The Effect of Functional Exercises on Balance With Postural Thoracic Kyphosis
Condition: Postural Kyphosis; Balance
MeSH terms: Kyphosis
Study type: Interventional

Summary: 
      In a normal spine, the sagittal plane has four curvatures that balance each other. The
      cervical and lumbar spine is lordotic, the thoracic spine and sacral region are kyphotic. In
      the sagittal plane, there is an average of 40 kyphosis angles between the T1 vertebrae upper
      end plate and the T12 vertebra lower end plate. Thoracic kyphosis is defined as an increase
      in the normal thoracic curvature (above 40) of the spine. Postural kyphosis usually occurs
      when individuals with weak muscle strength exert excessive external loads on their vertebrae.
      In rapidly growing young people, the abnormal flexion of the spine prevents the development
      of internal organs and excess thoracic kyphosis causes changes in respiratory functions, as
      well as postural disorders negatively affect the standing balance. In addition, the posture
      and appearance of young people with postural kyphosis are affected, which can affect their
      physical and psychological health.The incidence of hyper-kyphosis abnormality was reported to
      be 15.3% in 11 year-old children, 38% in 20 to 50 years old adults and 35% in 20 to 64 years
      old adults. This abnormality is managed by various methods including manual therapy, postural
      retraining, taping, orthoses and corrective exercises.

      When a literature review was conducted, it was observed that no balance evaluation was
      performed in individuals between 18 and 25 years of age who had postural kyphosis. Therefore,
      the aim of this study was to investigate the effect of Schroth-based functional exercise and
      postural exercise on balance, respiratory functions and thoracic angle, who has with postural
      kyphosis and 18-25 years of age.
    

Detailed description: 
      Participants will be randomly allocate 40 participants with kyphosis to two groups; Group I
      (n=20), Group II (n=20). The Group I, will receive postural exercise for 60 min/day 2
      times/week for 8 weeks, while the Group II receive Schroth three-dimensional exercise therapy
      program for 60 min/day 2 times/week for 8 weeks. Assessment procedure will be held at the
      beginning and 9th week of study. All subjects will be assessed by each angle of thoracic
      kyphosis, forward head and forward shoulder angles were measured by using the lateral
      photographic method, trunk flexibility (lateral and hyperextension), balance (BİODEX balance
      system) , respiratory function test (measurement of pulmonary function and respiratory muscle
      strength) , Quality of life SRS-22 and Numeric Rating Scale for pain.
    

Intervention name(s): The Group I Postural Exercise; The Group II Three-dimensional Exercise Therapy Program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Spine anatomy and daily life activities will be informed about proper posture. Strengthening of postural muscles, stretching (Pectoral Region, M. Psoas Major) and breathing exercise will be performed under the supervision of a physiotherapist. The Group I will receive postural exercise for 60 min/day 2 times/week for 8 weeks.; The Group II Schroth method corrects the kyphotic posture, with the help of proprioceptive and exteroceptive stimulation and mirror control in the sagittal plane, using specific corrective breathing patterns. The Schroth method three-dimensional exercise therapy program adapted for the specific posture will be exercised in four specific positions (sitting, supine, standing, prone) under the supervision of a physiotherapist. Exercise include, trunk elongation, symmetrical sagittal straightening, shoulder traction, corrective breathing and muscle activation by increasing tension (isometric tension). The Group II will receive Schroth's three-dimensional exercise therapy program for 60 min/day 2 times/week for 8 weeks.
Other intervention name(s): The Group I Postural Exercise Program; The Group II Schroth Exercise Therapy Program
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized double-blind
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Postural Kyphosis; Exercises; Balance; Respiratory Functions