The CBP® mirror image® approach to reducing thoracic hyperkyphosis: a retrospective case series of 10 patients.
Paul A Oakley, Jason O Jaeger, John E Brown and 4 others
PMID 30154597WHAT IT FOUND
Ten adults with thoracic hyperkyphosis reported lower thoracic curve angles, pain and disability after combined extension traction, extension exercises and spinal manipulative therapy.
There was no comparison group, so it cannot show which part helped or that treatment works.
Key findings
01The reported pre- to post-treatment averages showed an 11.3° reduction in thoracic kyphosis angle (from 60.7° to 49.4°), a 3-point reduction in pain (from 3.9/10 to 1.2/10), and a 22% reduction in disability (from 27% to 5%).
02The reported treatment was a combined package of mirror image thoracic extension exercise, traction and spinal manipulative therapy.
STILL TO COME
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What it does not show
Only 10 patients were included, selected from existing clinical files, and the paper does not report a comparison group, so it cannot show that the treatment caused the reported changes. All patients received thoracic extension traction, thoracic extension exercises and spinal manipulative therapy together, so the contribution of any single component cannot be separated. Patients with scoliosis, vertebral compression fracture, concurrent treatment elsewhere, discontinued care or missing follow-up radiographs were excluded, so the results do not apply to those groups. The age range was 20 to 68 years, and the authors note that treatment effects in younger versus older patients need clarification. The authors report payment for manuscript writing and teaching or product sales related to the treatment method.
Declared interests
PAO is paid by CBP NonProfit for writing the manuscript. JOJ and DEH teach rehabilitation methods and sell products to physicians for patient care as used in this manuscript.
The easy way to misread this
Do not read the average 11.3° reduction as proof that CBP mirror image therapy works or that traction caused it. The paper does not report a comparison group, and all 10 patients received extension traction, extension exercises and spinal manipulative therapy together, so the contribution of any single component cannot be separated.