Analysis of the association between reading and writing postures and comorbidity of myopia and scoliosis in junior middle school students.

Abstract

Objective: Given the emerging co-prevalence of myopia and scoliosis as significant public health challenges among Chinese adolescents, and considering sustained poor reading/writing postures as a potential shared risk factor contributing to onset, progression, and comorbidity, this study aimed to investigate the epidemiological association between myopia and scoliosis, specifically evaluate the synergistic effects of poor reading/writing postures on these conditions, and establish evidence-based strategies for coordinated prevention of comorbid orthopaedic-ophthalmic disorders.

Methods: The study population comprised adolescents aged 11-15 years enrolled in junior middle schools across Shanghai. All participants underwent comprehensive ocular examinations, standardized scoliosis screening, and completed structured questionnaires assessing demographic and behavioral risk factors.

Results: This study included 9,583 middle school students (mean age 12.59 ± 1.17 years). Overall myopia prevalence was 77.6%, while the scoliosis prevalence was 1.7%. Notably, 87.2% of the scoliosis cohort had concurrent myopia, compared to 77.4% in the non-scoliosis group. The dual-disease comorbidity rate was 1.5% (males: 1.0%; females: 2.1%). Multivariable logistic regression analysis revealed that poor reading/writing postures (OR = 1.17, 95% CI: 1.02-1.34) and scoliosis screening positivity (OR = 1.74, 95% CI: 1.09-2.76) were significantly associated with increased myopia risk. Conversely, myopia demonstrated a bidirectional association with elevated scoliosis susceptibility (OR = 1.73, 95% CI: 1.09-2.75). For dual-disease cases, advancing school grade and female sex were positively correlated with comorbidity. Systematic implementation of postural breaks after 30-minute near-work intervals (OR = 0.65, 95% CI: 0.46-0.91) and teacher-mediated posture monitoring (OR = 0.66, 95% CI: 0.45-0.97) significantly reduced comorbidity risks compared to sporadic practice.

Conclusions: A significant bidirectional association exists between adolescent myopia and scoliosis, with non-ergonomic reading/writing postures identified as a shared modifiable risk factor. Education functional departments should implement evidence-based interventions including postural ergonomics education, routine vision and spinal screening programs, and structured postural breaks after near-work intervals to mitigate dual-disease burdens in adolescents.