Computational protocol: IMMEDIATE AND FOLLOW-UP EFFECTS OF A POSTURE EDUCATION PROGRAM FOR ELEMENTARY SCHOOL STUDENTS

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[…] In this longitudinal study, the sample was defined by sample calculation, using the software G*Power and assuming moderate effect size (f=0.3), α=0.05, and power of 90%, which resulted in a minimum sample of 25 subjects. Considering the probability of loss in longitudinal studies, the initial sample consisted of 44 schoolchildren aged 8-12 years, mean age of 8.8±1.1 years, 54.5% (n=24) female, who attended the third grade of the elementary school of a state school in the city of Porto Alegre, Rio Grande do Sul. The selection of the school was by convenience and the research period was from April 2015 to November 2015.In order to be included in the sample, students should be at least seven years old and be physically fit for the assessment of ADLs. The exclusion criterion was missing in one of the evaluative meetings in both assessment categories (video and test). All students voluntarily participated in the study, after receiving permission from parents or guardians, by signing the informed consent form. The study is part of a larger project named Posture Education Program for Schoolchildren, which was approved by the Ethics and Research Committee of the Universidade Federal do Rio Grande do Sul (UFRGS) (CAAE: 15356913.2.0000.5347) and seek to implement a PEP for schoolchildren in state schools of the State of Rio Grande do Sul.Subjects were evaluated at three different moments: Before attending the PEP (pretest).After attending the PEP (post-test).Five months after attending the PEP, immediately after completion of four review classes (five months follow-up). Before attending the PEP (pretest).After attending the PEP (post-test).Five months after attending the PEP, immediately after completion of four review classes (five months follow-up).The PEP which the subjects attended, was based on the Back School of the Physical Education Department of UFRGS, and also in the School of Adapted posture proposed by Candotti et al. The PEP is structured in ten meetings, as follows: one for the administration of the pretest, eight for the delivery of theoretical and practical content, and one for the application of the post-test. Each class lasted 90 minutes and took place once a week. The contents delivered in class involved the study of the structures, curvatures, and functions of the spine, and ADLs, such as remaining standing and walking, carrying a backpack, picking up objects from the ground, sitting, chewing, and lying down. Each class had the following dynamics: review of the homework, brief review of the previously delivered content, presentation of new content, practice on the new content, feedback about the class, and explanation of homework.The learning review was conducted three months after the end of the PEP and was structured in four meetings of 90 minutes each, with a 15-day interval. Theoretical and practical contents, which were developed during the PEP, were reviewed during those meetings. The same PEP teaching methodology was maintained for the review classes, except for the last meeting, during which a final review was carried out. In this final review, a brochure that illustrated the story of each class in relation to children’s learning about posture was used as the study material. This brochure was elaborated by the researchers according to topics generated by the students in the previous class (). In the week after the fourth meeting, the students were re-evaluated according to the same post-test procedures, which characterized the five months follow-up. Figure 1: Participants completed two types of examinations: a questionnaire to evaluate the theoretical knowledge of the spine and body posture, and a filmed circuit to evaluate the dynamic posture during ADL. In the pretest, only the assessment of the dynamic posture was performed. In the post-test and five months follow-up, all subjects of the sample completed both the assessments.The questionnaire developed and administered by the researchers addressed questions concerning the structure of the spine and the ways to perform ADLs. It had 12 objective and descriptive questions, with a total score of 12 points, in which higher scores represent higher level of theoretical knowledge. Owing to the different topics included in the questions, they were divided into two sections: “anatomy” and “postural habits,” totaling 5 and 7 points, respectively. The first section included questions in which the participants should name regions of the spine and structures, such as ischium, vertebrae, and intervertebral disc, whereas in the second section, the participants needed to indicate appropriate and inappropriate attitudes represented in figures.To verify the dynamic posture of the students during ADLs, the layout for assessing the dynamic posture - LADy was used. This is an instrument proposed and validated by Noll et al. The LADy enables the assessment of the dynamic body posture in schoolchildren in nine ADLs, by means of filming. In this study, we chose to evaluate only five ADLs: Carrying the schoolbag.Picking up an object on the ground.Carrying the object.Seated on a backless bench.Seated in the chair to write. Carrying the schoolbag.Picking up an object on the ground.Carrying the object.Seated on a backless bench.Seated in the chair to write.The participants were filmed while performing the LADy. The analysis of dynamic posture was performed later through the observation of the films, which was conducted by a single evaluator who was trained in the method. There are different elements which are given a score based on the analyzed posture. Considering the five ADLs evaluated in this study, each child could reach a maximum total score of 27 points (the higher the score achieved, the more adequate was the execution of ADL). The circuit used and the items evaluated in each ADL are shown in . Figure 2: Statistical analysis was performed using the software Statistical Package for Social Sciences (SPSS), version 20.0. Shapiro-Wilk test was applied to verify the normality of the data, in addition to descriptive statistics with mean and standard deviation (SD). The Friedman test (considering α<0.05) was applied to verify the differences between the evaluative moments; and in order to compare the different moments, post hoc Wilcoxon test and Bonferroni correction (α/3, where 3 is the number of comparisons performed - pretest versus post-test, pretest versus follow-up, and post-test versus follow-up) were performed, adopting α<0.017 at the post hoc, according to Field’s suggestion. […]

Pipeline specifications

Software tools G*Power, SPSS
Application Miscellaneous