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. 2025 Apr 13;20(1):372.
doi: 10.1186/s13018-025-05760-w.

Correlation between abnormal posture, screen time, physical activity, and suspected scoliosis: a cross-sectional study

Hongxin Chen #  1   2   3 , Liyang Wu #  2 , Yi Zhang #  2 , Jinyi Liu  2 , Rui Huang  2 , Jinyang Xie  2 , Zhenfeng Guo  1   2   3 , Tao Huang  1   2   3 , Cuiling Chen  1   2   3 , Kaimin Yang  2 , Yuying Bai  2 , Xuanxuan Huang  2 , Zhuopeng Zhang  4 , Ruike Zhang  5   6   7
Affiliations

Correlation between abnormal posture, screen time, physical activity, and suspected scoliosis: a cross-sectional study

Hongxin Chen et al. J Orthop Surg Res. .

Abstract

Background: Scoliosis considerably affects adolescents' physical well-being and quality of life. Current research offers scant data concerning the correlation between abnormal posture, screen time, physical activity, and adolescent scoliosis. This study aimed to investigate their potential correlations with suspected scoliosis in teenagers aged 10-13 years.

Methods: This is a cross-sectional study. School scoliosis screening was conducted on adolescents aged 10-13 years from nine schools in Guangzhou, China. The survey encompassed demographic attributes, postural traits, and daily lifestyles. Logistic regression analysis was performed to analyze the correlations between various variables and the occurrence of suspected scoliosis.

Results: A total of 1297 questionnaires were distributed, and 1231 (94.9%) valid responses were received. All participants with valid responses underwent scoliosis screening. The overall prevalence of suspected scoliosis was 5.1%, with the highest prevalence observed in 11-year-old students, primarily affecting the thoracic spine. Significant correlations were found between suspected scoliosis and right-sided flatfoot, flat upper back, positive forward bend test (FBT), After-school screen time, weekend outdoor time, and weekend TV time.

Conclusions: The results show a substantial correlation between the incidence of suspected scoliosis and abnormal posture. Moreover, a marked correlation exists between distinct activity patterns, particularly extended usage of electronic devices and television, and the incidence of suspected scoliosis. Screening for abnormal posture and performing the FBT can help detect suspected scoliosis, which requires further clinical assessment to differentiate between postural deviations and scoliosis. We advise middle and primary school kids to modify their daily routines by decreasing sedentary behavior and enhancing physical activity to mitigate the potential occurrence of trunk asymmetries.

Keywords: Abnormal posture; Influencing factors; Physical activity; Screen time; Suspected scoliosis.

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Conflict of interest statement

Declarations. Ethics approval and informed consent: This study was conducted in accordance with the Declaration of Helsinki. The research protocol was approved by the Ethics Committee of the Fifth Affiliated Hospital of Guangzhou Medical University. Written informed consent was obtained from the parents or guardians of participants under 18 years old, permitting the use of their data and images in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of suspected scoliosis cases across thoracic, thoracolumbar, and lumbar regions
See this image and copyright information in PMC

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