Clinical trial NCT06907914: Schroth and Scapular Muscle Activation in Hyperkyphosis
Official title: The Effect of Schroth Exercises on Scapular Muscle Activation in Children With Thoracic Hyperkyphosis
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Hyperkyphosis, Adolescent
Muscle Activation
Scapula; Deformity, Acquired
Exercise Therapy
Keywords: Spine
Schroth
sEMG
Physiotehrapy
Scapula
Thoracic Hyperkyphosis
Lead sponsor: Istanbul University - Cerrahpasa
Sponsor class: OTHER
First posted: 2025-04-02
Enrollment: 56
Sex: ALL
Minimum age (years): 7
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Participants will be randomly assigned to one of two parallel groups: the intervention group receiving Schroth exercises combined with postural education, and the control group receiving only postural education while placed on a waiting list. Both groups will be evaluated at baseline and after the 8-week intervention period
Primary purpose: TREATMENT

Brief summary: This randomized controlled trial aims to investigate the effects of Schroth exercises on scapular muscle activation in children with thoracic hyperkyphosis. A total of 56 participants will be randomly assigned to either the Schroth exercise group or the control group receiving postural education. The intervention group will complete an 8-week supervised Schroth program focusing on three-dimensional correction, rotational breathing, and postural awareness. Primary outcome is scapular muscle activation measured by surface EMG. Secondary outcomes include muscle strength, scapular endurance, kyphotic appearance, posture, and pain. The results will guide clinical management and preventive strategies for children with postural thoracic hyperkyphosis.

Detailed description: This prospective, randomized controlled trial aims to investigate the effects of Schroth-based three-dimensional exercises on scapular muscle activation in children with postural thoracic hyperkyphosis. Thoracic hyperkyphosis, commonly observed during childhood and adolescence, not only leads to spinal deformity but also negatively impacts scapular positioning, upper extremity function, and overall posture. Weakness and poor activation of scapular stabilizing muscles may contribute to the progression of kyphosis and functional limitations.

The Schroth method is a scoliosis-specific exercise approach designed to improve spinal alignment through three-dimensional postural correction, rotational breathing, and muscle stabilization techniques. Although widely used for spinal deformities such as scoliosis and kyphosis, its specific effects on scapular muscle activation remain insufficiently studied. This study will explore the potential of Schroth exercises to enhance scapular muscle function, which may contribute to improved posture, increased muscle strength and endurance, better scapular performance, reduced kyphotic appearance, and alleviation of pain.

The intervention group will participate in an 8-week supervised exercise program consisting of individualized Schroth exercises, focusing on postural awareness and scapular control during functional activities. By targeting scapular muscle activation, the study seeks to determine whether integrating Schroth exercises into physiotherapy practice can improve clinical outcomes and inform evidence-based approaches for managing postural thoracic hyperkyphosis in the pediatric population. Findings from this study may also contribute to developing preventive health strategies to protect musculoskeletal health in children and adolescents.

Eligibility criteria: Inclusion Criteria:

* Thoracic kyphosis angle (Cobb) between ≥40° and \<70° on lateral radiographs
* Aged 7-18 years
* Risser stage 0-5, indicating ongoing skeletal development

Exclusion Criteria:

* Congenital or rigid spinal deformities/anomalies
* Major musculoskeletal surgery or trauma, especially involving the spine
* Physiotherapeutic intervention for the spine in the last 6 months
* Current brace use
* BMI ≥ 30
* Regular upper extremity sports involvement (e.g., swimming, volleyball) at least twice a week for one year
* More than 60 minutes of moderate-to-high intensity physical activity per week
* Visual impairments or light sensitivity
* Positive vestibular (Unterberger) test
* Hearing impairments
* Cognitive difficulties affecting comprehension
* Systemic diseases (diabetes, hypothyroidism, infection, malignancy)
* Neurological disorders
* Active rheumatic diseases

Primary outcomes:
measure: Muscle Activation (sEMG)
timeFrame: 8 weeks
Secondary outcomes:
measure: Muscle Strength
timeFrame: 8 weeks
measure: Scapular Muscle Endurance Test
timeFrame: 8 weeks
measure: Kyphosis-Specific Spinal Appearance Questionnaire
timeFrame: 8 weeks
measure: PostureScreen Mobile Application
timeFrame: 8 weeks
measure: Postural Habits and Awareness Scale
timeFrame: 8 weeks
measure: Numeric Rating Scale (NRS)
timeFrame: 8 weeks
measure: Global Rating of Change (GROC) scale
timeFrame: 8 weeks
Other outcomes:
Locations:
Study officials:
affiliation: Istanbul University - Cerrahpasa
name: Ayşe Zengin Alpözgen, Assoc Prof.
role: PRINCIPAL_INVESTIGATOR
References: