Extension Exercise For Thoracic Kyphosis

:dropcap_open:G:dropcap_close:reetings and welcome to Science In Brief. This column is an extension of ScienceInBrief.com, our chiropractic literature review service. The Science In Brief project scans the scientific literature base, both past and current, for articles of interest to practicing chiropractors, and then distills each paper’s pertinent points into “plain English” format for busy practitioners. Reviews are delivered weekly to your in-box and there is absolutely no charge to subscribe. The American Chiropractor has graciously allowed us to publish a monthly column to help in our efforts to keep the profession abreast of the latest relevant research. The following is a review of a 2008 article that didn’t get a lot of attention at the time. Thanks to our chiropractic sciences contributor Roger Coleman, DC (Othello, Washington) for this interesting article. I hope you find it and future articles to be helpful.
Spinal extension exercises prevent natural progression of kyphosis
The Facts:
  1. The authors sought to determine if spinal extension exercises could prevent the natural progression of thoracic kyphosis in women.
  2. Kyphosis tends to progress with age and increases are greatest in the 50 to 59 age group.
  3. The study involved 250 women who did not exhibit either scoliosis or compression fracture of the thoracic spine. 
  4. Participants were prescribed a series of nine extension exercises directed at the middle back, shoulder girdle, neck, and lower back. Participants were to perform the exercises three times weekly and were followed up at one year. 
  5. Participants exhibited less progression of kyphosis than the controls who did not do the exercises.
  6. The difference in the two groups was “highly significant.”
  7. Compliance was a problem as they were only able to get 18% of the subjects to perform the exercises regularly.
Take Home:
Although this was only a pilot study, extension exercises appear to be helpful in the prevention of kyphosis progression. More study is needed.
Reviewer’s Comments
Most doctors of chiropractic utilize exercise in their treatment programs, although it is probable that many do not recommend exercises specifically for thoracic kyphosis. This paper should encourage doctors to look more closely at implementing appropriate programs of extension exercises for their patients with thoracic kyphosis.
Roger Coleman, DC
Ball JM, Cagle P, Johnson BE, Lucasey C, Lukert BP. Spinal extension exercises prevent natural progression of kyphosis. Osteoporos Int. 2009;20:481-9. Epub 2008 Jul 26.
Link to Abstract
The authors point out that more study is needed. Nevertheless, I think the paper has practical application. Patients with kyphosis present in chiropractic offices with great regularity, so the subject is relevant. Also, by chiropractic standards, this wasn’t a particularly small study. Furthermore, the design and conclusions seem fairly straightforward. Best of all, there’s minimal risk and cost associated with the treatment involved. Taken together, I’m very comfortable recommending extension exercise for my patients with kyphotic deformity. 
Finally, it’s noteworthy that the authors, who are all faculty members of the Department of Physical Therapy Education, University of Kansas, experienced the same problems with patient compliance that many of us see in practice. This study tells us that, although it can be frustratingly difficult to actually get patients to do their self-care programs, the results for those who do participate are definitely worthwhile.
This column extends out of ScienceInBrief.com, our chiropractic literature review service.
Dr. Mark R Payne, Phenix City, AL is Editor of ScienceInBrief.com, a scientific literature review for busy chiropractors. He is also President of Matlin Mfg Inc. a manufacturer of postural rehabilitation products since 1988. Subscription to ScienceInBrief.com is FREE to doctors of chiropractic and chiropractic students. Reviews of relevant scientific articles are emailed weekly to subscribers.

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