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Regional Cobb and centroid angles are valid and reliable measures of thoracic kyphosis in people with osteoporosis. However, the Cobb angle is biased by endplate tilt, suggesting that the centroid angle is more appropriate for this population.

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The individually designed Pilates-based exercise program was feasible for healthy older adults, and the high attendance rate supports the suitability of the exercise program over a long period. Considering the variability of the baseline measure, small improvement was only observed in the thoracic kyphosis during standing. The long-term effect of Pilates exercise requires further investigation.