An interventional study of Schroth in Hyperkyphosis, Adolescent, Muscle Activation and Scapula; Deformity, Acquired, sponsored by Istanbul University - Cerrahpasa. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 7 Years to 18 Years. Per ClinicalTrials.gov, last updated 2025-10-01.
Sponsored by Istanbul University - Cerrahpasa · Not applicable, Interventional, and Treatment
This randomized controlled trial aims to investigate the effects of Schroth exercises on scapular muscle activation in children with thoracic hyperkyphosis. A total of 56 participants will be randomly assigned to either the Schroth exercise group or the control group receiving postural education. The intervention group will complete an 8-week supervised Schroth program focusing on three-dimensional correction, rotational breathing, and postural awareness. Primary outcome is scapular muscle activation measured by surface EMG. Secondary outcomes include muscle strength, scapular endurance, kyphotic appearance, posture, and pain. The results will guide clinical management and preventive strategies for children with postural thoracic hyperkyphosis.
This prospective, randomized controlled trial aims to investigate the effects of Schroth-based three-dimensional exercises on scapular muscle activation in children with postural thoracic hyperkyphosis. Thoracic hyperkyphosis, commonly observed during childhood and adolescence, not only leads to spinal deformity but also negatively impacts scapular positioning, upper extremity function, and overall posture. Weakness and poor activation of scapular stabilizing muscles may contribute to the progression of kyphosis and functional limitations.
The Schroth method is a scoliosis-specific exercise approach designed to improve spinal alignment through three-dimensional postural correction, rotational breathing, and muscle stabilization techniques. Although widely used for spinal deformities such as scoliosis and kyphosis, its specific effects on scapular muscle activation remain insufficiently studied. This study will explore the potential of Schroth exercises to enhance scapular muscle function, which may contribute to improved posture, increased muscle strength and endurance, better scapular performance, reduced kyphotic appearance, and alleviation of pain.
The intervention group will participate in an 8-week supervised exercise program consisting of individualized Schroth exercises, focusing on postural awareness and scapular control during functional activities. By targeting scapular muscle activation, the study seeks to determine whether integrating Schroth exercises into physiotherapy practice can improve clinical outcomes and inform evidence-based approaches for managing postural thoracic hyperkyphosis in the pediatric population. Findings from this study may also contribute to developing preventive health strategies to protect musculoskeletal health in children and adolescents.
781 studies on the registry are indexed under Congenital Abnormalities; 77 are open to participants now.
This study's planned enrollment of 56 is above the median of 40 across 466 interventional studies indexed under Congenital Abnormalities.
Browse Congenital Abnormalities studies →Istanbul University - Cerrahpasa is the lead sponsor of 699 studies on the registry; 213 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
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BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants in the experimental group will undergo a supervised 3D Schroth-based exercise program with postural education. The intervention will be applied 3 times per week for 8 weeks, totaling 24 sessions, each lasting approximately 45 minutes, delivered in-person by a trained physiotherapist. Exercises will include corrective postural training, scapular stabilization, rotational breathing, and static stretching. The program is delivered in two progressive phases: Weeks 1-4: Postural awareness and basic muscle activation Weeks 5-8: Functional integration and advanced stabilization Progression criteria are based on repetitions: exercises begin at 9 reps × 3 sets, and progress to 15 reps × 3 sets. Static stretches start with 20 seconds × 2 sets and are increased to 3 sets before progressing. All exercises are individualized based on clinical assessment.
Other: Schroth
The control group will receive a single, standardized session of postural education at the beginning of the study, during which general information about correct posture, ergonomic principles, and spinal health will be provided. Following this session, participants in the control group will be placed on a waiting list and monitored for a period of 8 weeks. During this time, they will not receive any specific exercise intervention or additional therapeutic program related to posture or muscle strengthening. Regular follow-up will be conducted to ensure participant safety and to monitor any changes or adverse events throughout the waiting period.
The Schroth intervention consists of a structured, three-dimensional exercise program based on scoliosis-specific principles. It incorporates corrective postural alignment, rotational breathing techniques, and targeted activation of spinal and scapular stabilizing muscles. The exercises are designed to improve postural control, enhance muscle endurance, and promote neuromuscular re-education for better functional alignment during daily activities.
Muscle Activation (sEMG)
Surface electromyography (sEMG) will assess the activation of the upper, middle, lower trapezius, and serratus anterior muscles, following SENIAM protocols. Signals will be normalized to %MVC and analyzed for concentric, isometric, and eccentric phases using RMS methods with a 20 Hz high-pass filter.
Time frame: 8 weeks
Muscle Strength
Scapular stabilizing muscle strength will be measured using a handheld dynamometer (Lafayette Instrument). Higher force values (in Newtons) indicate greater muscle strength and improved functional capacity of the scapular muscles. An increase in the score reflects muscle strength gains, while a decrease indicates weakness or functional decline.
Time frame: 8 weeks
Scapular Muscle Endurance Test
Scapular muscle endurance will be evaluated using the Scapular Muscle Endurance Test, which measures the duration (in seconds) that scapular muscles can sustain an isometric contraction. A higher score indicates better endurance capacity, while a lower score reflects fatigue or reduced muscle endurance.
Time frame: 8 weeks
Kyphosis-Specific Spinal Appearance Questionnaire
The Kyphosis-Specific Spinal Appearance Questionnaire is a 10-item, 5-point Likert scale (range: 1 to 5 per item, total score range: 10 to 50) designed to assess patients' perception of their spinal appearance related to thoracic hyperkyphosis. Higher scores indicate worse perceived deformity and greater concern about appearance.
Time frame: 8 weeks
PostureScreen Mobile Application
Provides objective measurements of postural deviations. Improvements are indicated by reductions in deviation angles or distances.
Time frame: 8 weeks
Postural Habits and Awareness Scale
The Postural Habits and Awareness Scale consists of 19 items, each scored on a 5-point Likert scale (total score range: 19 to 95). Higher scores indicate better postural habits and awareness.
Time frame: 8 weeks
Numeric Rating Scale (NRS)
Pain intensity will be measured using the Numeric Rating Scale (NRS) during rest, physical activity, and at night. The scale ranges from 0 (no pain) to 10 (worst possible pain). A decrease in NRS scores indicates pain relief, while an increase signifies worsening pain.
Time frame: 8 weeks
Global Rating of Change (GROC) scale
Participant satisfaction with the intervention will be assessed using the Global Rating of Change (GROC) scale. The GROC is an 7-point scale ranging from -3 (very much worse) to +3 (completely recovered), with 0 indicating no change. Positive scores indicate perceived improvement, zero represents no change, and negative scores indicate worsening of symptoms or dissatisfaction with the treatment.
Time frame: 8 weeks
Started Jun 2025 (actual). Primary completion is estimated for May 2026, 10 months after the start.
Of 71 non-industry interventional studies with no phase under Congenital Abnormalities, half reached primary completion within 37 months of starting (the median), counting those still running; a quarter within 14 and three quarters within 71. This study's planned 10 months is below that.
Counting every sponsor, half of 76 studies reached it within 37 months; a quarter within 14 and three quarters within 72.
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