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

NCT06835608 | Recruiting

• 1 other identifier: KA24/125
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Postural Kyphosis; Chronic Neck Pain

Keywords

postural hyperkyphosis; chronic neck pain

Outcome Measures

Primary Outcomes (1)

• Angle of thoracic kyphosis

  The kyphosis angles of the participants will be measured using a flexible ruler and an inclinometer.As stated in the literature, thoracic kyphosis will be measured from C7-T12 spinal processes.Prior to molding the flexicurve ruler to the subject's spine, the C7 and T12 posterior spinous processes were located via palpation.The flexicurve ruler was then molded over the spine midline from C7 to T12. The resulting curve was traced on paper, and the locations of the C7 and T12 processes were labelled. The measurement was performed while the participant stood in a neutral upright posture with feet shoulder-width apart.The flexible ruler will be placed on the marked reference points. It will then be placed on the millimetrically divided paper without distorting its shape. The angular value of the curvature drawn on the paper from the contour of the flexible ruler will then be calculated. Another kyphosis angle will be measured by the same procedure using an inclinometer.

  Baseline,4th week, 8th week

Secondary Outcomes (7)

• Trunk Muscle Strength

  Baseline,4th week, 8th week

• Balance Assessment

  Baseline,4th week, 8th week

• Spinal Stabilisation Activity

  Baseline,4th week, 8th week

• Visual Analogue Scale (VAS)

  Baseline,4th week, 8th week

• Occiput Wall and Tragus Wall Distance

  Baseline,4th week, 8th week

Study Arms (2)

three-dimensional schroth exercise group

EXPERIMENTAL

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.

Other: Schroth Exercise Group

corrective exercises for posture

ACTIVE COMPARATOR

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

Other: Postural Exercises Group

Interventions

Postural Exercises Group 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.

corrective exercises for posture

Schroth Exercise Group 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.

three-dimensional schroth exercise group

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• 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

You may not qualify if:

• History of trauma or surgery on spinal joints,
• Participants with rheumatological and metabolic disorders,
• Participants with congenital postural deformity and scoliosis

Sponsors & Collaborators

• Baskent University: lead
• Baskent University Ankara Hospital: collaborator

Study Sites (1)

Baskent University Umitkoy Outpatient Clinic

Ankara, Çankaya, 06800, Turkey (Türkiye)

RECRUITING

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  RESULT

Study Officials

• Tuğçe BAYRAM ERKOYUNCU

  Baskent University

  STUDY CHAIR

• Hayri Baran YOSMAOĞLU, Prof.

  Baskent University

  STUDY DIRECTOR

• Selin ÖZEN, Assoc. prof.

  Baskent University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Tuğçe BAYRAM ERKOYUNCU, PHD Student

CONTACT

+905079668252; bayramtugce91@gmail.com

Hayri Baran YOSMAOĞLU, Proffesor

CONTACT

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The study consists of two groups. Group 1 : exercise group Group 2: Control group

Study Record Dates

• First Submitted: February 14, 2025
• First Posted: February 19, 2025
• Study Start: February 25, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): August 23, 2026
• Last Updated: December 3, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)