Effectiveness of Face-to-Face vs. Telerehabilitation in Children Aged 9-12 with Thoracic Hyperkyphosis

This study aimed to compare the effects of face-to-face rehabilitation and tele-rehabilitation in reducing thoracic hyperkyphosis in Turkish children aged 9-12. Given the reliance on technology and the challenges of global health crises, understanding the efficacy of these rehabilitation approaches is crucial. The findings aim to contribute valuable insights to the literature and inform future rehabilitation practices for children with thoracic hyperkyphosis.

This randomized clinical trial involved twenty children diagnosed with thoracic hyperkyphosis (Thoracic Kyphosis Angle >40 degrees). Participants' Visual Analog Scale (VAS) scores and Manual Muscle Tests (MMT) were assessed before and after the intervention. Exclusion criteria included congenital spinal malformations and mental health issues. Participants were randomly assigned to either the face-to-face rehabilitation group (Group 1) or the online telerehabilitation group using the Fiziu platform (Group 2). Both groups followed a thoracic corrective exercise program consisting of four exercises performed three times a week for six weeks. The flexicurve ruler was used to measure thoracic kyphosis at baseline and post-intervention. Statistical analyses were conducted using SPSS version 23.

Independent and paired sample t-tests evaluated changes in Thoracic Kyphosis Angle (TKA), MMT, and VAS between groups. Significant improvements were noted in TKA for both groups: Face-to-Face Rehabilitation (t(9) = 6.708, p .001) and Tele-Rehabilitation (t(9) = 4.490, p = 0.002). Initial TKA values were 47.100 (SD = 2.558) for Face-to-Face and 45.000 (SD = 2.582) for Tele-Rehabilitation, with final values of 45.100 (SD = 2.424) and 43.450 (SD = 2.254), respectively. Significant differences were found in MMT, with Face-to-Face (t(9) = -3.000, p = 0.015) showing a mean increase from 2.700 (SD = 0.675) to 3.200 (SD = 0.422), and Tele-Rehabilitation from 2.800 (SD = 0.632) to 3.200 (SD = 0.632) (t(9) = 2.449, p = 0.037). VAS scores improved significantly for both groups: Face-to-Face (t(9) = 5.460, p .001) from 7.500 (SD = 1.080) to 5.600 (SD = 1.265) and Tele-Rehabilitation (t(9) = 3.284, p = 0.009) from 7.200 (SD = 1.317) to 5.900 (SD = 0.738). No significant differences were found between groups for TKA (t(18) = 0.987, p = .337), MMT (t(18) = 0.429, p = .673), and VAS (t(18) = 1.138, p = .270), indicating comparable effectiveness.

Both face-to-face and telerehabilitation were effective in treating thoracic hyperkyphosis in Turkish children aged 9-12. The Fiziu platform provides a flexible option that can be especially useful in modern settings where convenience is important.

These findings provide insights for researchers and practitioners assessing rehabilitation efficacy. Future studies with larger samples are encouraged to enhance generalizability, and further exploration of telerehabilitation's usability and effectiveness is warranted in clinical practice.