Spinal Postures of Children seated on the floor in Schools in Ahmedabad District, India

Megha Sandeep Sheth, Nehal Paresh Shah, Yash Ahuja, Zishan Belim Khan, Parth Parmar, Priyasingh Bhagirath Rangey


Purpose: In some schools in India, children sit on the floor during class time due to non-availability of furniture. The present study was conducted to assess the spinal postures of school-going children when seated in various positions on the floor.

Method: The cross-sectional survey included 62 children by random selection. The boys and girls were from classes 1 - 8. Photographs were taken in four positions: A-standing; B-sitting on the floor while looking at teacher or board; C-sitting on the floor and looking down while writing in books; D-sitting on the floor and copying from the blackboard. Markers were placed on anatomical points: tragus, canthus, C7 vertebra, T12 vertebra, greater trochanter and the lateral malleolus. Craniovertebral angle (CVA), gaze angle, trunk angle and sway angle in degrees were measured using Surgimap software. Differences in mean angles in various positions were compared using Kruskal-Wallis test. Post-hoc analysis was performed using Dunn-Sidak correction test.

Results: Mean CVA in position A (standing) was 54.11+7.0 degrees; in position B it was 41.7+9.2 degrees; in position C it was 43.60+43.09 degrees; and, in position D it was 8.8+16.85 degrees. Mean gaze angle in position A was 20.01+9.18 degrees; in position B it was 26.99+10.15 degrees; gaze angle could not be measured in position C (when the students looked into their books); and, in position D it was 35.08+9.164 degrees. Mean trunk angle in position A was 147.95+9.6 degrees; in position B it was 132.80+10.11 degrees; in position C it was 132.80+10.69 degrees; and, in position D it was 128.64+10.80 degrees. Mean sway angle was 160.91+7.70 degrees in standing position. Statistics showed significant difference between the angles in all the different positions (p<0.001).

Conclusion: In schools without appropriate furniture, sitting on the floor leads to a significant alteration in spinal postures among school-going children. Increased stress on the neck and back may predispose these children to early degenerative changes. Suitable furniture needs to be provided and good posture needs to be taught to children.

Limitations: Detailed pain assessment and comparison between higher and lower classes could not be done.


Craniovertebral angle; gaze angle; sway angle; trunk angle; children

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Afaf S, Reem B (2012). Quantitative assessment of head posture of young adults based on lateral view photographs. J Phys. Ther. Sci; (24)5: 391-394. https://doi.org/10.1589/jpts.24.391

Coban G, Coven I, Cifci BE, Yildirim E, Yazici AC, Horasanli B (2014). The importance of craniovertebral and cervicomedullary angles in cervicogenic headache. Diagnostic and Interventional Radiology; 20(2): 172-177. https://doi.org/10.5152/dir.2013.13213. PMCid:PMC4463298

do Rosario JL (2014). Photographic analysis of human posture: A literature review. J Body Mov Ther; 18(1): 56-61. https://doi.org/10.1016/j.jbmt.2013.05.008. PMid:24411150

Dudonienė V, Šakalienė R, Švedienė L, Musteikytė-Petrauskienė I (2013). Differences of age and gender related posture in urban and rural schoolchildren aged 7 to 10. Education. Physical Training. Sport; 88(1): 25-31. https://doi.org/10.33607/bjshs.v1i88.142

Dutta S, Dhara PC (2012). Evaluation of different sitting postures of rural primary school boys in the classroom. J Ergonomics; 2(105): 2. https://doi.org/10.4172/2165-7556.1000105

Gouda J, Das KC, Goli S, Pou LMA (2013). Government versus private primary schools in India: An assessment of physical infrastructure, schooling costs and performance. International Journal of Sociology and Social Policy; 33(11/12): 708-724. https://doi.org/10.1108/IJSSP-12-2012-0105

Helmy AN, El-Sayed MM, Kattabeib OM (2015). Intra-rater and inter-rater reliability of Surgimap Spine software for measuring spinal postural angles from digital photographs. Bulletin of Faculty of Physical Therapy; 20(2): 193-199. https://doi.org/10.4103/1110-6611.174719

Kaur S, Mahi KPS (2017). An analytical study of postural deformities in school children of rural area in Punjab. International Journal of Yoga, Physiotherapy and Physical Education; 2(5): 219-221.

Keegan J (1953). Alterations of the lumbar curve related to posture and seating. Journal of Bone and Joint Surgery; 35-A(3): 589-603. https://doi.org/10.2106/00004623-195335030-00007

Lehman KR, Psihogios JP, Meulenbroek RG (2001). Effects of sitting versus standing and scanner type on cashiers. Ergonomics; 44(7): 719-738. https://doi.org/10.1080/00140130119569. PMid:11437205

Mandal AC (1981). The seated man (Homo Sedens): The seated work position, theory and practice. Applied Ergonomics; 12(1): 19-26. https://doi.org/10.1016/0003-6870(81)90089-2

Perooru R, Malarvilzhi D, Prasanth D, Sivakumar VPR (2016). Effects of sitting posture modification and exercises in schoolgoing children with neck pain in rural area in Tamil Nadu. International journal of clinical skills; 10(2): 22-25. https://doi.org/10.4172/Clinical-Skills.1000105

Radzevičienė L, Kazlauskas A (2016). Posture disorders and their causes in rural schools' pupils. Social Welfare: Interdisciplinary Approach; 1(6): 118-125. https://doi.org/10.21277/sw.v1i6.241

Ruivo RM, Pezarat-Correia P, Carita AI (2014). Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz J Phys Ther; 18(4): 364-371. https://doi.org/10.1590/bjpt-rbf.2014.0027. PMid:25054381 PMCid:PMC4183261

Savanur CS, Ghosh S, Dhar U, De A (2004). An ergonomic study of comparison between school classroom furniture and student's anthropometry. Proceedings of National Conference of Humanising Work and Work Environment. National Institute of Industrial Engineering, Mumbai, India.

Zacharkow D (1988). Posture: sitting, standing, chair design and exercise. Thomas, Springfield, IL, USA.

DOI: https://doi.org/10.5463/dcid.v31i1.864

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