The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial

Effects of an 8-Week Corrective Dance Exercises Intervention on Thoracic Hyperkyphosis, Scapular Position, Respiratory Function, and Happiness in Girls Aged 10-12 Years

PURPOSE

This study examined the impact of an 8-week corrective dance intervention on thoracic hyperkyphosis, scapular position, breathing, and happiness in girls aged 10-12 years.

METHODS

Sixty participants were randomly assigned to either an experimental (EX) or control (CO) group. The intervention involved rhythmic and corrective movements conducted 3 times a week. Measurements were taken before and after the intervention for thoracic hyperkyphosis angle, scapular position, lung function, and happiness levels.

RESULTS

EX showed greater improvements (P = .001) than CO for the decrement of thoracic hyperkyphosis angle (48.20-42.80°) than in CO (47.66°-46.59°), and scapular position improved more (P = .003) in EX (1.48°-1.20°) than in CO (1.44°-1.42°). Forced vital capacity (P = .001) and forced expiratory volume in 1 second (P = .001) significantly increased in EX (FVC: 2.65-3.40 L; FEV1: 2.32-2.74 L), while they remained stable in CO. Happiness levels significantly improved (P = .001) in EX (42.20-49.79) and slightly decreased in CO (41.80-40.15).

CONCLUSIONS

The 8-week dance program improved posture, scapular position, breathing, and happiness in girls aged 10-12 years. It enhances physical health, emotional well-being, and social skills in children and adolescents.

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.

Lateral Epicondylalgia and Thoracic Kyphosis: A Study on Young Athletes

OBJECTIVE

The etiology of lateral epicondylalgia (LE) remains unclear, although it has been linked to various factors. Recent theories suggest a potential connection between LE and impairments in the kinetic chain. In our study, we aimed to investigate the association between another factor influencing kinetic chain impairment, specifically an increased angle of thoracic kyphosis, and the presence of initial signs of LE in young athletes.

DESIGN

This study employed an observational, case-control design.

SETTING

The participants underwent examination during a routine preventive checkup conducted by a sports physician at Novi Sad Healthcare Center, Sports Medicine Center.

PARTICIPANTS

One hundred young athletes aged 10 to 15 years were included in the study. Half of the participants reported pain in the lateral aspect of the elbow during maximal hand grip, while the remaining athletes served as controls and did not experience any pain.

ASSESSMENT OF INDEPENDENT VARIABLES

Thoracic kyphosis inclination angles were measured using a digital inclinometer.

MAIN OUTCOME MEASURES

Pain was assessed using the pressure pain threshold at a specific point associated with lateral epicondylalgia, measured by a digital algometer.

RESULTS

Participants exhibiting initial signs of LE displayed significantly different angles of anteroposterior curvatures of the spine compared with the control group. Moreover, the angle of thoracic kyphosis was significantly associated with pain in the lateral aspect of the elbow.

CONCLUSIONS

Our findings confirm an association between initial signs of lateral epicondylalgia and the grade of thoracic kyphosis in young athletes.

Comparison of the effects of core stability and whole-body electromyostimulation exercises on kyphosis angle and core muscle endurance of inactive people with hyper kyphosis: A quasi-experimental pre-post study

OBJECTIVE

Restoring the degree of kyphosis to be consistent with good sagittal alignment of the spine is a key concern. This study aimed to compare the effect of core stability exercises (CSE) versus whole-body electromyostimulation (WB-EMS) and a combined program (PLUS) on kyphosis angle and core muscle endurance in sedentary individuals with hyperkyphosis.

DESIGN

A quasi-experimental single group pre-post study.

SETTINGS

Laboratory of corrective exercise.

PARTICIPANTS

seventy-five untrained men (28.9 ± 5.3 years) with thoracic hyperkyphosis.

MAIN OUTCOME MEASURES

A flexible ruler was used to measure the angle of kyphosis and McGill's test was used to evaluate core stability.

RESULTS

The results of the post hoc test demonstrated that the kyphosis angle was improved in the WB-EMS and PLUS groups compared to that in the CG (P < 0.05), but no significant difference was observed among the three groups(P > 0.05). In the post-test, core stability was significantly improved in CSE, WB-EMS and PLUS groups compared to that in the CG.

CONCLUSIONS

The WB-EMS and PLUS protocols as new training methods seem to be effective in changing posture parameters and correcting postural deformities, including kyphosis. Therefore, these protocols along with other rehabilitation programs can be used to correct kyphosis and improve core muscle endurance.

Adding corrective exercises along with bracing for postural hyperkyphosis among adolescents: A randomized controlled trial

BACKGROUND

Although most attention has been paid to the effectiveness of corrective exercises and bracing to improve thoracic hyperkyphosis, no study, to the best of our knowledge, has compared the effects of exercises plus bracing to bracing alone.

OBJECTIVE

To compare the effect of corrective exercises and bracing and bracing alone on the Cobb angle of thoracic kyphosis.

DESIGN

A parallel-group, blinded, randomized, controlled trial.

PARTICIPANTS

The participants included 180 adolescents with thoracic hyperkyphosis who were randomized into corrective exercises plus bracing (N = 60), only bracing (N = 60), and a waitlist control group (N = 60).

INTERVENTION

Intervention groups received their programs for 24 weeks, whereas the control group was placed on a waitlist for 6 months before receiving a delayed intervention.

MAIN OUTCOME MEASUREMENTS

The primary outcome was change from baseline to 6 months in Cobb angle measured from standing lateral spine radiographs.

RESULTS

Significant differences were observed in the Cobb angle of thoracic kyphosis between all groups at the posttest (p <.001). In post hoc analyses, we found significant differences between the corrective exercise plus bracing group (15.5° decline) and the bracing only group (8.8° decline), p <.001; both groups had bigger improvements than the control group, which increased by 1.2° (p <.001).

CONCLUSION

The combination of corrective exercises and bracing demonstrated better overall outcomes in Cobb angle compared to only bracing, as well as waitlist control in adolescents with thoracic hyperkyphosis.

Relation between Photogrammetry and Spinal Mouse for Sagittal Imbalance Assessment in Adolescents with Thoracic Kyphosis

The evaluation of postural alignment in childhood and adolescence is fundamental for sports, health, and daily life activities. Spinal Mouse (SM) and photogrammetry (PG) are two of the most debated tools in postural evaluation because choosing the proper instrument is also important to avoid false or misleading data. This research aims to find out the best linear regression models that could relate the analytic kyphosis measurements of the SM with one or more PG parameters of body posture in adolescents with kyphotic posture. Thirty-four adolescents with structural and non-structural kyphosis were analyzed (13.1 ± 1.8 years; 1.59 ± 0.13 m; 47.0 ± 12.2 kg) using SM and PG on the sagittal plane in a standing and forward-bending position, allowing us to measure body vertical inclination, trunk flexion, and sacral inclination and hip position during bending. The stepwise backward procedure was assessed to estimate the variability of the grade of inclination of the spine and thoracic spine curvature with fixed upper and lower limits, evaluated with SM during flexion. In both models, the PG angle between the horizontal line and a line connecting the sacral endplate-C7 spinous process and the PG hip position were the best regressors (adjusted-R2 SM bend = 0.804, p < 0.001; adjusted-R2 SM fixed bending = 0.488, p < 0.001). Several Spinal Mouse and photogrammetry parameters showed significant correlations, especially when the Spinal Mouse measurements were taken when the adolescents were in the forward-bending position. Physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction.

The Effect of a Comprehensive Corrective Exercise Program on Kyphosis Angle and Balance in Kyphotic Adolescents

This study aimed to investigate the effects of a comprehensive corrective exercise program on the kyphosis angle and balance in kyphotic adolescents. A total of 62 male adolescents (between the ages of 10 and 18, mean BMI 21.7 kg/m2) with a thoracic kyphosis (TK) angle of ≥ 50° were divided into three groups using the simple randomization method: CCEP (comprehensive corrective exercise program), TEP (thoracic exercise program) and control group. The CCEP program consisted of corrective exercises plus postural perception training (PPT). Exercise programs were applied for 40−50 min, 3 days a week for 12 weeks. The kyphosis angle was measured using a flexible ruler, and balance was assessed using the Romberg index obtained from pedobarography. After training, a highly significant reduction in the kyphosis angle was observed in the CCEP and TEP groups (p < 0.001). Comparison among the groups showed a greater reduction in the kyphosis angle in the CCEP group (p < 0.020). Postural perception improved in the CCEP group versus other groups (p < 0.001). Improvement of the Romberg index (balance) was found only in the CCEP group upon within-group comparison (p < 0.001), with no difference among the groups (p > 0.05). The use of postural perception in combination with corrective exercise programs for thoracic kyphosis represents a comprehensive approach, and PPT can increase the effectiveness of the intervention.

The evaluation of static and dynamic postural balance in children with thoracic hyperkyphosis

BACKGROUND

To investigate how postural balance is affected by thoracic hyperkyphosis compared to healthy children and elucidate the relationship between balance and strength and tightness.

METHODS

A cross-sectional analysis using standardized measures to identify balance function in children with thoracic hyperkyphosis (n = 31) and compare age-matched healthy children (n = 31). Primary outcome measurements were performed for the static and dynamic balance with the biodex balance system and limits of stability with the functional reach test. Secondary outcome measurements were strength with a hand-held dynamometry, tightness with the length test of pectoralis minor and hip flexors, and the sit-reach test for hamstrings. Mann-Whitney U test was used to compare the difference between the groups. Spearman's correlation was used to analyze the possible correlations between balance and strength and tightness.

RESULTS

A significant difference was found between the groups for static balance with eyes closed (except double-leg stance anteroposterior stability index) and for the forward reach distance (p < 0.05). Strength and tightness were significantly different in children with thoracic hyperkyphosis than in healthy children (p < 0.05). Also, it was found that muscle strength of trunk extension and hip abduction and tightness of hip flexors and hamstring were factors associated with static balance with eyes closed (r > 0.10, p < 0.05).

CONCLUSIONS

Static balance in children with thoracic hyperkyphosis is affected when visual input is particularly removed, and static balance with eyes closed is correlated with changed strength and tightness in some of the trunk and lower extremity muscles.

Variation in human 3D trunk shape and its functional implications in hominin evolution

This study investigates the contribution of external trunk morphology and posture to running performance in an evolutionary framework. It has been proposed that the evolution from primitive to derived features of torso shape involved changes from a mediolaterally wider into a narrower, and antero-posteriorly deeper into a shallower, more lightly built external trunk configuration, possibly in relation to habitat-related changes in locomotor and running behaviour. In this context we produced experimental data to address the hypothesis that medio-laterally narrow and antero-posteriorly shallow torso morphologies favour endurance running capacities. We used 3D geometric morphometrics to relate external 3D trunk shape of trained, young male volunteers (N = 27) to variation in running velocities during different workloads determined at 45–50%, 70% and 85% of heart rate reserve (HRR) and maximum velocity. Below 85% HRR no relationship existed between torso shape and running velocity. However, at 85% HRR and, more clearly, at maximum velocity, we found highly statistically significant relations between external torso shape and running performance. Among all trained subjects those with a relatively narrow, flat torso, a small thoracic kyphosis and a more pronounced lumbar lordosis achieved significantly higher running velocities. These results support the hypothesis that external trunk morphology relates to running performance. Low thoracic kyphosis with a flatter ribcage may affect positively respiratory biomechanics, while increased lordosis affects trunk posture and may be beneficial for lower limb biomechanics related to leg return. Assuming that running workload at 45–50% HRR occurs within aerobic metabolism, our results may imply that external torso shape is unrelated to the evolution of endurance running performance.

A randomized controlled study of the effect of functional exercises on postural kyphosis: Schroth-based three-dimensional exercises versus postural corrective exercises

PURPOSE

To compare the effects of postural corrective and Schroth-based three-dimensional exercises on thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), balance and quality of life (QoL) in individuals with postural kyphosis.

METHODS

This was a single-blind randomized controlled clinical trial with a total of 63 subjects (57 women, 6 men) with TKA of ≥40°. Subjects were separated into three groups: postural corrective exercise group (PCEG), Schroth-based three-dimensional exercise group (SBEG) and control group (CG). Participants in the exercise groups participated in the exercise program twice a week for eight weeks under the supervision of a physiotherapist: CG performed no exercise but was generally informed. The primary outcome variable was TKA. Secondary outcome variables were LLA, balance and QoL.

RESULTS

After the functional exercise programs, TKA (mean change for PCEG, SBEG: -9.71, -14.76, p < 0.001), static postural stability index overall (-0.22, -0.40, p < 0.05), and QoL (-0.41, -0.37, p < 0.001) significantly improved in both training groups compared with CG. The LLA (-3.95, p = 0.003) was significantly lower in the SBEG group than in CG.

CONCLUSION

This study demonstrated that Schroth-based three-dimensional exercises are an effective treatment for individuals with postural kyphosis and have a large effect size that improves TKA, LLA, balance and QoL. Clinical trial registration number: NCT03706495 Implications for rehabilitationEight weeks of postural corrective or Schroth-based three-dimensional functional exercise programs are effective in addressing thoracic kyphosis angle (TKA), balance, and quality of life in individuals with postural kyphosis.An eight-week Schroth-based three-dimensional exercise program was more effective than postural corrective exercises in improving TKA, lumbar lordosis angle, and balance for patients with postural kyphosis.Schroth-based three-dimensional exercise programs could promote balance and spinal health in young adults with thoracic kyphosis.

The comparison of two corrective exercise approaches for hyperkyphosis and forward head posture: A quasi-experimental study

BACKGROUND

Hyperkyphosis (HKP) and forward head posture (FHP) occur due to prolonged poor postures and repetitive activities.

OBJECTIVE

The present study aimed to compare the effects of the National Academy of Sports Medicine (NASM) and Sahrmann corrective exercises on HKP and FHP correction.

METHODS

This quasi-experimental study was conducted on 30 subjects with HKP and FHP, who were randomly assigned to the NASM (n= 15) and Sahrmann groups (n= 15). The ImageJ software and a spinal mouse device were used to measure FHP and HKP deformities, and neck and shoulder muscle strength, range of motion (ROM), and pulmonary function were assessed as the secondary outcomes before and after the eight-week intervention.

RESULTS

FHP improved more significantly in the Sahrmann group compared to the NASM group (P< 0.05), while no significant difference was observed between the groups in HKP (P> 0.05). The improvement in the neck and shoulder muscle strength was more significant in the Sahrmann group compared to the NASM (P< 0.05), except for the neck flexors. In addition, the neck extension ROM enhanced more significantly in the Sahrmann group compared to the NASM group (P< 0.05).

CONCLUSION

According to the results, the Sahrmann corrective exercises that focused on the correction of imbalanced muscle stiffness had more significant effects on the correction of FHP, neck and shoulder muscle strength and neck extension ROM.

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.

Relationship of back muscle and knee extensors with the compensatory mechanism of sagittal alignment in a community-dwelling elderly population

Compensatory mechanisms, such as a decrease in thoracic spine kyphosis and posterior tilting or rotation of the pelvis, aim to achieve optimal alignment of the spine. However, the effect of muscle strength on these compensatory mechanisms has not been elucidated. This study aimed to investigate the impact of back muscle and lower extremity strength on compensatory mechanisms in elderly people. Overall, 409 community-dwelling elderly participants (164 men, 245 women) were included. Age, disc degeneration, and 2 or more vertebral fractures showed a significant increase of risk for sagittal vertical axis (SVA) deterioration. Conversely, stronger back, hip flexor, and knee extensor muscles reduced the risk for SVA deterioration. To investigate the association of each muscle's strength with compensatory mechanisms, 162 subjects with pelvic incidence-lumbar lordosis > 10° were selected. The linear regression model for thoracic kyphosis demonstrated a negative correlation with back muscle strength and positive correlation with vertebral fracture. The regression analysis for pelvic tilt demonstrated a positive correlation with knee extensor strength. Back, hip flexor, and knee extensor muscle strength were associated with sagittal spinal alignment. Back muscle strength was important for the decrease in thoracic kyphosis, and knee extensor strength was associated with pelvic tilt.

Functional Analysis of the Spine with the Idiag SpinalMouse System among Sedentary Workers Affected by Non-Specific Low Back Pain

WHO describes “low back pain” (LBP) as the most common problem in overall occupational-related diseases. The aim of this study was to evaluate characteristics of spinal functionality among sedentary workers and determine usability of the SpinalMouse^® skin-surface measurement device in workplace settings in a risk population for LBP. The spinal examination was implemented at National Instruments Corporations’ Hungarian subsidiary, Debrecen in October, 2015, involving 95 white-collar employees as volunteers to assess spinal posture and functional movements. Data from the physical examination of 91 subjects (age: 34.22 ± 7.97 years) were analyzed. Results showed significant differences (p < 0.05) in posture and mobility of the spinal regions in sitting compared to standing position. Significant positive correlations were observed between values measured in standing and sitting positions in all observed regions and aspects of the spine (p < 0.05) except posture of lumbar extension (p = 0.07) and mobility of sacrum/hip in E-F (p = 0.818). Significant (p < 0.001) difference (5.70°) was found between the spinal inclination in sitting 6.47 ± 3.55° compared to standing 0.77 ± 2.53 position. Sitting position has a negative effect on the posture and mobility of the spine among white-collar employees. The SpinalMouse can be used effectively to determine spinal posture and mobility in cross-sectional studies and impact analysis of physical exercise interventions.

The efficacy of Theraband versus general active exercise in improving postural kyphosis

BACKGROUND

Thoracic kyphotic posture is accompanying increased biomechanical load of the backbone which is possibly problematic.

OBJECTIVE

The current study aimed to examine the effects of general active exercise versus Theraband exercise on female kyphotic posture.

METHODS

An experimental study was conducted at the biomechanical lab. in Physical Therapy College, Cairo University. Fourteen female volunteers with kyphotic posture aged from 18 to 30 years were selected and equally distributed into two groups; 1st group received Theraband exercises (neck retraction exercise, scapular retraction exercise, and resistive shoulder blade squeeze) and 2nd group received general active exercises (Thoracic stretching exercise, thoracic extension exercises, and extension in lying with cervical retraction exercises). Each exercise was conducted properly for 60 min in 3 sessions per week for 4 weeks (total of 12 sessions per week). The Index of kyphosis (IK) was calculated before and after treatment. Moreover, the percentage of back disability index questionnaire (PBDI) and pain score were also detected.

RESULTS

Multivariate analysis of covariance (MANCOVA) was used to compare the post-treatment's means between the first and second groups and control the pre-treatment variables. No significant differences were found post-treatment (P > 0.05). Moreover, IK measures showed a statistically significant difference post-treatment (P < 0.05). The paired sample t-test showed statistically significant differences (P < 0.05) in all variables within the first and second groups.

CONCLUSION

The current study demonstrated the positive effect of both techniques in reducing the IK, percentage of back disability index, and pain score with a more positive effect of Theraband in reducing the IK measures post-treatment.

Effect of 9-month Pilates program on sagittal spinal curvatures and hamstring extensibility in adolescents: randomised controlled trial

The percentage of spine misalignment increases during the childhood and adolescence stages. The Pilates method has been associated with an improvement in the sagittal spine disposition, but no studies have been conducted on adolescents. Therefore, the present study aimed to evaluate the effectiveness of a 9-month Pilates exercise program (PEP) on hamstring extensibility and sagittal spinal curvatures on adolescents. This randomised controlled trial included 236 adolescents. The experimental group (EG) received a PEP (9 months, 2 sessions/week, 15 minutes/session). The control group (CG) did not receive any intervention. Hamstring extensibility was measured with the passive and active straight leg raise and toe-touch tests. Sagittal spinal curvatures and pelvic tilt was assessed in relaxed standing, active alignment and toe-touch test positions. The EG had significant changes in hamstring extensibility, lumbar curvature and pelvic tilt in standing sagittal curvature. The CG became significantly worse in thoracic kyphosis in standing. This study provides evidence of nine-months of a PEP increased the hamstring extensibility; averted the increase of the thoracic curvature, and decreased the curvature of the lumbar lordosis and pelvic tilt in standing position; avoided a greater increase of thoracic curvature in active alignment in standing position; and avoided the increase of thoracic curvature in trunk flexion.

Effects of a Virtual Reality Dance Training Program on Kyphosis Angle and Respiratory Parameters in Young Women With Postural Hyperkyphosis: A Randomized Controlled Clinical Trial

CONTEXT

Thoracic hyperkyphosis, one of the most common spinal deformities, may lead to undesirable pulmonary outcomes.

OBJECTIVE

To study, the efficacy of virtual reality exercise training on thoracic hyperkyphosis and respiratory parameters in young women.

DESIGN

Randomized clinical trial.

SETTING

Laboratory setting.

PARTICIPANTS AND INTERVENTION

Participants were randomly assigned to one of two 4-week exercise training groups: regular training (RT), which involved stretch and strength training, or virtual reality with RT (VRRT), which involved dance training with the Xbox 360 Kinect® game in addition to the exercises, which the RT group received.

MAIN OUTCOME MEASURES

The authors measured kyphosis angle with a Flexicurve ruler and recorded respiratory parameters (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1]) with a spirometer in each participant at baseline and postintervention. Separate 2 × 2 repeated-measure analysis of variances were used to analyze differences between means for kyphosis angle, FEV1, and FVC. Based on the significant interactions between time and group, the paired t test was used to compare the results at baseline and postintervention, and the independent sample t test was used to compare the differences in changes between groups. Level of significance was considered at P < .05 except for paired t test that was adjusted to P < .025 for each variable in 2 groups.

RESULTS

The results showed statistically significant interactions between time and group for kyphosis angle, FEV1, and FVC. Postintervention thoracic kyphosis angle decreased and FVC increased significantly in both groups and FEV1 improved significantly in virtual reality with RT group. The improvements in thoracic kyphosis, FVC, and FEV1 in the virtual reality with RT group were significantly greater (P < .001) than in the RT group.

CONCLUSION

Dance training with the Xbox 360 Kinect game was an effective therapy in improving thoracic kyphosis angle, FVC, and FEV1 in young women with thoracic hyperkyphosis.

Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials

Despite the widespread use of postural correction in exercise interventions, limited experimental evidence exists for its effectiveness. The present study aimed to systematically review the literature on the efficacy of exercise interventions in improving postural malalignment in head, neck, and trunk. A systematic review was performed by screening four scientific databases (MEDLINE, Web of Science, EBSCO, and Cochrane database) for published randomized controlled trials (RCTs) in English from 1996–2019. The review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Two researchers independently performed study screening, extracting data and assessing the risk of bias for each included study using the Cochrane Collaboration tool for evaluating the risk of bias. A total of 22 RCTs comprising 1,209 participants were identified for inclusion in the review. There was a high risk of bias across most of the included studies (12 studies). Only two studies were classified as low risk of bias, and eight studies were classified as moderate risk of bias. The intervention duration ranged from 2 to 13 weeks, frequency from 2 to 4 days per week, and duration of each session between 15 to 60 min. The insufficiency and quality of included studies did not allow an integrated assessment of the efficacy of exercise interventions on postural malalignments; however, the positive effects noticed in most of the studies indicate some advantages but underscores the necessity of adequately designed RCTs in this field.

Commercial Postural Devices: A Review

Wearables are devices worn on the human body and are able to measure various health parameters, such as physical activity, energy expenditure and gait. With the advancement of technology, the general population are now spending more hours craning our necks and slouching over smartphones, tablets and computers, et cetera. Bodily posture is representative of physical and mental health. Poor posture can lead to spinal complications and the same can be said vice versa. As the standard of living increases, there is an increase in consumerism and the expectation to maintain such a lifestyle even in the aging population. Therefore, many are able to afford small luxuries in life, such as a piece of technology that could potentially improve their health in the long run. Wearable technology is a promising alternative to laboratory systems for movement and posture analysis. This article reviews commercial wearable devices with a focus on postural analysis. The clinical applicability of posture wearables, particularly in preventing, monitoring and treating spinal and musculoskeletal conditions, along with other purposes in healthcare, will be discussed.