Greendale Gail A, Huang Mei-Hua, Karlamangla Arun S, Seeger Leanne, Crawford Sybil
Division of Geriatrics, Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
J Am Geriatr Soc. 2009 Sep;57(9):1569-79. doi: 10.1111/j.1532-5415.2009.02391.x. Epub 2009 Jul 21.
To assess whether a specifically designed yoga intervention can reduce hyperkyphosis.
A 6-month, two-group, randomized, controlled, single-masked trial.
Community research unit.
One hundred eighteen women and men aged 60 and older with a kyphosis angle of 40 degrees or greater. Major exclusions were serious medical comorbidity, use of assistive device, inability to hear or see adequately for participation, and inability to pass a physical safety screen.
The active treatment group attended hour-long yoga classes 3 days per week for 24 weeks. The control group attended a monthly luncheon and seminar and received mailings.
Primary outcomes were change (baseline to 6 months) in Debrunner kyphometer-assessed kyphosis angle, standing height, timed chair stands, functional reach, and walking speed. Secondary outcomes were change in kyphosis index, flexicurve kyphosis angle, Rancho Bernardo Blocks posture assessment, and health-related quality of life (HRQOL).
Compared with control participants, participants randomized to yoga experienced a 4.4% improvement in flexicurve kyphosis angle (P=.006) and a 5% improvement in kyphosis index (P=.004). The intervention did not result in statistically significant improvement in Debrunner kyphometer angle, measured physical performance, or self-assessed HRQOL (each P>.1).
The decrease in flexicurve kyphosis angle in the yoga treatment group shows that hyperkyphosis is remediable, a critical first step in the pathway to treating or preventing this condition. Larger, more-definitive studies of yoga or other interventions for hyperkyphosis should be considered. Targeting individuals with more-malleable spines and using longitudinally precise measures of kyphosis could strengthen the treatment effect.
评估一项专门设计的瑜伽干预措施是否能减轻脊柱后凸。
一项为期6个月的两组随机对照单盲试验。
社区研究单位。
118名年龄在60岁及以上、脊柱后凸角度为40度或更大的男性和女性。主要排除标准包括严重的内科合并症、使用辅助器械、因听力或视力不足而无法参与、以及无法通过身体安全筛查。
积极治疗组每周参加3天、每次时长1小时的瑜伽课程，共持续24周。对照组参加每月一次的午餐会和研讨会，并收到邮件资料。
主要结局指标为使用德布勒纳脊柱后凸测量仪评估的脊柱后凸角度、站立身高、定时起立试验、功能性前伸距离和步行速度从基线到6个月的变化。次要结局指标为脊柱后凸指数、弯曲型脊柱后凸角度、兰乔 Bernardo 姿势评估以及健康相关生活质量（HRQOL）的变化。
与对照组参与者相比，随机分配到瑜伽组的参与者弯曲型脊柱后凸角度改善了4.4%（P = .006），脊柱后凸指数改善了5%（P = .004）。该干预措施在德布勒纳脊柱后凸测量仪角度、实测身体功能或自我评估的HRQOL方面未产生具有统计学意义的改善（各P > .1）。
瑜伽治疗组弯曲型脊柱后凸角度的减小表明脊柱后凸是可矫正的，这是治疗或预防该疾病过程中的关键第一步。应考虑开展规模更大、更具确定性的瑜伽或其他脊柱后凸干预措施的研究。针对脊柱更具柔韧性的个体并采用纵向精确的脊柱后凸测量方法可能会增强治疗效果。
