Department of Physical Therapy, School of Health Professions, The University of Texas Medical Branch, Galveston.
Department of Physical Therapy, College of Health Science, Cheongju University, Chungcheong Province, South Korea.
J Geriatr Phys Ther. 2019 Jul/Sep;42(3):E17-E27. doi: 10.1519/JPT.0000000000000146.
The purpose of this study was to identify the effects of a corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in Korean community-dwelling older women.
Fifty women 65 years of age and older, recruited from 2 senior centers, participated in this study. Participants were assigned to either the experimental group (EG) or the control group (CG) on the basis of convenience of location, and 22 in each were analyzed. Participants in the EG underwent a thoracic corrective exercise program 1 hour each session, twice per week for 8 weeks (a total of 16 sessions), which consisted of specific exercises to enhance breathing, thoracic mobility and stability, and awareness of thoracic alignment. The CG received education on the same thoracic corrective exercise program and a booklet of the exercises. Outcome measures included the extent of postural abnormality (angle of thoracic kyphosis, kyphosis index calculated both in relaxed- and best posture using flexicurve, the ratio of the kyphosis index calculated best posture/relaxed posture, craniovertebral angle, and tragus-to-wall distance), balance (Short Physical Performance Battery and limit of stability), and well-being (Geriatric Depression Scale Short Form and the 36-Item Short Form Health Survey [SF-36]). All data were collected by 6 blinded assessors at baseline, at 8 weeks after the completion of intervention, and at 16 weeks for follow-up.
For participants of the EG, means of all parameters showed significant improvements over time (P < .05), with improved values both in comparison of baseline to postintervention and baseline to follow-up. Means of CG parameters were significantly improved in only the angle of thoracic kyphosis and the tragus-to-wall distance (P < .05). Furthermore, in all parameters, percent change between baseline and postintervention data was significantly (P < .05) higher for the EG than that for the CG, except for the limit of stability and SF-36 which improved but not significantly. All parameters between baseline and follow-up data were significantly (P < .05) higher for the EG than those for the CG, except for the limit of stability.
The findings of this study suggest that a well-designed exercise program may be beneficial to improve spinal posture, balance, and well-being in older women with thoracic hyperkyphosis. We recommend the use of the therapeutic strategies utilized in this study to enhance thoracic posture, balance, and well-being of older women with thoracic hyperkyphosis. Future research is needed to apply this exercise protocol on a larger and more diverse population.
本研究旨在探讨胸椎过度后凸矫正运动对韩国社区老年女性的姿势、平衡和幸福感的影响。
本研究招募了来自 2 个老年人中心的 50 名 65 岁及以上的女性，将她们按照方便的地点分为实验组（EG）和对照组（CG），每组 22 人进行分析。EG 组接受 1 小时/次、2 次/周、8 周（共 16 次）的胸椎矫正运动方案，包括增强呼吸、胸椎活动度和稳定性以及胸椎对线意识的特定运动。CG 组接受了相同的胸椎矫正运动方案和运动手册的教育。结果测量包括姿势异常程度（胸椎后凸角度、放松和最佳姿势下使用 flexicurve 计算的后凸指数、最佳姿势/放松姿势计算的后凸指数比值、颅颈角和耳屏到墙距离）、平衡（短体适能测试和平衡极限测试）和幸福感（老年抑郁量表简短版和 36 项简明健康调查 [SF-36]）。所有数据均由 6 名盲法评估者在基线时、干预结束后 8 周时和随访 16 周时收集。
对于 EG 组的参与者，所有参数的平均值均随时间显著改善（P <.05），与干预前相比，基线值和随访值均有改善。CG 组的参数平均值仅在胸椎后凸角度和耳屏到墙距离方面显著改善（P <.05）。此外，除平衡极限测试和 SF-36 外，所有参数的基线到干预后数据的百分比变化在 EG 组均显著（P <.05）高于 CG 组，这些参数均有改善但不显著。与 CG 组相比，EG 组的基线到随访数据的所有参数均显著更高（P <.05），除平衡极限测试外。
本研究结果表明，设计良好的运动方案可能有助于改善老年女性胸椎过度后凸的脊柱姿势、平衡和幸福感。我们建议使用本研究中使用的治疗策略来增强老年女性的胸椎姿势、平衡和幸福感。未来的研究需要在更大、更多样化的人群中应用此运动方案。
