Background & Aims: Normal lung function varies among individuals due to factors such as age, gender, physical activity level, body mass index, and lifestyle habits (1). Postural abnormalities refer to undesirable changes that disrupt the skeletal structure and normal alignment of the body (2). The modern sedentary lifestyle—characterized by children sitting in school for 6 to 7 hours, followed by several additional hours in front of a television or computer—poses significant health risks. One crucial factor in promoting a healthy lifestyle for school-age children and preventing postural abnormalities is daily physical activity (4). Therefore, the present study aims to determine whether Pilates, yoga, and Theraband exercises affect the maximum oxygen consumption of female students with postural kyphosis.
Methods: This study is prospective in design, semi-experimental in methodology, and applied in subject matter. A total of 45 eligible female students, aged 14 to 18 years, were purposefully selected to participate. The sample size was determined using G*POWER software, with an effect size of 0.6, an alpha level of 0.05, and a beta level of 0.85. Participants were divided into three training groups: Pilates (15 participants), yoga (15 participants), and Theraband (15 participants). Inclusion criteria included dorsal kyphosis greater than 42 degrees and absence of respiratory problems. Exclusion criteria were excessive fatigue during exercises due to severe musculoskeletal weakness, absence from two consecutive sessions, or absence from three non-consecutive sessions. All participants completed a consent form and a data collection form. To conduct the study, the researcher visited schools in Natanz city where they worked and invited female students with kyphosis greater than 42 degrees to participate. After coordinating with the school principal and obtaining parental consent, the researcher assessed kyphosis variables and lung volume indices. The subjects were then assigned to one of the three exercise groups—Pilates, yoga, or Theraband—and participated in the exercise program for eight weeks. Upon completion, the subjects were re-evaluated during the post-test phase.
A kyphometer was utilized in this study to evaluate kyphosis. To determine the angle of dorsal kyphosis, the angle between the spinous processes of the T3-T4 and T11-T12 vertebrae was measured. For the assessment, the subject was instructed to stand barefoot with their weight evenly distributed between both legs and their arms positioned straight at their sides. In this posture, the block connected to the marker point was placed on the first numbered point, while the block connected to the protractor was positioned on the second marker point (19). Pulmonary Function Indices: In this study, pulmonary function indices were measured using spirometry to assess lung capacity and volume, in accordance with the standards set by the American Thoracic Society. A portable calibrated spirometer (COMPACT model, manufactured by Vital graph, England) was employed in a medical center by a trained technician. The average predicted percentages of each lung function variable, based on age and gender, were calculated and estimated using the spirometer. To familiarize the participants with spirometry, they received necessary training. Before the test, the subjects were seated for 5 minutes, after which they were asked to stand in front of the spirometer in a normal and comfortable position while placing a special clip on their noses. At least three acceptable tests were conducted for each subject, and from these tests, the highest values of forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were selected. The spirometry indices examined in this study included forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the ratio of forced expiratory volume in the first second to vital capacity (FEV1/FVC) (20). Pilates Exercise Program: The program was conducted over an 8-week period, with three sessions per week. It included breathing exercises, warm-up (stretching and balance), basic and specialized Pilates exercises, and a cool-down consisting of stretching exercises (21). Yoga Exercise Program: Participants performed general Iyengar yoga three days per week (one hour each day) (Table 2) and Iyengar yoga exercises emphasizing the spine and shoulders two days per week (30 minutes each day). All exercise sessions began with the mountain pose (Tadasana), followed by poses primarily focused on lengthening the spine and improving flexibility, balance, muscle strength, and endurance. The yoga exercises were performed for 8 weeks, with a 10-minute warm-up before and a 10-minute cool-down after the sessions (22). Theraband Exercises: This program was conducted over 8 weeks with three sessions per week. The exercises are presented in the table below. A 10-minute warm-up was performed before the exercises, and a 10-minute cool-down was performed afterward (23).
Results: The results of the present study demonstrated that all three exercise programs significantly reduced the angle of dorsal kyphosis (P = 0.001). Additionally, studies on pulmonary function indices revealed that Pilates and yoga exercises significantly improved vital capacity (FVC) (P = 0.001) and forced expiratory volume in the first second (FEV1) (P = 0.001). In the intergroup comparison, the results also indicated a significant difference between the Pilates and Theraband groups (P = 0.001) as well as between the Yoga and Theraband groups (P = 0.001).
Conclusion: The present study demonstrated the effects of exercises using Theraband, Pilates, and yoga on reducing dorsal kyphosis in female students. Additionally, regarding respiratory function indices, the results indicated that Pilates and yoga exercises have a greater impact compared to Theraband exercises. It is recommended that this study be extended to individuals with upper crossed syndrome. Furthermore, the long-term effects of Pilates, yoga, and Theraband exercises on the dorsal kyphosis angle and respiratory function indices in girls with dorsal hyperkyphosis should be investigated. Regarding their effect on reducing dorsal kyphosis, Pilates and yoga engage the entire body, strengthening the deep trunk muscles and improving dorsal kyphosis (30). Concerning yoga, the concentration involved in these exercises also benefits respiratory muscles. McKay et al. (2016), in their study titled Effect of Continuous Yoga Breathing Practice on the Human Cardiorespiratory System, these exercises significantly alter end-expiratory gases, leading to complex fluctuations in cardiovascular and cerebrovascular variables and, with continuous practice, may reduce chemical sensitivity (39).