Department of Chiropractic, Macquarie University, Sydney, Australia.
Department of Chiropractic, Macquarie University, Sydney, Australia.
Musculoskelet Sci Pract. 2021 Dec;56:102438. doi: 10.1016/j.msksp.2021.102438. Epub 2021 Aug 5.
A variety of treatments aim to reduce thoracic hyperkyphosis in adults, thereby improving posture and reducing possible complications.
To investigate the effectiveness of treatments to reduce thoracic hyperkyphosis.
Systematic review and meta-analysis.
MEDLINE, EMBASE, CINAHL, and CENTRAL were searched from inception to March 2021. Two authors independently selected randomised controlled trials assessing the effectiveness of treatments to reduce thoracic hyperkyphosis in adults. Raw data on mean change in thoracic kyphosis were extracted and standardised mean differences (SMD) calculated. Meta-analysis was performed on studies homogenous for study population and intervention. Strength of evidence was assessed using GRADE.
Twenty-eight studies were included, with five meta-analyses performed. Low to moderate-quality evidence found structured exercise programs of three-months duration or less effective in reducing thoracic hyperkyphosis in younger (SMD -2.8; 95%CI -4.3 to -1.3) and older populations (SMD -0.3; 95%CI -0.6 to 0.0). Low-quality evidence found bracing for three months or more effective in older participants (SMD -1.0, 95%CI -1.3 to -0.7). A single study demonstrated the effectiveness of multimodal care in younger participants. The available evidence suggests multimodal care, structured exercise programs over three months duration, and taping in older adults, and biofeedback and muscle stimulation in younger adults, are ineffective in reducing thoracic hyperkyphosis.
Low to moderate-quality evidence indicates that structured exercise programs are effective to reduce thoracic hyperkyphosis. Low-quality evidence indicates that bracing is effective to reduce thoracic hyperkphosis in older adults.
多种治疗方法旨在减少成年人的胸椎后凸畸形，从而改善姿势并减少可能的并发症。
研究减少胸椎后凸畸形的治疗效果。
系统评价和荟萃分析。
从建库至 2021 年 3 月，检索 MEDLINE、EMBASE、CINAHL 和 CENTRAL 数据库。两名作者独立筛选评估治疗方法减少成年人胸椎后凸畸形的有效性的随机对照试验。提取胸椎后凸畸形平均变化的原始数据，并计算标准化均数差（SMD）。对研究人群和干预措施相同的研究进行荟萃分析。使用 GRADE 评估证据强度。
共纳入 28 项研究，进行了 5 项荟萃分析。低到中等质量证据表明，持续时间为 3 个月或更短的结构化运动方案在年轻人群（SMD -2.8；95%CI -4.3 至 -1.3）和老年人群（SMD -0.3；95%CI -0.6 至 0.0）中减少胸椎后凸畸形的效果不佳。低质量证据表明，支具治疗 3 个月或更长时间对老年参与者有效（SMD -1.0，95%CI -1.3 至 -0.7）。一项研究表明多模式护理对年轻参与者有效。现有证据表明，多模式护理、持续 3 个月以上的结构化运动方案以及老年患者的贴扎、年轻患者的生物反馈和肌肉刺激在减少胸椎后凸畸形方面无效。
低到中等质量证据表明，结构化运动方案可有效减少胸椎后凸畸形。低质量证据表明，支具对老年患者减少胸椎后凸畸形有效。
