Manual & exercise therapies are similarly effective for postural hyperkyphosis

Study Type: Therapy
OE Level of Evidence: 2
Journal Level of Evidence: N/A
46 women with postural hyperkyphosis were randomized to either manual therapy or exercise therapy to determine whether there are significant differences in kyphosis angle and muscle strength following treatment with these interventions. The results of this trial indicated that both therapies improved kyphosis angles and muscle strength from based line; however, outcomes were comparable between the two treatments at final follow-up. Future studies should Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Non-Industry funded
Sponsor: Shiraz University of Medical Sciences, Faculty of Rehabilitation Sciences
Conflicts: None disclosed
Why was this study needed now?
Hyperkyphosis is characterized by a hunching of the back due to an extreme concave curvature of the thoracic spine. This postural defect is often developed during youth via slouching. Hyperkyphosis may be associated with muscle deficiency and may lead to chronic musculoskeletal pathologies. Previous trials have reported the efficacy of exercise therapy in mitigating spinal deformities and benefits of manual therapy on pain reduction, circulation improvement, correction of spinal alignment, and facilitation of joint movements. However, comparisons between exercise therapy with manual therapy have yet to be conducted, thus, warranting the present study.
What was the principal research question?
Are there significant differences between manual therapy and exercise therapy for treating postural hyperkyphosis after 5 weeks of treatment?
Population: 46 female patients between 18 and 30 years of age with postural hyperkyphosis were included in this study. Eligible patients had a thoracic kyphosis angle of more than 45 degrees. Patients with scoliosis, cancer, spinal tumors, history of spinal column fracture, or rheumatoid arthritis were ineligible. All patients received 15 treatment sessions of 20-30 minute duration of their randomized groups, which lasted for 5 weeks.
Intervention: Manual therapy group: four techniques were used during manual therapy sessions, which consisted of massage, mobilization, muscle energy, and myofascial release. Massage therapy was performed to the back extensor muscles for 10 minutes. Mobilization was performed with 10 repetitions on all thoracic vertebrae and 40 repetitions on the middle thoracic spine. A muscle energy technique was performed five times each session and myofascial release was performed twice per session. (n= 23, 23 completed; Mean age: 23.6 +/- 2.9 years)
Comparison: Exercise therapy group: exercises in this study consisted of: stretching the pectoralis major muscle, stretching the extensor muscles and strengthening the anterior neck flexors, stretching the latissimus dorsi muscle, and strengthening the back extensor. All exercise positions were held for 15 seconds and repeated 10 times. (n=23, 16 completed; Mean age: 23.1 +/- 2.3 years)
Outcomes: Outcomes of this study include the thoracic kyphosis angle measured by a six-camera motion analysis system (ProReflex, Qualysis, Gothenburg, Sweden), and muscle strength testing measured with a digital dynamometer (MIE, Leeds, UK).
Methods: RCT
Time: Outcomes were assessed after 5 weeks of treatment.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.