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Biomechanical and Developmental Perspectives on Upper Body Postural Adaptations Among School-Aged Children: A Comprehensive Narrative Review
Age, body mass index, and modern technological influences predisposed to high prevalence of postural deviations such as forward head posture and thoracic hyperkyphosis, and rounded shoulders among school-aged children. The comprehensive integration of developmental and biomechanical perspectives on these adaptations is limited Upper-body postural adaptations reflect a complex interplay between developmental growth and biomechanical loading. Regular posture assessment in schools and clinical settings is crucial for early detection and culturally tailored prevention. Future longitudinal and cross-cultural studies are essential to establish normative postural values and clarify causal pathways across populations
This review aims to synthesize existing literature addressing age- and BMI-related upper-body postural adaptations and biomechanical loading interact to impact spinal and shoulder alignment, muscular strength, and postural control efficiency in school-aged children. Methods: A structured narrative synthesis was conducted utilizing literature from PubMed, Scopus, and Google Scholar databases. Inclusion criteria focused on studies involving school-aged children (6-18 years) that investigated head, thoracic, and shoulder posture, as well as muscle strength in relation to age, BMI, and lifestyle factors. Age-related maturation influences spinal curvature, cervical alignment, and scapular positioning through evolving neuromuscular control. Elevated BMI alters load mechanics and mass distribution, increasing thoracic kyphosis, forward head posture, and shoulder protraction while reducing relative neck and shoulder strength. Obesity-related intramuscular fat infiltration and sedentary life style further impair postural stability and muscle performance
Age
6 - 18 years
Sex
ALL
Healthy Volunteers
No
King Faisal Medical Complex
El Taif, El Taif, Saudi Arabia
Start Date
October 1, 2025
Primary Completion Date
November 30, 2025
Completion Date
November 30, 2025
Last Updated
December 29, 2025
100
ACTUAL participants
postural instruction
BEHAVIORAL
Lead Sponsor
Lincoln University College
NCT06864780
NCT07039565
NCT07484555
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