Core Stability and Respiratory Parameters in Children With Thoracic Hyperkyphosis

Completed

• Conditions: Hyperkyphosis; Respiratory Failure

• Registration Number: NCT06853548
• Lead Sponsor: Istinye University

Brief Summary

Hyperkyphosis, defined as an excessive curvature of the thoracic spine beyond normal limits, is among the factors that reduce chest wall mobility and lung function. In modern society, increased sitting durations contribute to increased thoracic kyphosis. Studies have indicated that an increase in thoracic kyphosis and a decrease in thoracic spinal mobility are associated with reduced respiratory functions, such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1).

The diaphragm forms the upper part of the core stability system. When contracted, it increases intra-abdominal pressure, contributing to core stability. The diaphragm also contracts in advance of and during limb movements to assist in postural control. Additionally, the diaphragm is the primary respiratory muscle responsible for inspiration. Any functional loss in the diaphragm, which alone accounts for 65-80% of vital capacity, can significantly reduce inspiratory capacity. During forced expiration, muscles such as the rectus abdominis, transversus abdominis, internal obliques, and external obliques play an active role. Specifically, the transversus abdominis, like the diaphragm, increases intra-abdominal pressure and supports trunk stabilization. However, the relationship between respiratory muscle strength and the endurance of core stability muscles remains unclear.

In light of this information, this study aims to investigate the relationship between the endurance of core muscles, which contribute to trunk stabilization, and respiratory parameters in children with thoracic hyperkyphosis.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2025-02-25
• Study First Submitted QC: 2025-02-25
• Study Start: 2025-03-01
• Study First Posted: 2025-03-03
• Primary Completion: 2025-03-30
• Status Verified: 2025-04
• Study Completion: 2025-04-14
• Last Update Submitted: 2025-04-14
• Last Update Posted: 2025-04-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 33

Inclusion Criteria

• Be between the ages of 7 and 18
• Have a thoracic kyphosis angle (Cobb) of ≥45˚ on a lateral X-ray or a kyphosis index of ≤13

Exclusion Criteria

• Individuals who have undergone major surgery or trauma related to the musculoskeletal system, particularly the spine and upper extremities
• Difficulty in understanding given instructions
• Presence of rigid deformity in the spine (Scheuermann's Kyphosis)
• Presence of congenital deformities (Congenital Kyphosis)

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Forced vital capacity	2 weeks	Forced vital capacity is the volume of gas expelled from the lungs in a fast, forced and deep expiration after a deep, forced inspiration. Forced vital capacity will be performed in a sitting position using a portable spirometer (Spirobank; MIR, Rome, Italy) according to American Thoracic Society guidelines.
Forced expiratory volume in the first second	2 weeks	Forced expiratory volume in the first second is the amount of air expelled from the lungs in the first second with forced expiration. Forced expiratory volume in the first second will be performed in a sitting position using a portable spirometer (Spirobank; MIR, Rome, Italy) according to American Thoracic Society guidelines.
Forced vital capacity/Forced expiratory volume Ratio	2 weeks	The Forced vital capacity/Forced expiratory volume Ratio, also called the modified Tiffeneau-Pinelli index, is a calculated ratio used in the diagnosis of obstructive and restrictive lung disease. The ratio will be performed in a sitting position using a portable spirometer (Spirobank; MIR, Rome, Italy) according to American Thoracic Society guidelines.
Peak expiratory flow rat	2 weeks	Peak expiratory flow rate is the volume of air forcefully expelled from the lungs in one quick exhalation, and is a reliable indicator of ventilation adequacy as well as airflow obstruction. The ratio will be performed in a sitting position using a portable spirometer (Spirobank; MIR, Rome, Italy) according to American Thoracic Society guidelines.
prone bridge test	2 weeks	In the prone bridge test, participants will start in a prone position, supported on their knees and forearms. When they feel ready, they will be instructed to lift their knees off the ground without any verbal cues, maintaining a position supported by their forearms and toes. The duration for which they can hold this position will be recorded in seconds.
Respiratory Muscle Strength	2 weeks	Respiratory muscle strength will be assessed using maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with an electronic pressure transducer
side bridge test	2 weeks	In the side bridge test, participants will begin in a side-lying position on their dominant side. When ready, they will be instructed to lift their hips without any verbal cues, supporting themselves with one arm. They will be asked to maintain a straight body line and hold this position for as long as possible. Participants will be instructed to place their free hand on their opposite shoulder. The duration for which they can maintain the position will be recorded in seconds.
flexor endurance test	2 weeks	In the flexor endurance test, participants will begin in a supine position. When they feel ready, they will be instructed to pull their knees towards their chest in parallel with the ground without any verbal cues. They will then raise their upper body, lifting the lower edge of their scapula off the ground. The duration for which they can hold this position will be recorded in seconds.
Sorenson test	2weeks	In the Sorenson test, participants will start in a prone position on a stretcher, with their upper body resting on the stretcher. They will be repositioned so that the part of their body in contact with the bed is the anterior superior iliac spine. Participants will be instructed to hold onto the sides of a chair with their hands to maintain balance. A researcher will secure their legs, and when participants feel ready, they will cross both hands over their shoulders without any verbal instructions. They will be asked to hold the position parallel to the ground. The duration for which they can maintain this position will be recorded in seconds.

Trial Locations

Locations (1)

Istinye University; 🇹🇷 Istanbul, Turkey