Effects of Telerehabilitation versus Physical Rehabilitation on Kyphotic Index in Adolescent Girls: A Randomised Controlled Study

Introduction: One of the major concerns during adolescence is the development of postural deviations and musculoskeletal disorders, particularly affecting the cervical, thoracic, and lumbar spine. Thoracic kyphosis is characterised by an excessive anterior curvature of the thoracic spine. The Kyphotic Index (KI) is a quantitative indicator representing the ratio of thoracic width to thoracic length. Aim: To compare the effectiveness of telerehabilitation and physical (in-person) rehabilitation on KI in adolescent girls. Materials and Methods: The present Randomised Controlled Trial (RCT) was conducted among adolescent girls studying in peri-urban schools located in Dhayri and Khadakwasla, Pune, Maharashtra, India. Schoolgirls between 12 and 16 years of age who were beginning puberty were selected. Girls with protracted shoulders and a forward head posture were included. Girls with documented musculoskeletal, neurological, or cardiopulmonary diseases, as well as those with functional or structural scoliosis or visual impairment, were excluded from the study. The KI was used as a quantitative metric to assess the degree of thoracic spinal curvature. A total of 114 schoolgirls were selected and divided into three groups: telerehabilitation, physical rehabilitation, and control. The intervention was conducted over eight weeks with three sessions per week, and KI was measured pre- and postintervention. Strengthening exercises for the rotator cuff, scapular stabilisers, and cervical muscles, along with stretching for the pectoral and neck muscles, were administered in the intervention groups. The telerehabilitation group received sessions via an online video platform, whereas physical rehabilitation was delivered in person at school. Post-hoc comparisons using the Bonferroni adjustment were conducted to examine differences in postintervention KI (Post_ Kyp) between treatment groups. Results: Physical rehabilitation produced the greatest improvement (adjusted mean=9.59) compared to telerehabilitation (10.26) and control (10.65). These results indicate that both physical rehabilitation and telerehabilitation significantly reduced postintervention KI compared to the control group, with physical rehabilitation showing a greater reduction than telerehabilitation (p-value <0.001). Conclusion: The telerehabilitation group significantly reduced KI in adolescent girls; however, physical rehabilitation showed a greater reduction than telerehabilitation.