The Effects of Basic Body Awareness Therapy Added to a Corrective Exercise Program on Body Image, Self-Esteem, and Posture in Adolescents With Postural Hyperkyphosis
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Body Awareness - Body Awareness Questionnaire (BAQ)
Study Overview
Brief Summary
This study is designed as a randomized controlled trial to evaluate the additional benefits of Basic Body Awareness Therapy (BBAT) when combined with a corrective exercise program for adolescents with postural hyperkyphosis. Postural hyperkyphosis, defined as a thoracic kyphosis angle of 40 degrees or greater, often leads to physical misalignments and psychosocial issues such as decreased self-esteem and poor body image during adolescence. Participants will be randomly assigned to either Group A (Experimental) or Group B (Control) using a stratified block randomization method. Both groups will participate in a 12-week intervention consisting of supervised Schroth corrective exercises performed twice weekly. Group A will additionally receive one session per week of BBAT, a physiotherapy method focusing on movement quality, mental awareness, and the integration of physical and mental self-awareness through lying, sitting, standing, and walking exercises. Group B will receive Autogenic Training, a systematic relaxation technique, as an active control. Assessments will be conducted at baseline and at the end of the 12-week program. The primary outcome measures include body awareness (Body Awareness Questionnaire), aesthetic perception of the spine (Kyphosis Specific Spinal Appearance Questionnaire), self-esteem (Rosenberg Self-Esteem Scale), and digital posture analysis (PostureScreen Mobile). Secondary outcomes involve clinical measurements of kyphosis (Flexicurve and Wall-Occiput Distance), dynamic and static balance (Y-Balance Test and Single-Leg Stance Test), thoracic joint position sense, health-related quality of life (SRS-30), and pain intensity (Numeric Pain Rating Scale). The study aims to provide a comprehensive understanding of how mindfulness and movement awareness can enhance traditional physical rehabilitation for spinal postural disorders.
Detailed Description
This study is a randomized controlled trial designed to evaluate the impact of integrating Basic Body Awareness Therapy (BBAT) into a corrective exercise protocol for adolescents with postural hyperkyphosis. Postural hyperkyphosis is defined in this study as a thoracic kyphosis angle of 40 degrees or greater. The research explores how this combined approach affects physical posture as well as psychosocial variables like body image and self-esteem. Participants will be randomly assigned to either the experimental group (Group A) or the control group (Group B) using stratified block randomization based on age and gender. Both groups will undergo a 12-week intervention consisting of supervised Schroth corrective exercises performed twice weekly in a clinical setting. Group A will receive an additional weekly session of BBAT. This intervention focuses on movement quality and the integration of mental and physical self-awareness through a series of lying, sitting, standing, and walking exercises. Group B will serve as the active control group and will receive Autogenic Training, which is a systematic relaxation technique, in addition to their corrective exercises. Evaluations will be performed at baseline and after the 12-week intervention period. Clinical assessments include digital posture analysis via PostureScreen Mobile and measurement of the thoracic kyphosis angle using the Flexicurve method and Wall-Occiput Distance. Dynamic and static balance will be assessed using the Y-Balance Test and the Single-Leg Stance Test. Furthermore, the study will measure thoracic joint position sense through active repositioning tests. Psychosocial and quality-of-life data will be gathered using the Body Awareness Questionnaire, the Kyphosis Specific Spinal Appearance Questionnaire, the Rosenberg Self-Esteem Scale, and the SRS-30 questionnaire.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 10 Years to 18 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adolescents aged between 10 and 18 years.
- •Diagnosis of postural hyperkyphosis confirmed by a thoracic kyphosis angle of 40 degrees or greater.
Exclusion Criteria
- •Diagnosis of congenital or rigid spinal deformities, such as Scheuermann's kyphosis.
- •History of major spinal surgery, severe spinal trauma, or significant orthopedic conditions.
- •Presence of diagnosed neurological or vestibular diseases that may affect balance or movement.
- •Use of spinal braces or other corrective orthotic devices during the study period.
- •Having received formal physiotherapy or a structured exercise program for posture within the last 6 months.
Arms & Interventions
Group A
Participants in Group A will receive a multimodal program combining Schroth-based corrective exercises and Basic Body Awareness Therapy (BBAT). The intervention includes posture-focused Schroth movements and BBAT elements such as body scanning, breathing awareness, and center-of-line stimulation. The intervention will be delivered twice weekly over 12 weeks, with an additional weekly group BBAT session, totaling 36 supervised 60-minute sessions by a certified physiotherapist
Intervention: Corrective Exercise and Basic Body Awareness Therapy (BBAT) (Other)
Group B
Participants in Group B will receive a program combining Schroth-based corrective exercises and Autogenic Training. Corrective exercises will be performed with the same intensity and frequency as Group A, adjusted to individual tolerance. Autogenic Training includes self-suggestion formulas for deep relaxation, focusing on sensations of heaviness and warmth. The intervention will be delivered twice weekly over 12 weeks, totaling 24 supervised 60-minute sessions by a physiotherapist.
Intervention: Corrective Exercise and Autogenic Training (Other)
Outcomes
Primary Outcomes
Body Awareness - Body Awareness Questionnaire (BAQ)
Time Frame: 12 weeks
The Body Awareness Questionnaire is an 18-item scale designed to assess a person's sensitivity to non-pathological bodily processes, such as body rhythms and changes in bodily states. Each item is rated on a 7-point Likert scale, with total scores ranging from 18 to 126. A higher total score indicates a greater level of body awareness. This measure will evaluate how the interventions influence the participants' internal perception of their bodies.
Aesthetic Perception of the Spine - Kyphosis Specific Spinal Appearance Questionnaire (KSAQ)
Time Frame: 12 weeks
The Kyphosis Specific Spinal Appearance Questionnaire consists of 22 items specifically tailored to evaluate how adolescents with hyperkyphosis perceive the aesthetic appearance of their spine. The scale uses a 5-point Likert system where higher scores reflect a more negative perception of spinal appearance and higher treatment expectations. This tool provides insight into the psychosocial impact of postural changes and the perceived effectiveness of the treatment from the patient's perspective.
Self-Esteem - Rosenberg Self-Esteem Scale (RSES)
Time Frame: 12 weeks
The Rosenberg Self-Esteem Scale is a widely validated 10-item instrument used to measure global self-worth and self-acceptance. Participants rate each item on a 4-point Likert scale ranging from strongly agree to strongly disagree. It captures both positive and negative feelings about the self, providing a total score that reflects the individual's overall level of self-esteem throughout the therapeutic process.
Posture Analysis - PostureScreen Mobile (PSM) Assessment
Time Frame: 12 weeks
PostureScreen Mobile is a digital postural analysis application used to objectively quantify postural deviations. It measures shifts and tilts in centimeters or degrees by analyzing photos taken from anterior, posterior, and lateral views. The assessment focuses on identifying improvements in spinal alignment and the reduction of forward head posture or thoracic kyphosis after the 12-week intervention.
Secondary Outcomes
- Thoracic Kyphosis Angle Measured by Flexicurve(12 weeks)
- Wall-Occiput Distance (WOD)(12 weeks)
- Y-Balance Test (YBT)(12 weeks)
- Single-Leg Stance Test (SLS)(12 weeks)
- Joint Position Sense(12 weeks)
- Scoliosis Research Society-30 (SRS-30) Questionnaire(12 weeks)
- Numeric Pain Rating Scale (NPRS)(12 weeks)
- Global Rating of Change (GROC) Scale(12 weeks)
Investigators
Ayse Zengin Alpozgen
Associate Professor
Istanbul University - Cerrahpasa