Updated: Jun 21, 2020
In contrast to pectus excavatum, the mainstay treatment for moderate to severe pectus carinatum is bracing therapy. Despite the widespread use of this treatment, there is a significant lack of data supporting its use and its long-term efficacy.
In a new study published in Pediatric Surgery International, Dr. Nuray Alaca and colleagues studied clinical outcomes of 30 male patients with pectus carinatum. They randomized the patients to receive bracing alone, or bracing with physiotherapy exercise, for 12 weeks.
The rehabilitation program involved diaphragmatic respiration, lower lateral costal respiration, middle and upper lateral costal respiration, respiratory exercises separately for each lung lobe, and a combination of these exercises, as well as several stretching and strength-based exercises, focused on the chest and abdominal muscles.
The researchers measured the severity of the carinatum deformities before and after the treatment plans using the maximum protrusion angle, craniocaudal length, and lateral length. They also recorded the patient's perception of their deformity and their pain, as well as a postural evaluation.
Overall both groups improved after the treatment with regards to their pectus carinatum protrusion severity. However, the group which included bracing and exercise improved more. In addition, in the group which included exercise, patients reported a better perception of their deformity, posture, psychological life quality, and treatment satisfaction.
This study is encouraging and suggests the need to study this topic in more depth. The major limitations of this study were that it is relatively small and the outcomes were only based on a 12-week program. Long-term outcomes remain open to further studies.