Abstract
Purpose: This study serves to determine the effectiveness of either chiropractic spinal manipulative therapy to the thoracic spine or stretch and strengthening exercises (stretching the pectoralis major muscle and strengthening the rhomboid, middle and inferior trapezius muscles) versus the combined treatment of chiropractic spinal manipulative therapy to the thoracic spine in conjunction with stretch and strengthening exercises.Method: A randomised study design with thirty female participants between the ages of twenty and thirty nine was selected. Group 1 (n = 10) received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 (n = 10) received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 (n = 10) received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. The study consisted of seven consultations for Group 1 (they received treatment once a week for six weeks) and for Groups 2 and 3 there were nineteen consultations (they received three treatments a week for six weeks). Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1, and the first, tenth and nineteenth consultations for Groups 2 and 3. On the seventh consultation (for Group 1) and nineteenth consultation for Groups 2 and 3, only data collection was done. Objective data were obtained by using the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal) view photographs at the beginning of the initial and final consultations.Results: Statistical analysis revealed significant statistical changes for the intragroup results for all three groups. No significant statistical difference was found between the groups for the inter-group analysis.Conclusion: The study showed that all three treatment protocols for Groups 1, 2, and 3 were effective. However, Group 1 had not shown a great improvement in their postural kyphosis, Group 3 had shown a relatively good improvement in their posture, while Group 2 had shown the best results with regards to improvement of the participants' posture. Therefore, in conclusion, Groups 2 and 3 treatment protocols can be used effectively to treat postural kyphosis but Group 2's treatment protocol, consisting of chiropractic spinal manipulative therapy to the thoracic spine in combination with stretch and strengthening exercises, will yield the best results.
Highlights
Thoracic kyphosis is defined as an increase in the normal thoracic curvature of the spine (Teixeira & Carvalho, 2007)
Postural kyphosis most commonly presents in young women owing to a number of factors, such as: sitting with a slouched posture; carrying heavy bags or backpacks to school or university; watching television; breast development leading to insecurity in some individuals; and heavy manual work, as well as those owing to fashion trends, such as wearing high heeled shoes (Britnell et al, 2005)
Group 2 had a mean decrease in thoracic kyphosis of 30.66% and Group 3 had a mean decrease in thoracic kyphosis of 27.22%
Summary
Thoracic kyphosis is defined as an increase in the normal thoracic curvature of the spine (Teixeira & Carvalho, 2007). Postural kyphosis most commonly presents in young women owing to a number of factors, such as: sitting with a slouched posture; carrying heavy bags or backpacks to school or university; watching television; breast development leading to insecurity in some individuals (thereby causing shoulder protraction); and heavy manual work, as well as those owing to fashion trends, such as wearing high heeled shoes (Britnell et al, 2005). In older women (twenty five to forty five years of age), the increased kyphosis has been attributed to certain sporting activities, financial stresses, physical abuse, pregnancy and wearing high heeled shoes (Britnell et al, 2005)
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