Postural Reeducation to Improve Spinal Posture and Pain in Adolescents Who Use Digital Screens (POSTURE-SCREEN)

February 10, 2026 updated by: Ercília Patricia Oliveira Costa, University of Vigo

Postural Reeducation: Effects On Spinal Posture And Pain In Adolescents Using Digital Screens

This study evaluated whether a postural reeducation program could improve spinal posture and reduce musculoskeletal pain in adolescents who frequently use digital devices. Prolonged screen use is common among students and is often associated with inadequate sitting or standing postures, which may increase back and neck pain.

A total of 187 adolescents participated in the study. Students were assigned to an experimental group or a control group. The experimental group received a 12-week intervention integrated into the warm-up phase of Physical Education classes, while the control group continued with the usual warm-up used in these classes. The experimental group performed two sessions per week, each lasting 15 minutes, at the beginning of the class. Initially, students completed strength and mobility exercises for the spine and shoulder girdle. From the third week onward, active global stretching postures were added to improve flexibility and postural control.

Spinal posture was assessed at baseline and after the intervention using a noninvasive device (SpinalMouse®). Pain and postural habits were evaluated using a validated questionnaire. Adolescents who participated in the postural reeducation program showed improvements in postural alignment and functional mobility, as well as reductions in back and neck pain, compared with the control group.

This study suggests that a brief school-based postural reeducation program may be an effective preventive strategy to promote spinal health and reduce musculoskeletal pain in adolescents.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Actual)

187

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Portugal
      • Vila Nova de Famalicão, Portugal, 4760
        • Agrupamento de Escolas D. Maria II

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

Yes

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm 1 - Experimental
Participants assigned to the experimental group will receive a 12-week postural reeducation program integrated into Physical Education classes. The program includes strength and mobility exercises for the spine and shoulder girdle and active global stretching postures designed to improve flexibility and postural control. Sessions are delivered twice per week for 15 minutes at the beginning of the class.
Behavioral: Postural Reeducation Program
Behavioral: Postural Reeducation program The intervention consists of a 12-week school-based program integrated into Physical Education classes. Students perform two 15-minute sessions per week including strengthening and mobility exercises for the spine and shoulder girdle, followed by active global stretching postures aimed at improving flexibility and postural control.
Other Names:
  • Active Global Stretching
  • School physical education postural program
No Intervention: Arm 2 - Control
Participants assigned to the control group will follow their usual Physical Education classes and standard warm-up routines. They will not receive any specific postural reeducation program or additional structured exercises beyond the regular school curriculum.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in sagittal spinal curvature (thoracic kyphosis and lumbar lordosis)
Time Frame: Baseline and 14 weeks (post-intervention)
Sagittal spinal posture will be assessed using the Spinal Mouse® device at baseline (pre-intervention) and after 14 weeks (post-intervention). Thoracic kyphosis and lumbar lordosis angles will be recorded in degrees (°). The outcome will be expressed as the difference in angular values between baseline and post-intervention and compared between the intervention and control groups.
Baseline and 14 weeks (post-intervention)
Change in thoracic and lumbar range of motion
Time Frame: Baseline and 14 weeks (post-intervention)
Thoracic and lumbar range of motion (ROM) will be assessed using the Spinal Mouse® device at baseline (pre-intervention) and after 14 weeks (post-intervention), during maximum trunk flexion. ROM will be recorded as a global angular value in degrees (°). The outcome will be expressed as the difference in angular values between baseline and post-intervention and compared between the intervention and control groups.
Baseline and 14 weeks (post-intervention)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in low back pain intensity (BackPEI-CA)
Time Frame: Baseline and 14 weeks (post-intervention)
Low back pain intensity will be assessed using the Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA) at baseline (pre-intervention) and after 14 weeks (post-intervention). Pain intensity will be reported as a questionnaire score. The outcome will be expressed as the change in score between baseline and post-intervention and compared between the intervention and control groups.
Baseline and 14 weeks (post-intervention)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Vigo

Investigators

  • Study Director: Águeda Gutiérrez-Sánchez, PhD, University of Vigo - Faculty of Education and Sport Sciences
  • Principal Investigator: Ercília Oliveira-Costa, PhD Student, University of Vigo - Faculty of Education and Sport Sciences

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 22, 2024

Primary Completion (Actual)

May 10, 2024

Study Completion (Actual)

May 10, 2024

Study Registration Dates

First Submitted

December 27, 2025

First Submitted That Met QC Criteria

January 23, 2026

First Posted (Actual)

February 2, 2026

Study Record Updates

Last Update Posted (Actual)

February 13, 2026

Last Update Submitted That Met QC Criteria

February 10, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 04-181233

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the study involves minors and contains sensitive health-related information. Data will be used exclusively for research purposes within the project team, in accordance with institutional and ethical approvals.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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