Orthotic treatment of idiopathic hyperkyphosis with Milwaukee brace

Adding corrective exercises along with bracing for postural hyperkyphosis among adolescents: A randomized controlled trial

BACKGROUND

Although most attention has been paid to the effectiveness of corrective exercises and bracing to improve thoracic hyperkyphosis, no study, to the best of our knowledge, has compared the effects of exercises plus bracing to bracing alone.

OBJECTIVE

To compare the effect of corrective exercises and bracing and bracing alone on the Cobb angle of thoracic kyphosis.

DESIGN

A parallel-group, blinded, randomized, controlled trial.

PARTICIPANTS

The participants included 180 adolescents with thoracic hyperkyphosis who were randomized into corrective exercises plus bracing (N = 60), only bracing (N = 60), and a waitlist control group (N = 60).

INTERVENTION

Intervention groups received their programs for 24 weeks, whereas the control group was placed on a waitlist for 6 months before receiving a delayed intervention.

MAIN OUTCOME MEASUREMENTS

The primary outcome was change from baseline to 6 months in Cobb angle measured from standing lateral spine radiographs.

RESULTS

Significant differences were observed in the Cobb angle of thoracic kyphosis between all groups at the posttest (p <.001). In post hoc analyses, we found significant differences between the corrective exercise plus bracing group (15.5° decline) and the bracing only group (8.8° decline), p <.001; both groups had bigger improvements than the control group, which increased by 1.2° (p <.001).

CONCLUSION

The combination of corrective exercises and bracing demonstrated better overall outcomes in Cobb angle compared to only bracing, as well as waitlist control in adolescents with thoracic hyperkyphosis.