AIM: To evaluate the effects of a 9-month Pilates exercise programme on the sagittal spinal posture and hamstring extensibility of adolescents with thoracic hyperkyphosis. DESIGN: Randomised controlled trial with blinded examiner. PATIENTS: One-hundred and three adolescents with thoracic hyperkyphosis. INTERVENTIONS: Participants were randomly placed into an experimental group which participated in a Pilates exercise programme implemented for a total of 38 weeks (two sessions/week, 15 min/session) (Pilates group (PG), sample = 49, or control group (CG), sample = 48). MAIN OUTCOME MEASURES: The outcome measures were the thoracic curve in sagittal spinal curvature in relaxed standing, sagittal spinal curvatures and pelvic tilt in relaxed standing and sit-and-reach positions, and hamstring extensibility. RESULTS: There was a significant adjusted mean difference between groups in favour of the PG in the thoracic curve in relaxed standing position (-5.6 degree, p = 0.003), pelvic tilt (-2.9 degree, p = 0.03) and all straight leg tests (p < 0.001). The PG showed a significant change in thoracic curve (-5.9, p < 0.001) and in lumbar angle (4.0, p = 0.001) in relaxed standing position and in all straight leg raise tests (+6.4 to +15 degree, p < 0.0001). CONCLUSIONS: The adolescents with thoracic hyperkyphosis from the PG had a decreased thoracic kyphosis in relaxed standing position, and improved hamstring extensibility as compared with the CG. More than 50% of the participants obtained kyphosis values inside normality, showing an adjusted mean difference between groups in the thoracic curve of about 73% of the baseline mean, resulting in a large improvement and high clinical importance. TRIAL REGISTRATION NUMBER: NCT03831867.
Reproduced with permission from the BMJ Publishing Group.

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