Does stretching of anterior structures alone, or in combination with strengthening of posterior structures, decrease hyperkyphosis and improve posture in adults? A Systematic Review and Meta-analysis.

Kyphosis can lead to back pain, poor posture, and increased falls risk. This systematic review aimed to synthesize research on stretching alone, or in combination with strengthening, as a management for hyperkyphosis in the adult population (≥18 years old). An electronic database search was conducted from February to March 2022. The author and an independent reviewer screened titles and abstracts for inclusion criteria - those whose intervention involved stretching alone or with strengthening exercises. The author appraised and extracted data from included articles and performed a meta-analysis where appropriate. The database and citation search yielded 327 articles, 18 of which met inclusion criteria. One study included performed stretching as a standalone intervention; the remainder used a combination of stretching and strengthening. The meta-analysis (n=3, with 5 exercise groups) found a statistically significant difference (MD = -6.97 (95% CI -9.84, -4.10), p<0.00001) in post-intervention measures of hyperkyphosis favouring the exercise group. The narrative review of studies agrees with this finding, demonstrating statistically significant improvement in hyperkyphosis following various exercise programs. This review suggests that stretching and strengthening exercises improve hyperkyphosis in the short and long term. Low-quality evidence supports stretching as a standalone intervention. Further, more robust research is required to recommend procedures and determine if stretching alone is effective for treating hyperkyphosis in adults.

Women's perceptions or experiences of physical activity and exercise interventions to improve bone health: a systematic review.

Exercise is an important intervention to maintain bone health in women with osteopenia and osteoporosis. This systematic review aims to gain insight into the experiences or perceptions females have toward bone health interventions, to promote uptake and adherence. Four electronic databases were searched: MEDLINE, CINAHL, PubMed and PsycInfo. Inclusion Criteria: Qualitative studies examining perceptions or views of women to physical activity or exercise interventions aimed at improving bone health. 1,406 papers were identified. After screening, data were extracted from 2 studies considering experiences and 2 papers presenting perceptions of exercise for bone health. All studies scored >8 out of 10 on the CASP Quality Tool. Older women perceived barriers such as safety and advice, and facilitators of tangible results and feedback within supervised group sessions. Older womens' experiences of a digitally delivered exercise intervention included social interactions and voice reminders, with barriers of lack of feedback and knowledge. Younger women expressed enablers as feeling the benefits and physical literacy, and barriers of previous experience participating in tedious exercise. Supervised sessions, with different intensity levels and variety, offering feedback to promote confidence, are valuable to uptake and adherence in both younger and older females.