Group A will be given Klapp method exercises to the participant for a period of 1 month twice in a week for 50min. Group B will be given printed information on an at-home exercise program, such, posture correction,corrective exercises and breathing exercises. They will be asked to perform the exercises twice weekly during the study and follow-up period. All these sessions will be of 50 minute for 2 session per week for 4 weeks
The Klapp exercises program, is an active therapeutic exercise that aims to stretch, mobilize, and strengthen the spine, offering both pain reduction and postural improvement. This method is widely applied, for the correction of vertebral deformities such as kyphosis, lordosis and scoliosis, to the treatment of thoracic cage abnormalities and thoracic cage shape changes after thoracoplasty, as well as in the treatment of spinal muscle interference from polio and spinal osteochondrosis. The aim of this study to investigate the effects of klapp method exercises on pain, posture correction and self-efficacy in breast feeding females with kyphotic posture. This will be a randomized Controlled trial conducted on (32) participants. Data will be collected from Civil hospital and Al-siddique hospital, Sialkot by using non-probability convenience sampling technique. Breast feeding females between the age of 22 to 30 with kyphotic posture. Participants who had a history orthopedic disorder, orthopedic surgery, history of recent fracture, non-lactating females will be excluded from this study. A sample of (32) will be divided in to two groups with (16) participants in each group. Group A will be given Klapp method exercises to the participant for a period of 1 month twice in a week for 50min. Group B will be given printed information on an at-home exercise program, such, posture correction, corrective exercises and breathing exercises. They will be asked to perform the exercises twice weekly during the study and follow-up period. All these sessions will be of 50 minute for 2 session per week for 4 weeks. Pre and post assessment of pain, pain will be assessed by visual analogue scale, posture will be evaluated by inclinometer, self-efficacy breast feeding will be assessed self-efficacy breastfeeding scale (BSES-SF). Data will be analyzed by using SPSS version 26.0
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
The researcher will administer Klapp method exercises to the participant for a period of 1 month (twice in a week for 50 min .The researcher will perform stretching of upper limb, neck and thoracic region to the participants as a baseline treatment. Klapps exercises program include four point walk followed by two point walk and back walk, breathing exercise from kneeling position, breathing exercise from quadrapedal position, simple bounce glide with simulanteos breathing, bunny hop greeting. Each exercise will be performed with 10 repetitions
theywill begiven printed information on an at-home exercise program, such corrective exercises (Chin tuck, stretchingof neck extensormuscles andpectoral musclegroups instandingandsupinepositions) (16) ,posturecorrection exercises(Thisexerciseprogramconsistedof2strengthening(of thedeep cervical flexorsandshoulderretractors)(26) ,andbreathingexercises(Deep breathing is an exercise that can regulate breathing patterns and improve posture. The deep breathing that is done repeatedly can overcome stiffness in the thoracic cage and straighten the curve of thoracic kyphosis)(27).Theywillbeaskedtoperformtheperiodof1month twiceinaweekfor50minwith10repetitionsofeachexercise.
Civil hospital and Al-siddique hospital
Sialkot, Punjab Province, Pakistan
Visual Analogue Scale
The pain VAS is a unidimensional measure of pain intensity, used to record patients' pain progression, or compare pain severity between patients with similar conditions. moderate to good reliability for disability in patients with chronic musculoskeletal pain VAS is widely used as a measure of pain intensity in globally. It has been shown that VAS is valid, reliable and interval scale. The majority of the studies showed that visual analogue scale is a valid and reliable scale. . High reliability when it is used for acute musculoskeletal pain and ICC = 0.99 \[95%CI 0.989 to 0.992\], and moderate to good reliability for disability in patients with chronic musculoskeletal pain. Also, it is an interval scale. So, in clinical practice we can use this scale in case of measurement as an outcome measure tool.
Time frame: 4th week
inclinometer
The gravity-dependent (analogue) inclinometer produces angles that are comparable to the modified Cobb angle obtained from radiographs, establishing its criterion validity as a safe clinical tool for measuring thoracic kyphosis. Inclinometer has high validity with (r=0.85-0.95) and high inter-rater reliability (ICC=0.85-0.98)
Time frame: 4th week
Self-efficacy breast feeding scale (BSES-S F questionnaire)
Breastfeeding self-efficacy is defined as a mother's confidence in ability to breastfeed and predicts "whether a mother chooses to breastfeed, how much effort she will expend, whether she will persevere in her attempts until mastery is achieved, whether she will have self enhancing or self-defeating thought patterns, and how she will emotionally respond to breastfeeding difficulties" BSES (n = 5 studies) or BSES-SF (n = 36studies) among demographically or culturally diverse populations. All versions of the instrument demonstrated good reliability, with Cronbach's alphas ranging from .72 to .97
Time frame: 4th week
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