Basic Body Awareness Therapy (BBAT) and Corrective Exercise for Adolescent Hyperkyphosis

Condition(s) studied

Investigational drug(s) / intervention(s)

Corrective Exercise and Basic Body Awareness Therapy (BBAT): This is a behavioral, non-drug intervention combining Schroth corrective exercises with somatic awareness through Basic Body Awareness Therapy (BBAT). Movements emphasize movement quality, postural alignment, and improved self-perception of the body. The approach supports individualized progression (targeting 4-6 on a perceived difficulty scale) and complements conventional physiotherapy for adolescent hyperkyphosis.

Corrective Exercise and Autogenic Training: This is a non-drug corrective exercise program tailored for adolescents with postural hyperkyphosis, combined with Autogenic Training for relaxation. It includes spinal strengthening and Schroth-specific postural corrections performed twice weekly. Additionally, participants perform Autogenic Training focusing on breathing, cardiac regulation, and abdominal warmth to support mental well-being alongside physical rehabilitation.

Study summary

This study is designed as a randomized controlled trial to evaluate the additional benefits of Basic Body Awareness Therapy (BBAT) when combined with a corrective exercise program for adolescents with postural hyperkyphosis. Postural hyperkyphosis, defined as a thoracic kyphosis angle of 40 degrees or greater, often leads to physical misalignments and psychosocial issues such as decreased self-esteem and poor body image during adolescence. Participants will be randomly assigned to either Group A (Experimental) or Group B (Control) using a stratified block randomization method. Both groups will participate in a 12-week intervention consisting of supervised Schroth corrective exercises performed twice weekly. Group A will additionally receive one session per week of BBAT, a physiotherapy method focusing on movement quality, mental awareness, and the integration of physical and mental self-awareness through lying, sitting, standing, and walking exercises. Group B will receive Autogenic Training, a systematic relaxation technique, as an active control. Assessments will be conducted at baseline and at the end of the 12-week program. The primary outcome measures include body awareness (Body Awareness Questionnaire), aesthetic perception of the spine (Kyphosis Specific Spinal Appearance Questionnaire), self-esteem (Rosenberg Self-Esteem Scale), and digital posture analysis (PostureScreen Mobile). Secondary outcomes involve clinical measurements of kyphosis (Flexicurve and Wall-Occiput Distance), dynamic and static balance (Y-Balance Test and Single-Leg Stance Test), thoracic joint position sense, health-related quality of life (SRS-30), and pain intensity (Numeric Pain Rating Scale). The study aims to provide a comprehensive understanding of how mindfulness and movement awareness can enhance traditional physical rehabilitation for spinal postural disorders.

Eligibility

Primary outcome measure(s)

• Body Awareness - Body Awareness Questionnaire (BAQ) — 12 weeks
  The Body Awareness Questionnaire is an 18-item scale designed to assess a person's sensitivity to non-pathological bodily processes, such as body rhythms and changes in bodily states. Each item is rated on a 7-point Likert scale, with total scores ranging from 18 to 126. A higher total score indicates a greater level of body awareness. This measure will evaluate how the interventions influence the participants' internal perception of their bodies.
• Aesthetic Perception of the Spine - Kyphosis Specific Spinal Appearance Questionnaire (KSAQ) — 12 weeks
  The Kyphosis Specific Spinal Appearance Questionnaire consists of 22 items specifically tailored to evaluate how adolescents with hyperkyphosis perceive the aesthetic appearance of their spine. The scale uses a 5-point Likert system where higher scores reflect a more negative perception of spinal appearance and higher treatment expectations. This tool provides insight into the psychosocial impact of postural changes and the perceived effectiveness of the treatment from the patient's perspective.
• Self-Esteem - Rosenberg Self-Esteem Scale (RSES) — 12 weeks
  The Rosenberg Self-Esteem Scale is a widely validated 10-item instrument used to measure global self-worth and self-acceptance. Participants rate each item on a 4-point Likert scale ranging from strongly agree to strongly disagree. It captures both positive and negative feelings about the self, providing a total score that reflects the individual's overall level of self-esteem throughout the therapeutic process.
• Posture Analysis - PostureScreen Mobile (PSM) Assessment — 12 weeks
  PostureScreen Mobile is a digital postural analysis application used to objectively quantify postural deviations. It measures shifts and tilts in centimeters or degrees by analyzing photos taken from anterior, posterior, and lateral views. The assessment focuses on identifying improvements in spinal alignment and the reduction of forward head posture or thoracic kyphosis after the 12-week intervention.

Trial sites (1)

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