The Effect of Three-Dimensional Exercises ( Schroth Method ) on Trunk Muscle Endurance, Sleep Quality, and Quality of Life in Adolescents With Hyperkyphosis

Inclusion Criteria: * Adolescents between 12 and 18 years of age * Presence of thoracic kyphosis with a T3-T12 Cobb angle ≥45° measured on a lateral thoracic radiograph * Sufficient physical and cognitive ability to actively participate in the exercise protocol for at least 3 months * Adequate communication and cognitive capacity to understand the educational materials provided * Ability and willingness to regularly complete the exercise log throughout the study period Exclusion Criteria: * Scoliosis with a Cobb angle \>10° in the coronal plane * Presence of structural spinal deformities such as vertebral fracture, spondylolisthesis * History of previous spinal surgery * Neuromuscular disorders that may affect the spine (e.g., cerebral palsy, muscular dystrophy) * Structural or functional pathologies involving the spine, pelvic complex, or shoulder girdle * Balance disorders such as vestibular dysfunction, vertigo, or other conditions affecting postural control * Inability to comply with the exercise protocol due to intellectual disability, severe behavioral disorders, or significant communication impairments * Participation in professional-level sports activities that may influence exercise capacity or musculoskeletal function * Presence of serious cardiopulmonary diseases (e.g., congenital heart disease, pulmonary hypertension)