Abstract
Thoracic kyphosis represents a widely spread spinal deviation that affects an increasing number of children and adolescents. It effects not only the development of children but can also have consequences on the ventilatory parameters and on the aerobic functional capacity. The objectives of our study were to assess the respiratory function and functional capacity in children and adolescents with thoracic kyphosis who followed a physical therapy program and to compare these parameters to healthy controls. Another objective was to evaluate the adherence of this category of patients to a supervised exercise program. 20 children and adolescents diagnosed with thoracic kyphosis and 20 gender and age-matched healthy controls were included in the study. Our patients performed a twelve-week supervised exercise program. They were assessed at the beginning and at the end of rehabilitation by spirometry (forced vital capacity-FVC, forced expiratory volume in 1 second-FEV1, peak expiratory flow-PEF and FEV1/FVC ratio) and functional capacity testing (6-minute walk test: 6MWT). A final assessment was conducted with the parents of the children and the adolescents with thoracic kyphosis where they completed an adherence questionnaire. In patients with thoracic kyphosis, their FVC, FEV1, PEF and 6-MWT scores improved significantly after the twelve-week program (p˂0.0001). After rehabilitation there were no differences between the study patients and controls, except for the functional capacity which had lower values in children and adolescents with thoracic kyphosis. Adherence to an exercise-based program could improve the outcomes of the rehabilitation. Besides the respiratory function and functional capacity, assessing adherence to therapy and improving it should be considered when treating pediatric patients suffering from thoracic kyphosis.
Highlights
Thoracic kyphosis represents a widely spread spinal deviation that affects a high number of children and adolescents
The study included 20 children and adolescents with thoracic kyphosis, aged between 8 and 17 years old. 6 patients had Scheuermann disease, while the other 14 had postural thoracic kyphosis. 20 gender and age-matched healthy controls were recruited as controls
The patients were assessed at the beginning and at the end of their rehabilitation period by spirometry and functional capacity testing (6-minute walk test: 6MWT)
Summary
Thoracic kyphosis represents a widely spread spinal deviation that affects a high number of children and adolescents. The kyphosis can be related to poor posture or can be secondary to some diseases, the most frequent one being Scheuermann disease. Patients diagnosed with Scheuermann disease have an increased risk for back pain and a lower quality of the life than healthy patients (Ristolainen et al, 2012). Exaggerated thoracic kyphosis effects the development of children but can have consequences on their ventilatory parameters and aerobic functional capacity. The first-line treatment in pediatric patients with Scheuermann disease is conservative. It consists of rehabilitation and bracing (Bezalel et al, 2014; Pallazo et al, 2014; Bettany-Saltikov et al, 2017)
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