{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:52:46Z","timestamp":1790790766096,"version":"4.1.0"},"reference-count":67,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Federal Ministry of Education and Research","award":["BMBF 13GW0257"],"award-info":[{"award-number":["BMBF 13GW0257"]}]},{"name":"DIERS International GmbH","award":["BMBF 13GW0257"],"award-info":[{"award-number":["BMBF 13GW0257"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The rise in the occurrence of musculoskeletal disorders, such as thoracic hyperkyphosis (THK) or lumbar hypolordosis (LHL), is a result of demographic changes. Exercise therapy is an effective approach that can reduce related disabilities and costs. To ensure successful therapy, an individualized exercise program adapted to the severity of the disorder is expedient. Nevertheless, appropriate classification systems are scarce. This project aimed to develop and evaluate a severity classification focused on exercise therapy for patients with THK or LHL. A multilevel severity classification was developed and evaluated by means of an online survey. Reference limits of spinal shape angles were established by data from video rasterstereography of 201 healthy participants. A mean kyphosis angle of 50.03\u00b0 and an average lordosis angle of 40.72\u00b0 were calculated as healthy references. The strength of the multilevel classification consisting of the combination of subjective pain and objective spinal shape factors was confirmed by the survey (70% agreement). In particular, the included pain parameters were considered relevant by 78% of the experts. Even though the results of the survey provide important evidence for further analyses and optimization options of the classification system, the current version is still acceptable as therapeutic support.<\/jats:p>","DOI":"10.3390\/life13061392","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T01:32:57Z","timestamp":1686792777000},"page":"1392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Creation and Evaluation of a Severity Classification of Hyperkyphosis and Hypolordosis for Exercise Therapy"],"prefix":"10.3390","volume":"13","author":[{"given":"David","family":"Kaps","sequence":"first","affiliation":[{"name":"Center for Mental Health, Hospital Stuttgart-Bad Cannstatt Hospital, 70374 Stuttgart, Germany"},{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany"},{"name":"Institute of Social Science, Media, and Sports, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-2504","authenticated-orcid":false,"given":"Hannah","family":"Siebers","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2157-4287","authenticated-orcid":false,"given":"Ulrich","family":"Betz","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pfirrmann","sequence":"additional","affiliation":[{"name":"Institute of Social Science, Media, and Sports, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Eschweiler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Betsch","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Erlangen of the University Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Huthwelker","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8134-2664","authenticated-orcid":false,"given":"Claudia","family":"Wolf","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Drees","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2297-3482","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Konradi","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Banzer, W. 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