Combined Effects of Postural Education, Therapeutic Massage, Segmental Stretching, and Motor Control Exercise in a 19-Year-Old Male with Chronic Back Pain and Kypholordotic Posture: A Case Report

Abstract

Introduction: Sagittal spine malalignment has been linked with a number of health consequences including pain, disability, and suboptimal quality of life. Case Presentation: We present a 19-year-old male with 3 years history of chronic back pain associated with kypholordotic posture. Upon examination, lumbar hyperlordosis and thoracic hyperkyphosis were mainly associated with muscular imbalance around thechest,upperback,andlumbopelvic-hipregion. Thepatientreceivedtreatmentcomprisingposturaleducation(PE),therapeutic massage (TM), segmental stretching exercise (SSE), and motor control exercise (MCE) twice a week for 8 weeks. The patient demon-strated a significant improvement in lumbar lordotic (83.8 0 to 76.3 0 ) and thoracic kyphotic (65.2 0 to 60.6 0 ) curves as measured by flexible ruler, back pain (7.0 cm to 1.0 cm) as measured by visual analogue scale, spine ranges of motion (flexion: 5.2cm to 7.5cm; extension: 3.5cmto4.7cm)asmeasuredbymodifiedSchober’stest,andfunctionaldisability(46.7% to20.0%)asmeasuredbymodified Oswestry disability index. Conclusions: Theresultsshowedthatthecombinationof PE,TM,SSE,andMCEwaseffectiveinimprovingsagittalspinealignment, back pain, spine range of movement, and function.