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ORIGINAL ARTICLE |
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Year : 2020 | Volume
: 5
| Issue : 2 | Page : 154-159 |
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Truncal growth pattern of Yogasana-practising children and adolescents
Debjani Mandal1, Uday Sankar Ray2, Pratiti Ghosh1
1 Department of Physiology, West Bengal State University, Kolkata, West Bengal, India 2 Department of Physiology, West Bengal State University, Kolkata; Department of Sports Science and Yoga, Ramakrishna Mission Vivekananda Educational and Research Institute, Howrah, West Bengal, India
Date of Submission | 25-Feb-2020 |
Date of Decision | 17-Apr-2020 |
Date of Acceptance | 24-Apr-2020 |
Date of Web Publication | 18-Dec-2020 |
Correspondence Address: Prof. Pratiti Ghosh Department of Physiology, West Bengal State University, Berunanpukuria, Barasat, Kolkata - 700 126, West Bengal India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/bjhs.bjhs_13_20
BACKGROUND: Truncal growth forms a robust skeletal frame which determines athletic execution. At present, yogasana practice is in high demand. AIM: Thus, the evaluation of effect of yogasana on growth pattern during childhood and adolescence (aged 4–15 years) is required. MATERIALS AND METHODS: A cross-sectional study was conducted on Bengalee children of similar socioeconomic status. Anthropometric measurements, namely height (stature), biacromial breadth, and bicristal breadth were analyzed from 864 yogasana-practitioners (YPs) and 738 untrained control participants (CPs), subgrouped into yogasana-practising boys (YBs), yogasana-practising girls (YGs), control boys (CBs), and control girls (CGs). Unpaired t-test was performed to assess the level of significance between the anthropometric parameters of different groups. Correlation of breadth ratio and stature with biacromial and bicristal breadth was determined by Pearson's correlation coefficient. RESULTS: YP had significantly greater biacromial breadth (P < 0.05) and bicristal breadth (P < 0.05) than CP. The mean biacromial breadth decreased, especially in YG. The shoulder and pelvis size were significantly different between YB and CB but not so among females. Growth in breadth ratio was also strongly correlated with bicristal breadth growth. CONCLUSION: Medium-sized shoulder and pelvis in YB and medium-sized shoulder relative to narrow-sized pelvis in YG nullifies the effect of yogasana training on specific bodily growth of YP. Hence, in contrast with high-demand sports, yogasana practice is not reflected on truncal growth.
Keywords: Adolescence, biacromial, bicristal breadth, truncal growth, yogasana
How to cite this article: Mandal D, Ray US, Ghosh P. Truncal growth pattern of Yogasana-practising children and adolescents. BLDE Univ J Health Sci 2020;5:154-9 |
Physical growth is a dynamic statement of general health of children and adolescents, relating to changes in overall stature and proportional relationship of body parts specifically, of different sets of bones, namely the shoulders, hips, wrists, and elbows,[1] constituting a robust skeletal frame. During adolescence, the transitional phase is associated with pubertal growth and maturation, affecting the physiological system, which can be evaluated by physical anthropometry. Individual variation is observed in timing and tempo of growth spurt during adolescence,[2] starting at 10 years for girls and 12 years for boys.[3] Although genetic factors predominantly determine human growth potentiality,[4] nutrition, socioeconomic condition,[5] and ecological, geographical, and racial factors are also vital.[6],[7] Physical exercise or active sports of moderate intensity also positively modulate adolescent growth.[8] Thus, truncal growth pattern helps to identify the variation in sports-specific growth in young athletes, namely handball players,[9] footballers,[10] wrestlers,[11] and gymnasts.[12] These changes in truncal skeletal growth are reflected in the truncal skeletal breadth measurements.[13] Wide shoulders and narrow hips featuring handball players and gymnasts indicate differential truncal growth pattern during adolescence.[9],[14],[15] Change in truncal growth pattern favors the performance of young athletes in sports but also increases risk of injuries.[12] Yogasana is now popular among children from an early age, but scientific studies on the truncal growth pattern of yogasana-practising children and adolescents are yet to be assessed. Hence, the present study intends to measure their different body segments and evaluate their truncal growth pattern. This study also aims to identify the association between truncal breadth dimensions, namely biacromial and bicristal breadth with stature and breadth ratio.
Materials and Methods | |  |
Two thousand school-going boys and girls of 4–15 years were selected on the basis of their physical activities. The participants who suffered from chronic diseases, inborn physical deformities, any infectious diseases, or injury were not included in the study. Of them, 255 who were trained in various other sports or dancing regime were excluded from the study. Of the remaining 1745 boys and girls, 915 were involved in only yogasana practice for at least 6 months and 830 in untrained casual physical activities and thus segregated as yogasana practitioners (YPs) and control participants (CPs), respectively. Anthropometric and sociodemographic data could be analyzed from 864 YPs and 738 CPs who were available throughout the study period. The YPs were again grouped into yogasana-practising boys (YBs: n = 484), yogasana-practising girls (YGs: n = 380). Of the rest 738 age and sex matched CPs, 361 were control boys (CBs) and 377 were control girls (CGs) involved in different light untrained physical activities.
A cross-sectional study was conducted without any bias for 3 years (2016–2019), on the truncal growth pattern of 1602 Bengalee preadolescent (4–8 years) and adolescent boys and girls (9–15 years), free from any type of physical and mental disorders. They belonged to a lower middle-income group (LMIG) of South Bengal, according to the modified Kuppuswamy's socioeconomic scale.[16] The study was approved by the Institutional Ethics Committee of West Bengal State University (Reg. No.WBSU/IEC/10/03, dated June 6, 2016) and written consent was preobtained from the guardians.
The YPs were instructed by two qualified yoga trainers for three alternate days per week for an hour each, at the yogasana training centers according to a training schedule [Table 1]. It started with 5-min prayer, 20–30-min warming up with freehand exercises, and 10-min Shavasana, followed by core training (designed according to age groups) and finally cooling down. The younger YPs aged 4–6 years initially practised some easy postures. Each yogic posture was held for 15–30 s. Progressive load was introduced according to their age group and proficiency level. Yogasanas were followed by yogic breathing maneuvers for 20 min. | Table 1: Yogasanas and yogic breathing maneuvers* practised by the Yogasana Practitioners
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Age- and sex-specific anthropometric measurements were performed during resting position, as recommended by the International Society for the Advancement of Kinanthropometry on YPs and CPs.[17] All participants completed a pretested questionnaire on age, ethnicity, dietary pattern, and sociodemographic profile before being subjected to anthropometric measurements, namely standing height (stature) (portable standardized anthropometer; Span Surgical Co., Coimbatore, India) and biacromial and bicristal breadths (Rod Compass; Span Surgical Co., Coimbatore, India). All the measurements of CPs were taken in the schools after official hours and of YPs in their yoga training centers. In addition to these, the ratio of bicristal-to-biacromial breadth, relative biacromial breadth index, and relative bicristal breadth index were also derived.
The breadth ratio (bicristal/biacromial) was derived to identify changes in relationship between the shoulder and hip breadth between YPs and CPs.
The changes in shoulder size were expressed as Relative Biacromial Breadth Index (biacromial breadth (cm)/stature (cm) ×100). Similarly, the pelvis size across the iliac crest of the YPs and CPs was expressed as Relative Bicristal Breadth Index (bicristal breadth (cm)/stature (cm) ×100). Both the sizes were segregated into three categories – narrow-, medium-, and broad-sized shoulder and pelvis (Brugsch's descriptions).[18]
The data were statistically analyzed using mean, standard deviation and standard error of mean. Unpaired t-test (two tailed) was performed to test the level of significance between the anthropometric parameters of different age groups and Pearson's correlation (r) test to identify the relation of truncal breadth dimensions (biacromial and bicristal breadths) with stature and breadth ratio of YPs and CPs during the onset of adolescent spurt. All the data were analyzed using Microsoft Office Excel 2007 (Microsoft, Redmond, Washington, USA) and GraphPad QuickCalcs Software (GraphPad Software, San Diego, California, USA).[19]
Results | |  |
The anthropometric data were analyzed from 484 YBs, 380 YGs, 361 CBs and 377 CGs who were available for assessment during the study period. The biacromial breadth, bicristal breadth, breadth ratio, relative biacromial breadth index, and relative bicristal breadth index were analyzed and compared between YPs and CPs. Each age group was considered in integral number of years till 11 months. The upper boundary of the same group was similarly extended till 11 months 4 years and 0–11 months may be considered as the lower boundary, whereas 5 years and 0–11 months may be considered as the upper boundary of 4–5 years age group.
Biacromial breadth
A significant (P < 0.05) change in biacromial breadth growth was observed in YP compared to CP, except at 10 and 15 years in YG and 10 and 13 years in YB. The differences in biacromial breadth between YG and CG were greater in YG at preadolescence phase (4–8 years). Although breadth retardation was observed at the onset of adolescence in YG at 9 years (0.27 cm or 0.94%) and 10 years (–0.30 cm or lowered by 1.00%), it increased till 14 years of age. On the other hand, the mean biacromial breadth of YB was significantly (P < 0.05) higher till 12 years. At the initial stage of adolescent spurt (13 years) in YB, this breadth decreased (0.50 cm or 1.48%) but was not retarded as in YG [Figure 1]. | Figure 1: The increase in mean biacromial breadth for age of YB (+) and YG (*) was significantly greater than CB and CG except during the onset of adolescence (9–10 years) while the distance curve of YG decreased compared to CG. (P <0.05 [*/+], <0.01 [**/++], <0.001 [***/+++])
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Besides, in CP, a significant increment (P < 0.05) in this breadth was observed from 7 to 15 years for CG and 7–13 years for CB (except during 10–11 years in CG and 10–12 years in CB), which was also higher than YP in those age groups.
Bicristal breadth
Comparison of the mean growth of bicristal (hip) breadth between YP and CP showed [Figure 2] similar changes in growth pattern as biacromial breadth [Figure 1]. Bicristal breadth was significantly (P < 0.05) greater in YG than CG in all age groups (except 10 and 12 years). The mean breadth of girls was almost the same at 12 years, but marginal retardation (–0.16 cm or lowered by 0.67%) was observed in YG at 10 years. Hence, on approaching adolescence, this growth rate decreased (except in 11 years) in YG and further increased steadily from 13 years as compared to CG. In boys, bicristal breadth of YB was significantly higher (P < 0.05) than CB of 6–11 years of age though the difference (1.01 cm or 4.05%) was lowest at 13 years of age [Figure 2]. | Figure 2: Broadening of bicristal breadth was significantly observed in YB (+) and YG (*) except at the onset of adolescent growth spurt. (P <0.05 [*/+], <0.01 [**/++], <0.001 [***/+++])
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Besides, the increment in intragroup bicristal breadth increased significantly (P < 0.05) among YP at preadolescence. During adolescence, at 11–12 years, the significant increase in the mean bicristal breadth increment rate was observed in both CB (P = 0.0269) and CG (P = 0.0001), and it was also higher than their corresponding YB (P = 0.2417) and YG (P = 0.4659) groups.
Breadth ratio (bicristal/biacromial)
The distance curves indicate the broadening of the hip in girls and widening of the shoulder in boys during adolescence [Figure 3]. This breadth ratio of YP increased with age and also was higher than CP (except at 12 years due to decreased growth rate in bicristal breadth increment) [Figure 3]. During adolescence (10 years), this ratio in YG and CG remained unaltered (0.78 ± 0.01). From 13 years of age, this ratio was significantly (P < 0.01) greater in YG than CG. Thus, the growth pattern reflected in bicristal to biacromial breadth ratio was similar to that of the mean bicristal breadth [Figure 2]. | Figure 3: Increase in mean (±SEM) breadth ratio of YB (+) and YG (*) was significantly greater than CB and CG respectively except at 12 years. (P <0.05 [*/+], <0.01 [**/++])
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Relative biacromial breadth index
YB had significantly broader shoulder at preadolescence (P < 0.01) and medium-sized shoulder from 8 to 15 years of age (P < 0.05), whereas in CB medium and narrow sized shoulder was observed during preadolescence and adolescence, respectively (except during 10 years as CB possessed medium-sized shoulder). In girls, YP possessed significantly (P < 0.05) broad-sized shoulder at preadolescence (P < 0.05) and adolescence (P < 0.05) except during adolescent growth spurt (9–10 years), whereas CP possessed medium-sized and narrow shoulder in those age groups.
At the onset of adolescent spurt, significant (P < 0.01) change in shoulder size has been found between YB (medium-sized shoulder) and CB (narrow shoulder), but a similar change was not observed in girls, as both possessed medium-sized shoulder.
Relative bicristal breadth index
The study revealed that YB possessed significantly broad- and medium-sized pelvis during preadolescence (P < 0.05) and adolescence (P < 0.05) period, respectively (except 15 years) when compared to CB with narrow-sized pelvis. The pelvis size of girls was significantly different in preadolescence (P < 0.01) and adolescence (P < 0.05). No significant change in pelvis size was observed at the onset of adolescence, as both YG and CG possessed narrow-sized pelvis.
Relation between relative biacromial breadth index (shoulder size) and relative bicristal breadth index (pelvis size)
Comparative analysis of shoulder size relative to pelvis size indicated that YB possessed broad-sized shoulder and pelvis at preadolescence and YG possessed broader shoulder relative to medium-sized pelvis in preadolescence and after adolescent growth spurt. On the contrary, CP had significantly medium-sized shoulder (P < 0.05) relative to narrow-sized pelvis (P < 0.01) at preadolescence.
During adolescence, medium-sized shoulder and pelvis features were found in YB, whereas in CB, narrowing of the shoulder and pelvis was observed. Medium-sized shoulder relative to narrow-sized pelvis was observed in all girls when adolescent growth spurt occurred.
Relation between biacromial and bicristal breadth with stature and breadth ratio
As growth of the truncal breadth dimensions is related to overall stature changes, the relation among them was assessed. During the growth spurt, the biacromial breadth decreased in YP [Figure 1] and intragroup biacromial breadth increment of YP was also lower than CP. Although bicristal breadth of YG and CG remained unaltered, the rate of increase was lower in YG during adolescence.
On analysis through Pearson's product moment (r), strong positive correlation was observed between biacromial breadth and stature at the onset of adolescent spurt (at 13 years: YB (r) =0.80, P = 0.00001; CB (r) =0.73, P = 0.00001 and at 10 years: YG (r) =0.61, P = 0.00019; CG (r) =0.41, P = 0.0219). Besides, the breadth ratio of YG was also highly correlated with bicristal breadth of YG, whereas CG showed weak positive correlation between these two variables during adolescence (at 10 years: YG (r) =0.86, P = 0.00001 and CG (r) =0.50, P = 0.0041). No correlation was observed between the increased breadth ratio and biacromial breadth during adolescence in YP and CP (except at 10 years in YG (r) =0.41, P = 0.0197).
This indicates that the biacromial breadth growth was related to growth in stature and the increase in bicristal to biacromial breadth ratio was at par with the increment in bicristal breadth of YG.
Discussion | |  |
Success in sports depends on the growth pattern of body segments of young athletes. Variation in truncal growth pattern also helps in deducing the sports-specific growth pattern of young athletes. This change in truncal skeletal growth is reflected through biacromial breadth, bicristal breadth, breadth ratio, and relative biacromial and bicristal breadth index. Truncal growth pattern during adolescence was thus assessed where all the study partcipants were selected without any bias. Although at the onset of adolescent growth spurt, biacromial breadth of YP decreased [Figure 1], the percent change of breadth in YB was not as retarded as in YG, implying that the growth in mean biacromial breadth strongly correlated with stature. Hence, yogasana practice may affect the biacromial breadth growth, which is related to the growth of stature of the present study participants.
Musculoskeletal growth is influenced by physical training.[8] Gymnasts,[14] handball players, and wrestlers have broad shoulder relative to narrow hip as compared to nonathletes.[9],[11] This truncal growth pattern helps them to execute their athletic skill, especially, postural control. Although their competency level is improved, the risk of overuse injury exists.[20] Shoulder dominant gymnasts are more prone to the whole body general stability risk whereas pelvis dominant gymnasts are more susceptible to lumbo pelvic stability risk or lumbar lordosis due to increased biomechanical stress on their immature bones.[12] Nonsignificant biacromial breadth growth retardation in YG in adolescent growth spurt may be akin to such conditions, as the slow and steady flow of movement into subsequent yogasana postures is usually difficult to maintain in young frolic age. Hence, chances of overuse injury may exist. During adolescent growth spurt, no significant change was observed in the size of the shoulder and pelvis of girls, as they possessed medium-sized shoulder relative to narrow pelvis. Although YB showed significant changes in their shoulder and pelvis size, compared to CB with narrow-sized shoulder and pelvis, the former had medium-sized shoulder along with medium-sized pelvis. Hence, yogasana practice does not much modulate adolescent's truncal growth pattern unlike other sports.
Musculoskeletal growth is partly influenced by the growth of bicristal-to-biacromial breadth ratio.[12] This ratio is characterized by sexual dimorphism in biacromial and bicristal breadth growth, which conforms with the study of Malina et al.[21] During adolescence, bicristal-to-biacromial breadth ratio increased in girls and decreased in boys, which is strongly correlated only with bicristal breadth growth (our unpublished data). Bicristal breadth comprises a greater percentage of biacromial breadth in girls than in boys. Thus, YG and CG both have broader hip relative to shoulder, whereas YB and CB have more broadening of the shoulder than the hip during adolescence.
Thus, YP had greater truncal breadth dimensions than CP except at the onset of adolescent growth spurt in YG, which indicates the effect of yogasana practice on biacromial and bicristal breadth growth during the adolescent growth spurt. Shoulder and pelvis sizes of YB were significantly different from CB during adolescence, yet YB possessed medium-sized shoulder and pelvis, whereas the size of shoulder and pelvis remained the same among YG and CG when growth spurt occurs in girls. Hence, yogasana training does not affect the truncal skeletal growth (biacromial and bicristal breadth) pattern, unlike other physical training. These results may be extended to yoga practising adolescents globally, as Bengalees are known to be cosmopolitan group. The limitation of this study was restricted population size and ethnicity.
Conclusion | |  |
In the present study, YP and CP both belonged to the same ethnic group and socioeconomic condition and have followed similar dietary pattern, so physical training, namely yogasana practice, may be emphasized as a strong determinant of truncal growth. Yogasana training provides sufficient stimuli to improve the physical fitness of children and adolescents but does not significantly change the size of shoulder and pelvis, rather the truncal skeletal growth pattern, unlike other sports, thus obliterating risk of injury. Thus, variations in physical activity differentially affect the growth pattern in adolescents. Further studies on radiographic assessment of the growing bones may be undertaken on a larger scale with multiethnic subjects to confirm the generalization of the study.
Acknowledgment
The authors hereby acknowledge the school authorities and yogasana training centers, participants, and their guardians for their ardent cooperation in completion of this study.
Financial support and sponsorship
This is a self-funded research with equipments from West Bengal State University.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]
[Table 1]
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