Efficacy of exercise intervention on thoracic kyphosis in adults: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Zhao ^1,2 , ZHENG Tingting ¹ , WANG Yushu ¹ , LUO Fei ¹ ,  LIU Lei ¹

1. The First Affiliated Hospital of Army Medical University, Chongqing 400000, P. R. China;
2. The General Hospital of Western Theater Command, PLA, Chengdu 610000, P. R. China;

Corresponding author：

LIU Lei, Email: ttcrystalma@163.com

Keywords：

Thoracic kyphosis; Exercise; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.202211174

Video：

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Objective To systematically review the efficacy of exercise interventions on thoracic kyphosis in adults. Methods The PubMed, EMbase, Web of Science, CINAHL, Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) related to the objective from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. Results A total of 10 RCTs involving 482 patients were included. The results of meta-analysis showed that exercise interventions could reduce kyphosis angle (MD=−5.27, 95%CI −8.37 to −2.17, P<0.01) and improve quality of life (SMD=0.78, 95%CI 0.52 to 1.04, P<0.01) in thoracic kyphosis in adults, but there were no significant differences between the two groups in pain and physical function. Conclusion Current evidence suggests that exercise interventions can reduce thoracic kyphosis angle and improve quality of life in adults, but the effects on pain and physical function are unclear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： ZHANG Zhao, ZHENG Tingting, WANG Yushu, LUO Fei, LIU Lei. Efficacy of exercise intervention on thoracic kyphosis in adults: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(5): 534-538. doi: 10.7507/1672-2531.202211174 Copy

1.	Yaman O, Dalbayrak S. Kyphosis and review of the literature. Turk Neurosurg, 2014, 24(4): 455-465.
2.	Kado DM, Prenovost K, Crandall C. Narrative review: hyperkyphosis in older persons. Ann Intern Med, 2007, 147(5): 330-338.
3.	McDaniels-Davidson C, Davis A, Wing D, et al. Kyphosis and incident falls among community-dwelling older adults. Osteoporos Int, 2018, 29(1): 163-169.
4.	Zhou Z, Liu F, Li R, et al. The effects of exercise therapy on adolescent idiopathic scoliosis: an overview of systematic reviews and meta-analyses. Complement Ther Med, 2021, 58: 102697.
5.	张威, 卜淑敏, 王涛, 等. 运动干预对青少年轻、中度特发性脊柱侧弯患者疗效的Meta分析. 中国循证医学杂志, 2022, 22(8): 896-900.
6.	González-Gálvez N, Gea-García GM, Marcos-Pardo PJ. Effects of exercise programs on kyphosis and lordosis angle: a systematic review and meta-analysis. PLoS One, 2019, 14(4): e0216180.
7.	Ponzano M, Tibert N, Bansal S, et al. Exercise for improving age-related hyperkyphosis: a systematic review and meta-analysis with GRADE assessment. Arch Osteoporos, 2021, 16(1): 140.
8.	Bautmans I, Van Arken J, Van Mackelenberg M, et al. Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med, 2010, 42(2): 129-135.
9.	Bennell KL, Matthews B, Greig A, et al. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord, 2010, 11: 36.
10.	Çergel Y, Topuz O, Alkan H, et al. The effects of short-term back extensor strength training in postmenopausal osteoporotic women with vertebral fractures: comparison of supervised and home exercise program. Arch Osteoporos, 2019, 14(1): 82.
11.	Kamali F, Shirazi SA, Ebrahimi S, et al. Comparison of manual therapy and exercise therapy for postural hyperkyphosis: a randomized clinical trial. Physiother Theory Pract, 2016, 32(2): 92-97.
12.	Katzman WB, Parimi N, Gladin A, et al. Sex differences in response to targeted kyphosis specific exercise and posture training in community-dwelling older adults: a randomized controlled trial. BMC Musculoskelet Disord, 2017, 18(1): 509.
13.	Katzman WB, Vittinghoff E, Lin F, et al. 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. Osteoporos Int, 2017, 28(10): 2831-2841.
14.	Naderi A, Rezvani M H, Shaabani F, et al. Effect of kyphosis exercises on physical function, postural control and quality of life in elderly men with hyperkyphosis. Salmand, 2019, 2019: 464-479.
15.	Navega MT, Furlanetto MG, Lorenzo DM, et al. Effect of the Mat Pilates method on postural balance and thoracic hyperkyphosis among elderly women: a randomized controlled trial. Rev Brasil Geriat Geront, 2016, 19(3): 465-472.
16.	Özdemir Görgü S, Algun ZC. A randomized controlled study of the effect of functional exercises on postural kyphosis: Schroth-based three-dimensional exercises versus postural corrective exercises. Disabil Rehabil, 2022, 1-11.
17.	Seidi F, Rajabi R, Ebrahimi I, et al. The efficiency of corrective exercise interventions on thoracic hyper-kyphosis angle. J Back Musculoskelet Rehabil, 2014, 27(1): 7-16.
18.	Gum JL, Carreon LY, Glassman SD. State-of-the-art: outcome assessment in adult spinal deformity. Spine Deform, 2021, 9(1): 1-11.
19.	Mizutani M, Eguchi Y, Toyoguchi T, et al. A 2-year longitudinal study of skeletal muscle mass in women over 40 years of age with degenerative lumbar scoliosis. Eur Spine J, 2022, 31(5): 1158-1165.
20.	Cristante AF, Silva RTE, Costa GHRD, et al. Adult degenerative scoliosis. Rev Bras Ortop (Sao Paulo), 2021, 56(1): 1-8.
21.	López-Torres O, Mon-López D, Gomis-Marzá C, et al. Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: a systematic review. J Bodyw Mov Ther, 2021, 27: 16-25.
22.	Monticone M, Ambrosini E, Cazzaniga D, et al. Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial. Eur Spine J, 2016, 25(10): 3120-3129.

1. Yaman O, Dalbayrak S. Kyphosis and review of the literature. Turk Neurosurg, 2014, 24(4): 455-465.
2. Kado DM, Prenovost K, Crandall C. Narrative review: hyperkyphosis in older persons. Ann Intern Med, 2007, 147(5): 330-338.
3. McDaniels-Davidson C, Davis A, Wing D, et al. Kyphosis and incident falls among community-dwelling older adults. Osteoporos Int, 2018, 29(1): 163-169.
4. Zhou Z, Liu F, Li R, et al. The effects of exercise therapy on adolescent idiopathic scoliosis: an overview of systematic reviews and meta-analyses. Complement Ther Med, 2021, 58: 102697.
5. 张威, 卜淑敏, 王涛, 等. 运动干预对青少年轻、中度特发性脊柱侧弯患者疗效的Meta分析. 中国循证医学杂志, 2022, 22(8): 896-900.
6. González-Gálvez N, Gea-García GM, Marcos-Pardo PJ. Effects of exercise programs on kyphosis and lordosis angle: a systematic review and meta-analysis. PLoS One, 2019, 14(4): e0216180.
7. Ponzano M, Tibert N, Bansal S, et al. Exercise for improving age-related hyperkyphosis: a systematic review and meta-analysis with GRADE assessment. Arch Osteoporos, 2021, 16(1): 140.
8. Bautmans I, Van Arken J, Van Mackelenberg M, et al. Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med, 2010, 42(2): 129-135.
9. Bennell KL, Matthews B, Greig A, et al. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord, 2010, 11: 36.
10. Çergel Y, Topuz O, Alkan H, et al. The effects of short-term back extensor strength training in postmenopausal osteoporotic women with vertebral fractures: comparison of supervised and home exercise program. Arch Osteoporos, 2019, 14(1): 82.
11. Kamali F, Shirazi SA, Ebrahimi S, et al. Comparison of manual therapy and exercise therapy for postural hyperkyphosis: a randomized clinical trial. Physiother Theory Pract, 2016, 32(2): 92-97.
12. Katzman WB, Parimi N, Gladin A, et al. Sex differences in response to targeted kyphosis specific exercise and posture training in community-dwelling older adults: a randomized controlled trial. BMC Musculoskelet Disord, 2017, 18(1): 509.
13. Katzman WB, Vittinghoff E, Lin F, et al. 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. Osteoporos Int, 2017, 28(10): 2831-2841.
14. Naderi A, Rezvani M H, Shaabani F, et al. Effect of kyphosis exercises on physical function, postural control and quality of life in elderly men with hyperkyphosis. Salmand, 2019, 2019: 464-479.
15. Navega MT, Furlanetto MG, Lorenzo DM, et al. Effect of the Mat Pilates method on postural balance and thoracic hyperkyphosis among elderly women: a randomized controlled trial. Rev Brasil Geriat Geront, 2016, 19(3): 465-472.
16. Özdemir Görgü S, Algun ZC. A randomized controlled study of the effect of functional exercises on postural kyphosis: Schroth-based three-dimensional exercises versus postural corrective exercises. Disabil Rehabil, 2022, 1-11.
17. Seidi F, Rajabi R, Ebrahimi I, et al. The efficiency of corrective exercise interventions on thoracic hyper-kyphosis angle. J Back Musculoskelet Rehabil, 2014, 27(1): 7-16.
18. Gum JL, Carreon LY, Glassman SD. State-of-the-art: outcome assessment in adult spinal deformity. Spine Deform, 2021, 9(1): 1-11.
19. Mizutani M, Eguchi Y, Toyoguchi T, et al. A 2-year longitudinal study of skeletal muscle mass in women over 40 years of age with degenerative lumbar scoliosis. Eur Spine J, 2022, 31(5): 1158-1165.
20. Cristante AF, Silva RTE, Costa GHRD, et al. Adult degenerative scoliosis. Rev Bras Ortop (Sao Paulo), 2021, 56(1): 1-8.
21. López-Torres O, Mon-López D, Gomis-Marzá C, et al. Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: a systematic review. J Bodyw Mov Ther, 2021, 27: 16-25.
22. Monticone M, Ambrosini E, Cazzaniga D, et al. Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial. Eur Spine J, 2016, 25(10): 3120-3129.

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