RecruitingNot ApplicableNCT07261358

The Effect of Three-Dimensional Exercises ( Schroth Method ) on Trunk Muscle Endurance, Sleep Quality, and Quality of Life in Adolescents With Hyperkyphosis

Sponsor

Gaziosmanpasa Research and Education Hospital

Enrollment

60 participants

Start Date

Oct 6, 2025

Study Type

INTERVENTIONAL

Conditions

Sleep Quality Adolescent Spine Deformity Trunk Muscle Endurance Kyphosis

Summary

Adolescence is a critical period for spinal growth, and progression of thoracic hyperkyphosis may lead to pain, weak trunk muscles, sleep disturbances, and reduced quality of life. This study aims to investigate the effects of three-dimensional exercise program based on the Schroth Method on trunk muscle endurance, thoracic kyphosis angle, pain, sleep quality and quality of life in adolescents aged 12-18 years with hyperkyphosis.

Eligibility

Min Age: 12 YearsMax Age: 18 Years

Inclusion Criteria5

Adolescents between 12 and 18 years of age
Presence of thoracic kyphosis with a T3-T12 Cobb angle ≥45° measured on a lateral thoracic radiograph
Sufficient physical and cognitive ability to actively participate in the exercise protocol for at least 3 months
Adequate communication and cognitive capacity to understand the educational materials provided
Ability and willingness to regularly complete the exercise log throughout the study period

Exclusion Criteria9

Scoliosis with a Cobb angle \>10° in the coronal plane
Presence of structural spinal deformities such as vertebral fracture, spondylolisthesis
History of previous spinal surgery
Neuromuscular disorders that may affect the spine (e.g., cerebral palsy, muscular dystrophy)
Structural or functional pathologies involving the spine, pelvic complex, or shoulder girdle
Balance disorders such as vestibular dysfunction, vertigo, or other conditions affecting postural control
Inability to comply with the exercise protocol due to intellectual disability, severe behavioral disorders, or significant communication impairments
Participation in professional-level sports activities that may influence exercise capacity or musculoskeletal function
Presence of serious cardiopulmonary diseases (e.g., congenital heart disease, pulmonary hypertension)

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Interventions

DIAGNOSTIC_TESTKyphosis Study Form

Kyphosis study form consisting of clinical and radiological measurements of patients aged 12-18 years who applied to the outpatient clinic with spine deformity will be filled in detail.

DIAGNOSTIC_TESTScoliosis X-ray (Orthoroentgenogram)

Adolescents aged 12-18 years presenting to the scoliosis outpatient clinic will undergo a standardized physical examination. Posture will be assessed in standing position from both anterior and lateral views in front of a posture chart. In patients where thoracic kyphosis is clinically suspected, a standing orthoroentgenogram (whole-spine radiograph) will be requested. On these radiographs, thoracic kyphosis angles will be measured to confirm the diagnosis and establish baseline values. Clinical and radiological data will be recorded in detail before study group allocation.

DIAGNOSTIC_TESTInclinometer Measurement

Thoracic kyphosis angle will also be assessed using a bubble inclinometer during physical examination. The participant will stand in a relaxed upright position, and the inclinometer will be placed over the spinous processes from T3 to T12 to measure the sagittal alignment of the thoracic spine. Three consecutive measurements will be taken for each participant, and the mean value will be recorded for analysis. This provides a reliable clinical estimate of thoracic kyphosis in addition to radiographic assessment.

DIAGNOSTIC_TESTBiering-Sorensen Test (Back Extensor Endurance Test)

The Biering-Sorensen test is a standardized clinical assessment used to evaluate the isometric endurance of the trunk extensor muscles. During the test, the participant lies prone on an examination table with the upper edge of the iliac crests aligned with the edge of the table. The lower body (pelvis, knees, and ankles) is stabilized using straps or manual fixation. The upper body is extended horizontally beyond the edge of the table, with the arms crossed over the chest. The participant is instructed to maintain the unsupported horizontal trunk position for as long as possible without assistance. The outcome is recorded as the duration, in seconds, that the participant can hold the trunk in a straight horizontal alignment before fatigue, deviation from the position, or voluntary termination occurs.