© Borgis - New Medicine 2/2007, s. 37-39
*Anna Zwierzchowska, Krystyna Gawlik
Deaf children and adolescents and defective posture
Dept. Of Correction and Special Education, Academy of Physical Education
Head of the Department: prof. dr hab. Jan Slężyński
Summary
Summary
Background. The auditory system participates in coordinating the actions of the postural muscles. That is why hearing problems can have a negative effect on body posture. The aim of the research presented here was to discover how often defective posture occurs among deaf children and adolescents and to determine what type of defective posture occurs most often.
The research involved 54 deaf children and adolescents aged 10 to 16 (24 girls and 30 boys). Body posture examination was based on photometric Moire method which allowed us to create points of body posture asymmetries and to create the range of kyphosis and lordosis in a standing position.
Defective posture occurs in 100% of the tested children and adolescents in the sagittal plane and/or in the frontal plane. The deaf children and adolescents had scoliotic defect of posture and/or different defect posture in the sagittal plane. Rounded back (hyperkyphosis) is the most frequent type of this defect posture.
The obtained results lead to the conclusion that deaf children and adolescents require careful observation and control regarding defective posture and should be covered by prophylactic and correction programmes.
INTRODUCTION
The thesis that deafness has a negative effect on body posture is widely accepted, mainly for the reason that maintenance of postural stability is an extremely complex task, in which many body systems are engaged, especially vestibular, visual and proprioceptive parts of the central nervous system. In the case of people with hearing disorders there is a great probability that the proper work of at least one of those systems is disturbed [1, 2].
The aim of the presented research was to evaluate body posture of deaf children and adolescents.
It was assumed that 100% of those tested would encounter defects of the spine in the frontal plane and/or in the sagittal plane. The following research questions were set:
1. How often does defective posture occur among the tested deaf?
2. What kind of defect most often occurs in the sagittal plane?
3. What are the predominant defects in the frontal plane?
RESEARCH METHODS
We used the non-invasive photometric Moire method in our research on body posture. The research stand consists of a computer, a projecting-reception device with a camera and darts, one of which has a raster. The method depends on taking photographs of the back with so-called Moire rods. Thanks to a special optical system the computer generates a three-dimensional picture of the back and analyses several parameters of the frontal plane and sagittal plane.
The research is conducted in a darkened room, after marking on the examined person´s back spined process vertebra from C7 to S1, angles of the shoulder blades and the posterior superior iliac spines. During the examination the examined person is positioned with his back to the projecting-reception device 2.5 m away, and the pictures are taken. The analysis is conducted without the examined person. From over a dozen photographs registered in the computer´s memory only the one depicting the person´s habitual posture is chosen. On the basis of the registered picture and the marked points on the model the computer calculates parameters determining posture in the frontal and sagittal plane.
In the presented research, positioning of the spine in the sagittal and frontal plane was analyzed. Defects in the sagittal plane were assessed on the basis of angles of anterior curvature and backward curvature of the spine. The C7 – S1 route in relation to a vertical line was the basis for evaluation of defect of body posture, and the angle of trunk tilting (ATT) made it possible to assess the spine in the frontal plane.
The results were compiled on an "Excel” spreadsheet, calculating arithmetic averages (x) and standard deviation (s).
RESEARCH MATERIAL
The research was conducted on a chosen group of deaf girls and boys, without any other dysfunctions, who attended special schools for the hearing impaired. The presented results were obtained in the year 2005, part of a longitudinal research project lasting three years (2004-2007) [3, 4]. 54 tested deaf children and adolescents aged 11-17 (24 girls, 30 boys) were divided into three age groups of characteristic phases of ontogenetic development. The choice of age groups was intentional, based on findings from research made on a large population of deaf children and adolescents from Upper Silesia, which revealed that the pace of development of deaf children from Upper Silesia is slower than that of their hearing peers by 1.5 to 2 years in both sexes [3]. That is why age groups assumed the differences between them in respect of the nature of developmental differences (Table 1).
Table 1. Number of tested deaf children.
| Group | Age | Total |
| 11 | 14 | 17 |
| Girls | 5 | 6 | 13 | 24 |
| Boys | 10 | 10 | 10 | 30 |
Hearing loss in the tested group was 100%, which means that all children had hearing damage above 80dB. None of the tested children have implants. The diagnosed location of the damage or defect differentiated the group into perceptive damage, 85%, and central damage, 15%. Aetiology of deafness is shown in Figure 1.
Fig. 1. Aetiology of deafness in the tested groups.
RESULTS
Research has shown that defective posture in the sagittal plane appears in 75% of the estimated deaf. An analysis of angles in thoracic kyphosis and lumbar lordosis showed that defective posture most often occurs in the sagittal plane, that is a rounded back, with 44.4%, concave back 14.8%. A small percentage is made up by a flat back, 3.7% (Figure 2).
Fig. 2. Defective posture in the sagittal plane among the examined deaf.
Moreover, the average of the angles in thoracic kyphosis and lumbar lordosis was calculated for each age group of deaf boys and girls. Kyphosis angle value of both boys and girls is progressive between the ages of 10 and 16. However, there is a noticeable reversal in the value of lumbar lordosis angles, which becomes flattened between the age of 10 and 16 among girls, but at the same age is progressive among boys.
Table 2. Thoracic kyphosis and lumbar lordosis angle values among deaf girls and boys.
| | Age 11 | Age 14 | Age 17 |
| G | B | G | B | G | B | G | B | G | B | G | B |
| X | S | X | S | X | S |
| Kth | 24.5 | 29.5 | 3.1 | 4.4 | 27.7 | 30.9 | 5.0 | 6.0 | 28.1 | 31.5 | 4.6 | 5.5 |
| LL | 28 | 24.8 | 6.4 | 6.8 | 23.7 | 24.1 | 3.1 | 7.1 | 21.8 | 29.8 | 6.3 | 19.6 |
(G – girls; B – boys)
Symmetrical posture of the frontal plane is the basic criterion for the assessment of proper body condition. The conducted research showed that defective posture occurred in the frontal plane (scoliosis) among 44% of the deaf. Scoliosis and scoliosis postures are more common among deaf girls (54%) than deaf boys (46%). Among girls thoracic scoliosis is predominant, while lumbar scoliosis is predominant among boys. The majority was left-sided scoliosis (70%).
DISCUSSION
A deaf child is in a high-risk group as far as defective posture is concerned. A smaller level of physical activity and as a consequence worse motor development in the first years of life, lack of sensual control (hearing) in the process of creating a habit to keep the body in proper posture, frequent problems with balance, asthenic body build, and weight and height deficiencies, can play a vital role in the formation of abnormalities in body posture. The presented research showed that 100% of those tested do have defective posture. We assume that this is due to intentional selection of the tested group in the presented research. The confirmation of the thesis we made is a novelty if we take into account previous research on the deaf population. In the majority of research to date the authors point out the fact that defective posture is common in the sagittal plane (40-50%).
Research has shown that defects predominantly occur in the sagittal plane (75%), but there are also a large number of those tested burdened with defects in the frontal plane (44%). Posture was proper in the sagittal plane (25%), but defects occur in the frontal plane (scoliosis, posture of scoliosis).
Regarding the evaluation of the type of posture in the sagittal plane among the deaf, the obtained results are similar to those presented by Śliwa, Wilińska and Kasperczyk, although all of them used different methods [5]. Śliwa diagnosed defective posture in only 50% of those tested, defining the kyphotic type as dominant, similarly to Kasperczyk and Wilińska, Grabara Szczygieł [6-9]. This is confirmed by the presented research; however, we revealed a greater number of abnormalities among both sexes.
In the frontal plane our research results show that left-sided scoliosis is more common, which could be caused by the children being right-handed and greater muscular strength of that side of the body. Asymmetrical load to a weak musculature could be the cause of adopting a defective posture, leading to spinal curvature. This is confirmed by tests conducted on a population of deaf children and adolescents. We could state that, regardless of the testing tool, there is a universal quality to the phenomenon of defective posture occurrence in the frontal plane among the deaf, which most often is left-sided thoracic among girls and left-sided lumbar for boys.
The frequency of defective posture among deaf children and adolescents is alarming and requires more attention on the part of medical doctors, physical education teachers, and above all rehabilitation instructors. It is vital to guarantee all deaf children early intervention in this respect to prevent the formation of a defective posture.
A modification in the school curriculum to include rehabilitation exercises and to enhance knowledge/consciousness of the problem seems logical.
CONCLUSION
1. The obtained results lead to the conclusion that deaf children and adolescents require careful observation and control regarding postural defects and should be covered by prophylactic and rehabilitation programmes.
2. The presented research findings can be used in rehabilitation programmes and in designing physical lessons for children and adolescents with hearing impairment.
Piśmiennictwo
1. Bobrowicz K., Skolimowski T.: Występowanie zaburzeń symetrii postawy w płaszczyźnie czołowej u dzieci od 6-9 lat. Fizjoterapia 1995, nr 2, p. 26-29. 2. Grabara M., Zwierzchowska A, Gawlik K.: Dysfunkcje narządu wzroku a asymetrie postawy ciała. Pediatria Polska 1, 2004, p.37-42. 3. Zwierzchowska A., Gawlik K.: Korektywa dzieci i młodzieży z dysfunkcjami wzroku lub słuchu. AWF, Katowice, 2006. 4. Zwierzchowska A.: Niedobór słuchu a rozwój fizyczny i motoryczny dzieci i młodzieży z aglomeracji śląskiej. Praca doktorska AWF Katowice 2001. 5. Śliwa W, Chlebicka E., Kowal M: Postawa ciała dzieci głuchych w wieku 7-15 lat. W Sport w rehabilitacji niepełnosprawnych. Red.: J. Ślężyński. PSON Kraków 1999. s.151-160. 6. Grabara M.: Dysfunkcje narządu słuchu a asymetrie postawy ciała. Polish Journal of Physioterapy 2006;6(2);121-125. 7. Szczygieł A.: Postawa ciała dzieci i młodzieży niepełnosprawnej w zależności od rodzaju dysfunkcji i stopnia aktywności ruchowej. W Sport w rehabilitacji niepełnosprawnych. Red.: J Ślężyński. PSON Kraków 1999 s. 141-150. 8. Wilińska K. Kasperczyk T.: Czucie równowagi dynamicznej a postawa ciała dzieci i młodzieży z dysfunkcją narządu wzroku i słuchu. W: Postawa ciała jej wady i sposoby korekcji. Red. J. Ślężyński AWF Warszawa 1990. 9. Wilińska K.: Ocena częstości występowania postaw wadliwych oraz wytrzymałość mięśni posturalnych u dzieci i młodzieży z dysfunkcją narządu słuchu wzroku. W Postępowanie korekcyjne i rekreacja ruchowa w rozwoju fizycznym dzieci i młodzieży. red.: T Kasperczyk. Warszawa 1986.
