Table 1.
Physiotherapy and home exercise program
| Technique/Exercise | Dosage | Weeks |
|---|---|---|
| Postural taping * | Worn full time | 1 |
| from anterior aspect of each shoulder, posteriorly and obliquely down to opposite rib cage | ||
| Soft tissue massage * | 5 mins | 1-10 |
| Performed in prone to erector spinae, rhomboids, upper trapezius -stroking, circular frictions and petrissage | ||
| Passive accessory postero-anterior vertebral mobilisation * | 5 mobilising movements at each central level × 2 reps | 1-10 |
| In prone starting at T1 down to 2 levels below the most painful vertebral region Grade 2-3 depending on level | ||
| Supine lying over rolled up towel | 5-10 mins | 1 |
| Towel placed lengthways along the back to facilitate thoracic extension | Daily | |
| Erect sitting with transversus abdominus stabilising | 10 sec hold × 5 reps | 1-10 |
| Sitting forward on a chair or stool with no back rest. Chin retraction, scapular retraction and TA contraction | Daily | |
| Elbows back in sitting | 5 sec hold × 5 reps | 1-10 |
| Hands behind head with elbows pointing out to side. Pressing elbows back by performing scapular retraction | Daily | |
| Trunk mobility in sitting | 5 reps in each direction | 1-10 |
| Hands on shoulders, gentle rotation in both directions and lateral flexion to each side | Daily | |
| Head to wall in standing | 10 sec hold × 5 reps | 1-10 |
| Back and heels against wall with rolled up towel behind head. Chin retraction | Daily | |
| Standing corner stretch | 10-30 sec hold × 3 reps | 2-10 |
| Facing corner, both hands at chest height placed on wall and moving in closer to stretch anterior chest | Daily | |
| Walking hands up wall in standing | 5 sec hold × 5 reps | 3-10 |
| Facing wall, walking hands up wall until arms upstretched then holding hands off wall | Daily | |
| Shoulder flexion in supine | 10 sec hold × 5 reps | 3-10 |
| Arms outstretched holding onto a cane/towel and taking arms over head to hold at end of range | Daily | |
| Standing wall push ups | 8-10 reps × 2 | 1-10 |
| Facing wall with arms in front at shoulder height. Keeping body straight, bending and straightening elbows | 3×/week | |
| Seated row with dumbbells | 8-10 reps × 2 | 1-10 |
| Upright sitting and pull hands up towards chest by bending elbows and then lowering | 3×/week | |
| Seated overhead dumbbell press | 8-10 reps × 2 | 3-10 |
| With elbows bent and out to side, press dumbbells straight up until arms extended overhead | 3×/week | |
| Bridging in supine | 5-10 sec hold × 5 | 1-2 |
| Knee bent and feet flat on ground. Pushing through feet to lift back and pelvis off ground | 3×/week | |
| Hip extension in prone | 8-10 reps × 2 | 3-10 |
| Raising one leg off the ground and then the other | 3×/week | |
| Half squats - progress to holding dumbbells | 8-10 reps × 2 | 1-2 |
| Standing in front of chair and squatting down to touch chair with buttocks then standing up | 3×/week | |
| Step ups - progress to holding dumbbells | 8-10 reps × 2 | 3-10 |
| Stepping up and down a 10 cm step. Alternate legs | 3×/week | |
| Scapular retraction with theraband in sitting | 8-10 reps × 2 | 1-10 |
| Holding theraband in both hands with elbows tucked into sides and performing wrist extension, supination and shoulder external rotation then scapular retraction | 3×/week | |
| Four point kneeling with transversus abdominus | 8-10 reps × 2 | 2 |
| Push into floor with hands, knees and feet then draw navel up and in. Hold 5 secs | 3×/week | |
| Four point kneeling with one arm and leg lift | 8-10 reps × 2 | 3-10 |
| As above, then lift one arm off ground. Progress to also lifting extended leg off ground at same time | 3×/week | |
| Prone lying with arm elevation | 5-10 sec hold × 5 | 2-3 |
| Arms at shoulder height and bent at elbows. Scapular retraction then lift arms off floor | 3×/week | |
| Prone trunk extension | 5-10 sec hold × 5 | 4-10 |
| Lift head and shoulders off floor while maintaining chin retraction | 3×/week |
* performed by the therapist