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Published in: Osteoporosis International 8/2015

01-08-2015 | Original Article

The relationship of thoracic kyphosis to gait performance and quality of life in women with osteoporosis

Authors: F. Sangtarash, F. D. Manshadi, A. Sadeghi

Published in: Osteoporosis International | Issue 8/2015

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Abstract

Summary

Thoracic kyphosis angle (TKA) increases with osteoporosis. This study aimed to investigate the relationship between magnitude of TKA and quality of life and gait performance in 34 osteoporotic women. Our results suggest that increasing TKA is significantly associated with decreasing quality of life (r = −0.48, p < 0.005) and gait performance (r = −0.74, p < 0.0005).

Introduction

Osteoporosis and its related effects are threatening health and quality of life especially in postmenopausal women. Increased thoracic kyphosis angle (TKA), as one of the most common adverse musculoskeletal changes, could be regarded as a quantitative index for osteoporotic patients’ assessment. Dual digital inclinometer (DDI) is one of the latest tools for non-invasive TKA measurement. The main purpose of this study was to determine whether a relationship existed between the magnitude of TKA, gait performance, and quality of life in a group of osteoporotic women.

Methods

Thirty-four osteoporotic women, aged 50–68, participated in this descriptive analytic study. The magnitude of TKA measured by using DDI and expressed as the kyphosis index (KI). Quality of life and gait performance were assessed using short form 36 (SF36) questionnaire and functional gait assessment test, respectively. Back extension range of motion (ROM) and back extensor strength were also assessed. Pearson’s correlation test was used to analyze the data, with the significance level of p < 0.05.

Results

The findings revealed a statistically significant negative correlation between KI and quality of life (r = −0.48, p < 0.005) and KI and gait performance (r = −0.74, p < 0.0005). There was also a significantly negative relation between KI and back extension ROM and back extensor strength (p < 0.05).

Conclusion

The results of this study demonstrated that increased thoracic kyphosis negatively affects gait performance and quality of life. This finding could be regarded as an important implication for therapist to pay more attention to the magnitude of thoracic kyphosis angle and its changes, when selecting appropriate therapeutic methods to improve gait performance and quality of life in osteoporosis women.
Literature
1.
go back to reference Vasikaran S et al (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22(2):391–420PubMedCrossRef Vasikaran S et al (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22(2):391–420PubMedCrossRef
2.
go back to reference Holroyd C, Cooper C, Dennison E (2008) Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab 22(5):671–685PubMedCrossRef Holroyd C, Cooper C, Dennison E (2008) Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab 22(5):671–685PubMedCrossRef
3.
4.
go back to reference Sinaki M (1998) Musculoskeletal challenges of osteoporosis. Aging Clin Exp Res 10(3):249–262CrossRef Sinaki M (1998) Musculoskeletal challenges of osteoporosis. Aging Clin Exp Res 10(3):249–262CrossRef
5.
go back to reference Lynn SG, Sinaki M, Westerlind KC (1997) Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil 78(3):273–277PubMedCrossRef Lynn SG, Sinaki M, Westerlind KC (1997) Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil 78(3):273–277PubMedCrossRef
6.
go back to reference Chow SB, Moffat M (2004) Relationship of thoracic kyphosis to functional reach and lower-extremity joint range of motion and muscle length in women with osteoporosis or osteopenia: a pilot study. Top Geriatr Rehabil 20(4):297–306CrossRef Chow SB, Moffat M (2004) Relationship of thoracic kyphosis to functional reach and lower-extremity joint range of motion and muscle length in women with osteoporosis or osteopenia: a pilot study. Top Geriatr Rehabil 20(4):297–306CrossRef
7.
go back to reference Burke TN et al (2010) Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J 128(4):219–224PubMedCrossRef Burke TN et al (2010) Postural control among elderly women with and without osteoporosis: is there a difference? Sao Paulo Med J 128(4):219–224PubMedCrossRef
8.
go back to reference Harrison RA et al (2007) Osteoporosis-related kyphosis and impairments in pulmonary function: a systematic review. J Bone Miner Res 22(3):447–457PubMedCrossRef Harrison RA et al (2007) Osteoporosis-related kyphosis and impairments in pulmonary function: a systematic review. J Bone Miner Res 22(3):447–457PubMedCrossRef
9.
go back to reference Ünlüsoy D et al (2011) Postural balance in women with osteoporosis and effective factors. Turkish J Osteoporos 79(2):37–43 Ünlüsoy D et al (2011) Postural balance in women with osteoporosis and effective factors. Turkish J Osteoporos 79(2):37–43
10.
go back to reference Heinonen A et al (1996) Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet 348(9038):1343–1347PubMedCrossRef Heinonen A et al (1996) Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet 348(9038):1343–1347PubMedCrossRef
11.
go back to reference Granito RN et al (2012) Comparison of thoracic kyphosis degree, trunk muscle strength and joint position sense among healthy and osteoporotic elderly women: a cross-sectional preliminary study. Arch Gerontol Geriatr 54(2):e199–e202PubMedCrossRef Granito RN et al (2012) Comparison of thoracic kyphosis degree, trunk muscle strength and joint position sense among healthy and osteoporotic elderly women: a cross-sectional preliminary study. Arch Gerontol Geriatr 54(2):e199–e202PubMedCrossRef
12.
go back to reference Greig A et al (2007) Balance impairment is related to vertebral fracture rather than thoracic kyphosis in individuals with osteoporosis. Osteoporos Int 18(4):543–551PubMedCrossRef Greig A et al (2007) Balance impairment is related to vertebral fracture rather than thoracic kyphosis in individuals with osteoporosis. Osteoporos Int 18(4):543–551PubMedCrossRef
13.
go back to reference Sinaki M et al (2005) Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int 16(8):1004–1010PubMedCrossRef Sinaki M et al (2005) Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int 16(8):1004–1010PubMedCrossRef
14.
go back to reference Lotz J, Cheal E, Hayes W (1995) Stress distributions within the proximal femur during gait and falls: implications for osteoporotic fracture. Osteoporos Int 5(4):252–261PubMedCrossRef Lotz J, Cheal E, Hayes W (1995) Stress distributions within the proximal femur during gait and falls: implications for osteoporotic fracture. Osteoporos Int 5(4):252–261PubMedCrossRef
15.
go back to reference Grahn Kronhed A-C et al (2009) Effect of training on health-related quality of life, pain and falls in osteoporotic women. Adv Physiother 11(3):154–165CrossRef Grahn Kronhed A-C et al (2009) Effect of training on health-related quality of life, pain and falls in osteoporotic women. Adv Physiother 11(3):154–165CrossRef
16.
go back to reference Sanfélix-Genovés J et al (2011) Impact of osteoporosis and vertebral fractures on quality-of-life. A population-based study in Valencia, Spain (the FRAVO study). Health Qual Life Outcomes 9(1):20PubMedCentralPubMedCrossRef Sanfélix-Genovés J et al (2011) Impact of osteoporosis and vertebral fractures on quality-of-life. A population-based study in Valencia, Spain (the FRAVO study). Health Qual Life Outcomes 9(1):20PubMedCentralPubMedCrossRef
17.
go back to reference Hallberg I et al (2004) Health-related quality of life after osteoporotic fractures. Osteoporos Int 15(10):834–841PubMedCrossRef Hallberg I et al (2004) Health-related quality of life after osteoporotic fractures. Osteoporos Int 15(10):834–841PubMedCrossRef
18.
go back to reference Watts NB et al (2008) National Osteoporosis Foundation 2008 clinician’s guide to prevention and treatment of osteoporosis and the World Health Organization fracture risk assessment tool (FRAX): what they mean to the bone densitometrist and bone technologist. J Clin Densitom 11(4):473–477PubMedCrossRef Watts NB et al (2008) National Osteoporosis Foundation 2008 clinician’s guide to prevention and treatment of osteoporosis and the World Health Organization fracture risk assessment tool (FRAX): what they mean to the bone densitometrist and bone technologist. J Clin Densitom 11(4):473–477PubMedCrossRef
19.
go back to reference Sangtarash F et al (2014) Validity and reliability of dual digital inclinometer in measuring thoracic kyphosis in women over 45 years. J Spine 3(170):2 Sangtarash F et al (2014) Validity and reliability of dual digital inclinometer in measuring thoracic kyphosis in women over 45 years. J Spine 3(170):2
20.
go back to reference Azadinia F et al (2014) The Validity and reliability of noninvasive methods for measuring kyphosis. J Spinal Disord Tech 27(6):E212–E218PubMedCrossRef Azadinia F et al (2014) The Validity and reliability of noninvasive methods for measuring kyphosis. J Spinal Disord Tech 27(6):E212–E218PubMedCrossRef
21.
go back to reference Montazeri A et al (2005) The short form health survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 14(3):875–882PubMedCrossRef Montazeri A et al (2005) The short form health survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 14(3):875–882PubMedCrossRef
22.
go back to reference Wrisley DM et al (2004) Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther 84(10):906–918PubMed Wrisley DM et al (2004) Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther 84(10):906–918PubMed
23.
go back to reference Akbari Kamrani AA et al (2010) Investigation of factor structure of Persian version of functional gait assessment in Iranian elderly. Iran J Ageing 5(17):16–22 Akbari Kamrani AA et al (2010) Investigation of factor structure of Persian version of functional gait assessment in Iranian elderly. Iran J Ageing 5(17):16–22
24.
go back to reference Lewis JS, Valentine RE (2010) Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord 11(1):39PubMedCentralPubMedCrossRef Lewis JS, Valentine RE (2010) Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord 11(1):39PubMedCentralPubMedCrossRef
25.
go back to reference Hislop H, Avers D, Brown M (2013) Daniels and Worthingham’s muscle testing: techniques of manual examination and performance testing. Philadelphia, Saunders, p 249–274 Hislop H, Avers D, Brown M (2013) Daniels and Worthingham’s muscle testing: techniques of manual examination and performance testing. Philadelphia, Saunders, p 249–274
26.
go back to reference Norkin CC, White DJ (2009) Measurement of joint motion: a guide to goniometry. FA Davis, p 21–26 Norkin CC, White DJ (2009) Measurement of joint motion: a guide to goniometry. FA Davis, p 21–26
27.
go back to reference Ryan SD, Fried LP (1997) The impact of kyphosis on daily functioning. J Am Geriatr Soc 45(12):1479–1486PubMedCrossRef Ryan SD, Fried LP (1997) The impact of kyphosis on daily functioning. J Am Geriatr Soc 45(12):1479–1486PubMedCrossRef
28.
go back to reference Hirose D et al (2004) Posture of the trunk in the sagittal plane is associated with gait in community-dwelling elderly population. Clin Biomech 19(1):57–63CrossRef Hirose D et al (2004) Posture of the trunk in the sagittal plane is associated with gait in community-dwelling elderly population. Clin Biomech 19(1):57–63CrossRef
29.
go back to reference Kado DM et al (2005) Hyperkyphotic posture and poor physical functional ability in older community-dwelling men and women: the Rancho Bernardo study. J Gerontol A: Biol Med Sci 60(5):633–637CrossRef Kado DM et al (2005) Hyperkyphotic posture and poor physical functional ability in older community-dwelling men and women: the Rancho Bernardo study. J Gerontol A: Biol Med Sci 60(5):633–637CrossRef
30.
go back to reference Takahashi T et al (2005) Trunk deformity is associated with a reduction in outdoor activities of daily living and life satisfaction in community-dwelling older people. Osteoporos Int 16(3):273–279PubMedCrossRef Takahashi T et al (2005) Trunk deformity is associated with a reduction in outdoor activities of daily living and life satisfaction in community-dwelling older people. Osteoporos Int 16(3):273–279PubMedCrossRef
31.
go back to reference O’Brien K, Culham E, Pickles B (1997) Balance and skeletal alignment in a group of elderly female fallers and nonfallers. J Gerontol A: Biol Med Sci 52(4):B221–B226CrossRef O’Brien K, Culham E, Pickles B (1997) Balance and skeletal alignment in a group of elderly female fallers and nonfallers. J Gerontol A: Biol Med Sci 52(4):B221–B226CrossRef
32.
go back to reference Lyles KW et al (1993) Association of osteoporotic vertebral compression fractures with impaired functional status. Am J Med 94(6):595–601PubMedCrossRef Lyles KW et al (1993) Association of osteoporotic vertebral compression fractures with impaired functional status. Am J Med 94(6):595–601PubMedCrossRef
33.
go back to reference Krall EA, Dawson-Hughes B (1994) Walking is related to bone density and rates of bone loss. Am J Med 96(1):20–26PubMedCrossRef Krall EA, Dawson-Hughes B (1994) Walking is related to bone density and rates of bone loss. Am J Med 96(1):20–26PubMedCrossRef
34.
go back to reference Adachi J et al (2001) The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int 12(11):903–908PubMedCrossRef Adachi J et al (2001) The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int 12(11):903–908PubMedCrossRef
35.
go back to reference Burger H et al (1997) Vertebral deformities and functional impairment in men and women. J Bone Miner Res 12(1):152–157PubMedCrossRef Burger H et al (1997) Vertebral deformities and functional impairment in men and women. J Bone Miner Res 12(1):152–157PubMedCrossRef
36.
go back to reference Ettinger B et al (1994) Kyphosis in older women and its relation to back pain, disability and osteopenia: the study of osteoporotic fractures. Osteoporos Int 4(1):55–60PubMedCrossRef Ettinger B et al (1994) Kyphosis in older women and its relation to back pain, disability and osteopenia: the study of osteoporotic fractures. Osteoporos Int 4(1):55–60PubMedCrossRef
37.
go back to reference De Smet AA et al (1988) Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis. Radiology 166(2):497–500PubMedCrossRef De Smet AA et al (1988) Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis. Radiology 166(2):497–500PubMedCrossRef
38.
go back to reference Ross P et al (1991) Evaluation of adverse health outcomes associated with vertebral fractures. Osteoporos Int 1(3):134–140PubMedCrossRef Ross P et al (1991) Evaluation of adverse health outcomes associated with vertebral fractures. Osteoporos Int 1(3):134–140PubMedCrossRef
39.
go back to reference Lombardi I Jr et al (2005) Evaluation of pulmonary function and quality of life in women with osteoporosis. Osteoporos Int 16(10):1247–1253PubMedCrossRef Lombardi I Jr et al (2005) Evaluation of pulmonary function and quality of life in women with osteoporosis. Osteoporos Int 16(10):1247–1253PubMedCrossRef
40.
go back to reference Balzini L et al (2003) Clinical characteristics of flexed posture in elderly women. J Am Geriatr Soc 51(10):1419–1426PubMedCrossRef Balzini L et al (2003) Clinical characteristics of flexed posture in elderly women. J Am Geriatr Soc 51(10):1419–1426PubMedCrossRef
41.
go back to reference Miyakoshi N et al (2003) Impact of postural deformities and spinal mobility on quality of life in postmenopausal osteoporosis. Osteoporos Int 14(12):1007–1012PubMedCrossRef Miyakoshi N et al (2003) Impact of postural deformities and spinal mobility on quality of life in postmenopausal osteoporosis. Osteoporos Int 14(12):1007–1012PubMedCrossRef
42.
Metadata
Title
The relationship of thoracic kyphosis to gait performance and quality of life in women with osteoporosis
Authors
F. Sangtarash
F. D. Manshadi
A. Sadeghi
Publication date
01-08-2015
Publisher
Springer London
Published in
Osteoporosis International / Issue 8/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3143-9

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