Schroth and Scapular Muscle Activation in Hyperkyphosis

NCT ID: NCT06907914

Last Updated: 2025-10-01

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

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-15

Study Completion Date

2026-08-01

Brief Summary

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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

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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.

Conditions

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Hyperkyphosis, Adolescent Muscle Activation Scapula; Deformity, Acquired Exercise Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

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 Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
This study will employ assessor and statistician blinding. The physiotherapists performing baseline and post-intervention assessments will be blinded to group allocation to minimize bias. Additionally, statistical analyses will be conducted by a researcher blinded to group assignments. Participants and therapists delivering the intervention will not be blinded due to the nature of the exercise-based intervention.

Study Groups

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Group A

Participants in the experimental group will undergo a supervised 3D Schroth-based exercise program with postural education. The intervention will be applied 3 times per week for 8 weeks, totaling 24 sessions, each lasting approximately 45 minutes, delivered in-person by a trained physiotherapist.

Exercises will include corrective postural training, scapular stabilization, rotational breathing, and static stretching. The program is delivered in two progressive phases:

Weeks 1-4: Postural awareness and basic muscle activation

Weeks 5-8: Functional integration and advanced stabilization

Progression criteria are based on repetitions: exercises begin at 9 reps × 3 sets, and progress to 15 reps × 3 sets. Static stretches start with 20 seconds × 2 sets and are increased to 3 sets before progressing. All exercises are individualized based on clinical assessment.

Group Type EXPERIMENTAL

Schroth

Intervention Type OTHER

The Schroth intervention consists of a structured, three-dimensional exercise program based on scoliosis-specific principles. It incorporates corrective postural alignment, rotational breathing techniques, and targeted activation of spinal and scapular stabilizing muscles. The exercises are designed to improve postural control, enhance muscle endurance, and promote neuromuscular re-education for better functional alignment during daily activities.

Group B

The control group will receive a single, standardized session of postural education at the beginning of the study, during which general information about correct posture, ergonomic principles, and spinal health will be provided. Following this session, participants in the control group will be placed on a waiting list and monitored for a period of 8 weeks. During this time, they will not receive any specific exercise intervention or additional therapeutic program related to posture or muscle strengthening. Regular follow-up will be conducted to ensure participant safety and to monitor any changes or adverse events throughout the waiting period.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Schroth

The Schroth intervention consists of a structured, three-dimensional exercise program based on scoliosis-specific principles. It incorporates corrective postural alignment, rotational breathing techniques, and targeted activation of spinal and scapular stabilizing muscles. The exercises are designed to improve postural control, enhance muscle endurance, and promote neuromuscular re-education for better functional alignment during daily activities.

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

7 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istanbul University - Cerrahpasa

OTHER

Sponsor Role lead

Responsible Party

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Ayse Zengin Alpozgen

Assoc. Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ayşe Zengin Alpözgen, Assoc Prof.

Role: PRINCIPAL_INVESTIGATOR

Istanbul University - Cerrahpasa

Locations

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Istanbul University-Cerrahpasa

Istanbul, Istanbul, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Kübra Kardeş, PhD

Role: CONTACT

905387115631

Turgut Akgül, Prof

Role: CONTACT

Facility Contacts

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Ayşe Zengin Alpozgen, Assoc. Prof.

Role: primary

05526830479

Other Identifiers

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aza_isu2

Identifier Type: -

Identifier Source: org_study_id

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