A Comparison of the Effects of Exercise Methods for Adolescent Hyperkyphosis on the Sensorimotor System

November 2, 2026 updated by: Ayse Zengin Alpozgen, Istanbul University - Cerrahpasa

Comparıson Of The Effects Of Schroth And Conventıonal Exercıses On The Sensorımotor System In Adolescents Wıth Hyperkyphosıs

This study will compare two home exercise programs for adolescents aged 10-17 years with postural hyperkyphosis: kyphosis-specific Schroth exercises and traditional stretching and strengthening exercises. It will examine whether one program is more effective at improving the ability to sense and reproduce a corrected upper-back posture. The researchers expect the Schroth program to lead to greater improvement.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This study will compare two home-based exercise programs for adolescents aged 10-17 years with postural hyperkyphosis. Participants will follow either kyphosis-specific Schroth exercises or conventional stretching, strengthening, and stabilization exercises for eight weeks, approximately 45 minutes per session, three days a week.

The study will assess whether the programs affect participants' ability to recognize and reproduce a corrected thoracic posture. Other outcomes will include balance, spinal curvature and posture, muscle strength and endurance, flexibility, spinal pain, and participants' perceptions of their condition and overall change. Exercise participation, how accurately the exercises are performed, and any adverse events will also be recorded.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
58

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
    • Bakırköy
      • Istanbul, Bakırköy, Turkey (Türkiye)
        • Istanbul University-Cerrahpaşa, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
        • Contact:
        • Principal Investigator:
          • Ayşe Zengin Alpözgen, Assoc. Prof.
        • Sub-Investigator:
          • Kübra Kardeş, Asst Prof.
        • Sub-Investigator:
          • Çisemnur Gülnaz, BSc

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

10 years to 17 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Aged 10 through 17 years. Thoracic kyphosis Cobb angle greater than 40° and less than 70° from T4 to T12 on a lateral radiograph.

Flexible thoracic kyphosis that decreases with active correction on clinical examination.

Able to understand the exercise instructions and perform the home program. Written informed consent from a parent or legal guardian and written assent from the adolescent.

Exclusion Criteria:

Kyphosis other than postural kyphosis, including Scheuermann disease (at least 5° of wedging in three or more consecutive vertebrae), congenital kyphosis, or other structural or rigid kyphosis.

Structural scoliosis with a Cobb angle greater than 10°. Previous spinal surgery or major trauma affecting the spine. A diagnosed neurological condition or neurological symptoms that may affect postural control.

Diagnosed vestibular pathology or a history of vestibular problems, or current vertigo, dizziness, or balance complaints.

Visual impairment that cannot be corrected with glasses or contact lenses. Acute musculoskeletal injury or pain that would prevent assessment or exercise. Participation in physiotherapy or an exercise program for kyphosis within the previous 3 months.

Previous Schroth exercise training. Current brace treatment. Cognitive impairment that would prevent adherence to the exercise program.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Schroth exercise group

This group will perform a kyphosis-specific Schroth exercise program focused on active thoracic posture correction, axial elongation, and corrective breathing. Participants will practice the exercises at home, using a mirror for visual feedback and tactile cues to monitor their posture.
Behavioral: Kyphosis-Specific Schroth Exercise Program

Participants will perform the program at home 3 days per week for 8 weeks, with each session lasting approximately 45 minutes, including a 5-minute warm-up and a 3-minute cool-down. Three face-to-face training sessions will be provided during week 1, followed by face-to-face follow-up visits at the beginning of weeks 3 and 5. The program will have two stages. Participants who meet the prespecified progression criteria will advance to stage 2 at the week 5 follow-up.
Active Comparator: Conventional exercise group

This group will perform a conventional exercise program including stretching, scapular retraction, back extensor and trapezius strengthening, and trunk stabilization. The program will not include Schroth-specific active posture correction, corrective breathing, or mirror-based posture feedback.
Behavioral: Conventional Exercise Program

Participants will perform the program at home 3 days per week for 8 weeks, with each session lasting approximately 45 minutes, including a 5-minute warm-up and a 3-minute cool-down. Three face-to-face training sessions will be provided during week 1, followed by face-to-face follow-up visits at the beginning of weeks 3 and 5. The program will have two stages. Participants who meet the prespecified progression criteria will advance to stage 2 at the week 5 follow-up.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Thoracic Extension Absolute Repositioning Error
Time Frame: At baseline and at the end of Week 8

Thoracic position sense will be assessed with dual digital inclinometers placed at T1 and T12. With eyes closed, participants will reproduce a 15° thoracic extension target. The primary measure is the mean absolute difference between the target and reproduced angles across five trials, in degrees; lower values indicate smaller error. Flexion (30°) and right and left lateral flexion (20°) will also be measured as secondary directional outcomes.
At baseline and at the end of Week 8

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Balance
Time Frame: At baseline and at the end of Week 8

Balance will be assessed with the AI Balance system using the modified Clinical Test of Sensory Interaction on Balance (four eyes-open/eyes-closed conditions on firm and foam surfaces; three 30-second trials per condition) and the Limits of Stability test (weight shifting toward eight targets). Higher sway index values indicate greater sway; higher Limits of Stability scores indicate better performance.
At baseline and at the end of Week 8
Thoracic Curvature
Time Frame: At baseline and at the end of Week 8

Thoracic curvature will be measured with a Flexicurve ruler from C7 to T12. The kyphosis index will be calculated as the kyphosis apex depth divided by the curve length, multiplied by 100. The values above 13 indicate hyperkyphosis.
At baseline and at the end of Week 8
Sagittal Posture
Time Frame: At baseline and at the end of Week 8

Sagittal posture will be assessed from a lateral photograph using the PostureScreen Mobile application. Landmark displacement will be recorded in centimeters under standardized camera, posture, clothing, and hair conditions.
At baseline and at the end of Week 8
Muscle Strength
Time Frame: At baseline and at the end of Week 8

Isometric strength of the trunk flexors and extensors, upper, middle, and lower trapezius, and serratus anterior will be measured using a hand-held dynamometer and the make-test method. Three 5-second contractions will be performed for each muscle group. Mean force will be normalized to body weight and reported in N/kg.
At baseline and at the end of Week 8
Flexibility
Time Frame: At baseline and at the end of Week 8

Hamstring and lower-back flexibility will be measured with the sit-and-reach test; the maximum distance across three trials will be recorded in centimeters. Pectoralis minor muscle length will be measured bilaterally with a tape measure; the mean of three measurements will be analyzed.
At baseline and at the end of Week 8
Muscle Endurance
Time Frame: At baseline and at the end of Week 8

Scapular, trunk flexor, and trunk extensor endurance will be assessed using the isometric scapular endurance, McGill trunk flexor endurance, and Biering-Sørensen tests, respectively. The time each position is maintained without compensation will be recorded in seconds. Each test will be performed once, with at least 5 minutes of rest between tests.
At baseline and at the end of Week 8
Spinal Pain
Time Frame: At baseline and at the end of Week 8

Resting, activity-related, and nocturnal spinal pain during the previous week will be rated on a 0-10 cm Visual Analog Scale, where 0 indicates no pain and 10 indicates the worst possible pain.
At baseline and at the end of Week 8
Deformity Perception
Time Frame: At baseline and at the end of Week 8

Deformity perception will be assessed with the Turkish version of the Kyphosis-Specific Spinal Appearance Questionnaire. The 10-item questionnaire is scored from 1 to 5; the mean item score will be analyzed. Higher scores indicate a more negative perception of spinal appearance.
At baseline and at the end of Week 8
Perceived Global Change
Time Frame: At the end of Week 8

Overall perceived change will be assessed using the 7-point Global Rating of Change scale, from -3 (much worse) to +3 (much better), with 0 indicating no change. Scores of +2 or +3 will indicate a clinically meaningful perceived improvement.
At the end of Week 8

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Istanbul University - Cerrahpasa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

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Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 15, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 15, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 2, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 2, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 6, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 2, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IstanbulUC-FTR-CG-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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