Costovertebral Mobilization on Kyphotic Posture and Lung Function in Non-Smoker

Kyphosis is the curvature of the thoracic spine, formed by the shape of the vertebrae and the intervertebral discs and-in standing position-paraspinal muscle strength. Hyperkyphosis is usually associated with increased anteroposterior diameter of the thorax and a decrease in the distance between the xiphisternum and pubis and it is present when the kyphosis angle exceeds the normal ranges. This curve is concave anteriorly with a normal angle between 20˚ - 40˚.

The lungs are the foundational organs of the respiratory system,whose most basic function is to facilitate gas exchange from the environment into the bloodstream.The decline in lung function could be associated with hyperkyphosis, As the curvature of the thoracic spine increases and the posture becomes more hunched, the mobility of the rib cage could be limited and restrict the thoracic and lung expansions during inspiratory maneuver.

Different treatment strategies such as surgery, splinting, exercises and manual therapies such as massage, muscle energy technique, and passive joint mobilization have been used to treat hyperkyphosis. Costovertebral mobilization is a manual therapy technique, to improve the mobility and function of the joints between the ribs (costo) and the vertebrae (vertebral). This technique increases the range of motion of ribcage and spine, thus improve kyphosis posture and lung functions.

Inclusion criteria

• Non smoker
• Age: 20-40 years
• Normal Body Mass Index 18.5 To 24.9
• Both female and male gender
• Decrease forced expiratory volume-one second/ forced vital capacity ratio greater than or equal to 70%
• Increase Thoracic kyphotic posture greater than or equal to 40˚

Exclusion criteria

• Any respiratory disease of the upper or lower respiratory tracts e.g. asthma, chronic bronchitis, COPD, emphysema etc. which could altered the optimal lung functioning.
• Previous history of rib fractures, dislocations, sprains of costochondral, costosternal and interchondral joints.
• Smokers
• Scheuermann Disease
• Primary and Secondary neoplastic lesions of the spine and/or ribs
• Obvious advanced spinal deformity e.g. kyphoscoliosis
• Infection e.g. tuberculosis
• Primary and secondary neoplastic lesions of the soft tissue structures of the chest
• Inflammation e.g. acute rheumatoid arthritis or ankylosing spondylitis