Relationship of training with abnormal posture and spinal curvature disorders in specialized athletes

doi:10.12307/2025.923

Abstract

Abstract: OBJECTIVE: To evaluate the relationship between abnormal posture, spinal curvature disorders, and training in specialized athletes through a systematic review and meta-analysis, providing scientific evidence for spinal health management in these athletes.
METHODS: A systematic search was conducted in CNKI, VIP, WanFang, CBM, PubMed, Embase, Cochrane Library, and Web of Science databases for Chinese and English literature related to spinal health and sports training in specialized athletes from 2000 to the present. Three independent researchers screened the literature, extracted data, and assessed literature quality based on predefined inclusion and exclusion criteria. Data analysis was performed using Review Manager 5.4 software to evaluate differences in outcomes such as the incidence of scoliosis, thoracic kyphosis angle, and lumbar lordosis angle.
RESULTS: A total of 17 articles covering 18 studies with 48 234 participants were included. Studies have found that the odds ratio for scoliosis incidence in specialized athletes was 3.52 [95% confidence interval (CI): 2.18-5.69]. The average thoracic kyphosis angle in specialized athletes increased by 0.93° (95% CI: 0.23-1.62), while the lumbar lordosis angle decreased by 1.95° (95% CI: -2.71 to -1.18). Additionally, the average trunk tilt angle increased by 1.57° (95% CI: 0.96-2.17), and the trunk inclination deviation distance increased by 10.64 mm (95% CI: 3.21-18.06).
CONCLUSION: Long-term specialized training may pose a higher risk of spinal disorders in athletes. It is crucial to consider the impact of different sports, training methods, and individual differences on spinal health, and to develop targeted prevention and intervention strategies to reduce the incidence of spinal disorders, thereby enhancing athletes' performance and quality of life.

Key words: athletes, specialized training, abnormal posture, spinal curvature disorders, thoracic kyphosis angle, lumbar lordosis angle, spinal morphology, Meta-analysis

CLC Number:

Peng Hao, Jiang Yang, Song Yanping, Yao Na, Shen Zhen, Song Yueyu, Chen Qigang. Relationship of training with abnormal posture and spinal curvature disorders in specialized athletes[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(12): 3127-3133.

Figures/Tables 4

2.2 纳入文献的质量评价采用Combie横断面研究评价标准对17篇纳入文献进行评估，评估结果如图2所示。这些文献在整体质量上表现良好，其中6篇文献达到了A级标准[22，29，31-33，35]，11篇文献达到了B级标准[21，23-28，30，34，36-37]。然而，所有11篇文献在报告样本应答率方面和检验效能方面均未提及或未能提供明确信息。 2.3 纳入研究基本特征见表1。共纳入了17篇文献，共涉及18项研究，涵盖了多种运动类型和广泛的年龄范围，研究对象总计48 234名参与者，其中运动组934名，对照组47 300名。参与者年龄范围为11-23岁，主要集中在青少年阶段。纳入的研究涉及多种运动类型，包括对称性运动(如举重)和非对称性运动(如排球、手球、乒乓球、曲棍球)，以及特殊的身体训练项目，如芭蕾舞。运动组的参与者主要由两类人群构成：一是经过长期系统训练的专业运动者，二是遵循高强度训练计划的个体。而对照组由年龄匹配未曾接受长期或高强度的专业运动训练的非运动者组成。 2.4 专项运动者脊柱侧弯检出率对4项研究进行Meta分析显示[29，32，36-37]，运动组相较于对照组的合并优势比(OR)为3.52(95%CI：2.18-5.69)，这表明运动组的脊柱侧弯风险检出率是对照组的3.52倍。异质性检验结果(Chi2=18.24，df=3，P=0.000 4，I2=84%)揭示了研究间存在高度异质性。总体效应量检验(Z=5.14，P < 0.000 01)表明该效应具有显著统计学差异，见图3。 2.5 专项运动者胸椎后凸角度和腰椎前凸角度对14项研究的合并分析表明[21-28，30，32-35]，运动组的胸椎后凸角度平均增加了0.93°(95%CI：0.23-1.62)。该效应具有显著统计学差异(Z=2.61，P=0.000 9)，但存在高度异质性(Chi2=89.40，df=13，P < 0.000 1，I2=85%)。漏斗图呈现不对称分布，提示可能存在由选择性报告、编辑偏好等因素导致的发表偏倚，见图4A。同时，对12项研究的整合分析发现[21，23-28，30，32-33，35]，运动组的腰椎前凸角度平均减少了1.95°(95%CI：-2.71至-1.18)。该效应具有显著统计学差异(Z=4.96，P < 0.000 01)，但同样存在显著异质性(Chi2=27.88，df=11，P=0.000 3，I2=61%)。值得注意的是，相关漏斗图呈现对称分布，表明无明显发表偏倚，见图4B。 2.6 专项运动者躯干倾角和躯干倾斜偏移距离对5项研究的合并分析表明[24-26，28]，相较于对照组，运动组的躯干倾角平均增加了1.57°(95%CI：0.96-2.17)。该效应具有显著统计学差异(Z=5.06，P < 0.000 01)，且研究间无显著异质性(Chi2=1.14，df=4，P=0.89，I2=0%)，见图5A。同时，对3项研究的整合分析发现[25-26]，运动者的躯干倾斜偏移距离较对照组平均增加了10.64 mm(95%CI：3.21-18.06)。这一差异同样具有显著统计学差异(Z=2.81，P=0.005)，且研究间无显著异质性(Chi2=0.36，df=2，P=0.83，I2=0%)，见图5B。"

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