Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture

Abstract

Background: Hyperkyphosis may cause balance impairment in elderly people. Although the effectiveness of orthoses for improving balance in hyperkyphotic elderly people has received much attention, the mechanisms by which devices affect balance remain unknown. Objectives: The objective of this study was to evaluate changes in balance performance, thoracic kyphosis angle, craniovertebral angle, back muscle endurance and joint position sense after 3 months of wearing a Spinomed orthosis. The study also included a secondary exploratory analysis to determine whether changes in any of the above-mentioned outcome measures can predict balance performance improvement in elderly people with hyperkyphosis. Study design: Parallel group randomized controlled trial. Methods: In total, 44 hyperkyphotic elderly people were randomly allocated to an experimental group, who wore a Spinomed orthosis and a control group, who did not. No other treatment or change in physical activity was permitted during the study. A blinded assessor evaluated thoracic kyphosis angle, joint position sense, craniovertebral angle, back muscle endurance, Timed Up and Go Test time and Berg Balance Scale score at baseline and after 5, 9 and 13 weeks. All dependent variables were measured without the orthosis and analyzed separately using a 2 × 4 (time × group) mixed model analysis of variance. Based on the results of correlation analysis, thoracic kyphosis angle, back muscle endurance and joint position sense were selected as independent variables in a stepwise multiple regression model. Results: The two-way (group × time) interactions were significant in terms of Berg Balance Scale ( F = 11.6, P ⩽ 0.001, [Formula: see text]), Timed Up and Go Test ( F = 3.74, P = 0.013, [Formula: see text]), thoracic kyphosis angle ( F = 43.39, P ⩽ 0.001, [Formula: see text]), craniovertebral angle ( F = 5.245, P = 0.002, [Formula: see text]) and joint position sense ( F = 4.44, P = 0.005, [Formula: see text]). The two-way interaction was not significant in terms of back muscle endurance; however, the main effect of group was significant for this variable ( F = 3.85, P = 0.025). Stepwise multiple regression showed that thoracic kyphosis angle and joint position sense were significant determinants of Timed Up and Go Test time ( R2 = 0.155, P = 0.037 and R2 = 0.292, P = 0.012, respectively). Conclusion: Wearing a Spinomed orthosis for 3 months improved the posture, position sense and muscle performance of hyperkyphotic elderly people. Orthoses may improve balance performance by correcting spinal alignment and increasing proprioceptive information.

Comparing Spinomed® and Elderly Spinal Orthosis Use on Kyphosis Angle, Back Pain, and Quality of Life in Elderly With Thoracic Hyperkyphosis

“…Although the reduction in kyphosis angle was slight in the SOE group, the Sinaki et al study shows that a 2-8 degrees reduction in kyphosis angle can effectively strengthen the back extensor muscles [34]. The reduction of kyphosis angle due to the use of Spinomed ® orthosis is consistent with the study findings of Hosseinabadi et al and Pfeiffer et al However, the lack of change in kyphosis angle in the exercising alone group contrasts with the Sidi et al and Katzman et al studies [16,[35][36][37]. Fascinatingly, at the beginning of the Sidi et al study, the mean kyphosis angle was significantly lower than in the present study.…”

The Effects of Spinomed Orthosis on Balance and Walking Performance in Elderly People with Thoracic Hyperkyphosis

“…Spinal orthoses have been used in the management of hyperkyphosis (6). Spinomed orthosis is one of the frequently recommended orthotic recommendations for hyperkyphosis in the elderly (7)(8)(9). Spinomed orthosis contributes to the improvement of balance and walking performance as well as correcting posture (6)(7)(8)(9).…”

“…Spinomed orthosis is one of the frequently recommended orthotic recommendations for hyperkyphosis in the elderly (7)(8)(9). Spinomed orthosis contributes to the improvement of balance and walking performance as well as correcting posture (6)(7)(8)(9). Previous studies have demonstrated that Spinomed orthosis may be beneficial to improving the balance and walking ability in elderly people by decreasing postural sway, improving proprioception, correcting skeletal alignment, and correcting the spinal vertebrae (6,7,9).…”

“…Spinomed orthosis contributes to the improvement of balance and walking performance as well as correcting posture (6)(7)(8)(9). Previous studies have demonstrated that Spinomed orthosis may be beneficial to improving the balance and walking ability in elderly people by decreasing postural sway, improving proprioception, correcting skeletal alignment, and correcting the spinal vertebrae (6,7,9). One of the studies was conducted on women with postmenopausal osteoporosis (6).…”

“…One of the studies was conducted on women with postmenopausal osteoporosis (6). In other studies, it is seen that functional tests were used to evaluate only balance by using Berg balance scale (7) and walking speed (9). However, all parameters of balance or walking were not examined comprehensively.…”