Exercises for Kyphosis

Overseen By Cristabelle Alexander, BS

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Cedars-Sinai Medical Center

Disqualifiers: Congenital kyphosis, Scoliosis >30°, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 6

Duration: 6 months

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial investigates whether daily stretching exercises can help correct kyphosis, a forward rounding of the back. It focuses on postural kyphosis and Scheuermann's kyphosis, where the spine curves more than normal. Suitable participants have noticed a significant forward curve in their upper back, particularly if it exceeds 45 degrees. Participants will join an exercise group to determine if their posture improves over time. As an unphased trial, this study provides a unique opportunity to contribute to understanding how stretching exercises might enhance posture and quality of life.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these exercises are safe for correcting kyphosis?

Research shows that exercise is generally safe and well-tolerated by most people. Studies have found that certain exercise programs can help reduce kyphosis, a forward curve of the back. Participants noticed improved posture after these exercises, indicating their effectiveness and safety.

In another study, exercises to strengthen the spine and improve posture over six months reduced kyphosis without harmful side effects. These results suggest that posture-improving exercises are safe for most people. Therefore, the stretching exercises in this trial are expected to be safe and could potentially improve back posture without significant risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using exercise to treat kyphosis because it's a simple, non-invasive approach that focuses on daily stretching exercises. Unlike conventional treatments like bracing or surgery, which can be more intense and costly, exercise offers a low-risk, accessible option that people can do at home. This method not only aims to improve posture but also enhances flexibility and overall spinal health, making it an appealing alternative for both patients and healthcare providers.

What evidence suggests that exercise is effective for correcting kyphosis?

Research has shown that exercise programs can improve posture and reduce the forward curve of the upper back, known as thoracic kyphosis. Studies have found that both short-term and long-term exercise programs can decrease this exaggerated curve. One study found that specific exercises significantly reduced the curve of the spine, making it less pronounced. Another study reported that exercises targeting kyphosis improved the strength of trunk muscles, which can support better posture. In this trial, participants in the exercise group will perform daily stretching exercises. These findings suggest that regular stretching exercises may help correct kyphosis, whether due to posture or a condition called Scheuermann's kyphosis. ^{5 6 7 8 9}

Who Is on the Research Team?

David L Skaggs, MD, MMM

Principal Investigator

Cedars-Sinai Medical Center

Are You a Good Fit for This Trial?

This trial is for young individuals aged 8-21 with a significant curve in their upper back, known as kyphosis. It's specifically for those with more than 45 degrees of curvature or excessive bending at the junction between the mid and lower back. Parents who can complete surveys will also participate.

Inclusion Criteria

I am aged 8-21 with a severe curve in my upper back.

My parents are over 18 and can complete a survey.

My parents are over 18 and can complete a survey.

Exclusion Criteria

My records do not have 'break the glass' or 'research opt out' flags.

Patients with congenital kyphosis or scoliosis

I am under 18 or unable to complete a survey due to cognitive reasons.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants perform stretching exercises daily as a conservative treatment option for kyphosis

6 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Follow-up assessments at 6 months and 2 years

Long-term follow-up

Participants are monitored for long-term outcomes and adherence

2 years

What Are the Treatments Tested in This Trial?

Interventions

• Exercise

Trial Overview The study is testing if stretching exercises can help correct the spine's curvature in patients with postural or Scheuermann's kyphosis. The goal is to see if these non-invasive exercises are an effective treatment option.

How Is the Trial Designed?

Group I: Exercise group Experimental Treatment 1 Intervention

Patients perform stretching exercises daily.

Who Is Running the Clinical Trial?

Cedars-Sinai Medical Center

Lead Sponsor

Trials

523

Recruited

165,000+

Published Research Related to This Trial

A 6-month randomized controlled trial involving 99 older adults (average age 70.6 years) demonstrated that spine-strengthening exercises and posture training significantly reduced the Cobb angle of kyphosis by an average of -3.0°, indicating a meaningful improvement in spinal alignment.

Participants in the exercise group also reported enhanced self-image and satisfaction with their appearance, suggesting that this intervention not only improves physical measures of kyphosis but also positively affects psychological well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial. Katzman, WB., Vittinghoff, E., Lin, F., et al.[2019]

A 36-year-old male with upper thoracic pain showed significant improvements in pain threshold and thoracic kyphosis angle after three different exercise sessions focused on thoracic stretching, thoracic extension, and cervical/scapular posture.

The study suggests that effective treatment for thoracic pain and kyphosis should include exercises targeting not just the thoracic region but also the cervical and scapular muscles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. Yoo, WG.[2021]

In a study of 41 elderly women, those who participated in thorax correction exercises showed significant improvements in posture and chest function compared to a control group, indicating the exercises' effectiveness.

The exercise program, which included breathing and mobility training, was conducted twice a week for 8 weeks and led to better thoracic kyphosis angles and increased chest expansion, suggesting a beneficial intervention for age-related hyperkyphosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of thorax correction exercises on flexed posture and chest function in older women with age-related hyperkyphosis. Jang, HJ., Kim, MJ., Kim, SY.[2020]

A 3-month kyphosis exercise and posture training intervention in older adults showed that kyphosis did not progress over an average follow-up of 3 years, indicating long-term maintenance of treatment effects.

Participants experienced significant long-term improvements in lumbar lordosis, with differences observed between males and females in physical function and health-related quality of life, suggesting that gender may influence the outcomes of such interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long-Term Efficacy of Treatment Effects After a Kyphosis Exercise and Posture Training Intervention in Older Community-Dwelling Adults: A Cohort Study. Katzman, WB., Parimi, N., Gladin, A., et al.[2023]

Exercise interventions significantly improve kyphosis angle and back extensor muscle strength in adults aged 45 and older with hyperkyphosis, based on a review of 24 studies.

These interventions also enhance health-related quality of life and reduce general pain, with no serious adverse events reported, indicating a safe approach to managing hyperkyphosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise for improving age-related hyperkyphosis: a systematic review and meta-analysis with GRADE assessment. Ponzano, M., Tibert, N., Bansal, S., et al.[2022]

This systematic review aims to evaluate various exercise programs specifically designed for older adults with hyperkyphosis, focusing on their impact on back shape, posture, balance, and the fear of falling.

The review will synthesize both published and unpublished studies to provide a comprehensive understanding of how different exercise interventions can improve physical outcomes in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

PROTOCOL: Exercise interventions to improve back shape/posture, balance, falls and fear of falling in older adults with hyperkyphosis: A systematic review. Duangkaew, R., Bettany-Saltikov, J., van Schaik, P., et al.[2023]

A review of 13 studies on exercise interventions for adults aged 45 and older with hyperkyphosis found that 8 of these studies reported improvements in posture, indicating that exercise may help reduce the angle of thoracic kyphosis.

While the data quality was variable and a formal meta-analysis was not conducted, the findings suggest that exercise is a feasible and potentially beneficial intervention for managing age-related hyperkyphosis, warranting further research through well-designed randomized controlled trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise for improving age-related hyperkyphotic posture: a systematic review. Bansal, S., Katzman, WB., Giangregorio, LM.[2022]

Strengthening exercises for patients with unstable lumbar fractures can lead to significant changes in spinal posture, specifically causing either kyphotic or lordotic movements in the lumbar spine, as measured through X-rays.

Different shoulder exercises affect spinal movement differently: flexing the shoulder to 45 degrees causes kyphosis, while flexing to 110 degrees and abducting to 90 degrees results in lordosis, indicating that exercise angles and loads play a crucial role in spinal alignment during rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Movements in the lumbar spine during exercises of the upper extremities. A roentgenologic study in para- and tetraplegic patients. Hein-Sørensen, O., Irstam, L.[2016]

A 3-month targeted kyphosis exercise and posture training intervention showed that older adults with low physical function and hyperkyphosis can improve their physical function, as indicated by a significant change in the Short Physical Performance Battery scores.

The intervention was safe, with no adverse events reported, and had a high adherence rate of 83% among participants with low physical function, suggesting that such programs can be effectively implemented in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Secondary analysis of change in physical function after exercise intervention in older adults with hyperkyphosis and low physical function. Gladin, A., Katzman, WB., Fukuoka, Y., et al.[2022]

A 4-month physical activity program significantly improved respiratory function in 34 surgical patients with adolescent idiopathic kyphosis, as evidenced by enhanced pulmonary function test results including FVC and FEV1.

Patients also showed improved overall physical performance, demonstrated by better results in the 6-minute walk test, indicating that exercise can positively impact both respiratory health and general well-being in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study and influence of exercise program on respiratory function of adults with kyphosis. Ghanbarzadeh, M., Mehdipour, A.[2016]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11312307/

The Effectiveness of Exercise Programs in Adolescents ... Exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis.

2. sciencedirect.com sciencedirect.com/science/article/pii/S2352013223000297

A feasibility study on home-based kyphosis-specific ... A previous review found that long-term and short-term exercise programs were effective in reducing hyperkyphosis [26]. The kyphosis-specific exercise program ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT06835608

Effects of Schroth-Based Exercise on Kyphosis Angle ... This randomized controlled trial aims to evaluate the effects of a Schroth-based three-dimensional exercise program on kyphosis angle, trunk muscle strength, ...

4. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0216180

Effects of exercise programs on kyphosis and lordosis angle The results suggest that exercise programs may have a positive effect on thoracic kyphosis angle, but no clear effect on lordotic angle. This ...

5. mdpi.com mdpi.com/2227-9032/10/12/2478

The Effect of a Comprehensive Corrective Exercise ... After training, a highly significant reduction in the kyphosis angle was observed in the CCEP and TEP groups (p < 0.001). Comparison among the ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9778671/

The Effect of a Comprehensive Corrective Exercise ... After training, a highly significant reduction in the kyphosis angle was observed in the CCEP and TEP groups (p < 0.001). Comparison among the ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5873977/

Targeted spine strengthening exercise and posture training ... A 6-month randomized controlled trial of spine-strengthening exercise and posture training reduced both radiographic and clinical measures of kyphosis.

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0003999313005145

Exercise for Improving Age-Related Hyperkyphotic Posture Thirteen studies were abstracted and included in the review; of these, 8 studies saw improvements in ≥1 measure of posture. The main sources of bias were ...

9. mdpi.com mdpi.com/2227-9032/12/15/1503

The Effectiveness of Exercise Programs in Adolescents ... Exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis.