THORACIC SPINAL MOBILITY IN ADULTS: CLINICAL ASSESSMENTS AND EXERCISE INTERVENTION

The thoracic spine is one of the most under-researched regions of the spine. However, it is often treated by clinical therapists with manipulation or manual therapy techniques to reduce neck, shoulder, and lower back pain indirectly. High-quality, evidence-based research on the effects of exercise interventions as a treatment modality needs to be improved. It is believed that an increased curvature and lack of mobility of the thoracic spine can negatively influence the functional biomechanics of the entire spine, including breathing and posture.

The global aims of this study were to explore the existing research investigating the effects of exercise interventions on improving thoracic kyphosis and mobility, determine which clinical tools are valid and reliable for assessing thoracic spine mobility, and determine the impact of a corrective exercise intervention on thoracic spine mobility.

This dissertation is comprised of four main studies. Study One is a systematic review summarising the quality of studies and the effect of exercise interventions on thoracic spine mobility. The systematic review revealed that exercise interventions effectively improve thoracic kyphosis or mobility, but these studies were of poor quality. Therefore, more high-quality, evidence-based research on the effect of exercise interventions applied to the thoracic spine must be done. Study Two was a reliability and concurrent validity study performed on smartphones and mobile phone applications (Apps). This study revealed that smartphones are reliable and valid tools, acting like digital inclinometers, for determining sagittal plane measurements. Study Three investigated the reliability and concurrent validity of a smartphone and clinical tools used to measure thoracic spine mobility of asymptomatic adults. This study revealed that a smartphone is a reliable and valid tool for thoracic spine assessments. Study Four was a cross-over study that determined the effectiveness of a corrective exercise intervention on thoracic spine mobility of asymptomatic adults. This study confirmed that a corrective exercise intervention improved thoracic spine rotation in hyperkyphotic asymptomatic adults.