JORT Journal

Introduction

Research indicates that sensory systems—particularly ocular (vision) and podal (feet) receptors—play a central role in receiving proprioceptive and exteroceptive information, contributing to body structuring, positioning, alignment, and the maintenance of the postural tonic system in both static and dynamic situations [1–8].

Imbalances in the oculomotor or foot musculature may lead to compensatory movements in anatomical segments, manifested as tilts and rotations, thereby compromising posture and potentially resulting in musculoskeletal dysfunctions. Posture is regulated by musculoskeletal chains—comprising muscles and joints—and dysfunctions within these chains can lead to functional adaptations, alterations in postural tone, and muscular imbalances. These changes may modify the structure of striated muscles and connective tissue, reducing range of motion and maximal contraction strength, thus contributing to the onset of pain and injury [3,8,9].

During adolescence, accurate postural assessment is essential, as motor patterns may be compromised, leading to misalignments and musculoskeletal dysfunctions [10,11]. This developmental period is marked by the onset of specialized training and is accompanied by significant biopsychosocial changes, such as rapid physical growth, sexual maturation, social development, and heightened body image perception. These factors directly influence physical activity, sports performance, and the capacity to adapt to training loads [12–18].

Sports training during this phase may contribute to postural deviations and musculoskeletal injuries due to high physical demands, unilateral movement patterns, and mechanical overload, reinforcing the need for systematic assessment and monitoring protocols [19–23].

Postural assessment using digital biophotogrammetry has emerged as an effective diagnostic tool, enabling the identification of postural misalignments, musculoskeletal imbalances, and injury risks. Additionally, it supports the monitoring of body growth and development in individuals aged 6 to 18 years [11,23–28].

In the context of youth sports, significant gaps remain in integrating postural assessment with training prescription. This study aimed to investigate the relationship between anatomical profiles and postural deviations in young athletes engaged in individual sports.

Materials and Methods Sample Characterization

A total of 183 young athletes participated in this study, including 98 females and 85 males, aged 11 to 19 years. Participants were engaged in six individual sports disciplines: athletics, combat sports, artistic and rhythmic gymnastics, swimming, and tennis. All athletes competed at the regional, national, or international level and followed a training schedule consisting of five weekly sessions, each lasting 90 to 120 minutes. The sample was stratified into two age groups: 11–14 years and 15–19 years.

Ethical Considerations

All participants, or their legal guardians, signed an informed consent form in accordance with Resolution CNS No. 466/2012 [29]. The study was approved by the Research Ethics Committee of Universidade São Judas Tadeu (protocol No. 1.051.414).

Data Collection Procedures

Sociodemographic and sport-related data were collected using a structured anamnesis form, recorded in Microsoft Excel 2016. The information gathered included sex, age, place of birth, previous medical diagnoses (such as sprains, musculoskeletal pain, fractures, surgeries, and diseases), years of education, years of sports participation, best competition results, body mass (kg), and height (cm).

The anatomical segments assessed included the eyes, shoulders, spinal column, hips, knees, and feet. The anatomical reference standards used for evaluation are presented in Table 1.

Table 1: Anatomical reference standards for postural assessment

Postural assessment was conducted using digital biophotogrammetry

Athletes were positioned in orthostatic posture and photographed from anterior, right lateral, posterior views and left lateral. Horizontal and vertical reference lines were drawn between anatomical segments to identify symmetries and asymmetries (Figure 1).

Figure 1: Model of positions adopted for postural assessment via digital biophotogrammetry with horizontal and vertical axes.

During the assessment, female athletes wore shorts and sports tops, while male athletes wore shorts or swim briefs. All participants were barefoot. Athletes with long hair were instructed to tie it back to facilitate observation of the cervical region.

Image Acquisition and Analysis

Images were captured using a Lenovo Vibe K5 smartphone equipped with a 13-megapixel camera, positioned 1.5 meters from the athlete and 1 meter above ground level. The analysis was conducted using CorelDRAW X7® (2016) software, following the principles of biophotogrammetry—a technique that enables precise and reliable metric assessment of body alignment [24,25,30,31].

Statistical Analysis

Data normality was assessed using the Shapiro–Wilk test, and homogeneity of variances was evaluated with Levene’s test. Continuous variables were expressed as means and standard deviations, while categorical variables were presented as percentage frequencies. Group comparisons were performed using Multivariate Analysis of Variance (MANOVA), with sex (male and female), age group (11– 14 and 15–19 years), and their interaction as factors. When significant differences were found, Bonferroni post hoc tests were applied. The Chi-square (χ²) test was used to examine the distribution of postural deviations by sex and age group. The significance level was set at p < 0.05. All statistical analyses were conducted using SPSS® version 22.0.

Results

Table 2 presents the profile of the young athletes, stratified by sex and age group. Statistically significant differences (p < 0.05) were found for all analyzed variables: age, years of schooling (YS), years of sports practice (YSP), body mass (BM), and height. Older athletes (15–19 years) exhibited higher averages in all variables for both sexes. Significant differences between sexes were also observed, particularly in height and body mass, both of which were higher among males.

Statistical analysis was performed using a multivariate MANOVA test (GLM), with Bonferroni post hoc. From this, the critical value (F) and the level of significance (p) were obtained for the factors of gender, age group, and their interaction;

*Significant difference compared to the 11–14-year-old group; † Significant difference compared to the female group

Table 2: Profile of young athletes practicing individual sports, by sex and age group

Table 3 presents the frequency of the anatomical profile across different body segments. A predominance of right-eye dominance was observed (72.9% in boys and 69.4% in girls), with no significant difference between sexes. However, statistically significant differences were found in the shoulders, spinal column, and feet segments exclusively among females, with high percentages of asymmetries, particularly in athletes aged 11 to 14 years. Notably, 95.9% of the girls exhibited shoulder asymmetries, 88.8% in the spinal column, and 70.4% in the feet.

Table 3: Anatomical profile by percentage frequency (%) in young athletes practicing individual sports, according to sex and age group

Table 4 presents the types of postural alterations identified, categorized by sex and age group. Forward head posture was the most prevalent alteration in both sexes (80.0% in boys and 79.6% in girls), followed by pelvic lateral rotation (94.1% and 70.4%, respectively) and knee hyperextension (94.1% in boys and 96.9% in girls).

A Significant difference compared to the 11–14 years age group of the male sex. B Significant difference compared to the 15–19 years age group of the male sex.

C Significant difference compared to the total male group.

Table 4. Percentage frequency (%) of postural alterations by age group and sex in young athletes engaged in individual sports