The targeted rehabilitation program with corrective exercises on trainable mentally handicapped people with upper body disorders

Mohammadi, Roya; Imeri, Behrooz; Shabani, Mohammad

doi:10.22059/sshr.2021.86130

The targeted rehabilitation program with corrective exercises on trainable mentally handicapped people with upper body disorders

Document Type : Research Paper

Authors

¹ Master of Sport injury, Instructor of Rehabilitation and Welfare Organization, Gonbad Kavous, Golestan, Iran

² Department of Sport Sciences, Faculty of Human Sciences and Sport Sciences, University of Gonbadekavoos

³ Department of Sport Sciences, University of Bojnord, Bojnord, Iran

10.22059/sshr.2021.86130

Abstract

Background: Community-based rehabilitation is a multi-dimensional approach to improve the function and quality of life to mentally ill people.
Aim: This study examined the effect of rehabilitation protocol that were the spine strengthening exercises on adult mentally disabled men with upper body anomalies.
Materials and Methods: This study was performed on 28 educable mentally disabled with the age range of 30-45. These subjects had positional hyperkyphosis angle, more than 45° and FHP more than 46°. They were randomly divided into two groups of experimental (n=16) and control (n=12). Experimental group followed the three-step training protocol for two months. A spinal mouse and a digital camera were used to measure the deviation of thoracic area’s hyperkyphosis and the FHP angle respectively. The dependent and independent t-tests were applied for within and between groups’ comparisons respectively. The significance level was considered at 0.05, all analysis of study was done by SPSS₂₃.
Results: The mean of hyperkyphosis and FHP angles in experimental group, significantly decreased (P= 0.008, 0.003), respectively. But there was no significant change in control group (P= 0.101, 0.122). The independent t-test results for both variables indicated a significant difference between control and experimental subjects after the protocol (P= 0.001).
Conclusion: The combined corrective exercises caused a reduction in head, neck and trunk disorders of study subjects.

Keywords

References

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[4] Booth FW, Roberts CK, Laye MJ. "Lack of exercise is a major cause of chronic diseases". Comprehensive Physiology. 2012; 2(2): 1143-211. doi: 10.1002/cphy.c110025. PMCID: PMC4241367.

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[11] Hosman AJ, de Kleuver M, Anderson PG, van Limbeek J, Langeloo DD, Veth RP, et al. "Scheuermann kyphosis: the importance of tight hamstrings in the surgical correction". Spine. 2003; 28(19): 2252-9. doi: 10.1097/01.BRS.0000085097.63326.95. PMID: 14520040.

[12] Patwardhan AG, Khayatzadeh S, Havey RM, Voronov LI, Smith ZA, Kalmanson O, et al. "Cervical sagittal balance: a biomechanical perspective can help clinical practice". European Spine Journal. 2018; 27(Suppl 1): 25-38. doi: 10.1007/s00586-017-5367-1. PMID: 29110218.

[13] Clark MA, Lucett SC, Sutton BG. NASM Essentials of Corrective Exercise Training. Editor: Jones & Bartlett Learning. Jones & Bartlett Learning, Burlington, MA, 2014.

[14] Pop MS, Mihancea P, Debucean D. "Posture optimization–is it the key to myofascial neck pain relief". Arch Balk Medical Union. 2018; 53(4). doi: 10.31688/ABMU.2018.53.4.14.

[15] Singla D, Veqar Z. "Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature". Journal of Chiropractic Medicine. 2017; 16(3): 220-9. doi: 10.1016/j.jcm.2017.03.004. PMCID: PMC5659804. PMID: 29097952

[16] Carmeli E, Imam B. "Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities". Frontiers in Public Health. 2014; 2: 31. doi: 10.3389/fpubh.2014.00031. PMCID: PMC3995041. PMID: 24783190.

[17] Quek J, Pua Y-H, Clark RA, Bryant AL. "Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults". Manual Therapy. 2013; 18(1): 65-71. doi: 10.1016/j.math.2012.07.005. PMID: 22959228.

[18] Patel DR, Kinsella E. "Evaluation and management of lower back pain in young athletes". Translational Pediatrics. 2017; 6(3): 225. doi: 10.21037/tp.2017.06.01. PMID: 28795014 PMCID: PMC5532202.

[19] Vaughn DW, Brown EW. "The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles". Journal of Back and Musculoskeletal Rehabilitation. 2007; 20(4): 155-65. doi: 10.3233/BMR-2007-20404.

[20] Kendall FP, McCreary EK, Provance P, Rodgers M, Romani W. Muscles: Testing and Function with Posture and Pain (Kendall, Muscles). 2005. PMCID: PMC1858872.

[21] Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. "Exertional heat illness during training and competition". Medicine & Science in Sports & Exercise. 2007; 39(3): 556-72. doi: 10.1249/MSS.0b013e31802fa199. PMID: 17473783.

[22] Senthil P, Sudhakar S, Radhakrishnan R, Jeyakumar S. "Efficacy of corrective exercise strategy in subjects with hyperkyphosis". Journal of Back and Musculoskeletal Rehabilitation. 2017; 30(6): 1285-9. doi: 10.3389/fpain.2022.1038269. PMCID: PMC9811681. PMID: 36618579

[23] Feng Q, Wang M, Zhang Y, Zhou Y. "The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial". Clinical Rehabilitation. 2018; 32(1): 48-56. doi: 10.1177/0269215517714591. PMID: 28610442.

[24] Jang HJ, Hughes LC, Oh DW, Kim SY. "Effects of corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in older women: a double-blind, group-matched design". Journal of Geriatric Physical Therapy. 2019; 42(3): E17-E27. doi: 10.1519/JPT.0000000000000146.PMID: 28914720.

[25] Bautmans I, Van Arken J, Van Mackelenberg M, Mets T. "Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis". Journal of Rehabilitation Medicine. 2010; 42(2): 129-35. doi: 10.2340/16501977-0486.PMID: 20140408.

[26] Fuentes JP, Armijo Olivo S, Magee DJ, Gross DP. "Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis". Physical Therapy. 2010; 90(9): 1219-38. doi: 10.2522/ptj.20090335.PMID: 20651012.

[27] Itoi E, Sinaki M. Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age. InMayo Clinic Proceedings 1994 Nov 1 (Vol. 69, No. 11, pp. 1054-1059). doi: 10.1016/s0025-6196(12)61372-x. PMID: 7967758.

[28] O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Möller NE, Richards KV. "The effect of different standing and sitting postures on trunk muscle activity in a pain-free population". Spine. 2002; 27(11): 1238-44. doi: 10.1097/00007632-200206010-00019. PMID: 12045525.

[29] Katzman W, Vittinghoff E, Lin F, Schafer A, Long R, Wong S, et al. "Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial". Osteoporosis International. 2017; 28(10): 2831-41. doi: 10.1007/s00198-017-4109-x. PMID: 28689306. PMCID: PMC5873977.

[30] Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, Muehlbauer T. "The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review". Sports Medicine. 2013; 43(7): 627-41. doi: 10.1007/s40279-013-0041-1.PMID: 23568373.

[31] Briggs A, Wrigley T, Tully E, Adams P, Greig A, Bennell K. "Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles". Skeletal Radiology. 2007; 36(8): 761-7. doi: 10.1007/s00256-007-0284-8.PMID: 17437103.

[32] Tarasi Z, Rajabi R, Minoonejad H, Shahrbanian S. "The effect of spine strengthening exercises and posture training on functional thoracic hyper kyphosis in young individuals". Journal of Advances in Medical and Biomedical Research. 2019; 27(121): 23-31. doi: 10.30699/jambs.27.121.23.

[33] Pestana MB, Barbieri FA, Vitório R, Figueiredo GA, Mauerberg-deCastro E. "Efeitos do exercício físico para adultos com deficiência intelectual: uma revisão sistemática". Journal of Physical Education. 2018; 29(1).

[34] Lynch SS, Thigpen CA, Mihalik JP, Prentice WE, Padua D. "The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers". British Journal of Sports Medicine. 2010; 44(5): 376-81. doi: 10.1136/bjsm.2009.066837. PMID: 20371564.

[35] Bohannon RW. "Reference values for the timed up and go test: a descriptive meta-analysis". Journal of Geriatric Physical Therapy. 2006; 29(2): 64-8. doi: 10.1519/00139143-200608000-00004.PMID: 16914068

[36] Dixon-Ibarra A, Lee M, Dugala A. "Physical activity and sedentary behavior in older adults with intellectual disabilities: a comparative study". Adapted Physical Activity Quarterly. 2013; 30(1): 1-19. doi: 10.1123/apaq.30.1.1. PMID: 23283028.

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The targeted rehabilitation program with corrective exercises on trainable mentally handicapped people with upper body disorders

References

[2] Bishop KM, Robinson LM, VanLare S. "Healthy aging for older adults with intellectual and development disabilities". Journal of Psychosocial Nursing and Mental Health Services. 2013; 51(1): 15-8. doi: 10.3928/02793695-20121218-02. PMID: 23413456.

[3] Fisher K, Robichaux C, Sauerland J, Stokes F. "A nurses’ ethical commitment to people with intellectual and developmental disabilities". Nursing Ethics. 2020; 27(4): 1066-76. doi: 10.1177/0969733019900310. PMID: 32228209.

[4] Booth FW, Roberts CK, Laye MJ. "Lack of exercise is a major cause of chronic diseases". Comprehensive Physiology. 2012; 2(2): 1143-211. doi: 10.1002/cphy.c110025. PMCID: PMC4241367.

[5] Rohlmann A, Klöckner C, Bergmann G. "The biomechanics of kyphosis". Der Orthopade. 2001; 30(12): 915-8. doi: 10.1007/s001320170003. PMID: 11803743.

[7] Vaughn D, Brown EW. "The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles". Journal of Back and Musculoskeletal Rehabilitation. 2007; 20: 155-65. doi: 10.3233/BMR-2007-20404.

[8] Seidi F, Rajabi R, Ebrahimi I, Alizadeh M, Daneshmandi H. "The effect of a 10-week selected corrective exercise program on postural thoracic kyphosis deformity". Journal of Sport Medicine. 2013; 5: 5-22. doi: 10.22059/JSMED.2013.32159.

[10] Roghani T, Zavieh MK, Manshadi FD, King N, Katzman W. "Age-related hyperkyphosis: update of its potential causes and clinical impacts-narrative review". Aging Clinical and Experimental Research. 2017; 29(4): 567-77. doi: 10.1007/s40520-016-0617-3. PMCID: PMC5316378. PMID: 27538834.

[11] Hosman AJ, de Kleuver M, Anderson PG, van Limbeek J, Langeloo DD, Veth RP, et al. "Scheuermann kyphosis: the importance of tight hamstrings in the surgical correction". Spine. 2003; 28(19): 2252-9. doi: 10.1097/01.BRS.0000085097.63326.95. PMID: 14520040.

[12] Patwardhan AG, Khayatzadeh S, Havey RM, Voronov LI, Smith ZA, Kalmanson O, et al. "Cervical sagittal balance: a biomechanical perspective can help clinical practice". European Spine Journal. 2018; 27(Suppl 1): 25-38. doi: 10.1007/s00586-017-5367-1. PMID: 29110218.

[13] Clark MA, Lucett SC, Sutton BG. NASM Essentials of Corrective Exercise Training. Editor: Jones & Bartlett Learning. Jones & Bartlett Learning, Burlington, MA, 2014.

[14] Pop MS, Mihancea P, Debucean D. "Posture optimization–is it the key to myofascial neck pain relief". Arch Balk Medical Union. 2018; 53(4). doi: 10.31688/ABMU.2018.53.4.14.

[15] Singla D, Veqar Z. "Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature". Journal of Chiropractic Medicine. 2017; 16(3): 220-9. doi: 10.1016/j.jcm.2017.03.004. PMCID: PMC5659804. PMID: 29097952

[16] Carmeli E, Imam B. "Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities". Frontiers in Public Health. 2014; 2: 31. doi: 10.3389/fpubh.2014.00031. PMCID: PMC3995041. PMID: 24783190.

[17] Quek J, Pua Y-H, Clark RA, Bryant AL. "Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults". Manual Therapy. 2013; 18(1): 65-71. doi: 10.1016/j.math.2012.07.005. PMID: 22959228.

[18] Patel DR, Kinsella E. "Evaluation and management of lower back pain in young athletes". Translational Pediatrics. 2017; 6(3): 225. doi: 10.21037/tp.2017.06.01. PMID: 28795014 PMCID: PMC5532202.

[19] Vaughn DW, Brown EW. "The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles". Journal of Back and Musculoskeletal Rehabilitation. 2007; 20(4): 155-65. doi: 10.3233/BMR-2007-20404.

[20] Kendall FP, McCreary EK, Provance P, Rodgers M, Romani W. Muscles: Testing and Function with Posture and Pain (Kendall, Muscles). 2005. PMCID: PMC1858872.

[21] Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. "Exertional heat illness during training and competition". Medicine & Science in Sports & Exercise. 2007; 39(3): 556-72. doi: 10.1249/MSS.0b013e31802fa199. PMID: 17473783.

[22] Senthil P, Sudhakar S, Radhakrishnan R, Jeyakumar S. "Efficacy of corrective exercise strategy in subjects with hyperkyphosis". Journal of Back and Musculoskeletal Rehabilitation. 2017; 30(6): 1285-9. doi: 10.3389/fpain.2022.1038269. PMCID: PMC9811681. PMID: 36618579

[23] Feng Q, Wang M, Zhang Y, Zhou Y. "The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial". Clinical Rehabilitation. 2018; 32(1): 48-56. doi: 10.1177/0269215517714591. PMID: 28610442.

[24] Jang HJ, Hughes LC, Oh DW, Kim SY. "Effects of corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in older women: a double-blind, group-matched design". Journal of Geriatric Physical Therapy. 2019; 42(3): E17-E27. doi: 10.1519/JPT.0000000000000146.PMID: 28914720.

[25] Bautmans I, Van Arken J, Van Mackelenberg M, Mets T. "Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis". Journal of Rehabilitation Medicine. 2010; 42(2): 129-35. doi: 10.2340/16501977-0486.PMID: 20140408.

[26] Fuentes JP, Armijo Olivo S, Magee DJ, Gross DP. "Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis". Physical Therapy. 2010; 90(9): 1219-38. doi: 10.2522/ptj.20090335.PMID: 20651012.

[27] Itoi E, Sinaki M. Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age. InMayo Clinic Proceedings 1994 Nov 1 (Vol. 69, No. 11, pp. 1054-1059). doi: 10.1016/s0025-6196(12)61372-x. PMID: 7967758.

[28] O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Möller NE, Richards KV. "The effect of different standing and sitting postures on trunk muscle activity in a pain-free population". Spine. 2002; 27(11): 1238-44. doi: 10.1097/00007632-200206010-00019. PMID: 12045525.

[30] Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, Muehlbauer T. "The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review". Sports Medicine. 2013; 43(7): 627-41. doi: 10.1007/s40279-013-0041-1.PMID: 23568373.

[31] Briggs A, Wrigley T, Tully E, Adams P, Greig A, Bennell K. "Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles". Skeletal Radiology. 2007; 36(8): 761-7. doi: 10.1007/s00256-007-0284-8.PMID: 17437103.

[32] Tarasi Z, Rajabi R, Minoonejad H, Shahrbanian S. "The effect of spine strengthening exercises and posture training on functional thoracic hyper kyphosis in young individuals". Journal of Advances in Medical and Biomedical Research. 2019; 27(121): 23-31. doi: 10.30699/jambs.27.121.23.

[33] Pestana MB, Barbieri FA, Vitório R, Figueiredo GA, Mauerberg-deCastro E. "Efeitos do exercício físico para adultos com deficiência intelectual: uma revisão sistemática". Journal of Physical Education. 2018; 29(1).

[34] Lynch SS, Thigpen CA, Mihalik JP, Prentice WE, Padua D. "The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers". British Journal of Sports Medicine. 2010; 44(5): 376-81. doi: 10.1136/bjsm.2009.066837. PMID: 20371564.

[35] Bohannon RW. "Reference values for the timed up and go test: a descriptive meta-analysis". Journal of Geriatric Physical Therapy. 2006; 29(2): 64-8. doi: 10.1519/00139143-200608000-00004.PMID: 16914068

[36] Dixon-Ibarra A, Lee M, Dugala A. "Physical activity and sedentary behavior in older adults with intellectual disabilities: a comparative study". Adapted Physical Activity Quarterly. 2013; 30(1): 1-19. doi: 10.1123/apaq.30.1.1. PMID: 23283028.

Volume 13, Issue 2
July 2021
Pages 341-353

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The targeted rehabilitation program with corrective exercises on trainable mentally handicapped people with upper body disorders

References

[2] Bishop KM, Robinson LM, VanLare S. "Healthy aging for older adults with intellectual and development disabilities". Journal of Psychosocial Nursing and Mental Health Services. 2013; 51(1): 15-8. doi: 10.3928/02793695-20121218-02. PMID: 23413456.

[3] Fisher K, Robichaux C, Sauerland J, Stokes F. "A nurses’ ethical commitment to people with intellectual and developmental disabilities". Nursing Ethics. 2020; 27(4): 1066-76. doi: 10.1177/0969733019900310. PMID: 32228209.

[4] Booth FW, Roberts CK, Laye MJ. "Lack of exercise is a major cause of chronic diseases". Comprehensive Physiology. 2012; 2(2): 1143-211. doi: 10.1002/cphy.c110025. PMCID: PMC4241367.

[5] Rohlmann A, Klöckner C, Bergmann G. "The biomechanics of kyphosis". Der Orthopade. 2001; 30(12): 915-8. doi: 10.1007/s001320170003. PMID: 11803743.

[7] Vaughn D, Brown EW. "The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles". Journal of Back and Musculoskeletal Rehabilitation. 2007; 20: 155-65. doi: 10.3233/BMR-2007-20404.

[8] Seidi F, Rajabi R, Ebrahimi I, Alizadeh M, Daneshmandi H. "The effect of a 10-week selected corrective exercise program on postural thoracic kyphosis deformity". Journal of Sport Medicine. 2013; 5: 5-22. doi: 10.22059/JSMED.2013.32159.

[10] Roghani T, Zavieh MK, Manshadi FD, King N, Katzman W. "Age-related hyperkyphosis: update of its potential causes and clinical impacts-narrative review". Aging Clinical and Experimental Research. 2017; 29(4): 567-77. doi: 10.1007/s40520-016-0617-3. PMCID: PMC5316378. PMID: 27538834.

[11] Hosman AJ, de Kleuver M, Anderson PG, van Limbeek J, Langeloo DD, Veth RP, et al. "Scheuermann kyphosis: the importance of tight hamstrings in the surgical correction". Spine. 2003; 28(19): 2252-9. doi: 10.1097/01.BRS.0000085097.63326.95. PMID: 14520040.

[12] Patwardhan AG, Khayatzadeh S, Havey RM, Voronov LI, Smith ZA, Kalmanson O, et al. "Cervical sagittal balance: a biomechanical perspective can help clinical practice". European Spine Journal. 2018; 27(Suppl 1): 25-38. doi: 10.1007/s00586-017-5367-1. PMID: 29110218.

[13] Clark MA, Lucett SC, Sutton BG. NASM Essentials of Corrective Exercise Training. Editor: Jones & Bartlett Learning. Jones & Bartlett Learning, Burlington, MA, 2014.

[14] Pop MS, Mihancea P, Debucean D. "Posture optimization–is it the key to myofascial neck pain relief". Arch Balk Medical Union. 2018; 53(4). doi: 10.31688/ABMU.2018.53.4.14.

[15] Singla D, Veqar Z. "Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature". Journal of Chiropractic Medicine. 2017; 16(3): 220-9. doi: 10.1016/j.jcm.2017.03.004. PMCID: PMC5659804. PMID: 29097952

[16] Carmeli E, Imam B. "Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities". Frontiers in Public Health. 2014; 2: 31. doi: 10.3389/fpubh.2014.00031. PMCID: PMC3995041. PMID: 24783190.

[17] Quek J, Pua Y-H, Clark RA, Bryant AL. "Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults". Manual Therapy. 2013; 18(1): 65-71. doi: 10.1016/j.math.2012.07.005. PMID: 22959228.

[18] Patel DR, Kinsella E. "Evaluation and management of lower back pain in young athletes". Translational Pediatrics. 2017; 6(3): 225. doi: 10.21037/tp.2017.06.01. PMID: 28795014 PMCID: PMC5532202.

[19] Vaughn DW, Brown EW. "The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles". Journal of Back and Musculoskeletal Rehabilitation. 2007; 20(4): 155-65. doi: 10.3233/BMR-2007-20404.

[20] Kendall FP, McCreary EK, Provance P, Rodgers M, Romani W. Muscles: Testing and Function with Posture and Pain (Kendall, Muscles). 2005. PMCID: PMC1858872.

[21] Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. "Exertional heat illness during training and competition". Medicine & Science in Sports & Exercise. 2007; 39(3): 556-72. doi: 10.1249/MSS.0b013e31802fa199. PMID: 17473783.

[22] Senthil P, Sudhakar S, Radhakrishnan R, Jeyakumar S. "Efficacy of corrective exercise strategy in subjects with hyperkyphosis". Journal of Back and Musculoskeletal Rehabilitation. 2017; 30(6): 1285-9. doi: 10.3389/fpain.2022.1038269. PMCID: PMC9811681. PMID: 36618579

[23] Feng Q, Wang M, Zhang Y, Zhou Y. "The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial". Clinical Rehabilitation. 2018; 32(1): 48-56. doi: 10.1177/0269215517714591. PMID: 28610442.

[25] Bautmans I, Van Arken J, Van Mackelenberg M, Mets T. "Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis". Journal of Rehabilitation Medicine. 2010; 42(2): 129-35. doi: 10.2340/16501977-0486.PMID: 20140408.

[26] Fuentes JP, Armijo Olivo S, Magee DJ, Gross DP. "Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis". Physical Therapy. 2010; 90(9): 1219-38. doi: 10.2522/ptj.20090335.PMID: 20651012.

[27] Itoi E, Sinaki M. Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age. InMayo Clinic Proceedings 1994 Nov 1 (Vol. 69, No. 11, pp. 1054-1059). doi: 10.1016/s0025-6196(12)61372-x. PMID: 7967758.

[28] O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Möller NE, Richards KV. "The effect of different standing and sitting postures on trunk muscle activity in a pain-free population". Spine. 2002; 27(11): 1238-44. doi: 10.1097/00007632-200206010-00019. PMID: 12045525.

[30] Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, Muehlbauer T. "The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review". Sports Medicine. 2013; 43(7): 627-41. doi: 10.1007/s40279-013-0041-1.PMID: 23568373.

[31] Briggs A, Wrigley T, Tully E, Adams P, Greig A, Bennell K. "Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles". Skeletal Radiology. 2007; 36(8): 761-7. doi: 10.1007/s00256-007-0284-8.PMID: 17437103.

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Volume 13, Issue 2July 2021Pages 341-353

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Volume 13, Issue 2
July 2021
Pages 341-353