Background

A variety of treatments aim to reduce thoracic hyperkyphosis in adults, thereby improving posture and reducing possible complications.

Objective

To investigate the effectiveness of treatments to reduce thoracic hyperkyphosis.

Design

Systematic review and meta-analysis.

Methods

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.

Results

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.

Conclusion

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.

中文翻译：

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减少胸椎后凸——哪种治疗最有效？系统的文献综述和荟萃分析

背景

各种治疗旨在减少成人胸椎后凸畸形，从而改善姿势并减少可能的并发症。

客观的

研究减少胸椎后凸畸形的治疗效果。

设计

系统评价和荟萃分析。

方法

检索了 MEDLINE、EMBASE、CINAHL 和 CENTRAL，从开始到 2021 年 3 月。两位作者独立选择了随机对照试验，评估治疗对减少成人胸椎后凸畸形的有效性。提取胸椎后凸平均变化的原始数据并计算标准化平均差 (SMD)。对研究人群和干预措施相同的研究进行了荟萃分析。使用 GRADE 评估证据强度。

结果

纳入了 28 项研究，并进行了 5 项荟萃分析。低至中等质量的证据发现，持续三个月或更短的结构化锻炼计划可有效减少年轻人（SMD -2.8；95%CI -4.3 至 -1.3）和老年人群（SMD -0.3；95%CI - 0.6 到 0.0）。低质量证据发现，在老年参与者中使用支具三个月或更长时间是有效的（SMD -1.0，95%CI -1.3 至 -0.7）。一项研究证明了多模式护理对年轻参与者的有效性。现有证据表明，多模式护理、持续三个月以上的结构化锻炼计划、老年人的贴布以及年轻人的生物反馈和肌肉刺激对减少胸椎后凸畸形无效。

结论

低到中等质量的证据表明，结构化的锻炼计划可有效减少胸椎后凸。低质量证据表明，支具可有效减少老年人的胸廓高钾血症。