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Children
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Pediatric Postural Health: Orthopedic, Physical Therapy, and Exercise-Based Approaches
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Pediatric Postural Health: Orthopedic, Physical Therapy, and Exercise-Based Approaches

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Orthopedics & Sports Medicine".

Deadline for manuscript submissions: 20 June 2026 | Viewed by 691

Special Issue Editors

Dr. Guido Belli

E-Mail Website
Guest Editor
Department for Theoretical and Applied Science, eCampus University, 22060 Novedrate, Italy
Interests: physical activity for health; core balance training; postural control; physical therapy; sport injuries
Dr. Laura Bragonzoni

E-Mail Website
Guest Editor
Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
Interests: human motion analysis; biomechanics; testing; orthopedic diseases; adapted physical activity

Special Issue Information

Dear Colleagues,

Postural diseases in pediatric age represent a relevant health issue. The altered postural alignment in childhood and adolescence can be considered one of the most important sources of musculoskeletal problems, since it can negatively impact local and global muscular balance, body aesthetics, and self-image perception. Structural and non-structural misalignment affect the morphological profile, induce dysfunctional postures, and lead to bone changes, pain, and long-term complications. The current literature offers several contributions from medical and kinesiological fields to understand the appropriate approach to the prevention and treatment of postural diseases. In particular, advancements in body assessment technology and the application of emerging orthopedic and physiotherapeutic methods are yielding new insights.

This Special Issue aims to present an overview of current scientific knowledge on pediatric postural diseases (scoliosis, hyperkyphosis, spinal deformity, sagittal imbalances, lower body misalignment) from an integrated perspective, including orthopedic, physical therapy, and exercise-based approaches.

Systematic reviews, longitudinal and cross-sectional studies, case reports on human posture evaluation in static and dynamic conditions, orthopedic treatments of spine and lower body misalignment, and physiotherapeutic and kinesiological approaches are encouraged for submission.

Dr. Guido Belli
Dr. Laura Bragonzoni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric postural diseases
  • postural evaluation
  • musculoskeletal disorders
  • exercise treatment
  • physiotherapeutic specific exercise
  • scoliosis
  • hyperkyphosis
  • sagittal imbalances

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Published Papers (2 papers)

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Research

11 pages, 738 KB  
Article
Simultaneous Biarticular Growth Modulation for Ipsilateral Concomitant Valgus Deformities of the Knee and Ankle: Short-Term Results of a Case Series
by Robert Hennings, Thibaut Hiegel, Daniel Gräfe, Christoph-Eckhard Heyde and Eckehard Schumann
Children 2026, 13(5), 675; https://doi.org/10.3390/children13050675 (registering DOI) - 14 May 2026
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Abstract
Background/Objectives: Valgus deformities of the knee and ankle are frequently diagnosed during adolescence. Hemiepiphysiodesis (HED) using the tension-plate technique has become the standard approach for guided growth in both joints. Notably, valgus deformities may simultaneously affect both joints. While substantial data supports monoarticular [...] Read more.
Background/Objectives: Valgus deformities of the knee and ankle are frequently diagnosed during adolescence. Hemiepiphysiodesis (HED) using the tension-plate technique has become the standard approach for guided growth in both joints. Notably, valgus deformities may simultaneously affect both joints. While substantial data supports monoarticular guided growth, evidence for ipsilateral biarticular growth modulation remains limited. The aim of this case series was to evaluate the feasibility, safety and short-term radiographic outcome of simultaneous ipsilateral biarticular HED for concomitant valgus deformities in the knee and ankle (CKAVD). Methods: This retrospective monocentric observational study included 21 legs from 21 consecutive children treated with simultaneous ipsilateral biarticular HED for CKAVD between 2013 and 2022. The initiation and termination of growth modulation were based on clinical (intermalleolar distance, pain in both joints) and radiological parameters. Standing whole-leg coronal plain radiographs were evaluated at the start of modulation and after complete hardware removal, assessing the anatomical femorotibial angle (aFTA), anatomical lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA). Results: The mean age at implantation was 11.5 years (SD 1.08); females (n = 7) were younger than males (n = 14, p < 0.05). The mean duration of growth modulation was 14.3 months (SD 4.3). The intermalleolar distance improved by an average of 10 cm (SD 4.4). The aFTA improved by an average of 6.9 degrees (SD 2.6), the aLDFA by 6.7 degrees (SD 2.7), the MPTA by 7.2 degrees (SD 2.3), and the LDTA by 7.1 degrees (SD 3.0). Two-stage hardware removal was required in 6 legs (29%). In one case, a relapse of knee valgus occurred. Conclusions: Comprehensive evaluation of all major joints seems to be crucial during the diagnostic workup for coronal plane deformities of the lower extremity. For children with ipsilateral symptomatic CKAVD, simultaneous biarticular HED may be considered as a feasible treatment approach, demonstrating promising short-term outcomes and a low observed complication rate. Full article
(This article belongs to the Special Issue Pediatric Postural Health: Orthopedic, Physical Therapy, and Exercise-Based Approaches)
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14 pages, 6963 KB  
Article
Forward Head Angle and Shoulder Angle in Relation to Stabilometry in Children with Pectus Excavatum Included in an Exercise Program
by Marius Zoltan Rezumeș, Liliana Catan, Elena Constanta Amaricai, Ada Maria Codreanu, Andreea Ancuța Vataman and Vlad Laurentiu David
Children 2026, 13(5), 664; https://doi.org/10.3390/children13050664 (registering DOI) - 9 May 2026
Viewed by 212
Abstract
Background: Pectus excavatum (PE) is the most common anterior chest wall deformity in children and adolescents. It may lead to postural adaptations of the trunk and spine and can influence the distribution of the center of gravity. Methods: A total of [...] Read more.
Background: Pectus excavatum (PE) is the most common anterior chest wall deformity in children and adolescents. It may lead to postural adaptations of the trunk and spine and can influence the distribution of the center of gravity. Methods: A total of 35 patients with PE, with a Haller index < 3.25, aged 5–17 years, followed a structured exercise program including postural correction exercises, thoracic mobility exercises, breathing retraining, and trunk extensor strengthening for three months after proper instruction by a specialist. Patients were assessed before and after the intervention. Postural alignment was evaluated laterally (right and left) using the GaitON Posture Analysis System, and static balance was assessed using the PoDATA 2.0 stabilometric platform (Chinesport, Italy), which analyzes plantar pressure distribution and center of pressure (COP) displacement during orthostatic stance. Statistical analysis was performed using paired t-tests and Pearson correlation coefficients. Results: Stabilometric analysis demonstrated a reduction in COP trajectory length, confidence ellipse area, and maximum velocity, indicating improved postural control and reduced sway. Postural analysis revealed statistically significant improvements in head and shoulder girdle alignment. Correlations suggest a potential relationship between segmental alignment and stabilometric parameters and a possible reduction in thoracic hyperkyphosis associated with PE. Conclusions: Postural and stabilometric assessment in PE highlights changes in the analyzed parameters and suggest that a structured exercise program may be associated with improvements in biomechanical function and neuromuscular control. These methods can be integrated into conservative management and therapeutic strategies. Full article
(This article belongs to the Special Issue Pediatric Postural Health: Orthopedic, Physical Therapy, and Exercise-Based Approaches)
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