Sensed and actual posture of Grade 5 learners while carrying a schoolbag
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Background: The main aim for the current study was to stablish the difference between sensed and actual posture while a Grade 5 learner is standing and carrying a schoolbag. Sensed posture is invisible and is dependent on the person who senses it; while actual posture is considered as the postural alignment that is visible to others. Due to the difference between sensed posture and actual posture, understanding how the two differ and how the body senses its posture as opposed the actual posture, will influence correct postural control on a child's body and their joint positioning in standing, walking and activity engagement and therefore promote physical wellbeing of the children. Despite a few single-joint studies done on the concept of sensed and actual posture, no study investigated sensed and actual posture in children with respect to whole body postural alignment, especially when they carry a backpack. Methods: A descriptive cross-sectional study design was used in the current study. The study population consisted of 198 primary school learners in Grade 5. Participants had similar socio-economic status and were between the ages of 9.6 and 13.5, both boys and girls were included. The researcher used the Photographic Method of Postural Assessment (P-MPA) for assessment of postural alignment. The P-MPA was proved to accurately measure deviations between anatomical landmarks and the line of gravity, and also proved to be reliable in terms of reproducibility. In the set-up for the P-MPA, the participant assumed a position at 1 meter behind the plumb line, with the plumb line aligned with the lateral malleoli for the lateral standing position, and with the mid heels for the anterior standing position. The participant was asked to assume his/her most natural standing position. Photographs were taken by the researcher from 2m distance with a smartphone that was fixed on a tripod at a height of 950mm. Photographs were later printed and actual posture on the photographs was measured and results were captured on an excel spread sheet. The actual (real) distance on photos was established by calculating the ratio of measured (real) distance x distance from plumb line for each photo. A clinical significant difference from the reference point as measured on the photo was set at 10mm. The coding was done by the researcher, followed by data analysis. Descriptive statistics, namely frequencies and percentages for categorical data, medians and percentiles for numerical data, were calculated. The sensed and actual deviation at each landmark, was compared by means of 95% confidence intervals (Cl) for median differences for paired data. Results: Results indicate that there was no significant difference observed on all the anterior views with reference to the difference between sensed and actual posture for the respective anatomical landmarks. Evidence from this study further indicate that sensed and actual posture differ when observed from lateral view, especially when weight is involved, in this instance; when a learner is carrying a backpack. Besides the remarkable clinical and statistical difference on the affected landmarks, the earlobe demonstrated significant difference more regularly than other anatomical landmarks; mid knees, greater trochanter and acromion process on the lateral views. Noticeably, the values of deviations increased per anatomical landmark moving from lower anatomical landmark; lateral malleoli to higher anatomical landmark; earlobe. Lastly, in most instances the anatomical landmarks that displayed significant difference on the left side also displayed a difference on the right side. Biographical questionnaire results indicate that 53% of participants compensate by bending when carrying a backpack, of whom 88.3% stated that they bend involuntarily. Conclusion: Results from this study indicate the difference between sensed and actual posture while a Grade 5 learner is carrying a backpack, for all the respective landmarks noticeable from lateral views. These differences contribute to the knowledge base of factors that may have an impact on the learner's developing spine and wellbeing. It is recommended that these results be aligned with the lntergraded School Health Programme (ISHP) and to complement intervention strategies in order to enhance the wellbeing of individuals in school setting and the community at large.