Origins with Darwin
Our findings support Darwin’s original concept that QOL is often expressed by physical body positions (e.g., spine curvatures) with an overall moderate level of evidence. Further study using rigorous methods could validate this correlation, specifically in children with cancer. Not only should the measures of QOL and posture be explored together in this population, but future studies could examine relevant covariates depicted in Figure 3, such as sex differences, changes over time, disease status, treatment effects, and the relationship of the central venous catheter to QOL. Related to Darwin’s study of biologic evolution, the factors of sex and age differences in the relationship of posture and emotion may also prove to be important clinical assessments by clinicians. Interestingly, in our study of 100 children with cancer, although we did not find a significant difference in posture by sex, we did find that older age was correlated with worse posture (β = 0.41).12