The effect and durability of postural education and corrective games on the alignment of the thoracic and cervical spine and the daily habits in children

This study aims to compare the effects of posture education and corrective games on the alignment of the thoracic and cervical spine, as well as the daily habits in children. This is a three-armed individual-randomized trial design of three groups in blinded evaluators. The statistical population of this study was formed by elementary students with malalignments in the thoracic and cervical spine of Baharestan city (Iran). A total of 60 participants were assigned to this study and using a simple random method with computer-generated random numbers divided into posture education group (PE, n = 20) corrective games group (CG, n = 20) and control group (CON, n = 20) groups. Kyphosis angle, forward head posture and forward shoulder posture measured with a flexible ruler, goniometer, and double square, respectively. Also, daily habits measured with students' daily functional activities questioner. A repeated measures ANOVA analysis of variance (3 × 3, Group×Time) was utilized to analyze data. Significance was set at p ≤ 0.05. Both the PE and CG showed significant improvements in kyphosis (p = 0.01 for PE, p = 0.02 for CG), forward head posture (p = 0.02 for PE, p = 0.04 for CG), forward shoulder posture (p = 0.001 for PE, p = 0.02 for CG), and daily habits (p = 0.02 for PE, p = 0.03 for CG) after an 8-week training intervention compared to the CON group. Also, after the training period, the analysis revealed no statistically significant differences in the dependent variables between the PE group and the CG, with a p-value greater than 0.05. However, after a 3-month detraining period, the changes in both the PE and CG were found to be statistically insignificant (p > 0.05). The interventions effectively enhanced participants' posture and daily activity patterns, with no significant differences between the PE and CG groups. The sustainability of these improvements indicates that participants developed lasting skills and habits that promote spinal health. This study highlights the importance of integrating educational and engaging physical activities into curricula to support children's musculoskeletal well-being.Trial registration: IRCT registration number: IRCT20250316065103N1, Registration date: 2025-03-25 (Retrospectively registered), Trial Id: 82539.