**1. Introduction**

Statistical data show that about 4% of people in Sarajevo have spinal deformities to some degree [1]. This is due to the so-called incorrect body posture that has not been corrected on time. Functional disturbances, which have been caused by incorrect posture, are first noticed on the spine and later also on the chest, legs, and feet. The spine is the main contributor to the upright posture and carries all of a person's upper body weight. That is why the spine is often exposed to many deformities, which can seize the entire spine or just some parts of it. The spine can be contorted in three different ways [1]. The types of spinal distortion include kyphosis, scoliosis, and lordosis. One of the key persons in the prevention and suppression of these deformities is the physical and health education teacher, who has to work on correcting postural disorders [1]. He has to apply the appropriate exercises in order to prevent the incorrect body posture. The exercises should contribute to strengthening all the major muscle groups, which are important in preserving the upright

posture and preventing worsening of the deformity. Many authors have dealt with the problem of evaluating body posture, as well as spinal deformities and the reliability of these results [2–5]. The analysis of their work included the postural status of the children in the city of Novi Sad. It was a sample of 242 examinees, who were 6 years old. The evaluation of the postural status of the examinees was conducted with the analysis of certain segments of the body based on the method of Napoleon Wolanski [6]. The analysis of the results showed that the boys had good stomach and spine posture, while the posture of other segments was incorrect. The girls had incorrect stomach and spine posture, while the posture of the other segments was good [6]. At the end, the authors concluded that the postural status of the 6-year olds in Novi Sad was disconcerting, and, in the future, it would require taking appropriate measures in order to prevent and realign those postures to their original state [6]. Using the method of Napoleon Wolanski, an evaluation of the body posture of students in the fifth and seventh grade of an elementary school in Sarajevo was conducted. The results have shown that the students in the seventh grade have significantly worse body posture than the students in the fifth grade. It was concluded that the students in the seventh grade had more poor body posture more often located in the areas of the shoulders and neck [7]. This states that 53% of the examinees have incorrect body posture. In conjugation with this statistic, some authors point out that even more than 70% of the school children have some sort of body disorders and certain difficulties that are a consequence of a lack of body movement [8, 9]. The percentages of the presence of postural disorders in young people substantially vary with different authors, and it depends on the specificity of the sample, age, life area, and the applied methodology in detecting the disorders, etc. Winged blades and concave feet are significantly more present in both the boys and the girls from rural areas than those in urban settings. On the other hand, there is a greater presence of a flat foot deformity in both genders from urban areas. Also, we have noticed that the greatest number of disorders refer to the functional shape, which is at the same time the mildest. It is obvious that the presence of incompletely fixated and structural disorders is significantly smaller. It must be noted, however, that it is a significant percentage in the frequency of the more severe forms of body deviations. It is known that children from rural areas are thinner than the city children for several reasons. Not only are they more physically active, but also they are healthier and receive better nutrition. Considering the fact that the winged blades are a lot easily recognized in thinner examinees than those who have larger amounts of subcutaneous fat, this result is not a surprise. As for the status of the foot arch, the obtained results are only a confirmation that the children from urban areas are less mobile and are not prone to be a part of physical activities, especially those forms that are intended to strengthen the foot and lower leg muscles. The fact is that the greatest percentages of the postural disorders refer to the functional form. However, with an adequate program of corrective physical therapy, we can stop the further progression of the physical deviation into a worse stage and largely correct the postural disorder(s) and align the body to its normal position. Obviously, there is a significantly smaller presence of incompletely fixated and structural deformities [10]. A lot of research has been done on proper body posture [6, 8, 11– 13]. In comparison to the urban children, the everyday lifestyle of the children in rural schools requires more physical activity outside during the day and includes a healthier diet. In contrast, the urban children often eat unhealthy food from the school kitchen, such as pizza, croissants, pies, various pastries, etc. The students are still not aware enough to choose vegetables and eat less sweet. Foods with artificial flavors are easily within reach, and, once they taste it, everything else tastes bad. Fast food is a modern convenience and can lead to obesity. This has contributed to improper body posture and deformities in an increasing number of children. It can

also produce a series of other health difficulties later on in life. Another reason for these disorders is that urban children have difficulties making new friends. They do not go outside but increasingly use the computer and socialize on Facebook. The research conducted, which compared the problems in children from urban and rural areas, has definitely confirmed that the rural children have less postural disorders of any kind [12]. Today, a variety of programs for physical activity are more available to the school children, which can enhance their quality of life. There are many sports clubs, such as collective and individual sports. While urban areas also have natural resources and water sports as well as extreme sports, the research in this area points to the fact that "a great percentage of elementary school children are not included in sports activities, and that is the reason for a greater presence of

*Spinal Deformities with Students in Classroom Teaching in Urban and Rural Areas*

This research includes N = 1105 school age children, of which 528 students were from urban areas (261 girl and 267 boys) and 577 students from rural areas (281 girl and 296 boys). They attended 11 elementary schools in the Sarajevo Canton and the surrounding area, and their average age was M = 82.864. Students who were from first to fifth grade were tested in every school. The breakdown of students included:

In order to determine the spinal status, the following variable was used: the method of measuring the curvature of the spine based on Napoleon Wolanski's criteria from 1975, *D-5 spine posture (ESP)—Evaluation of spine posture*. To determine the spinal status, it was necessary for the examinee to turn his back to the examiner with slightly separated but parallel feet in his normal posture. All of the examinees were in their underwear in rooms where the temperature was from 20 to 23°C. The description of the measuring instrument—evaluation of spinal posture: 0—Physiological curve: normal and within the sagittal and frontal plane.

2—Deviation of some kind: a specific deformity or combination of deformities

The analysis of spinal deformities of students in school was done by using the descriptive chi-square statistics. Applying the descriptive statistics, the researchers could determine the numerical and percentage frequency of the spinal deformity.

1—First-degree deviation: kyphosis, scoliosis, and lordosis.

incorrect body posture."

*DOI: http://dx.doi.org/10.5772/intechopen.87977*

**2. Working method**

**2.1 Examinee sample**

**2.2 Variable sample**

but on a second-degree level

These are displayed in tables and graphs.

**2.3 Data-processing methods**

**25**

• First grade: 221 students (113 boys, 108 girls)

• Third grade: 218 students (107 boys, 111 girl)

• Fourth grade: 237 students (121 boys, 116 girls)

• Fifth grade: 215 students (113 boys, 102 girls)

• Second grade: 214 students (109 boys, 105 girls)

*Spinal Deformities with Students in Classroom Teaching in Urban and Rural Areas DOI: http://dx.doi.org/10.5772/intechopen.87977*

also produce a series of other health difficulties later on in life. Another reason for these disorders is that urban children have difficulties making new friends. They do not go outside but increasingly use the computer and socialize on Facebook. The research conducted, which compared the problems in children from urban and rural areas, has definitely confirmed that the rural children have less postural disorders of any kind [12]. Today, a variety of programs for physical activity are more available to the school children, which can enhance their quality of life. There are many sports clubs, such as collective and individual sports. While urban areas also have natural resources and water sports as well as extreme sports, the research in this area points to the fact that "a great percentage of elementary school children are not included in sports activities, and that is the reason for a greater presence of incorrect body posture."
