Pectus Carinatum
Conditions
Keywords
Pectus Carinatum, orthosis, exercise
Brief summary
Pectus Carinatum (PC); deformity in which the front wall of the chest protrudes forward. Non-invasive treatment approaches for PC include compression orthosis and exercises that target the deformity itself and concurrent postural impairment and scoliosis. In addition, the formation of muscles can help close the deformity. Although exercise training is recommended, there is no randomized study showing its effectiveness in the literature. Therefore, in our study, the investigators aimed to investigate the effectiveness of exercise therapy in addition to compression orthotics.
Detailed description
A chest wall deformity is a structural abnormality of the chest that can range from mild to severe. Chest wall deformities occur when the cartilage that connects the ribs grows unevenly. It is not clear why this happens, but the condition tends to run in families. The two most common types of chest wall deformity are Pectus excavatum and Pectus carinatum, Pectus carinatum goes far beyond a simple esthetical problem. It can be responsible of physical signs and symptoms and also has significant psychological impact. Defects tend to worsen during pubertal growth spurts and even during adult life. Recent evidence shows that these patients are at risk for a disturbed body image and reduced quality of life and many patients refer feelings of discomfort, shame, shyness, anxiety, anguish, and even depression, which can lead to social isolation. Chest pain or discomfort, especially when lying in prone position, intolerance to physical exercise, scoliosis, impaired shoulders and kyphotic position are some of the physical signs and symptoms.Non-invasive treatment approaches for PC include compression orthosis and exercises that target the deformity itself and concurrent postural impairment and scoliosis. In addition, the formation of muscles can help close the deformity. Most evidence of non-invasive treatment is retrospective or prospective case series. In a prospective case series, patients were instructed to perform chest wall strengthening exercises, but the effects of the exercises were not investigated . Although, exercise training is recommended, there is no randomized study showing its effectiveness in the literature. Therefore, in our study, the investigators aimed to investigate the effectiveness of exercise therapy in addition to compression orthotics.
Interventions
OTHERExercise
Orthosis, mobilization, strengthening, posture and segmental breathing exercises
Sponsors
Acibadem University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Prospective randomized controlled trial
Eligibility
Sex/Gender
MALE
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with PC by doctor and indicated for the first time orthotic use * A correction pressure of less than 10 pounds per square inch in the compression test * 10-18 years old, * Discontented with this deformity
Exclusion criteria
* Previous orthosis use * Severe scoliosis (Cobb angle above 20 degrees) * Having chronic systemic disease * Having serious psychiatric illness * Having complex mixed pectus deformity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pectus severity index | Change from Pectus severity index at 12 weeks | Thorax-caliper measurement: Pectus severity index (T.I.): (T3/T1) \* 100 (%), T1: upper edge of the manubrium, T2: Angulus Ludovici, T3: deepest point of the funnel chest, Pectus carinatum: T.I. \> 140. |
| patient's perception of deformity | Change from patient's perception of deformity at 12 weeks | patient's perception of deformity (0-10): The subject's self-perception of pectus carinatum was obtained through self-report using a scale from 0 (worst self-perception of pectus carinatum) to 10 (best self-perception of pectus carinatum). |
| Global Rating of Change Score | through study completion, an average of 12 weeks | The responses for the Global Rating of Change Score ismuch better (2); slightly better(1); stayed the same (0);slightly worse (-1) or much worse (-2). |
| Chest anthropometric measurement-1 | Change from baseline the extent of maximal protrusion at 12 weeks | The extent of maximal protrusion:distance from the point of maximum protrusion to the estimated normal level of chest wall (milimeter). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| New York Posture Rating Chart for posture assessment | Change from baseline score of New York Posture Rating Chart at 12 weeks | The scores of the remaining 10 body alignment segments are summed, allowing a range ofoverall score between 0 and 100, with a score of 100 representing ideal posture |
| Chest anthropometric measurement-3 | Change from baseline lateral length at 12 weeks | Lateral length: length of protruding zone, again measured through the point of maximum protrusion in the transverse direction |
| The Nuss Questionnaire modified for Adults (Patient Form) | Change from baseline score of The Nuss Questionnaire modified for Adults (Patient Form) at 12 weeks | Disease-specific health-related quality of life assessment tool for patients with pectus The patient version of the NQ-mA includes 12 items, scored 1 to 4. Possible minimum and maximum scores are 12 and 48 in the patient form; higher scores indicate a better quality of life. |
| Chest anthropometric measurement-2 | Change from baseline craniocaudal length at 12 weeks | Craniocaudal length: craniocaudal length of protruding zone, measured through the point of maximal protrusion |
| The Nuss Questionnaire modified for Adults (Parent Form) | Change from baseline score of The Nuss Questionnaire modified for Adults (Parent Form) at 12 weeks | Disease-specific health-related quality of life assessment tool for patients with pectus parent. The parent version of the NQ-mA includes 11 items, scored 1 to 4. Possible minimum and maximum scores are 11 and 44 in the parent form; higher scores indicate a better quality of life. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactNuray Alaca, PhD
Backup ContactMustafa Yüksel, Prof
Outcome results
None listed