Effect of holistic approach corrective exercise program on physical fitness and body image in kyphotic adolescents

Öz

Purpose: This study aimed to investigate the effect of holistic approach corrective exercise program on physical fitness and body image in kyphotic adolescents. Methods: A total of 62 kyphotic individuals with ages between 10-18 years were included in the study. Individuals were divided into three groups using simple randomization method. The groups were organized as holistic (n=21), thoracic (n=22) and control group (n=19). The holistic group program consists of corrective exercise program and postural perception education, the thoracic group program consists of thoracic exercises. Exercise programs were applied to the exercise groups for 12 weeks, 3 days a week and 40-50 minutes. No intervention was made in the control group. Physical fitness was evaluated using 6-minute walking test (6MWT) and the subheadings of the Munich physical fitness test,(MPFT), vertical jumping-stepping-ball bouncing-forward bending-hanging-weight throwing tests, body image was assessed by multidimensional body-self self/relationship scale (MBSRS). Results: After the training, 6MWT distance and VO2 max values decreased in the holistic and thoracic groups (p<0.05). In the holistic group, vertical jump, hanging and mean values, which are the sub-parameters of the MPF test, were increased (p<0.05). While the hanging value increased in the thoracic group (p<0.05), the forward bending and ball bouncing values decreased (p>0.05). There was a difference between groups in MPF throwing weights values (p<0.05). MBSRS scores decreased in the holistic and thoracic groups (p<0.05). There was a difference between groups in MBSRS values (p<0.05). Conclusion: In kyphotic adolescents, holistic and thoracic exercise programs were found to be effective in improving physical fitness, endurance and strength parameters. We think that these exercise programs can be applied to improve physical fitness in kyphotic individuals.

Anahtar Kelimeler

• Adolescent
• Kyphosis
• Physical fitness
• Body image

Kifotik adölesanlarda bütüncül yaklaşımlı düzeltici egzersiz programının fiziksel uygunluğa ve beden imajına etkisi

Öz

Amaç: Bu çalışmanın amacı kifotik adölesanlarda bütüncül yaklaşımlı düzeltici egzersiz programının fiziksel uygunluğa ve beden imajına etkisini incelemektir. Yöntem: Çalışmaya yaşları 10-18 yıl aralığında olan 62 kifotik birey dahil edildi. Bireyler basit rastgele yöntemle üç gruba ayrıldı. Gruplar, bütüncül (n=21), torakal (n=22) ve kontrol grubu (n=19) olarak düzenlendi. Bütüncül gruba düzeltici egzersizler ile birlikte postüral algı eğitimi verilirken, torakal gruba torakal bölge odaklı egzersizler uygulandı. Egzersiz gruplarına 12 hafta, haftada 3 gün 40-50 dakikalık egzersiz programları uygulandı. Kontrol grubuna müdahale yapılmadı. Fiziksel uygunluk 6 dakika yürüme testi (6DYT) ve Münih fiziksel uygunluk testinin (MFUT) alt başlıkları olan, vertikal sıçrama-basamak-top sektirme-öne eğilme-asılma-ağırlık atma testleri, beden imajı ise çok yönlü beden-benlik öz/ilişki ölçeği (ÇYBBÖ) kullanılarak değerlendirildi. Bulgular: Eğitim sonrası, 6DYT mesafesi ve VO2 maksimum değerleri bütüncül ve torakal gruplarda düşüş gösterdi (p<0,05). Bütüncül grupta, MFU testinin alt parametrelerinden vertikal sıçrama, asılma ve ortalama değerlerinde artış görüldü (p<0,05). Torakal grupta asılma değeri artış gösterirken (p<0,05), öne eğilme ve top sektirme değerleri düşüş gösterdi (p>0,05). MFU ağırlık atma değerlerinde, gruplar arası karşılaştırmada farklılık görüldü (p<0,05). ÇYBBÖ puanları bütüncül ve torakal gruplarda düşüş gösterdi (p<0,05). ÇYBBÖ değerlerinde gruplar arası karşılaştırma bütüncül ve torakal gruplar lehine farklılık görüldü (p<0,05). Sonuç: Kifotik adölesanlarda bütüncül ve torakal egzersiz programlarının, fiziksel uygunluğun endurans ve kuvvet parametrelerinin iyileştirilmesinde etkili oldukları görüldü. Bu egzersiz programlarının kifotik bireylerde fiziksel uygunluğu geliştirmek amacıyla uygulanabileceğini düşünüyoruz.

Anahtar Kelimeler

• Adölesan
• Kifoz
• Fiziksel uygunluk
• Beden imajı

Kaynakça

1. Y. Y. Aksiyal İskelet. In: Kas-İskelet Sistemi Kinezyolojisi. 1st Ed. Hipokrat Yayıncılık; p. 317–476.; 2018.
2. Lowe TG. Scheuermann’s Kyphosis. Neurosurg Clin N Am. 2007;18(2):305-315. doi:10.1016/j.nec.2007.02.011
3. Greig AM, Bennell KL, Briggs AM, Hodges PW. Postural taping decreases thoracic kyphosis but does not influence trunk muscle electromyographic activity or balance in women with osteoporosis. Man Ther. 2008;13(3):249-257. doi:10.1016/j.math.2007.01.011
4. Kamaci S, Yucekul A, Demirkiran G, Berktas M, Yazici M. The Evolution of Sagittal Spinal Alignment in Sitting Position During Childhood. Spine (Phila Pa 1976). 2015;40(13):E787-E793. doi:10.1097/BRS.0000000000000884
5. Kamali F, Shirazi SA, Ebrahimi S, Mirshamsi M, Ghanbari A. Comparison of manual therapy and exercise therapy for postural hyperkyphosis: A randomized clinical trial. Physiother Theory Pract. 2016;32(2):92-97. doi:10.3109/09593985.2015.1110739
6. Sinaki M. Critical appraisal of physical rehabilitation measures after osteoporotic vertebral fracture. Osteoporos Int. 2003;14(9):773-779. doi:10.1007/s00198-003-1446-8
7. Katzman WB, Vittinghoff E, Lin F, 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. Osteoporos Int. 2017;28(10):2831-2841. doi:10.1007/s00198-017-4109-x
8. 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. J Adv Med Biomed Res. 2019;27(121):23-31. doi:10.30699/jambs.27.121.23

9. 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. Clin Rehabil. 2018;32(1):48-56. doi:10.1177/0269215517714591
10. Wyszyńska J, Podgórska-Bednarz J, Drzał-Grabiec J, et al. Analysis of Relationship between the Body Mass Composition and Physical Activity with Body Posture in Children. Biomed Res Int. 2016;2016:1-10. doi:10.1155/2016/1851670
11. Meshgin S. The Relationship Between Upper Body Posture with Physical Activity, Psychological Properties and Electronic Entertainment Using Measures in Female Primary Students in Tehran. J Ergon. 2018;6(2):7-15. doi:10.30699/jergon.6.2.7
12. Asadi-Melerdi S, Rajabi-Shamli E, Sheikhhoseini R, Piry H. Association of Upper Quarter Posture with Depression, Anxiety, and Level of Physical Activity in Sixth Grade Elementary School Students of Karaj City. 2020;7:48-55. doi:10.30476/intjsh.2020.85300.1052
13. Katzman WB, Sellmeyer DE, Stewart AL, Wanek L, Hamel KA. Changes in Flexed Posture, Musculoskeletal Impairments, and Physical Performance After Group Exercise in Community-Dwelling Older Women. Arch Phys Med Rehabil. 2007;88(2):192-199. doi:https://doi.org/10.1016/j.apmr.2006.10.033
14. Naderi A, Rezvani MH, Shaabani F, Bagheri S. Effect of Kyphosis Exercises on Physical Function, Postural Control and Quality of Life in Elderly Men With Hyperkyphosis. Salmand. January 2019:464-479. doi:10.32598/SIJA.13.4.464
15. Tazegül Ü. Elit Düzeydeki Erkek Sporcuların Narsisizm Düzeyleri ve Beden Algıları Arasındaki İlişkinin Araştırılması,. 2017.
16. Appleton KM. 6 x 40 mins exercise improves body image, even though body weight and shape do not change. J Health Psychol. 2013;18(1):110-120. doi:10.1177/1359105311434756
17. Vaquero-Cristóbal R, López-Miñarro PÁ, Alacid F, González-Gálvez N, Esparza-Ros F. Evolution of body image perception and distorsion with mat and apparatus Pilates practice in adult women. Nutr Hosp. 2020. doi:10.20960/nh.03343
18. Loland NW. Body image and physical activity. A survey among Norwegian men and women. Int J Sport Psychol. 1998;29(4):339-365. https://eurekamag.com/research/003/055/003055625.php.
19. Katzman WB, Wanek L, Shepherd JA, Sellmeyer DE. Age-Related Hyperkyphosis: Its Causes, Consequences, and Management. J Orthop Sport Phys Ther. 2010;40(6):352-360. doi:10.2519/jospt.2010.3099
20. Medicine AC of S. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687-708.
21. Gruber W, Orenstein DM, Braumann KM, Hüls G. Health-related fitness and trainability in children with cystic fibrosis. Pediatr Pulmonol. 2008;43(10):953-964. doi:10.1002/ppul.20881
22. Doğan, O., Doğan S. Çok Yönlü Beden-Self İlişkileri Öl- çeği El Kitabı. Cumhur Üniversitesi Tıp Fakültesi Basımevi, Cumhur Üniversitesi Yayınları. 1992;No:53,:1-27.
23. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Routledge; 2013.
24. Bennell K, Khan K, McKay H. The role of physiotherapy in the prevention and treatment of osteoporosis. Man Ther. 2000;5(4):198-213. doi:10.1054/math.2000.0369
25. Katzman WB, Parimi N, Gladin A, Wong S, Lane NE. Long-Term Efficacy of Treatment Effects After a Kyphosis Exercise and Posture Training Intervention in Older Community-Dwelling Adults: A Cohort Study. J Geriatr Phys Ther. 2021;44(3):127-138. doi:10.1519/JPT.0000000000000262
26. Katzman WB, Vittinghoff E, Kado DM, et al. Study of Hyperkyphosis, Exercise and Function (SHEAF) Protocol of a Randomized Controlled Trial of Multimodal Spine-Strengthening Exercise in Older Adults With Hyperkyphosis. Phys Ther. 2016;96(3):371-381. doi:10.2522/ptj.20150171
27. Foley Davelaar CM. Body Image and its Role in Physical Activity: A Systematic Review. Cureus. February 2021. doi:10.7759/cureus.13379
28. Damon W HD. Self Understanding in Childhood and Adolescence. New York.: Cambridge University Press; 1988.
29. Nair S, Sagar M, Sollers J, Consedine N, Broadbent E. Do slumped and upright postures affect stress responses? A randomized trial. Heal Psychol. 2015;34(6):632-641. doi:10.1037/hea0000146
30. Asci, A., Tiryaki, G., Asci, F., Gokmen H. Self-concept and body image of Turkish high school male athletes and nonathletes. ADOLESCENCE,. 1997:959–968. doi:https://hdl.handle.net/11511/67848
31. Williams PA, Cash TF. Effects of a circuit weight training program on the body images of college students. Int J Eat Disord. 2001;30(1):75-82. doi:10.1002/eat.1056
32. Moore JB, Mitchell NG, Bibeau WS, Bartholomew JB. Effects of a 12-week resistance exercise program on physical self-perceptions in college students. Res Q Exerc Sport. 2011;82(2):291-301.