학술논문

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
Document Type
article
Source
Osteoporosis International. 28(10)
Subject
Biomedical and Clinical Sciences
Allied Health and Rehabilitation Science
Public Health
Health Sciences
Clinical Sciences
Sports Science and Exercise
Clinical Trials and Supportive Activities
Aging
Rehabilitation
Prevention
Clinical Research
Physical Rehabilitation
6.7 Physical
Evaluation of treatments and therapeutic interventions
Aged
Aged
80 and over
Exercise Therapy
Female
Humans
Kyphosis
Male
Middle Aged
Muscle Strength
Patient Satisfaction
Posture
Quality of Life
Radiography
Spine
Treatment Outcome
Clinical trials
Exercise
Radiology
Skeletal muscle
Biomedical Engineering
Public Health and Health Services
Endocrinology & Metabolism
Clinical sciences
Epidemiology
Language
Abstract
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.IntroductionThe 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.MethodsWe 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.ResultsThere 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  0.05.ConclusionsSpine-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 registerClinicalTrials.gov; identifier NCT01751685.