Klapp Exercises

Original Editors - Sofie Bourdinon as part of the Vrije Universiteit Brussel Project.

Top Contributors - Rucha Gadgil, Aminat Abolade, Admin, Peter Vaes, Sofie Bourdinon, WikiSysop and Uchechukwu Chukwuemeka  

Introduction

Klapp’s method also known as Kriechmethode ( crawling method) was developed in Germany at the beginning of the 20th century as a method for treating idiopathic scoliosis. Orthopaedist Bernhard Klapp created this concept and soon after, it was developed by his son Rudolf Klapp. It was a nonsurgical method for correcting spinal curvature by stretching and strengthening the back muscles.

It was noticed that during crawling on all fours, at a certain moment, the spine gets exposed to a mobilizing, exercising and corrective influence, so he established an exercise programme where children with idiopathic scoliosis were treated on all fours. The therapy of idiopathic scoliosis with the help of complex exercises on all fours became the most used therapy in Germany for treating scoliosis. but also as a prevention of wrong body posture by children in school age and is slowly gaining momentum worldwide.

Klapp stated that the spine protects and maintains the static and dynamic functions of the nerves and blood vessels. He emphasized that wrong posture leads to a muscle imbalance in the body leading to negative effects on the spine and leading to impairments of the same.

Clinical Relevance

Klapp divided the back impairments roughly into 8 general categories:

• Inborn scoliosis (often connected with “spina bifida”, inborn wrong leg joint position, dislocation of the hip, and chest anomalies)
• Scoliosis as a result of disease (tuberculosis, osteomyelitis, rickets…)
• Static scoliosis (different lengths of the legs, amputation)
• General scoliosis (from school, wrong body posture)
• Scoliosis after paralysis
• Post-traumatic scoliosis (burn…)
• Antalgic scoliosis (scoliosis caused by pain)
• Idiopathic scoliosis (over 90%)

Klapp's Crawling

It is a unique method, which uses crawling on all fours to correct body posture by reducing pressure on the spine and optimizing the use of back extensors.

The principle is in spreading your weight on the four supporting points while crawling which causes a rotation in the spine and simultaneous stretch - thus functionally strengthening the “muscle corset”.

The movement has to always start in the exact default position, and locomotion has to be slow, and smooth, along with your limbs pressing against the ground and keeping your spine straight. Even though idiopathic scoliosis has not been cured by Klapp’s method, it is very effective in optimizing the muscle tension in the back area thus helping to realign the posture non-surgically.

Indications:

• Scoliosis
• Wrong body posture
• Strengthening the muscle “corset”
• Trunk muscle imbalance

Exercises

Exercises are defined in such a way as to start from the default positions of the spine from the ground up to the straight erect spine working on each affecting the centre of mass of each segment of the spine to realign them.

Some of the exercises are:

1. Walking on knees

• Walking on knees with lengthened trunk
• Kyphotic walking on the knees with swimming motion in the arms
• Kyphotic walking on the knees with circling movement in the arms

2. Crawling on all fours:

• Crawling on one side at a time
• crawling alternate sides at a time
• Pushing

3. Creeping

With Klapp's method, it is possible to execute and integrate more challenging and complex exercises slowly and gradually progress towards correct posture and realignment of the spine and improve muscle balance in the trunk.

Drawback

• The exercises advocated by Klapp have a major drawback of affecting the children's knees due to continuous crawling and as a result, are not used rampantly today.
• Exercises that overemphasized flexibility created problems by making the spine more vulnerable to collapse.
• When treating patients with S- S-curves, it was difficult to plan an exercise programme accordingly.

Recent Research

Recent studies show that Klapp's Method is responsible for gibbosity stabilization and improving back strength in adolescents with idiopathic scoliosis.

Other related studies show that the Klapp method was an efficient therapeutic technique for treating asymmetries of the trunk and improving its flexibility. However, it was inefficient for pelvic asymmetry modifications in head positioning, cervical lordosis or thoracic kyphosis.