Department of Kinesiology, University of Waterloo, Waterloo, Canada.
Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, USA.
Arch Osteoporos. 2021 Sep 21;16(1):140. doi: 10.1007/s11657-021-00998-3.
We reviewed exercise trials in men and women ≥ 45 years with hyperkyphosis at the baseline and performed meta-analyses for kyphosis and health-related outcomes.
To determine the effects of exercise interventions on kyphosis angle, back extensor muscle strength or endurance, physical functioning, quality of life, pain, falls, and adverse events in adults 45 years or older with hyperkyphosis.
Multiple databases were searched to May 2020. Randomized controlled trials (RCTs), non-RCT, and pre-post intervention studies that had at least one group with a mean kyphosis angle of at least 40° at the baseline were included.
Twenty-four studies were included. Exercise or physical therapy improved kyphosis outcomes (SMD - 0.31; 95% confidence intervals [CI] - 0.46, - 0.16; moderate certainty evidence), back extensor muscle strength (MD 10.51 N; 95% CI 6.65, 14.38; very low certainty evidence), and endurance (MD 9.76 s; 95% CI 6.40, 13.13; low certainty evidence). Meta-analyses showed improvements in health-related quality of life (HRQoL) (SMD 0.21; 95% CI 0.06, 0.37; moderate certainty of evidence), general pain (MD - 0.26; 95% CI - 0.39, - 0.13; low certainty of evidence), and performance on the timed up and go (TUG) test (MD - 0.28 s; 95% CI - 0.48, - 0.08; very low certainty of evidence). The effects on the rate of falls (incidence rate ratio [IRR] 1.15; 95% CI 0.64, 2.05; low certainty evidence) or minor adverse events (IRR 1.29; 95% CI 0.95, 1.74; low certainty evidence) are uncertain. No serious adverse events were reported in the included studies.
Interventions targeting hyperkyphosis may improve kyphosis outcomes in adults with hyperkyphosis.
我们回顾了基线时存在严重后凸畸形的 45 岁及以上男性和女性的运动试验，并对后凸畸形和与健康相关的结局进行了荟萃分析。
确定运动干预对 45 岁及以上严重后凸畸形成人的后凸角度、腰背伸肌力量或耐力、身体机能、生活质量、疼痛、跌倒和不良事件的影响。
检索多个数据库至 2020 年 5 月。纳入至少有一组基线后凸角≥40°的随机对照试验（RCT）、非随机对照试验和前后干预研究。
共纳入 24 项研究。运动或物理疗法可改善后凸畸形结局（SMD-0.31；95%置信区间[CI]-0.46，-0.16；中等确定性证据）、腰背伸肌力量（MD 10.51 N；95%CI 6.65，14.38；极低确定性证据）和耐力（MD 9.76 s；95%CI 6.40，13.13；低确定性证据）。荟萃分析显示，与健康相关的生活质量（HRQoL）（SMD 0.21；95%CI 0.06，0.37；中等确定性证据）、一般疼痛（MD-0.26；95%CI-0.39，-0.13；低确定性证据）和计时起立行走测试（TUG）（MD-0.28 s；95%CI-0.48，-0.08；极低确定性证据）均有改善。跌倒发生率（发生率比[IRR]1.15；95%CI 0.64，2.05；低确定性证据）或轻微不良事件（IRR 1.29；95%CI 0.95，1.74；低确定性证据）的影响不确定。纳入研究均未报告严重不良事件。
针对严重后凸畸形的干预措施可能改善严重后凸畸形成人的后凸畸形结局。
