Hyperkyphosis: Evaluation & Treatment Considerations

1. Definition and Description of Hyperkyphosis

Hyperkyphosis is commonly seen by physical therapists, but there is often a lack of understanding of the differentiation between postural and structural deformity. This chapter will describe the clinical screening and examination of hyperkyphosis so that proper referral can be made for radiological diagnosis if indicated. The radiological criteria for structural hyperkyphosis – specifically Scheuermann’s Disease. There will be a video of clinical examination of a patient with Scheuermann’s Disease.

2. Treatment Indications and Goals for Hyperkyphosis

This chapter will use published references to describe the indications and goals for conservative treatment of hyperkyphosis. Goals are based upon the knowledge there is a flexible, postural component of hyperkyphosis that can be influenced by exercise, positioning, and bracing. The reader to gain an understanding of the intended benefits of physical therapy and bracing for hyperkyphosis with examples shown.

3. Physical Therapy Treatment Principles

Therapists seeing structural hyperkyphosis patients (such as Scheuermann’s Disease) should ideally have specific continuing education or refer to trained therapists. However, specialized care may not be readily available in all communities and continuing education may not be possible for all therapists. Therefore, this chapter will educate therapists on entry level concepts for treating hyperkyphosis when specialized therapy is not available. Fundamentals of physical therapy treatment will be described, using sagittal correction principles, respiration, and stability. Additional orthopedic considerations will be described for manual therapy, proprioception, joint mobilization, taping and exercise that can benefit hyperkyphosis patients.

4. Case Studies

Several hyperkyphosis case studies will be reviewed and outcomes given. A video of patient treatment will be shown.