Effectiveness of tele-exercise for correcting posture in elderly with thoracic kyphosis

Background: Thoracic kyphosis (TK) was an abnormality of the thoracic spine alignment in the elderly. The correct posture exercise was focused improving TK. However, the continuity of the exercise in health care service found numerous limitations. Telerehabilitation was a part of current treatment to increase compliance with the accessibility of the health system.Objective: comparison the effectiveness tele-exercise and exercise under supervision by physical therapy for correct posture in the thoracic kyphosis angle, forward head posture, back muscle strength, chest expansion, anterior reach test, and cost-effectiveness in elderly with thoracic kyphosis.Method: Twenty-two women 60 years of age and over, with thoracic angle over more than 45 degrees participated in this study. Participants were assigned to either the tele-exercise group (TG) or the clinic group (CG) on the basic of convenience of location, and 22 in each were analyzed. Participants in the TG underwent a thoracic corrective exercise program 1 hour each session, third per week for 8 weeks (a total of 24 sessions), via videoconference with real-time feedback. the CG received a thoracic corrective exercise program similar TG by face-to-face provider in clinic. Outcome measures included Thoracic angle (Dual digital inclinometer), forward posture (Tragus to wall test), back strength (Back-leg-chest dynamometry), balance (Anterior reach test), chest expansion (Tap measure) and Cost-effectiveness. All data were collected by blinded assessor at baseline and at 8 weeks after completion of intervention.Result: For participants of the both group, means of thoracic angle, forward posture and back strength showed significant improvements over time (P < .05) with improved values both in comparison of baseline to postintervention and baseline to follow-up. Means of lower chest expansion were significantly improved in only in TG (P < .05). Furthermore, cost-effectiveness showed cost of intervention in TG cheaper than CG about 133.78 US$.Conclusion: Our research is the first study on telerehabilitation in elderly with mild thoracic kyphosis in Thailand, which found that when comparing the effectiveness of treatment between conventional services. There is no difference in the effect of the intervention. As a result, it may be a guideline for future alternative treatment in case the elderly cannot come to the hospital. To alternative is the missed appointment to continue to optimize the treatment efficiency.