Effects of Schroth-Based Exercise on Kyphosis Angle, Muscle Strength, Balance, Pain, and Quality of Life in Hyperkyphosis With Chronic Neck Pain

NCT ID: NCT06835608

Last Updated: 2025-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-25

Study Completion Date

2026-08-23

Brief Summary

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The normal thoracic kyphosis angle of the spine is 20-40°, however, an angle of more than 40° is referred to as postural kyphosis, increased kyphosis or hyperkyphosis. Although postural kyphosis negatively affects individuals' general health status, physical performance, and quality of life, there is still no standardized protocol for correcting the thoracic kyphosis angle. Conservative treatment approaches such as postural training and exercises, manual therapy, postural corrective kinesiotaping, and orthotic use have been recommended for managing increased thoracic kyphosis. While numerous studies have demonstrated the effectiveness of three-dimensional exercise programs in the treatment of scoliosis, research examining their impact on kyphosis remains considerably limited.Nevertheless, the potential of these exercises to promote neuromuscular reorganization suggests that they may be similarly effective in individuals with thoracic kyphosis. This randomized controlled trial aims to evaluate the effects of a Schroth-based three-dimensional exercise program on kyphosis angle, trunk muscle strength, balance, pain, and quality of life in individuals with postural hyperkyphosis and chronic neck pain.

Detailed Description

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Increasing thoracic kyphosis, spinal extensor muscle weakness, decreased spinal extension mobility, lumbo-pelvic pain, muscle activation and displacement of the scapula with changing traction angles have been associated with postural changes. It is evident that such alterations in posture have a biomechanical effect on the cervical and lumbar vertebrae. The presence of thoracic dysfunction has been documented in individuals experiencing chronic neck pain. Increases in both the thoracic kyphosis angle and flexor posture have been demonstrated to result in anterior displacement of the central gravity line. Displacement of the body's centre of gravity anteriorly has the potential to exert adverse effects on postural control.The association between postural changes and spinal extensor muscle weakness, increased kyphotic posture, decreased spinal extension mobility, lumbo-pelvic pain, muscle activation and displacement of the scapula with changing traction angles has been demonstrated. These postural changes have been demonstrated to exert a detrimental effect on postural stability, back pain, physical performance and quality of life.

The present study was meticulously designed as a Schroth-based three-dimensional exercise group and a control group, with a duration of eight weeks. The two groups will both undergo a programme comprising 20 sessions of electrotherapy and exercise, to be administered over a period of four weeks. Subsequent to the completion of the fourth week of electrotherapy sessions, the exercise applications will be continued for a further four weeks by the physiotherapist responsible for the study, who will undertake the programme three days per week. The intervention will consist of a series of educational sessions focusing on the development of postural perception, with a particular emphasis on the identification of postural kyphosis and the adoption of optimal posture in daily living. These educational sessions will be administered to both groups. The training programme will be delivered in a practical manner by the physiotherapist. A brochure will be provided to patients, serving as a reference guide for the exercises and considerations.

Conditions

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Postural Kyphosis Chronic Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study consists of two groups. Group 1 : exercise group Group 2: Control group
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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corrective exercises for posture

Corrective exercise program for posture will consist of deep neck flexor muscle strengthening exercises, lower and middle trapezius strengthening, neck isometric exercises.

Group Type ACTIVE_COMPARATOR

Postural Exercises Group

Intervention Type OTHER

Patients to be included in the control group will receive electrotherapy treatment (ultrasound, tens, hotpack) to the neck area for 30 minutes in each session. After the electrotherapy treatment, posture corrective exercises will be applied. Corrective exercise program for posture will consist of deep neck flexor muscle strengthening exercises, lower and middle trapezius strengthening, neck isometric exercises. All strengthening exercises will be given 3 sets of 10 repetitions per day, each repetition for 10 seconds. Stretching exercises will be given to the shortened upper trapezius and pectoralis major muscles. Stretching exercises will be given 2 sets of 5 repetitions per day, with each repetition lasting 20 seconds. In the first 4 weeks, a total of 20 sessions of electrotherapy and exercise will be performed in corrective exercises for posture. At the end of the 4th week, exercise applications will continue for the other 4 weeks 3 days a week.

three-dimensional schroth exercise group

Schroth therapy, a three-dimensional exercise therapy program was developed in Germany in the 1920s by Katharina Schroth. The three-dimensional exercise program refers to the sagittal, frontal and horizontal planes. The three- dimensional Schroth exercise training consists of spinal lengthening and positional correction of the cervical, thoracic and lumbar regions in the sagittal plane, special breathing techniques and re-education of the neuromuscular system to improve kyphotic posture.

Group Type EXPERIMENTAL

Schroth Exercise Group

Intervention Type OTHER

The study group will receive electrotherapy treatment (hot pack, ultrasound, tens) to the neck area for 30 minutes in each session. After electrotherapy treatment, kyphotic posture correction exercises will be applied with the help of proprioceptive and extroceptive stimuli in the sagittal plane with mirror control and specific corrective breathing. In the exercise program, exercise practices will be performed in specific positions in supine, prone, sitting and standing. The exercise program will be planned for approximately 40 minutes in each session. A total of 20 sessions of electrotherapy and exercise will be performed for 4 weeks. At the end of the 4th week, after the electrotherapy sessions are completed, exercise applications will continue for the other 4 weeks by the physiotherapist who performs the exercise 3 days a week.

Interventions

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Schroth Exercise Group

The study group will receive electrotherapy treatment (hot pack, ultrasound, tens) to the neck area for 30 minutes in each session. After electrotherapy treatment, kyphotic posture correction exercises will be applied with the help of proprioceptive and extroceptive stimuli in the sagittal plane with mirror control and specific corrective breathing. In the exercise program, exercise practices will be performed in specific positions in supine, prone, sitting and standing. The exercise program will be planned for approximately 40 minutes in each session. A total of 20 sessions of electrotherapy and exercise will be performed for 4 weeks. At the end of the 4th week, after the electrotherapy sessions are completed, exercise applications will continue for the other 4 weeks by the physiotherapist who performs the exercise 3 days a week.

Intervention Type OTHER

Postural Exercises Group

Patients to be included in the control group will receive electrotherapy treatment (ultrasound, tens, hotpack) to the neck area for 30 minutes in each session. After the electrotherapy treatment, posture corrective exercises will be applied. Corrective exercise program for posture will consist of deep neck flexor muscle strengthening exercises, lower and middle trapezius strengthening, neck isometric exercises. All strengthening exercises will be given 3 sets of 10 repetitions per day, each repetition for 10 seconds. Stretching exercises will be given to the shortened upper trapezius and pectoralis major muscles. Stretching exercises will be given 2 sets of 5 repetitions per day, with each repetition lasting 20 seconds. In the first 4 weeks, a total of 20 sessions of electrotherapy and exercise will be performed in corrective exercises for posture. At the end of the 4th week, exercise applications will continue for the other 4 weeks 3 days a week.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Thoracic kyphosis angle \> 45 degrees,
* Aged between 20 and 50 years,
* Have neck pain for more than 3 months,
* Neck pain visual analogue scale \> 3,
* Not being treated for postural kyphosis in the last 6 months,
* Has no systemic disease

Exclusion Criteria

* History of trauma or surgery on spinal joints,
* Participants with rheumatological and metabolic disorders,
* Participants with congenital postural deformity and scoliosis
Minimum Eligible Age

20 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Baskent University Ankara Hospital

OTHER

Sponsor Role collaborator

Baskent University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tuğçe BAYRAM ERKOYUNCU

Role: STUDY_CHAIR

Baskent University

Hayri Baran YOSMAOĞLU, Prof.

Role: STUDY_DIRECTOR

Baskent University

Selin ÖZEN, Assoc. prof.

Role: PRINCIPAL_INVESTIGATOR

Baskent University

Locations

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Baskent University Umitkoy Outpatient Clinic

Ankara, Çankaya, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Tuğçe BAYRAM ERKOYUNCU, PHD Student

Role: CONTACT

+905079668252

Hayri Baran YOSMAOĞLU, Proffesor

Role: CONTACT

Facility Contacts

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Tuğçe Bayram Erkoyuncu

Role: primary

+905079668252

Selin ÖZEN

Role: backup

References

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Other Identifiers

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KA24/125

Identifier Type: -

Identifier Source: org_study_id

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