Postural Reeducation to Improve Spinal Posture and Pain in Adolescents Who Use Digital Screens

This study aims to evaluate the effects of a school-based postural reeducation program on spinal posture, functional mobility, and musculoskeletal pain in adolescents enrolled in lower secondary education (middle school level) who frequently use digital devices. Prolonged use of mobile phones, tablets, and other electronic devices is highly prevalent in this population and is associated with inadequate sitting and standing postures, increased thoracic kyphosis, and greater prevalence of neck and back pain. Preventive strategies implemented in school settings may help mitigate these negative musculoskeletal outcomes.

The primary objective of this study is to determine whether a 12-week intervention using a protocol based on strength and mobility exercises, combined with self-postures from the Global Active Stretching method and grounded in the principles of Global Postural Reeducation, integrated into Physical Education (PE) classes, improves spinal alignment and reduces pain perception in adolescents. Secondary objectives include assessing changes in postural habits related to digital device use and spinal mobility.

This study employed a repeated-measures pretest-posttest quasi-experimental controlled design with two groups parallel: an experimental group receiving the intervention and a control group continuing the usual PE warm-up. A total of 187 adolescents participated. During the first week, baseline assessment was performed, including spinal posture evaluation and questionnaire administration. The intervention program was then delivered over 12 consecutive weeks.

The intervention was implemented at the beginning of PE classes and consisted of two 15-minute sessions per week. The sessions included strength and mobility exercises for the spine and shoulder girdle based on the protocol proposed by Feng et al. (2018). In addition, active global stretching postures from the Souchard Active Global Stretching (AGS) method were progressively introduced to improve flexibility and postural control.

Spinal morphology in the sagittal plane was assessed at pretest and posttest using the non-invasive SpinalMouse® device. Postural habits and musculoskeletal pain were assessed using the validated Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA) questionnaire. All measurements were conducted under standardized conditions to ensure internal validity.

Participation involves minimal risk, limited mainly to temporary muscular discomfort during exercise performance. Potential benefits include improved postural awareness, spinal alignment, mobility, and musculoskeletal health.

This study is expected to contribute evidence supporting the feasibility and effectiveness of brief school-based postural reeducation programs as a low-cost preventive strategy to promote spinal health in adolescents.

Inclusion criteria

• Age between 13 and 15 years.
• Students enrolled in lower secondary education.
• Regular participation in Physical Education classes.
• Absence of recent musculoskeletal injuries.
• Absence of medical conditions limiting physical activity.
• Completion of the baseline questionnaire.
• Written informed consent signed by legal guardians.

Exclusion criteria

• Special educational needs preventing participation in the intervention.
• Medical contraindication for participation in Physical Education classes.
• Recent musculoskeletal injury or condition limiting exercise participation.
• Lack of informed consent.
• Failure to complete baseline or post-intervention assessments.