Effect of three-week posture correction exercise and thoracic manipulation on autonomic nervous system in thoracic...

Thoracic hyperkyphosis (THK) may affect the autonomic nervous system (ANS) as the thoracolumbar outflow governs the sympathetic nervous system, but there is a paucity of literature on the effect of postural correction on ANS functions. Therefore, the study was conducted to examine the effects of postural correction exercises and thoracic manipulation on ANS function in thoracic hyperkyphosis.

The study employed a pretest-posttest, active-comparator group design. A total of 80 adults aged 18-40 years with a kyphosis angle >45° and a numeric pain rating scale score >3 were randomly allocated to the experimental and active-comparator groups in a 1:1 ratio. Participants in the active-comparator group underwent postural correction exercise, whereas those in the experimental group received thoracic manipulation in addition to postural correction for 3 weeks. Pain, kyphosis angle, root mean square of successive differences (RMSSD) of R-R intervals, and Sympathetic Skin Response (SSR) are the outcome variables measured at baseline and after 3 weeks of the intervention.

Analysis of Covariance (ANCOVA) revealed significant group effects for HRV and SSR amplitude (p < 0.001, partial η² = 0.22 to 0.49) after adjusting for kyphosis angle and pain, whereas SSR latency remained non-significant. Additionally, kyphosis angle and pain were found significant covariates (p < 0.01), indicating a significant association with change in autonomic functions.

Postural correction exercise, along with thoracic manipulation, may improve autonomic functions among symptomatic individuals with THK. However, future studies employing advanced autonomic assessment tools and long-term follow-up are necessary to validate and generalize these findings.

CTRI/2024/04/066057.