Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial

Abstract

Summary A 6-month randomized controlled trial of spine-strengthening exercise and posture training reduced both radiographic and clinical measures of kyphosis. Participants receiving the intervention improved self-image and satisfaction with their appearance. Results suggest that spine-strengthening exercise and postural training may be an effective treatment option for older adults with hyperkyphosis. Introduction The purpose of the present study is to determine in a randomized controlled trial whether spine-strengthening exercises improve Cobb angle of kyphosis in community-dwelling older adults. Methods We recruited adults ≥60 years with kyphosis ≥40° and enrolled 99 participants (71 women, 28 men), mean age 70.6 ± 0.6 years, range 60–88, with baseline Cobb angle 57.4 ± 12.5°. The intervention included group spine-strengthening exercise and postural training, delivered by a physical therapist, 1-h, three times weekly for 6 months. Controls received four group health education meetings. The primary outcome was change in the gold standard Cobb angle of kyphosis measured from standing lateral spine radiographs. Secondary outcomes included change in kyphometer-measured kyphosis, physical function (modified Physical Performance Test, gait speed, Timed Up and Go, Timed Loaded Standing, 6-Min Walk), and health-related quality of life (HRQoL) (PROMIS global health and physical function indexes, SRS-30 self-image domain). ANCOVA was used to assess treatment effects on change from baseline to 6 months in all outcomes. Results There was a −3.0° (95% CI −5.2, −0.8) between-group difference in change in Cobb angle, p = 0.009, favoring the intervention and approximating the magnitude of change from an incident vertebral fracture. Kyphometer-measured kyphosis (p = 0.03) and SRS-30 self-esteem (p < 0.001) showed favorable between-group differences in change, with no group differences in physical function or additional HRQoL outcomes, p > 0.05. Conclusions Spine-strengthening exercise and posture training over 6 months reduced kyphosis compared to control. Our randomized controlled trial results suggest that a targeted kyphosis-specific exercise program may be an effective treatment option for older adults with hyperkyphosis. Trial registration number and name of trial register ClinicalTrials.gov; identifier NCT01751685

Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial

“…This may indicate that the kyphosis angle may be affected in a sub-acute stage, but it will be more difficult at a later stage. In the later stage, training of the back extensor muscle may be very important to prevent a progression of the kyphosis [ 11 , 18 , 40 ]. Wearing an activating spinal orthosis to strengthen the back extensor muscles and prevent progression of a kyphosis may become an alternative training method.…”

Alleviation of chronic spine pain and headaches by reducing forward head posture and thoracic hyperkyphosis: a CBP^® case report

“…A limitation to this case is the lack of a long-term follow-up. Further, multiple treatments were given during treatment, thus it is unknown which aspect of the treatment was most responsible for the posture improvements; although based on previous studies it seems that extension traction of the spine results in structural posture improvements 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ) , exercises may also contribute to improving THK 17 , 18 , 19 , 20 , 21 , 22 ) . Further research into non-surgical rehabilitation approaches to reversing AHT and THK need to clarify these issues.…”

“…The early diagnosis and treatment of THK is essential in the prevention of the otherwise associated typical poor health outcomes. Several clinical trials and case reports have documented the successful non-surgical reduction of THK in patients 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ) . These methods primarily involve back extension exercise regimens, and more recently thoracic extension traction methods 23 , 24 , 25 , 26 ) .…”

Radiophobia: 7 Reasons Why Radiography Used in Spine and Posture Rehabilitation Should Not Be Feared or Avoided

“…The common X-ray is an essential tool for doctors and manual therapists in the treatment of musculoskeletal and neuromusculoskeletal diseases and conditions associated with poor posture and spinal deformity. 1 – 10 There has been an ever-expanding evidence base substantiating the effectiveness of nonsurgical rehabilitative methods for the treatment of posture and spinal deformities, such as forward head posture, 11 – 20 cervical hypolordosis/kyphosis, 14 – 21 thoracic hyperkyphosis, 22 – 29 thoracic hypokyphosis, 30 , 31 lumbar hypolordosis/kyphosis, 32 – 37 and scoliosis. 38 – 41 …”

“…The common radiograph is an invaluable tool that will continue to be a “go to” procedure to assess and monitor treatment effects related to improving posture with contemporary treatment approaches. 11 – 41 There are, however, many fears concerning the exposure of radiation (ie, radiophobia), particularly for the acquisition of diagnostic medical X-rays (including computed tomography [CT] scans). 42 – 47 …”