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Objetivos: El objetivo fue describir el uso y transporte de la mochila de los escolares de Educación Secundaria Obligatoria, así como analizar la asociación entre éste y el dolor de espalda. Método: Utilizando un diseño transversal, se administró una encuesta a 275 adolescentes de 12 a 18 años. Resultados: El 98,91% de los escolares utilizaban mochila, el 65,45% pensaban que su mochila era demasiado pesada, y el 72% del alumnado desconocía cuánto pesaba su mochila con el material escolar dentro. Se determinó asociación significativa entre el dolor de espalda y la sensación de que la mochila sea demasiado pesada, así como entre el dolor de espalda y el desconocer el peso de la mochila. Conclusiones: La mayoría de los adolescentes utilizan mochila y la transportan sobre los dos hombros. Sentir que la mochila pesa demasiado y no conocer su peso han sido factores asociados al dolor de espalda.

El objetivo principal del presente estudio es describir la batería de cuestionarios y pruebas de campo del Programa Stop & Go para la valoración de los principales factores de riesgo de lesión de la extremidad inferior en jóvenes deportistas. Los 4 cuestionarios y 21 pruebas de campo que componen la batería Stop & Go fueron seleccionados de acuerdo a criterios científicos (altas puntuaciones de validez y fiabilidad), pudiendo ser estas agrupadas en tres grandes bloques. El primer bloque incluye procedimientos destinados a la obtención de información relacionada con las características personales o individuales de los deportistas (ej.: composición corporal, etapa madurativa y experiencia deportiva). Por su parte, el segundo bloque contiene una serie de cuestionarios que evalúan constructos psicológicos relacionados con el rendimiento deportivo (ej.: ansiedad, estrés y motivación). Finalmente, el tercer bloque presenta pruebas físicas diseñadas para valorar un elevado número de medidas del rendimiento físico (ej.: altura y longitud de salto, y tiempo en el sprint de 30 m), mecánica de las habilidades motrices fundamentales (ej.: aterrizaje tras acciones de salto y cambio de dirección), capacidad neuromuscular (ej.: rigidez muscular, estabilidad estática y dinámica), disposición sagital del raquis y rango de movimiento articular de la extremidad inferior. Para aquellos escenarios donde existan importantes limitaciones de tiempo y escasez de recursos humanos y materiales, este estudio también presenta una propuesta básica o reducida de la batería Stop & Go compuesta por 6 pruebas de valoración. En particular, esta propuesta básica reúne aquellas pruebas que, a juicio de los autores, podrían ser consideradas como las mínimas necesarias para la identificación de deportistas con una alta probabilidad de sufrir una lesión del tejido blando (músculo, tendón o ligamento) de la extremidad inferior.

La evaluación del cambio de dirección podría contribuir de forma importante tanto a orientar el entrenamiento preventivo como a guiar los procesos de recuperación de las futbolistas. Los objetivos de este estudio fueron describir la mecánica sagital del cambio de dirección (COD) de un grupo de jugadoras de fútbol y comparar la biomecánica sagital del COD, así como el rendimiento de las jugadoras en la prueba en función de su nivel competitivo. Para ello, se analizaron las mecánicas de flexión de rodilla y flexión de tronco de las futbolistas durante el penúltimo (PA) y último apoyo en un COD de 90º. Se realizó un estudio observacional, descriptivo y de corte transversal con 34 jugadoras de entre 16-28 años pertenecientes a dos equipos femeninos de diferente nivel competitivo. Para el análisis de la biomecánica sagital del COD se utilizó el software Kinovea. El tiempo de ejecución fue calculado mediante células fotoeléctricas. Se encontró que la posición media del tronco fue en flexión en el momento del contacto inicial durante el penúltimo apoyo, tanto en el COD hacia la derecha (7,0±4,8º), como en el COD hacia la izquierda (6,1±5,6º). La flexión de rodilla máxima (DER: 94,1±21º; IZQ: 91,5±26,7º) fue considerablemente superior (valores inferiores) a la flexión de rodilla en el contacto inicial (DER: 122,9±21,1º; IZQ: 122,4±24,1º) del último apoyo. Por otro lado, tanto la flexión de tronco inicial como máxima durante el último apoyo, presentaron valores significativamente superiores en el equipo de futbolistas de élite (inicial: 12,1±6,7º vs. 5,2±6,3º; máxima: 13,4±6,8º vs. 7,3±6º). En conclusión, las jugadoras de fútbol mostraron una estrategia de flexión de tronco de bajo riesgo durante el apoyo final, sin embargo, no realizaron una estrategia de deceleración clara y eficiente durante el PA, aunque sí que presentaron una adecuada flexión de rodilla. Las futbolistas de élite realizaron el cambio de dirección más rápido y de forma más segura.

Escasos trabajos han valorado el riesgo de lesión del LCA en fútbol femenino mediante un enfoque multifactorial. El objetivo del presente estudio fue describir los déficits funcionales y las asimetrías manifestadas por jugadoras de fútbol en diferentes pruebas de valoración, con el fin de realizar un análisis integrador del riesgo de lesión desde diferentes perspectivas funcionales y mecánicas. En este estudio de caso participaron 17 jugadoras de fútbol femenino de categoría Primera Autonómica y Preferente Autonómica Femenina española, con rangos de edad de 14 a 23 años. Las pruebas realizadas fueron: OverHead Squat (OHS), Drop Vertical Jump Test (DVJ), Tuck Jump (TJ) y Triple Hop Test (TH). Se halló que todas las jugadoras presentaron mejores resultados para la pierna dominante, mostrando una media mayor de flexión lateral del tronco (TLFA) al aterrizar con la pierna izquierda (8,88±5,15 º) que al aterrizar con la derecha (7,05±5,40 º) en el DVJ unipodal. Además, se encontró que gran parte de las jugadoras (41,20%) presentaron riesgo medio de lesión en el OHS, así como un desplazamiento medio de las rodillas en sentido medial (valgo) en el aterrizaje bipodal del DVJ (-1,88 cm), mientras que la mayoría de ellas (65%) no mostraron asimetrías neuromusculares de miembro inferior. En conclusión, las jugadoras muestran principalmente déficits funcionales en la estabilidad central (CORE) y en la estabilidad de rodilla para resistir y transmitir fuerzas en acciones de alto riesgo para el LCA como los saltos-aterrizajes. Por tanto, estos déficits deberían ser abordados de forma integral con las futbolistas.

En el alto nivel la detección del riesgo de lesión resulta crucial para alcanzar el éxito deportivo. Para ello, los equipos técnicos suelen buscar herramientas sencillas, económicas y que doten de mucha información, tales como los tests funcionales y registros de lesiones. Por lo tanto, los objetivos de este estudio fueron describir tanto las lesiones previas como las compensaciones manifestadas por jugadoras de fútbol en patrones básicos de movimiento, así como analizar la relación entre estas lesiones y los patrones motores fundamentales analizados. En este estudio de cohortes retrospectivo participaron 16 jugadoras de fútbol de segunda división [Edad: 22±4,11 años; práctica federada: 10±4,49 años]. Se evaluaron los patrones motores básicos mediante la Valoración Funcional Básica (VAFB) y se cumplimentó un cuestionario sobre las lesiones de la temporada anterior. Nueve jugadoras (56,25%) sufrieron alguna lesión, de entre las cuales ocho (88,89%) se localizaron en el miembro inferior y la mayoría de lesiones se produjeron por sobreuso, sin contacto (n=7). Los porcentajes medios de compensaciones y asimetrías en la VAFB fueron de 65,79%±11,80 y 15,30%±4,82, respectivamente. Los resultados de la valoración funcional fueron ligeramente mejores para las jugadoras que no sufrieron lesión, aunque las diferencias no fueron significativas [t=-,605; p=,555]. Los resultados de la VAFB podrían ser empleados en el diseño de programas preventivos individualizados en fútbol femenino.

Material docente para el alumnado en el que se muestran las bases del proyecto europeo PINC ( Patios de Recreo Inclusivos), el cual facilitará al alumnado de los grados de Educación y de Ciencias del Deporte las competencias necesarias para favorecer el juego inclusivo en edad escolar.

Material docente sobre los elementos del currículo en Educación Física y su análisis para la realización de programaciones didácticas en primaria y secundaria.

Aborda la definición de currículo y el análisis de sus elementos desde la mirada de la Educación Física.

Este material docente aborda la definición, clasificaciones y características comunes de las discapacidades motrices así como las estrategias para abordar la inclusión en el aula de Educación Física.

Este material docente aborda la definición, clasificaciones y características comunes del autismo, así como las estrategias para abordar la inclusión en el aula de Educación Física.

Aborda la definición de currículo y el análisis de sus elementos desde el prisma de la Educación Física.

Material docente en el que se describe y analiza el currículo de las enseñanzas de régimen especial de Técnico Deportivo y Técnico Deportivo Superior, así como la formación profesional de la familia profesional de las actividades físico-deportivas.

Este material docente aborda la definición, clasificaciones y características comunes de las discapacidades intelectuales, así como las estrategias para abordar la inclusión en el aula de Educación Física.

To explore the incidence, burden, and pattern of injuries in Spanish male youth soccer players during a 9-month competitive season (from September to May-June).Prospective cohort study.314 young (10-19 years) soccer players.Incidence, burden, location, type, severity, mechanism, and circumstance of injuries, as well as potential differences by tactical position, month of the year, age group, and maturity status.A total of 146 time-loss injuries were sustained by 101 different players. This resulted in an overall injury incidence of 3.1 injuries per 1000 h, a training injury incidence of 1.8 injuries per 1000 h, and a match injury incidence of 11.2 injuries per 1000 h. The probability of injury over the season was 34%. Most of the injuries affected the lower extremity and were classified as muscle/tendon injuries, with hamstring muscle injuries representing the most burdensome diagnosis. The incidence of injuries increased with age and maturation, but a heightened risk of overuse injuries during periods around peak height velocity was also identified.These findings suggest a need for implementing specific injury prevention measures. Due to the high burden shown, these measures should mainly focus on reducing the number and severity of hamstring muscle injuries.

This study aimed to explore the inter-session reliability of the measures obtained from 2 trunk extension (Biering-Sorensen and Dynamic Extensor Endurance (DEE) tests) and 3 trunk flexion (Ito, Side Bridge and Bench Trunk Curl-Up (BTC) tests) endurance field-based tests in adolescents by sex and age. A total of 208 (males, n = 100; females, n = 108) adolescents (ranging from 12 to 18 years) performed all the field-based tests on 2 separate testing sessions, 7-days apart. The inter-session reliability scores were explored for the total sample and by sex and age groups through relative reliability (intraclass correlation coefficient (ICC)), inter-session differences (systematic bias) and precision of measurements (i.e. absolute reliability) (standard error of measurement expressed as a percentage of the mean score (CVTE) and minimal detectable change (MDC95)). The sensitivity of each test was also assessed through the smallest worthwhile percentage change (SWC). No relevant sex and age groups differences were found for either test-retest reliability or sensitivity in each test, so the grouped scores were considered as generalizable for this cohort of high school-aged adolescents. Most of the trunk endurance measures demonstrated acceptable relative reliability (ICCs ranged from 0.75 to 0.94). However, significant inter-session differences were identified for measures from the DEE and BTC tests. Likewise, the precision of the measurement of each field-based test was poor (CVTE ranged from 11.3 to 24.4%) with the MDC95 revealing that changes higher than 42% for trunk extension endurance tests and 31.4% for trunk flexion endurance tests after an intervention are required to indicate a significant change above measurement error. All tests were sensitive enough to detect moderate to large changes in trunk muscle endurance. Therefore, the findings from this study indicate that only the BTC test demonstrates acceptable inter-session reliability (ICC > 0.9, CVTE ~ 10%, MDC95 ~ 30%) to monitor the changes in trunk endurance scores that may be expected in adolescents after performing an intervention program. The use of supervised familiarization sessions before performing the tests and strong encouragement to perform a maximal effort in each test may be helpful strategies to improve the reliability scores.

Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women. The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football. A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sportdiscus and the Cochrane Library databases. Twenty-two studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model. The overall incidence of injuries in female football players was 6.1 injuries/1000 h of exposure. Match injury incidence (19.2 injuries/1000 h of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000 h of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000 h of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000 h of exposure) and joint (non-bone) and ligament (1.5 injuries/1000 h of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1–3 days of time loss) were the most common. The incidence rate of injuries during matches in the top five world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000 h of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6–1.7) whereby on average players sustained more than one injury per season. Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. To markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics to make football players more capable of responding to the challenges that they have to deal with during match play. This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152).

Sidestep cuts between 60° and 180° and one-leg landings have been identified as the main mechanisms of ACL injuries in several sports. This study sought to determine intra- and inter-rater reliability of a qualitative tool to assess high-risk movements in a 90° change of direction when the test is applied in a real framework of sport practice. Female footballers from two teams (n = 38) participated in this study and were asked to perform 90° cutting trials to each side, which were simultaneously filmed from a frontal and a sagittal view. A total of 61 cases were selected for 2D qualitative observational analysis by three raters. Poor reliability was found among each pair of raters as well as moderate reliability when the Cutting Movement Assessment Score (CMAS) was given by the same rater at different moments, but with too high a minimum detectable change. On the other hand, raters presented a significant, as well as moderate-to-good intra-rater reliability for most items of the CMAS tool. There was, however, non-significant reliability between observers in rating most check-points of the tool. For these reasons, more objective guidelines and clearer definitions for each criterion within the CMAS, as well as a longer, standardised training period for novel observers, would be highly recommended to improve the reliability of this tool in an applied context with female footballers.

The global evaluation of motion patterns can examine the synchrony of neuromuscular control, range of motion, strength, resistance, balance and coordination needed to complete the movement. Visual assessments are commonly used to detect risk factors. However, it is essential to define standardized field-based tests that can evaluate with accuracy. The aims of the study were to design a protocol to evaluate fundamental motor patterns (FMP), and to analyze the validity and reliability of an instrument created to provide information about the quality of movement in FMP. Five tasks were selected: Overhead Squat (OHS), Hurdle Step (HS), Forward Step Down (FSD), Shoulder Mobility (SM), Active Stretching Leg Raise (ASLR). A list of variables was created for the evaluation of each task. Ten qualified judges assessed the validity of the instrument, while six external observers performed inter-intra reliability. The results show that the instrument is valid according to the experts&rsquo, opinion, however, the reliability shows values below those established. Thus, the instrument was considered unreliable, so it is recommended to repeat the reliability process by performing more training sessions for the external observers. The present study creates the basic functional assessment (BFA), a new protocol which comprises five tasks and an instrument to evaluate FMP.

Con el propósito de abordar las diversas problemáticas que afectan a la postura de los escolares, desde la materia de Educación Física se han implementado numerosas intervenciones de carácter preventivo con niños y adolescentes. Los programas desarrollados no presentan siempre las mismas valoraciones o contenidos tratados. El objetivo del presente estudio fue analizar las características de los programas de ejercicio físico para el cuidado de la espalda aplicados en la etapa escolar. El periodo de búsqueda estuvo comprendido desde el 1980 hasta 2016. Se analizaron tanto los contenidos teórico-prácticos tratados en el programa para el cuidado de la espalda como las pruebas de evaluación de los mismos en un total de 34 intervenciones en el ámbito escolar. Los resultados mostraron que el tipo de valoración más utilizada en los estudios analizados ha sido la medición a través de prueba de conocimientos (62%); resaltar que solo dos de las investigaciones (6%) valoraron el conocimiento sobre fuerza y flexibilidad para la mejora de la postura. La mayoría de las pruebas de conocimientos se centran en la higiene postural y ergonomía en las tareas de la vida diaria (95%). Los contenidos que predominaron en las intervenciones fueron higiene postural y ergonomía en las tareas cotidianas con un 82% de prevalencia, seguido de intervenciones con ejercicio físico con un 35% del total de las intervenciones. La higiene postural es el contenido más frecuente y más ampliamente evaluado, mientras que la fuerza y flexibilidad han sido incluidos escasamente en los programas del cuidado de la espalda analizados en el ámbito escolar.

To explore sagittal spinal alignment and pelvic disposition of schoolchildren in a slump sitting position is needed in order to establish preventive educational postural programs. The purposes of this study were to describe sagittal spinal alignment and pelvic tilt (LSA) in a slump sitting position and to explore the association of sagittal spine and pelvic tilt with back pain (BP) among 8&ndash, 12-year-old children. It was a cross-sectional study. Sagittal spinal curvatures, BP and pelvic tilt were assessed in 582 students from 14 elementary schools. It was found that 53.44% of children had slight thoracic hyperkyphosis and that 48.80% presented moderate lumbar hyperkyphosis and 38.66% presented slight lumbar hyperkyphosis. Those who did not suffer from BP in any part of the back had a higher lumbar kyphosis (24.64 &plusmn, 7.84) or a greater LSA (107.27 &plusmn, 5.38) than children who had some type of BP in the previous year or week (lumbar kyphosis: 23.08 &plusmn, 8.06, LSA: 105.52 &plusmn, 6.00), although with no clinically relevant differences. In fact, neither sufferers nor those who did not have BP presented normal mean values for lumbar kyphosis or LSA according to normality references. This study demonstrates the need to assess sagittal morphotype in childhood since schoolchildren remain incorrectly seated for many hours and it greatly affects their spinal curvatures.

The sagittal spinal morphology presents 4 physiological curvatures that increase endurance to axial compression forces and allow adequate postural balance. These curves must remain within normal ranges to achieve a static and dynamic balance, a correct functioning of the muscles and an adequate distribution of the loads, and thus minimize the injury risk. The purpose of this study was to categorize the sagittal spinal alignment according to the different morphotypes obtained for each curve in standing, slump sitting, and trunk forward bending positions in schoolchildren. It was a cross-sectional study. Sagittal spinal curvatures were assessed in 731 students from 16 elementary schools. In the sagittal standing position assessment, 70.45% and 89.06% of schoolchildren presented a &ldquo, normal&rdquo, morphotype for both dorsal and lumbar curves, respectively. After the application of the &ldquo, Sagittal Integral Morphotype&rdquo, protocol according to the morphotypes obtained in the three positions assessment (standing, slump sitting, and trunk forward bending), it was observed how the frequency of normal morphotypes for the dorsal and lumbar curve decreased considerably (only 32% and 6.6% of children obtained a &ldquo, normal sagittal integral morphotype&rdquo, for the thoracic and lumbar curvatures, respectively). These results show how it is necessary to include the slump sitting and trunk forward bending assessment as part of the protocol to define the &ldquo, integral&rdquo, sagittal alignment of the spine and establish a correct diagnosis. The use of the diagnostic classification presented in this study will allow early detection of misalignment not identified with the assessment of standing position.

Knowledge on back care is important to prevent back problems. The purpose of this study was to a) describe back pain and knowledge on back care related to physical activity in adolescents and b) determine the association between these two factors. This was a cross-sectional study. A total of 276 students (aged from 12 to 17 years old), from three Spanish public secondary schools, had to complete a survey about back pain and another one about their knowledge on back care related to physical activity. The results showed a mean score of 2.54 ± 1.85 (out of 10), and 90.58% of students failed the knowledge test. Those who suffered from back pain in the week before scored higher (2.91 ± 1.66) than non-sufferers (2.42 ± 1.90), with statistically significant differences (Z = −2.109; p = 0.035; r = 0.127), although with no academically relevant differences. Finally, despite the relationship between a higher mean score in the knowledge test and back pain within the previous week, it has been found that there was not a significant association because most of the students got very low scores in the knowledge test. It also shows an important lack of knowledge about physical activity for back care in adolescents.

BackgroundPhysiological sagittal spinal curvatures play an important role in health and performance in sports. For that reason, several scientific studies have assessed spinal morphology in young athletes. However, to our knowledge, no study has assessed the implications of Inline Hockey (IH) practice on sagittal integrative spinal morphotype in adolescent players.ObjectivesThe aims of the present study were to describe habitual sagittal spinal posture in young federated IH players and its relationship with training load and to determine the sagittal integrative spinal morphotype in these players.MethodsAn observational analysis was developed to describe the sagittal spinal morphotype in young federated IH players. A total of 74 IH players from the Technification Plan organized by the Skating Federation of the Valencian Community (aged from 8 to 15 years) participated in the study. Thoracic and lumbar curvatures of the spine were measured in a relaxed standing position (SP), in a slump sitting position (SSP) and in maximum flexion of the trunk (MFT) to determine the “Sagittal Integrative Morphotype” of all players. An unilevel inclinometer was used to quantify the sagittal spinal curvatures. The Hip Joint Angle test was used to quantify the Lumbo-Horizontal angle in flexion (L-H fx) of all participants with a goniometer.ResultsWhen thoracic curvature was analyzed according to normality references, it was found that 64.9% of IH players had thoracic hyperkyphosis in a SSP, while 60.8% and 74.3% of players were classified as normal in a SP and in MFT, respectively. As for the lumbar curve, 89.2% in a SP and 55.4% in MFT were normal, whereas 68.9% of IH players presented lumbar hyperkyphosis in a SSP. Regarding the “Sagittal Integrative Morphotype,” only 17.6% of players were classified as “Normal” in the three measured positions for the thoracic curve, while 37.8% had “Thoracic Hyperkyphosis” and 41.8% presented “Functional Thoracic Hyperkyphosis.” As for the “Sagittal Integrative Lumbar Morphotype,” only 23% of athletes had a normal curve in the three positions, whereas 66.2% presented “Functional Lumbar Hyperkyphosis.” When the L-H fx was evaluated, the results showed that only 16.2% of the athletes were classified as normal.ConclusionsFederative IH practice seems to cause specific adaptations in spinal sagittal morphotype. Taking into account the “Sagittal Integrative Morphotype” only 17.6% IH players presented “Normal Morphotype” with a normal thoracic kyphosis in the three measured positions, while only 23% IH players presented “Normal Morphotype” with a normal lumbar curvature in the three assessed positions. Furthermore, only 16.2% of IH players showed normal pelvic tilt. Exercise programs to prevent or rehabilitate these imbalances in young IH players are needed.

Context:Previous research has analyzed how the sport influences sagittal spinal curvatures in young athletes and has found that spinal curves may be modified as a consequence of repeated movement patterns and postures of each discipline.Objective:To analyze sagittal spinal alignment by equestrian discipline and its relation to training load, and to describe “sagittal integrative morphotype” in young riders.Design:Observational descriptive study.Setting:Training room.Participants:A total of 23 riders (aged 9–17 y)—13 dressage riders (3 males and 10 females) and 10 show jumping riders (5 males and 5 females)—participated voluntarily.Main Outcome Measures:Mann–WhitneyUtest was applied to determine differences between riders’ characteristics (gender, discipline, and training load) and spine variables.Results:According to normality ranges for spinal curves, females showed an increase for lumbar curvature in standing position. It was found that show jumping riders manifested an increment in thoracic and lumbar curves while standing and an increase in the thoracic curvature in slump sitting. Statistically significant differences were found when lumbar curvature, “sit and reach” distance, and lumbo-horizontal angle in flexion were analyzed by gender in “sit and reach” test. No statistical significant differences were found when spinal curves in each position were analyzed depending on the training load. With regard to “sagittal integrative morphotype,” all riders presented a hyperkyphotic dorsal morphotype no matter what their discipline. As for the lumbar curve, dressage and show jumping riders presented a functional hyperkyphotic morphotype.Conclusions:It is important to note that many riders presented a sagittal imbalance for the thoracic and lumbar curves. Therefore, as the sagittal spinal misalignments persist and worsen over time, exercise programs to prevent or rehabilitate these imbalances in young riders will be needed. The “sagittal integrative morphotype” assessment is an essential tool in order to identify the spinal misalignment.