The Sagittal Integral Morphotype in Male and Female Rowers

The goal of this study was to describe the integrated spinal assessment of the sagittal morphotype in rowers to determine whether the intense practice of rowing causes a modification of the sagittal curvatures of the spine, its relationship with the rowing technique, and training background. The second goal was to analyse how the dorsal and lumbar curves behave in the three phases of the rowing gesture, and to determine which phases can be detrimental to the correct development of the spine during growth. We analysed the spine curvatures in the sagittal plane of 29 females and 82 males, which were measured with an inclinometer in standing, slump sitting, maximal trunk flexion and during rowing performance. The average value of thoracic kyphosis in the rowers was 30° (mean, 30 + 8.27°). Thoracic hyperkyphosis was found in only two rowers (1.8%). Lumbar lordosis was within normal range in 84.1% of the males (mean, 27 + 9.57°) and 75.9% of female rowers (mean, 33°). Functional thoracic hyperkyphosis was observed in 57.4% of the males and 17.1% of the females. Functional lumbar hyperkyphosis was observed in 28 of the 69 males (40.5%) and five of 22 females (17.2%). Rowing seems to provide adequate spine alignment in the sagittal plane on standing. The integrated spinal assessment of the sagittal morphotype showed that half or our rowers presented with functional thoracic hyperkyphosis, and 43.2% presented with functional lumbar hyperkyphosis. Spine behaviour during the rowing technique shows that the thoracic kyphosis (98.2%) and lumbar spine (91%) perform within normative ranges and could explain the adequate positioning of the spine in the sagittal plane on standing. Years of rowing training tend to reduce thoracic kyphosis in males.

Comparing Spinomed® and Elderly Spinal Orthosis Use on Kyphosis Angle, Back Pain, and Quality of Life in Elderly With Thoracic Hyperkyphosis

Objectives: Thoracic hyperkyphosis is one of the most common conditions in the elderly. The use of orthosis and exercise is one of the most effective treatments suggested, but unfortunately, there is little evidence to support this treatment. The study aimed to compare the effect of Spinomed® orthosis and elderly spinal orthosis with exercise and exercise alone on the angle of kyphosis, quality of life, and pain in the elderly with thoracic hyperkyphosis. Methods: In this study, 40 older adults aged 60 years and older with a kyphosis angle of more than 50 degrees were recruited. The participants were allocated into three groups: Spinomed® orthosis and exercise (n=14), elderly spinal orthosis and exercise (n=15), and exercise only (n=11). The groups were treated for three months. Results: There was a significant decrease in the kyphosis angle of participants in the Spinomed® orthosis and exercise groups (P=0.005). Pain score was significantly decreased in the Spinomed® orthosis and exercise group (P=0.023). There was only a significant increase in the physical component summary in the Spinomed® orthosis and exercise group (P=0.03) and the elderly spinal orthosis and exercise group (P=0.04) . Discussion: The combination of Spinomed® orthosis with exercise is the best choice to correct the kyphosis angle, reduce pain, and increase the quality of life. Elderly spinal orthosis and exercise can also improve the quality of life scores.

Does mobilisation of the thoracic spine using mechanical massage affect diaphragmatic excursion in individuals with thoracic hyperkyphosis?

BACKGROUND: Thoracic mobilisation improves thoracic hyperkyphosis and respiratory function. Diaphragmatic excursion is associated with respiratory function; however, limited studies have assessed the effect of thoracic mobilisation on diaphragmatic excursion. OBJECTIVE: This study aimed to investigate the effects of thoracic mobilisation on diaphragmatic excursion and respiratory function in individuals with thoracic hyperkyphosis. METHODS: Participants were recruited through Internet advertising and participated voluntarily. Nineteen healthy participants (age: 33.37 ± 6.56 years; height: 170.32 ± 7.92 cm; weight: 69.77 ± 14.70 kg) with thoracic hyperkyphosis underwent thoracic mobilisation for 8 weeks. Diaphragmatic excursion, thoracic kyphosis, and respiratory function were measured. Thoracic mobilisation was provided using a mechanical massage device. RESULTS: Thoracic mobilisation for 8 weeks significantly improved diaphragmatic excursion during deep breathing (p= 0.015), forced vital capacity (p< 0.01), and thoracic hyperkyphosis (p< 0.01). CONCLUSIONS: Thoracic mobilisation can be recommended in respiratory rehabilitation programs to increase diaphragmatic excursion and respiratory function for the management and prevention of respiratory dysfunction in individuals with thoracic hyperkyphosis.

Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome—A Case Study and Brief Review

Upper cross syndrome (UCS) is a condition caused from prolonged poor posture manifesting as thoracic hyperkyphosis with forward head and shoulder postures. It has been associated with several other secondary conditions, causing pain and discomfort to those with the condition. This is a case report of a 35-year-old female presenting to clinic with a sharp pain in the neck, upper back, and sternum area for 4 weeks and gastroesophageal reflux disease (GERD). She had been working at home for several months after the shelter at home order was issued. Following evaluation and corrective treatment with cervical adjustment and soft tissue massage, the patient’s posture improved and reported full pain resolution. Her symptoms of GERD concurrently resolved as well. She continued to receive chiropractic adjustment two times per month for correcting spinal misalignment. Full restoration of posture was attained on the full spine radiographs at 9 months follow-up. The patient remained symptom-free at 12 months follow-up. Manipulative and preventive therapies aimed at treating and preventing UCS should be more widely adopted to prevent secondary conditions.

Effects of exercise on cervical muscle strength and cross-sectional area in patients with thoracic hyperkyphosis and chronic cervical pain

There is a lack of studies comparing the effects of different exercise types in patients with thoracic hyperkyphosis. Twenty-four subjects were divided into three groups: corrective exercise, resistance exercise, and physical therapy. The groups performed their respective interventions, two times per week for three months. Clinical outcomes, including the value of Cobb’s angle, cervical muscle strength and endurance, and the cross-sectional area of the cervical deep muscles were measured pre- and post-intervention. There was a significant difference in the changes in the thoracic Cobb’s angle between the groups (P < 0.001). The corrective exercise group revealed a significantly superior increase in muscle strength and endurance between pre- and post-intervention (P < 0.012). There was a significant difference in the cross-sectional area of the cervical deep muscles included longus capitis and multifidus between the groups (P < 0.036 and 0.007, respectively). The corrective exercise group showed the most significant increase in cross-sectional area between pre- and post-intervention (P < 0.012). A corrective exercise program is a more effective intervention than traditional resistance exercise and physical therapy for improving the thoracic Cobb’s angle, cervical muscle strength and endurance, and the cross-sectional area of the deep muscles in patients with thoracic hyperkyphosis.Trial registration: KCT0005292.

Efficacy of a multimodal physiotherapy treatment program for postural disorders and pain: a case report

The participant of this study was a 40-year-old female, who mainly complained of middle thoracic stiffness and pain in extension at the mid thoracic level with hyperkyphosis, forward head and mild thoracic dextroscoliosis. The subject participated in multimodal home-based physiotherapy program with the duration of 9 months, consisting of posture exercises, soft tissue massage therapy and thoracic manipulations. Comparison of initial and final evaluation revealed the improvement in all evaluated variables, including the reduction of thoracic hyperkyphosis, forward head posture and thoracic dextroscoliosis, freer and less painful thoracic spine extension mobility, no pain in the sacroiliac joint, and increased satisfaction with the posture. There was also notable improvement in the algometry of the paraspinal muscles, equalization of functional lower-leg length and rib-pelvic distance of both sides of body. In conclusion, the proposed physiotherapy protocol can be beneficial in addressing postural faults such as thoracic hyperkyphosis, forward head and scoliosis. However, further research is needed with a larger sample.