Association between physical activity and body posture: a systematic review and meta-analysis

Abstract

Objective: To estimate the possible associations between posture and physical activity (PA).

Design: A systematic review and meta-analysis.

Data sources: The search was conducted in seven databases (PubMed, Web of Science, SportDiscus, EMBASE, Scopus, Cochrane Library, and CINAHL) for studies published from inception to January 2023.

Eligibility criteria for selecting studies: Studies were required to meet following criteria: (1) study design: cross-sectional, case control and cohort studies. (2) Participants: people of all ages without any diagnosed diseases. (3) Exposure and outcome: studies that examined the possible effect or correlations between PA, physical inactivity, physical exertion and human body posture.

Results: Sixteen cross-sectional studies, two cohort studies and one case control study involving a total of 16772 participants aged from 6 to 79 years were included. Correlational studies showed that there was a significant relationship between PA and posture (C = 0.100, CI 95% = 0.012-0.186). However, regression studies demonstrated that there was not a significant association between PA and posture (C = 1.00, CI 95% = 0.998-1.002). Three studies investigated the association between PA and the lumbar lordosis and showed that there was not a significant association between the lordosis and PA (CI 95%: -0.253-0.048, P = 0.180). In addition, four studies showed that there were not any associations between scoliosis and PA (CI 95%: 0.819, 1.123, P = 0.607). The evidence of heterogeneity and publication bias was found among all analyzed data (P < 0.05). Also, meta regression was used for age and BMI and the results were not significant.

Conclusion: Although a weak correlation was shown to exist between PA and human posture, the odds ratio indicated that there was not a significant association between PA and human posture. The lack of a significant relationship may indicate that multiple biopsychosocial factors may be involved in human posture. In summary, our study highlights the need for caution when interpreting the results of meta-analyses, particularly when there is significant heterogeneity and publication bias in the included studies.

Keywords: Body posture; Lumbar lordosis; Meta-analysis; Physical activity; Scoliosis.

Fig. 1

Flow diagram of the included studies

Fig. 2

Forest plot of the correlation between Physical Activity and Posture. CI: Confidence interval

Fig. 3

Funnel plot assessing the presence of publication bias in a meta-analysis of correlations between Physical Activity and Posture. The white circles represent the studies that were actually observed, while the gray circles represent the studies that were imputed

Fig. 4

Forest plot regarding the association Physical activity and Posture. CI: Confidence interval

Fig. 5

Funnel plot assessing the presence of publication bias in meta-analysis for association of Physical Activity and Posture. The white circles represent the studies that were actually observed, while the gray circles represent the studies that were imputed

Fig. 6

Forest plot regarding the association of Physical Activity and Scoliosis. CI: Confidence interval

Fig. 7

Funnel plot assessing the presence of publication bias in meta-analysis for Physical Activity and Scoliosis. The white circles represent the studies that were actually observed, while the gray circles represent the studies that were imputed

Fig. 8

Forrest plot regarding the correlation of Physical Activity and Lumbar Lordosis. CI: Confidence interval

Fig. 9

Funnel plot assessing the presence of publication bias in meta-analysis for Physical Activity and Lumbar Lordosis