Background: This study aimed to (a) determine how frequently chiropractors use postural assessment when treating patients with back or neck pain, (b) determine the rationale for the use of postural assessment by chiropractors, (c) examine the assessment methods employed, (d) explore which specific aspects of posture are assessed and (e) determine the types of back and neck conditions being treated. Methods: An 11-item online questionnaire was developed. A link to this survey was distributed using SurveyMonkey to the entire membership of the Royal College of Chiropractors. Results: There were 272 respondents to the survey. Of the respondents, 79% ‘almost always’ used postural assessment when treating patients with back or neck pain. Respondents reported using postural assessment to help determine whether a patient was making progress (61.8%), provide an outcome measure (57.1%) and help inform the diagnosis (89.2%) and treatment plan (81.8%); almost all respondents (98.1%) reported carrying out a postural assessment visually, with no aids. Most respondents reported assessing their patients posteriorly, anteriorly and from both left and right sides, observing 44 specific anatomical items. The conditions treated included sacroiliac pain (96.7%), stiff neck (95.6%), non-specific lowback pain (92.6%), lumbar disc herniation (91.5%), cervical arthritis (89.7%), lumbar strain (87.1%), lumbar arthritis (86.4%), thoracic pain (86.4%), neck strain (84.9%) and whiplash (79.8%). Conclusions: The findings suggest that the unaided visual assessment of posture using a large range of anatomical points is used by UK chiropractors for the purposes of aiding diagnosis and treatment of patients with back and neck pathologies.

Background: Hyperkyphosis, an excessive curvature of the upper back, has been linked to increased falls and fear of falling. Previous work has focused on improving the hyperkyphosis curve itself. There is, however, a dearth of studies that have focused on improving falls, fear of falling, and participants’ satisfaction with the educational material. Objective: This study aimed to determine the effect of a hyperkyphotic-specific exercise programme on falling, fear of falling, and satisfaction with the educational material. Methods: Thirteen individuals with a hyperkyphosis of over 40 degrees were randomly divided into an exercise group (n=6; age: 71.50 ± 7.84 years) and a control group (n=7; age: 67.29 ± 9.76 years). The exercise group received a 16-week hyperkyphosis-specific exercise programme with educational material. The control group received only the educational material. Before and after the exercise programme, the history of falls in the past year and fear of falling were assessed by 2 questionnaires (the history of falls in the past year and the Fall Efficacy Scale-International). Satisfaction with the educational material was evaluated after the exercise programme. Data were analysed by descriptive statistics and a 2×2 model mixed between-within subjects analysis of variance. Results: There was no significant interaction between group and time for the history of falls in the past year (p = .182, effect size = .156) and fear of falling (p = .216, effect size = .135), but the effect size of the interaction effect was large. Furthermore, participants in both groups expressed positive satisfaction with the educational material. Conclusion: Hyperkyphosis-specific exercise programme resulted in improvement in the history of falls and fear of falling, but the results were not significant. A larger randomised controlled trial is needed to clarify the effectiveness of the exercise programme in reducing the number of falls and fear of falling in this population.

Background: Thorough knowledge of the management of age-related hyperkyphosis is crucial to physiotherapists’ effective handling of complex spinal deformities. Objective: This cross-sectional study investigated the knowledge, attitudes, and confidence of Thai physiotherapists regarding age-related hyperkyphosis. Methods: An online questionnaire with demographic, work-related, knowledge, attitude, and confidence questions was employed. The data analysis involved descriptive statistics, chi-square tests, and independent t-tests. Results: Complete responses were obtained from 314 physiotherapists. The correct responses amounted to 68.79% for the definition, 90.00% for causes, 14.97% for age of onset, 22.38% for prevalence, and 64.65% for the gold-standard diagnosis of hyperkyphosis. Most of the diagnostic methods involved visual examination. The respondents reported that hyperkyphosis disrupts respiratory function. The aim of treatment, according to 88.85%, was to increase spine mobility. Corrective posture exercises were the most common treatment strategy, but the range of treatments was diverse. Many cited undergraduate education as their primary evidence source. Respondents had conflicting attitudes towards “age-related hyperkyphosis is a normal aging process” but mostly positive attitudes towards the need for physiotherapy treatment. Approximately 22% reported fair confidence in treating hyperkyphosis. Conclusions: This study highlights the importance of raising awareness and enhancing knowledge, attitudes, and confidence among physiotherapists to improve care for older adults with hyperkyphosis.

Background: This study aimed to (a) determine how frequently chiropractors are using postural assessment when treating patients with back or neck pain, (b) determine the rationale for the use of postural assessment by chiropractors, (c) examine the assess-ment methods employed, (d) explore which specific aspects of posture are assessed and (e) determine the types of back and neck conditions being treated. Methods: An 11-item online questionnaire was developed. A link to this survey was distributed using Sur-veyMonkey to the entire membership of the Royal College of Chiropractors. Results: There were 272 respondents to the survey. Of the respondents, 79% ‘almost always’ used postural assessment when treating patients with back or neck pain. Respondents reported using postural assessment to help determine whether a patient was making progress (61.8%), provide an outcome measure (57.1%) and help inform the diagnosis (89.2%) and treatment plan (81.8%); almost all respondents (98.1%) reported carrying out a postural assessment visually, with no aids. Most respondents reported assessing their patient posteriorly, anteriorly and from both left and right sides, observing 44 specific anatomical items. The conditions treated included sacroiliac pain (96.7%), stiff neck (95.6%), non-specific low-back pain (92.6%), lumbar disc herniation (91.5%), cer-vical arthritis (89.7%), lumbar strain (87.1%), lumbar arthritis (86.4%), thoracic pain (86.4%), neck strain (84.9%) and whiplash (79.8%). Conclusions: The findings suggest that the unaided visual assessment of posture using a large range of anatomical points is used by UK chiropractors for the purposes of aiding diagnosis and treatment of patients with back and neck pathologies.