Investigating the Difference Between Thoracic Kyphosis and its Mobility in Community-Dwelling Older Men and Women
Abstract
Introduction: The amount of thoracic kyphosis and its mobility may be affected by gender in older adults. This study investigates gender differences in thoracic kyphosis and thoracic spine mobility in healthy older adults.
Materials and Methods: In this cross-sectional study, 36 participants among which 21 were female and 15 were male with an age range of 65-80 years participated. The amount of thoracic spine kyphosis was measured in a relaxed standing position and the position of maximum correction of thoracic kyphosis using a flexible ruler between the spinous processes of T12 and C7. The difference between the thoracic kyphosis of the relaxed state and the condition of the maximum correction is used to determine the degree of thoracic spine mobility. Finally, men and women were compared in terms of thoracic kyphosis and thoracic spine mobility. The student t-test was employed to compare kyphosis and spinal mobility between men and women, and the paired student t-test was used to compare kyphosis angle in a relaxed posture and maximum kyphosis correction status. Meanwhile, the Pearson test was utilized to evaluate the relationship between variables.
Results: Although there was no statistically significant difference in the mean thoracic kyphosis of relaxation (P=0.13) and maximal correction (P=0.18) status of healthy old men and women, there was a significant positive relationship between the rate of kyphosis angle and the amount of mobility of thoracic kyphosis (P=0.003; r=0.48).
Conclusion: There is no difference in the degree of kyphosis and thoracic spine mobility in older men and women. In addition, people with more thoracic kyphosis had more spinal mobility.
Koelé MC, Lems WF, Willems HC. The clinical relevance of hyperkyphosis: A narrative review. Frontiers in Endocrinology. 2020; 11:5. [DOI:10.3389/fendo.2020.00005] [PMID]
Katzman WB, Wanek L, Shepherd JA, Sellmeyer DE. Age-related hyperkyphosis: Its causes, consequences, and management. Journal of Orthopaedic & Sports Physical Therapy. 2010; 40(6):352-60. [DOI:10.2519/jospt.2010.3099] [PMID]
Kado DM, Miller‐Martinez D, Lui LY, Cawthon P, Katzman WB, Hillier TA, et al. Hyperkyphosis, kyphosis progression, and risk of non‐spine fractures in older community dwelling women: The Study of Osteoporotic Fractures (SOF). Journal of Bone and Mineral Research. 2014; 29(10):2210-6. [DOI:10.1002/jbmr.2251] [PMID]
Katzman WB, Vittinghoff E, Kado DM. Age-related hyperkyphosis, independent of spinal osteoporosis, is associated with impaired mobility in older community-dwelling women. Osteoporosis International. 2011; 22(1):85-90. [DOI:10.1007/s00198-010-1265-7] [PMID]
Katzman WB, Harrison SL, Fink HA, Marshall LM, Orwoll E, Barrett-Connor E, et al. Physical function in older men with hyperkyphosis. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2015; 70(5):635-40. [DOI:10.1093/gerona/glu213] [PMID]
Haghighi M, Hamledari A, Ghasemikahrizsangi G. The effect of inspiratory muscle training on the thoracic spine curve, inspiratory volume and cardio-respiratory endurance in boys with hyper-kyphosis. International Journal of Health Studies. 2020; 6(2):24-7. [DOI:10.22100/ijhs.v6i2.739]
Naderi A, Rezvani MH, Shaabani F, Bagheri S. [Effect of kyphosis exercises on physical function, postural control and quality of life in elderly men with hyperkyphosis (Persian)]. Iranian Journal of Ageing. 2019; 13(4):464-79. [DOI:10.32598/SIJA.13.4.464]
Hijikata Y, Kamitani T, Sekiguchi M, Otani K, Konno S-i, Takegami M, et al. Association of kyphotic posture with loss of independence and mortality in a community-based prospective cohort study: The Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS). BMJ Open. 2022; 12(3):e052421. [DOI:10.1136/bmjopen-2021-052421] [PMID]
McDaniels-Davidson C, Davis A, Wing D, Macera C, Lindsay S, Schousboe J, et al. Kyphosis and incident falls among community-dwelling older adults. Osteoporosis International. 2018; 29(1):163-9. [DOI:10.1007/s00198-017-4253-3] [PMID]
Greendale GA, Huang MH, Karlamangla AS, Seeger L, Crawford S. Yoga decreases kyphosis in senior women and men with adult‐onset hyperkyphosis: Results of a randomized controlled trial. Journal of the American Geriatrics Society. 2009; 57(9):1569-79. [DOI:10.1111/j.1532-5415.2009.02391.x] [PMID]
Eum R, Leveille SG, Kiely DK, Kiel DP, Samelson EJ, Bean JF. Is kyphosis related to mobility, balance and disability? American Journal of Physical Medicine & Rehabilitation. 2013; 92(11):980-9. [DOI:10.1097/PHM.0b013e31829233ee] [PMID]
Hinman MR. Comparison of thoracic kyphosis and postural stiffness in younger and older women. The Spine Journal. 2004; 4(4):413-7. [DOI:10.1016/j.spinee.2004.01.002] [PMID]
Benedetti MG, Berti L, Presti C, Frizziero A, Giannini S. Effects of an adapted physical activity program in a group of elderly subjects with flexed posture: Clinical and instrumental assessment. Journal of Neuroengineering and Rehabilitation. 2008; 5:32. [DOI:10.1186/1743-0003-5-32] [PMID]
Jang HJ, Hughes LC, Oh DW, Kim SY. Effects of corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in older women: A double-blind, group-matched design. Journal of Geriatric Physical Therapy. 2019; 42(3):E17-27. [DOI:10.1519/JPT.0000000000000146] [PMID]
Woods GN, Huang MH, Lee JH, Cawthon PM, Fink HA, Schousboe JT, et al. Factors associated with kyphosis and kyphosis progression in older men: The MrOS study. Journal of Bone and Mineral Research. 2020; 35(11):2193-8. [DOI:10.1002/jbmr.4123] [PMID]
Kado DM, Huang MH, Karlamangla AS, Cawthon P, Katzman W, Hillier TA, et al. Factors associated with kyphosis progression in older women: 15 years’ experience in the study of osteoporotic fractures. Journal of Bone and Mineral Research. 2013; 28(1):179-87. [DOI:10.1002/jbmr.1728] [PMID]
Kado DM, Prenovost K, Crandall C. Narrative review: Hyperkyphosis in older persons. Annals of Internal Medicine. 2007; 147(5):330-8. [DOI:10.7326/0003-4819-147-5-200709040-00008] [PMID]
Regolin F, Carvalho GA. Relationship between thoracic kyphosis, bone mineral density, and postural control in elderly women. Revista Brasileira de Fisioterapia (Sao Carlos (Sao Paulo, Brazil)). 2010; 14(6):464-9. [DOI:10.1590/S1413-35552010000600003] [PMID]
Katzman WB, Vittinghoff E, Ensrud K, Black DM, Kado DM. Increasing kyphosis predicts worsening mobility in older community‐dwelling women: A prospective cohort study. Journal of the American Geriatrics Society. 2011; 59(1):96-100. [DOI:10.1111/j.1532-5415.2010.03214.x] [PMID]
Mika A, Fernhall B, Mika P. Association between moderate physical activity, spinal motion and back muscle strength in postmenopausal women with and without osteoporosis. Disability and Rehabilitation. 2009; 31(9):734-40. [DOI:10.1080/09638280802308998] [PMID]
Roghani T, Khalkhali Zavieh M, Talebian S, Akbarzadeh Baghban A, Katzman W. Back muscle function in older women with age-related hyperkyphosis: A comparative study. Journal of Manipulative and Physiological Therapeutics. 2019; 42(4):284-94. [DOI:10.1016/j.jmpt.2018.11.012] [PMID]
Roghani T, Zavieh MK, Manshadi FD, King N, Katzman W. Age-related hyperkyphosis: update of its potential causes and clinical impacts-narrative review. Aging Clinical and Experimental Research. 2017; 29(4):567-77. [DOI:10.1007/s40520-016-0617-3] [PMID]
Mehrabi M, Roghani T, Allen DD, Rezaeian ZS, Katzman WB. The association between physical function and hyperkyphosis in older females: Protocol for a systematic review. International Journal of Preventive Medicine. 2022; 13:41. [DOI:10.4103/ijpvm.IJPVM_642_20] [PMID]
Fon GT, Pitt MJ, Thies Jr AC. Thoracic kyphosis: Range in normal subjects. American Journal of Roentgenology. 1980; 134(5):979-83. [DOI:10.2214/ajr.134.5.979] [PMID]
Katzman WB, Parimi N, Gladin A, Poltavskiy EA, Schafer AL, Long RK, et al. Sex differences in response to targeted kyphosis specific exercice and posture training in community dwelling older adults: A randomized controlled trial. BMC Musculoskeletal Disorders. 2017; 18(1):509. [DOI:10.1186/s12891-017-1862-0] [PMID]
Zappalá M, Lightbourne S, Heneghan NR. The relationship between thoracic kyphosis and age, and normative values across age groups: A systematic review of healthy adults. Journal of Orthopaedic Surgery and Research. 2021; 16(1):447. [DOI:10.1186/s13018-021-02592-2] [PMID]
de Oliveira TS, Candotti CT, La Torre M, Pelinson PP, Furlanetto TS, Kutchak FM, et al. Validity and reproducibility of the measurements obtained using the flexicurve instrument to evaluate the angles of thoracic and lumbar curvatures of the spine in the sagittal plane. Rehabilitation Research and Practice. 2012; 186156. [DOI:10.1155/2012/186156] [PMID]
Khalkhali M, Parnianpour M, Karimi H, Mobini B, Kazemnejad A. The validity and reliability of measurement of thoracic kyphosis using flexible ruler in postural hyper-kyphotic patients. Journal of Biomechanics. 2006; 39(Supplement 1):S541. [DOI:10.1016/S0021-9290(06)85226-7]
Murtagh J, Kenna CJ. Back pain & spinal manipulation a practical guide second edition. Oxford: Butterworth-Heinemman; 1997. [Link]
Ernst MJ, Rast FM, Bauer CM, Marcar VL, Kool J. Determination of thoracic and lumbar spinal processes by their percentage position between C7 and the PSIS level. BMC Research Notes. 2013; 6:58. [DOI:10.1186/1756-0500-6-58] [PMID]
Lundon KM, Li AM, Bibershtein S. Interrater and intrarater reliability in the measurement of kyphosis in postmenopausal women with osteoporosis. Spine. 1998; 23(18):1978-85. [DOI:10.1097/00007632-199809150-00013] [PMID]
Stanley H. Physical examination of the spine and extremities. New York: Appleton-Century-Crofts; 1976. [Link]
Youdas JW, Garrett TR, Egan KS, Therneau TM. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Physical therapy. 2000; 80(3):261-75. [DOI:10.1093/ptj/80.3.261] [PMID]
Giglio CA, Volpon JB. Development and evaluation of thoracic kyphosis and lumbar lordosis during growth. Journal of Children’s Orthopaedics. 2007; 1(3):187-93. [DOI:10.1007/s11832-007-0033-5] [PMID]
Milne JS, Williamson J. A longitudinal study of kyphosis in older people. Age and Ageing. 1983; 12(3):225-33. [DOI:10.1093/ageing/12.3.225] [PMID]
Milne JS, Lauder IJ. Age effects in kyphosis and lordosis in adults. Annals of Human Biology. 1974; 1(3):327-37. [DOI:10.1080/03014467400000351] [PMID]
Mellin G, Poussa M. Spinal mobility and posture in 8‐to 16‐year‐old children. Journal of Orthopaedic Research. 1992; 10(2):211-6. [DOI:10.1002/jor.1100100208] [PMID]
Widhe T. Spine: Posture, mobility and pain. A longitudinal study from childhood to adolescence. European Spine Journal. 2001; 10(2):118-23. [DOI:10.1007/s005860000230] [PMID]
Boyle JJ, Milne N, Singer KP. Influence of age on cervicothoracic spinal curvature: An ex vivo radiographic survey. Clinical Biomechanics. 2002; 17(5):361-7. [DOI:10.1016/S0268-0033(02)00030-X] [PMID]
Macagno AE, O’Brien MF. Thoracic and thoracolumbar kyphosis in adults. Spine. 2006; 31(19S):S161-70. [DOI:10.1097/01.brs.0000236909.26123.f8] [PMID]
Urrutia J, Besa P, Narvaez F, Meissner-Haecker A, Rios C, Piza C. Mid and lower thoracic kyphosis changes during adulthood: the influence of age, sex and thoracic coronal curvature. Archives of Orthopaedic and Trauma Surgery. 2022; 142(8):1731-7. [DOI:10.1007/s00402-021-03798-z] [PMID]
Pan F. The effect of age and sex on spinal shape and mobility in asymptomatic adults [PhD dissertation]. Berlin: Charité - Universitätsmedizin Berlin; 2019. [Link]
Issue | Vol 18 No 3 (2024) | |
Section | Research Article(s) | |
DOI | https://doi.org/10.18502/jmr.v18i3.16417 | |
Keywords | ||
Aging Thoracic kyphosis Mobility Sex difference |
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