# Exercise as it relates to Disease/Exercise for prevention and treatment of Kyphosis
## Exercise as a Tool for prevention and treatment of Kyphosis
### Background
#### Kyphosis

The spine has a natural curvature and excessive curvature can be detrimental to an individual, excessive curvature can be in the form of scoliosis, lordosis or Kyphosis. Kyphosis is the curvature within the thoracic region. Kyphosis can be split into two sub categories Hyperkyphosis: Excessive anterior-posterior curvature of the thoracic spine ≥40 degrees. Hypokyphosis: Insufficient anterior-posterior curvature of the thoracic spine ≤20 degrees.

#### Predisposition

There are multiple different genetic characteristics, diseases and other conditions that predispose an individual to kyphosis, including:
| Genetics | Diseases | Other Conditions |
| Age | Degenerative disc disease | Vertebrae Fractures |
| Gender | Other Spinal Deformities* | Muscle weakness |
| Body Mass | *Scoliosis | Decreased mobility |
| Height | *Lordosis | Sensory deficits |

#### Physiological Assessment

To assess if an individual has kyphosis, they individual should visit a professional (Physiotherapist).
There is a variety of assessments that can be used to deterime kyphosis and extent of kyphosis, these include:
* Visual Inspection,
* X-Ray,
* Photography,
* Inclinometry,
* Flexicurve
* Passive physiological intervertebral movements,
* Tragus to wall distance,
* Occiput to wall distance,
* Temporomandibular joint to wall distance,
with visual inspection and x-ray being the two most commonly used assessments.

#### Consequences

Kyphosis can have detrimental effects on the body, affecting the musculosketal, neuromuscular and respiratory system and increased mortality. Kyphosis reduces the overall quality of an individual’s life due to the affects it can have on day to day activities including:
* Poor balance,
* Difficultly climbing stairs,
* Difficultly completing house work,
* PAIN.
As the angle of kyphosis increases, the consequences become more prominent, making prevention and treatment of kyphosis a high priority to minimize the extent of effects it has on the body.

### Exercise

Exercise has been proven to help improve and prevent kyphosis, it helps to decrease the kyphosis angle, and improve the consequences caused from kyphosis. An exercise program for kyphosis usually involves:
| Activity | Duration | example of activities |
| Warm Up | 5–10 minutes | walk or slow run |
| Stretching exercises | 20–25 minutes | static stretches of the back and chest (Can be assisted stretches |
| Strengthening exercises | 20–25 minutes | isometric or isotonic exercises of the back muscles |
| Cool down | 5–10 minutes | walk or slow run |
An exercise program is usually done at least 3 times a week over an 8 week to 6 month period to ensure results. Exercises can be done on either land or water, as both land and water strengthening and stretching exercises have a beneficial effect on kyphosis. The theory behind preventing and treating kyphosis by exercising is to stretch and strengthen the muscles along the backside of the spinal column, increase the mobility and stability of the spinal column and muscles and re-educating the postal muscles. Individuals with kyphosis wishing to improve their conditions through exercise should seek professional help to have a exercise plan made specifically for their condition, due to kyphosis having detrimental consequences like increased risk of spinal fractures and increased risk of falls so require a particular exercises to be left out from their exercise routines.

### Other treatments/Preventions

* Medications
* Joint mobilization
* Soft tissue mobilization
* Bracing
* Surgery

### Recommended Readings

* http://www.nlm.nih.gov/medlineplus/ency/article/001240.htm
* http://www.webmd.com/back-pain/guide/types-of-spine-curvature-disorders
* http://www.mayoclinic.org/diseases-conditions/kyphosis/basics/definition/con-20026732
* http://body-disease.com/deformities-of-the-spine-lordosis-kyphosis-and-scoliosis/
* http://www.spine-health.com/conditions/spinal-deformities/scheuermanns-disease-thoracic-and-lumbar-spine

### References

* 1 2 3 4 Seidi, F., Rajabi, R., Ebrahimi, I., Alizadeh, M. and Minoonejad H. (2013). The efficiency of corrective exercise interventions on thoracic hyper-kyphosis angle. Journal of Back and Musculoskeletal Rehabilitation. Vol. 27 (1) pp.7-16
* 1 2 3 4 5 Azizi, A., Mahdavinejad, R., Tizabi, A., Mazreno, A., Nodoushan, E., Behdoust, M. (2012) The effect of 8 weeks specific corrective exercise in water and land on angle of kyphosis and some pulmonary indices in kyphotic boy students. Sport Science. Vol. 5 (2) pp.62-65
* 1 2 3 4 5 6 7 8 Katzman, W., Wanek, L., Shepherd, J., Sellmeyer, D. (2010) Age-Related Hyperkyphosis: Its Causes, Consequences, and Management. Journal of Orthopaedic & Sports Physical Therapy. Vol. 40 (6) pp.352-360
* 1 2 3 4 5 6 7 Perriman, D., Scarvell, J., Hughes, A., Lueck, C., Dear, K., Smith, P. (2012). Thoracic Hyperkyphosis: A Survey of Australian Physiotherapists. Physiotherapy Research International. Vol. 12 (3) pp.167-178
* 1 2 Fon, G., Pitt, M., Thies, A. (1980). Thoracic Kyphosis: Range in Normal Subjects. American Journal of Roentgenology. Vol. 134 (5) pp.979-983
* 1 2 3 4 Clément, J., Geoffray, A., Yagoubi, F., Chau, E., Solla, F., Oborocianu, I., Rampal, V. (2013). Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis. European Spine Journal. Vol. 22 (11) pp.2414-2420
* 1 2 Hershkovich, O., Friedlander, A., Gordon, B., Arzi, H., Derazne, E., Tzur, D., Shamiss, A., Arnon Afek, A. (2014). Association between body mass index, body height, and the prevalence of spinal deformities. The Spine Journal. Vol. 14 (8) pp.1581-1587
* 1 2 Choi, E., Hur, J., Yang, J., Park, D. (2005). The Effect of Thoracic Exercise Program on Thoracic Pain, Kyphosis, and Spinal Mobility. American Academy of Physical Medicine and Rehabilitation. Vol. 86 (9) pp.23
* 1 2 3 4 Paskaleva, R., Ivanova, V. (2013). Effect of isometric training and swimming for a strong muscular corset bulid up in children with spinal deformitis. Activities in Physical Education and Sport. Vol. 3 (2) pp.187-190
--U3083780 (discuss • contribs) 12:36, 30 September 2014 (UTC)