower gastrocnemius in resting and exercise states in patients with postural instability gait difficulty (PIGD) and tremor dominant (TD) Parkinson's disease patients using shear wave elastography (SWE). 75 PD patients from the Department of Parkinson's Disease Center in the Hospital from September 2021 to December 2022 were prospectively included, including 44 patients with PIGD and 31 with TD. In the same period, 40 healthy subjects matching gender and age were included as the control group. SWE was used to detect Young's modulus of both sides (right and left, R- and L-) of the lateral head of the gastrocnemius in resting (YM1) and exerciser states (YM2) in all participants and the absolute difference Young's modulus between resting and exercise state (ΔYM) was calculated. R-YM2 and R-ΔYM were the highest in the normal controls, followed by the TD group, and lowest in the PIGD group. There were no differences in L-YM2 and L-ΔYM between the PIGD group and the TD group (all p > 0.05), but they were lower than those in the normal control group (all p < 0.05). In addition, R-YM2 and R-ΔYM were negatively correlated with disease duration and UPDRS III scores in the PIGD group (all p < 0.05). R-ΔYM has the highest value in the differential diagnosis of PIGD and TD patients. The area under the receiver operating characteristic curve (ROC) curve is 0.812 (95%CI, 0.730-0.893), and the diagnostic threshold is 120.5 Kpa with a sensitivity of 63.6%, a specificity of 90.1%, a positive predictive of 80%, and a negative predictive value of 80%. Shear wave elastography is a sensitive ultrasound method for evaluating muscle strength in patients with PIGD and TD. It also provides a new biological indicator to distinguish between different phenotypes of patients with PD.

COMPLEX USE OF PHYSICAL THERAPY MEANS IN THE REHABILITATION OF SCHOOL-AGE CHILDREN WITH POSTURE DISORDERS

Relevance of the research topic. The problem of using physical therapy means in rehabilitation of school-age children with posture disorders becomes especially relevant in the context of the threat of serious spinal diseases, which can negatively affect the health and physical development of children in the future.Purpose and methods of the study. The aim of the work is to reveal the essence of complex use of physical therapy means in rehabilitation of school- age children with posture disorders. The research consisted of the analysis of scientists' works and description of the use of therapy for correction of school-age children's posture. Research methods and statistical analysis. We used both general scientific and special methods of research, namely: analysis, synthesis, structural-functional, description, generalization.Results. The article presents an analysis of the integrated use of physical therapy in the rehabilitation of school-age children with postural disorders. Various methods and techniques of physical therapy aimed at restoring optimal physical functioning and correcting postural defects are described. It is described that the main methods of physical therapy used in rehabilitation are therapeutic physical culture, correction of body position, therapeutic massage, hardening, hydrokinesitherapy and physiotherapy. Particular attention is paid to physical exercises that specialize in correcting specific types of posture disorders. Key findings. It has been shown that symmetrical and asymmetrical exercises, known as corrective exercises, are used to equalize the tone of the trunk muscles and strengthen relaxed muscles, helping to return the spine to its correct position. It has been proven that therapeutic massage, as an effective means of functional therapy, is used at all stages of medical and physical therapy to treat various diseases and injuries. The article analyzes the effectiveness of these methods and their role in achieving positive results in the rehabilitation of children with postural disorders.

DIAGNOSTICS OF POSTURAL DISORDERS IN CHILDREN USING COMPUTER PHOTOMETRY

Actuality of the research. Literary and statistical data show that the level of morbidity among children in Ukraine remains high. Important to note that musculoskeletal system and connective tissue diseases take the fifth place among the morbidity structure, while the postural disorders and scoliosis remain the most urgent problem in school­age children. The aim of study is to check the computer photometry method efficiency for postural disorders diagnostics in school­age children with different levels of motor activity. Research methodology. In order to improve the dynamic control over the posture state, to increase the study objectification, to reduce the examination time and simplify the statistical material processing, a software complex for diagnosing posture disorders using the computer photometry method was used. Results. It was found that 25% of examined school­age children had postural disorders. Most often, postural disorders were observed within the age of 10­13 years, while in girls, postural disorders were registered 10% more often than in boys. Systematic exercise does not automatically guarantee the correct posture formation. In children­athletes, more pronounced indicators of angular anthropometric parameters asymmetry were registered, as a result of asymmetric back muscles load distribution. Children who did not exercise were more prone to kyphotic posture developing. Conclusions. As instrumental diagnostics, the computer photometry method has high level of informativeness and reliability, helps to maximize the data objectification and is effective in postural disorders detecting during as screening and as mass examinations.