Elabd Omar M, Elsamahy Sara A, Abdelmutilibe Sahar M, Mohammed Amira H, Ali Faten, Elabd Aliaa M
From the Department of Orthopedics and its Surgeries, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt (OME); Department of Physical Therapy, Aqaba University of Technology, Aqaba, Jordan (OME); Basic Science Department, Faculty of Physical Therapy, Misr University for Science and Technology, Giza, Egypt (SAE); Department of Physical Therapy for Musculoskeletal Disorders and Its Surgeries, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt (SMA); Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt (AHM), Department of Physical Therapy for Internal Medicine and Geriatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt (FA); Basic Science Department, Faculty of Physical Therapy, Benha University, Benha, Egypt (AME).
Am J Phys Med Rehabil. 2025 Mar 1;104(3):203-209. doi: 10.1097/PHM.0000000000002622. Epub 2024 Sep 16.
The aim of the study was to investigate whether adding diaphragmatic release to corrective exercise could improve the Cobb angle and pulmonary function more than corrective exercise alone in hyperkyphotic adolescent girls.
This is a single-blinded, randomized, controlled trial.
One hundred eighteen adolescent hyperkyphotic girls were allocated randomly into two equal groups. Control group received only corrective exercise, while study group received diaphragmatic release in addition to corrective exercise. Primary outcome was Cobb angle, assessed by lateral radiographs. Secondary outcomes were pulmonary function testing, assessed by computerized spirometery. Outcomes were assessed before and after treatment, after 3 mos of interventions, in both groups.
Two-way analysis of variance revealed that both Cobb angle and pulmonary function testing significantly improved after treatment in both groups ( P < 0.001). Time*group interaction revealed that the study group had a superior improvement in Cobb angle and pulmonary function testing compared to the control group ( P < 0.003 and P < 0.001, respectively).
Adding diaphragmatic release to 3 mos of multimodal corrective exercise program showed superior improvements in Cobb angle and pulmonary function testing than corrective exercise alone in hyperkyphotic adolescent girls within a shorter timeframe compared to previous studies. These results strengthen the hypothesis of its potential as a beneficial addition to the treatment of thoracic hyperkyphosis.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
Upon completion of this article, the reader should be able to: (1) Recognize poor habits that play a significant role in developing hyperkyphosis in adolescents; (2) Construct the link between diaphragm malfunction and adolescent hyperkyphosis and its associated disorders of the cervical and thoracic spine and pulmonary function testing; (3) Carry out diaphragmatic myofascial release and corrective exercise for the spine; (4) Design a multimodal program to improve the Cobb angle and pulmonary function testing in hyperkyphotic adolescents; and (5) Measure the improvement of the Cobb angle and pulmonary function testing after treatment in hyperkyphotic adolescents.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在调查在脊柱后凸的青春期女孩中，在矫正运动基础上增加膈肌放松训练是否比单纯的矫正运动更能改善Cobb角和肺功能。
这是一项单盲、随机对照试验。
118名青春期脊柱后凸女孩被随机分为两组，每组人数相等。对照组仅接受矫正运动，而研究组在矫正运动基础上还接受膈肌放松训练。主要观察指标为通过脊柱侧位X线片评估的Cobb角。次要观察指标为通过电脑化肺量计评估的肺功能测试。在两组中，于治疗前后以及干预3个月后评估各项观察指标。
双向方差分析显示，两组治疗后Cobb角和肺功能测试均有显著改善（P<0.001）。时间*组间交互作用显示，与对照组相比，研究组在Cobb角和肺功能测试方面有更显著的改善（分别为P<0.003和P<0.001）。
与以往研究相比，在脊柱后凸的青春期女孩中，在为期3个月的多模式矫正运动方案中增加膈肌放松训练，在更短时间内改善Cobb角和肺功能测试方面比单纯矫正运动更具优势。这些结果强化了其作为胸椎后凸治疗有益补充的潜在作用的假设。
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阅读本文后，读者应能够：（1）识别在青少年脊柱后凸形成中起重要作用的不良习惯；（2）构建膈肌功能障碍与青少年脊柱后凸及其相关的颈椎和胸椎疾病以及肺功能测试之间的联系；（3）进行膈肌肌筋膜放松和脊柱矫正运动；（4）设计一个多模式方案以改善脊柱后凸青少年的Cobb角和肺功能测试；（5）测量脊柱后凸青少年治疗后Cobb角和肺功能测试的改善情况。
高级。
学术物理医学与康复医师协会经继续医学教育认证委员会认可，可为医生提供继续医学教育。学术物理医学与康复医师协会指定此基于期刊的继续医学教育活动最多可获得1.0个美国医学协会医师认可奖第1类学分™。医生应仅根据其参与活动的程度申请相应学分。
