CASE STUDY: Reducing hyperkyphotic posture using the gyrocoach

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Unique:
The concept of using laser pointers for retaining proprioception is supported in the literature as a valid and reliable approach. This novel approach using laser pointers as an external focus for spinal muscle recruitment has not been explored.

Purpose:
To document changes in hyperkyphotic posture following performance of thoracic extension while using a cross beam laser pointer as an external focus of attention.

Foundation:

  • Hyperkyphosis is a determinant of poor physical function.
  • Hyperkyphosis is progressive and affects up to 50% of older adults.
  • An external focus of attention enhances performance and learning when performing a motor task.

Case Description:

  • 78 year old male with Parkinson's disease
  • Chief complaint: Deteriorating posture with neck pain and diminished balance

Intervention:

  • Patient's Kyphosis Index was measured with a flexicurve ruler.
  • Two wearable cross beam lasers were placed on the subject, one on the sternum and one on the pelvis.
  • While lying in supine, the subject flexed his shoulders observing the movement of the laser beam on the ceiling. The subject was instructed to control the beam motion with the light on the pelvis stationary while allowing the sternal light to move.
  • He was instructed to keep the sternal light stationary at the point of greatest change. 

Observations:
Kyphosis Index:

  • Initial evaluation      KI 20
  • After 15 reps            KI 14
  • At 1 week                 KI 15
  • At 8 weeks               KI 15


Dynamic Gait Index:

  • Initial evaluation     DGI 15/24
  • At 8 weeks              DGI 20/24

Conclusions:

  • Laser pointers are an effective external cue for stimulating muscle recruitment.
  • Using laser pointers as an external focus of attention enhances performance of a motor task.
  • Learning is retained over time.
  • The effect is immediate.
  • Future studies should investigate the benefits of using cross beam laser pointers as an external focus of attention for teaching motor control.