Mid and lower thoracic kyphosis changes during adulthood: the influence of age, sex and thoracic coronal curvature

The Effectiveness of Exercise Programs in Adolescents with Thoracic Kyphosis: A Narrative Review

Thoracic kyphosis is a common postural problem affecting over 20% of adolescents. This condition can contribute to various spinal problems, leading to a decreased ability to perform daily activities, reduced quality of life, and impaired pulmonary function. This review aimed to investigate the effectiveness of exercise programs in adolescents with thoracic kyphosis. We systematically searched the PubMed, Embase, Cochrane Library, and Scopus databases for articles relevant to adolescents with thoracic kyphosis that had been published up to 14 May 2024. Our inclusion criteria focused on studies investigating the effects of exercise on improving thoracic kyphosis. A total of 1883 articles was identified using the search terms. After the titles and abstracts had been screened, 1868 articles were found not to meet our inclusion criteria and were excluded. The remaining 15 articles were then assessed for eligibility. Finally, only seven studies were included in this systematic review. Exercises targeting the entire spinal curvature demonstrated efficacy in enhancing the strength and function of the cervical, thoracic, lumbar, and pelvic muscles, resulting in a corrective effect on thoracic kyphosis in adolescents. Consequently, exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis.

Can Lumbopelvic Parameters Be Used to Predict Thoracic Kyphosis at all Ages? A National Cross-Sectional Study

STUDY DESIGN

National cross-sectional study.

OBJECTIVE

Thoracic kyphosis (TK) is related to sagittal parameters as pelvic tilt (PT), lumbar lordosis (LL) and pelvic incidence (PI). The equation TK = 2 (PT+LL-PI) was validated for adolescents. The purpose of this study was to investigate if this equation correctly predicts TK regardless of age.

METHODS

Sagittal alignment parameters were assessed on full spine radiographs of 2599 individuals without spine pathology (1488 females, 1111 males). Calculated TK (CTK) = 2 (PT+LL-PI) and measured TK (MTK) were compared by calculating the gap and using a linear regression between both parameters. Subgroup analyses were performed for gender, age, TK groups (≤20°, 21°-40°, 41°-60°, >60°), and PI groups (<45°, 45°-60°, >60°).

RESULTS

Average values in the total population were: MTK 45.0°, CTK 36.9°. Average TK gap was 8.1°, 5.2° in females (intercept 11.7, slope .61) and 11.9° in males (intercept 7.1, slope .58). The mean gap was 3.6° for 15-34 years, 5.7° under 15 years and it increased progressively after 35 years with a maximum of 19.9° over 80 years. The gap also increased with the amount of MTK: -3.5° for TK<20° up to 17.3° for TK >60°. Differences in gaps were minor between PI groups. The intercept was smallest and slopes >.6 for PI <45° and TK ≤20°.

CONCLUSION

The formula TK=2 (PT+LL-PI) yielded moderate accuracy for adolescents and young adults, but did not fit for over 35 years and under 15. The amount and variance in TK increased in elderly subjects, which made the formula less accurate.

Effects of Combined Exercise Program on Spinal Curvature and Balance Ability in Adolescents with Kyphosis

Thoracic hyperkyphosis is associated with postural abnormality, physical function, and quality of life. This study aimed to examine the effects of a combined exercise program on the spinal curvature and balance ability in adolescents with kyphosis. Fifty-one adolescents (mean age 21.95 ± 3.90 year, 23 male and 28 female) diagnosed with kyphosis were randomly divided into two groups: an experimental group (n = 25) and a control group (n = 26). All participants in the study group underwent a combined exercise program for 60 min, three times per week, for 12 weeks. Cobb’s angle and forward head angle showed significant differences between the two groups (p < 0.001). The anterior and posterior weight distributions of static and dynamic plantar foot pressures showed a significant difference between the two groups (p < 0.001), and significant differences were observed only in the study group (p < 0.001). However, the left and right static plantar foot pressures did not differ significantly. In conclusion, these results demonstrate that a combined exercise program is an effective intervention for the improvement of alignment in the spinal curve and balance in adolescents with postural kyphosis.

A Comprehensive Study on Epidemiology Case Studies Using Computational Analysis

Health-related issues and occurrences with regard to a particular population are the subject of an epidemiology study. This paper presents the results of a retrospective epidemiological investigation on 15922 hospitalized hand trauma patients from Central China between 2011 and 2020. Gender, age, onset season, injury mechanism, injury environment, injury location, and clinical characteristics are among the characteristics of the data gathered. The study is using computational analysis to draw inferences from the case studies collected in the databases of the hospitals. The types and characteristics of occupational injuries at home and outdoor are compared and analyzed. The purpose of the study is to present the findings from recent case studies for future reference and to recommend useful roles for the industrial sector in the care of patients with hand trauma in order to lower occupational harm. The injuries of preschool children are also analyzed. The incidence rate of hand injuries in infants has been increasing year by year which is directly related to the inefficient growth of children in rural areas. The data are collected from hospitals, then the data analytical tools are applied to draw conclusions. The suggested model is intelligently learned through the application of computational techniques, which are also used to suggest treatments to trauma victims. According to this study, males are more likely than females to sustain hand trauma; occupational injuries are more common than living injuries; males between the ages of 20 and 50 are at an increased risk of suffering an occupational injury. This study showed that the proportion of hand trauma in preschool children was higher (12.27%), and the 2-3-year-old group was the main injury target of preschool children (45.70%). The accidental injuries of newborns and young children can be reduced by government assistance, social support, and tighter monitoring.

Lower thoracic spine extension mobility is associated with higher intensity of thoracic spine pain

Objectives

To evaluate the association of thoracic spine (TS) posture and mobility with TS pain.

Methods

Participants with TS pain reported maximum, average, and night pain in TS area, and pain summary score was calculated. Upright and sitting TS postures were evaluated by inspection. TS posture and mobility (flexion and extension) were recorded using an inclinometer and a tape measure, respectively. Correlations between posture and mobility assessments were calculated using Spearman rank correlation, the association of TS posture and mobility with TS pain by logistic regression analysis.

Results

The participants’ (n = 73, 52 females, age range 22–56) TS pain duration was 12 weeks on average. The correlations for measurements of TS posture and flexion mobility were higher than correlations of other TS measurements being between 0.53 and 0.82. Decreased extension mobility of the upper (from 1^st to 6^th TS segments; Th1–Th6) TS was associated with higher worst pain (OR 1.04, 95% CI 1.00–1.07) and whole TS with pain sum score (OR 1.05, 95% CI 1.01–1.08). Less kyphotic whole TS was associated with lower pain sum score (OR 0.96, 95% CI 0.92–1.00). Greater flexion mobility of upper and lower (Th6–Th12) TS were associated with lower pain sum score (OR 0.96, 95% CI 0.91–1.00, and OR 0.96, 95% CI 0.91–1.00, respectively).

Conclusions

Reduced thoracic extension mobility was associated with higher pain scores and the greater flexion mobility with lower pain scores. Future research is warranted to evaluate if treatments geared toward TS extension mobility improvements would result in lower TS pain.