journal article·2025-03-17Open access

Sagittal Posture Measurement in Adolescent Athletes: Which Parameters Are Reliable over the Course of a Day?

Oliver Ludwig, Jonas Dully, Edwin Baun, Michael Fröhlich

Applied Sciences· Volume 15· Issue 6

Abstract

Analyzing the posture of athletes is an important preventive diagnostic tool, especially because some posture parameters appear to be associated with risk of muscle injury and complaints. So far, it is unclear how these parameters change during the day under sport-related stress. In this pilot study, the posture parameters of pelvic tilt, body lean, trunk lean, and pelvic displacement were analyzed in 20 soccer players (16.61 ± 0.28 years, 179.38 ± 6.40 cm, 70.35 ± 7.79 kg, playing in the German Youth Academy League) at three points in time on one day, in each case with habitual posture and active posture with eyes open and closed. Intensive sporting activities took place between the measurement points. A repeated two-factor ANOVA was calculated for each posture parameter with the factors of measurement time and posture. Cohen’s d was determined as a measure of the effect size, and the intra-class correlation coefficient was calculated for the three measurement times. Only pelvic tilt and body lean remained stable throughout the day. We therefore recommend using both parameters to assess the posture of athletes, especially because studies show that they can be associated with possible complaints and injuries. However, since the examined posture parameters change significantly depending on whether a habitual or actively tense posture is adopted, particular attention must be paid to reproducible postures and clear instructions to the test subjects.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Scoliosis diagnosis and treatment · Ergonomics and Musculoskeletal Disorders · Musculoskeletal pain and rehabilitation

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany

Institute of Sport and Sport Sciences, Albert-Ludwigs-Universität, 79102 Freiburg im Breisgau, Germany

References (62)

Show source-provided references
1. Correlations between somatic features, anteroposterior spinal curvatures and trunk muscle strength in schoolchildren
2. Evaluation of isokinetic trunk muscle strength in adolescents with normal and abnormal postures10.1016/j.jmpt.2015.06.010 ↗
3. Analysis of Body Posture Between Young Football Players and their Untrained Peers10.2478/v10038-012-0012-7 ↗
4. Effect of Individual Strengthening Exercises for Anterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROMs of a LBP Patient with Flat Back10.1589/jpts.25.1357 ↗
5. Ludwig, O., Kelm, J., Hammes, A., Schmitt, E., and Fröhlich, M. (2018). Targeted athletic training improves the neuromuscular performance in terms of body posture from adolescence to adulthood–Long-term study over 6 years. Front. Physiol., 9.10.3389/fphys.2018.01620 ↗
6. Klee, A., Jöllenbeck, T., and Wiemann, K. (2000, January 25–30). Correlation between muscular function and posture-lowering the degree of pelvic inclination with exercise. Proceedings of the ISBS-Conference Proceedings Archive, Hong Kong, China.
7. Comparison of pelvic tilt before and after hip flexor stretching in healthy adults10.1016/j.jmpt.2020.09.006 ↗
8. Comparison of sagittal spinal curvatures and hamstring muscle extensibility among young elite paddlers and non-athletes
9. The back squat: A proposed assessment of functional deficits and technical factors that limit performance10.1519/SSC.0000000000000103 ↗
10. How anterior pelvic tilt affects the lower extremity kinematics during the late swing phase in soccer players while running: A time series analysis10.1016/j.humov.2019.06.001 ↗
11. Pelvic tilt and range of motion in hips with femoroacetabular impingement syndrome10.5435/JAAOS-D-19-00155 ↗
12. Ludwig, O., Schneider, G., and Kelm, J. (2023). Improvement of Groin Pain in a Football Player with Femoroacetabular Impingement via a Correction of the Pelvic Position—A Case Report. J. Clin. Med., 12.10.3390/jcm12237443 ↗
13. Barczyk-Pawelec, K., Rubajczyk, K., Stefańska, M., Pawik, Ł., and Dziubek, W. (2022). Characteristics of body posture in the sagittal plane in 8–13-year-old male athletes practicing soccer. Symmetry, 14.10.3390/sym14020210 ↗
14. Effects of athletic training on the spinal curvature in child athletes10.1080/15438627.2015.1005297 ↗
15. Salsali, M., Sheikhhoseini, R., Sayyadi, P., Hides, J.A., Dadfar, M., and Piri, H. (2023). Association between physical activity and body posture: A systematic review and meta-analysis. BMC Public Health, 23.10.1186/s12889-023-16617-4 ↗
16. The association between athletic training time and the sagittal curvature of the immature spine10.1177/03635465000280040801 ↗
17. Posture class prediction of pre-peak height velocity subjects according to gross body segment orientations using linear discriminant analysis10.1007/s00586-013-3058-0 ↗
18. Classification system of the normal variation in sagittal standing plane alignement10.1097/BRS.0b013e318280cc4e ↗
19. A clinical postural model of sagittal alignment in young adolescents before age at peak height velocity10.1007/s00586-012-2416-7 ↗
20. Increased anterior pelvic tilt angle elevates the risk of hamstring injuries in soccer player10.1080/15438627.2024.2430662 ↗
21. Romero, V., Lahti, J., Castaño Zambudio, A., Mendiguchia, J., Jiménez Reyes, P., and Morin, J.-B. (2022). Effects of Fatigue Induced by Repeated Sprints on Sprint Biomechanics in Football Players: Should We Look at the Group or the Individual?. Int. J. Environ. Res. Public Health, 19.10.3390/ijerph192214643 ↗
22. Anterior pelvic tilt increases hamstring strain and is a key factor to target for injury prevention and rehabilitation10.1002/ksa.12045 ↗
23. Clinical measures of pelvic tilt in physical therapy10.26603/001c.27978 ↗
24. Intertester reliability for measuring pelvic tilt in standing10.1093/ptj/68.9.1347 ↗
25. Postural alignment in standing: A repeatability study10.1016/S0004-9514(14)60466-9 ↗
26. Reliability of photogrammetry for evaluating pelvic posture in healthy individuals
27. Photogrammetry: Reliability and lack of objectivity in posture evaluation
28. Reliability of photographic posture analysis of adolescents10.1589/jpts.27.3123 ↗
29. Reliability of a photographic method for assessing standing posture of elementary school students10.1016/j.jmpt.2010.06.002 ↗
30. Influence of muscular imbalances on pelvic position and lumbar lordosis: A theoretical basis
31. Sagittal standing posture, back pain, and quality of life among adults from the general population: A sex-specific association10.1097/BRS.0000000000000347 ↗
32. Relationship between mechanical factors and pelvic tilt in adults with and without low back pain10.3233/BMR-140177 ↗
33. Video Analysis of Sagittal Spinal Posture in Healthy Young and Older Adults10.1016/j.jmpt.2009.02.002 ↗
34. Is lumbar lordosis related to low back pain development during prolonged standing?10.1016/j.math.2015.01.001 ↗
35. Influences of the extensor portion of the gluteus maximus muscle on pelvic tilt before and after the performance of a fatigue protocol10.1590/S1413-35552010000300002 ↗
36. Non-structural misalignments of body posture in the sagittal plane10.1186/s13013-018-0151-5 ↗
37. Does postural assessment contribute to patient care?10.2519/jospt.2002.32.8.376 ↗
38. Pelvic tilt: Reliability of measuring the standing position and range of motion in adolescent athletes10.1136/bjsports-2014-093494.92 ↗
39. The reliability of quantifying upright standing postures as a baseline diagnostic clinical tool10.1016/j.jmpt.2003.12.003 ↗
40. Sample sizes for estimation in clinical research
41. Ludwig, O., Kelm, J., and Hopp, S. (2020). Impact of Quadriceps/Hamstrings Torque Ratio on Three-Dimensional Pelvic Posture and Clinical Pubic Symphysis Pain-Preliminary Results in Healthy Young Male Athletes. Appl. Sci., 10.10.3390/app10155215 ↗
42. Changes in Habitual and Active Sagittal Posture in Children and Adolescents with and without Visual Input—Implications for Diagnostic Analysis of Posture
43. Radiography and photogrammetry-based methods of assessing cervical spine posture in the sagittal plane: A systematic review with meta-analysis10.1016/j.gaitpost.2020.12.033 ↗
44. Two-dimensional digital photography for child body posture evaluation: Standardized technique, reliable parameters and normative data for age 7–10 years10.1186/s13013-017-0146-7 ↗
45. Photogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review10.1016/j.jcm.2017.01.005 ↗
46. Sample size of 12 per group rule of thumb for a pilot study
47. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies10.1016/S0140-6736(07)61602-X ↗
49. R_Core_Team (2021). R: A Language and Environment for Statistical Computing, R Core Team.
50. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM
51. The effect of the pelvis position in the sagittal plane on loads in the human musculoskeletal system10.37190/ABB-01606-2020-02 ↗
52. The relationship between lumbar lordosis and pelvic tilt angle10.3233/BMR-2000-141-205 ↗
53. Furlan, L., and Sterr, A. (2018). The applicability of standard error of measurement and minimal detectable change to motor learning research—A behavioral study. Front. Hum. Neurosci., 12.10.3389/fnhum.2018.00095 ↗
54. Multivariable modeling of factors associated with spinal pain in young adolescence10.1007/s00586-016-4629-7 ↗
55. Sagittal standing posture and its association with spinal pain: A school-based epidemiological study of 1196 Flemish adolescents before age at peak height velocity10.1097/BRS.0b013e3182408053 ↗
56. Factors associated with low back and neck pain in young adolescence: A multivariable modeling study10.1016/j.physio.2015.03.1983 ↗
57. A systematic review of the angular values obtained by computerized photogrammetry in sagittal plane: A proposal for reference values10.1016/j.jmpt.2014.01.002 ↗
58. Biomechanical and neurophysiological mechanisms related to postural control and efficiency of movement: A review10.3109/08990220.2012.725680 ↗
59. The effect of trunk muscle fatigue on postural control of upright stance: A systematic review10.1016/j.gaitpost.2019.06.010 ↗
60. Which biomechanical models are currently used in standing posture analysis?10.1016/j.neucli.2015.07.004 ↗
61. Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain10.1097/BRS.0b013e31817ec3b0 ↗
62. Implications for the use of postural analysis as a clinical diagnostic tool: Reliability of quantifying upright standing spinal postures from photographic images10.1016/j.jmpt.2005.06.006 ↗