Roghani Tayebeh, Allen Diane D, Gladin Amy, Rahimi Alireza, Mehrabi Marziyeh, Rezaeian Zahra Sadat, Farajzadegan Ziba, Katzman Wendy B
Musculoskeletal Research Center, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Graduate Program in Physical Therapy, University of California San Francisco/San Francisco State University, San Francisco, California.
J Geriatr Phys Ther. 2024;47(2):85-96. doi: 10.1519/JPT.0000000000000371. Epub 2024 Jan 9.
Thoracic hyperkyphosis may adversely influence physical function in older adults, but the literature is mixed and confounded by possible sex differences. This systematic review and meta-analysis aimed to examine the association between hyperkyphosis and physical function in older females.
Scopus, ISI Web of Science, Cochrane Library, PubMed, CINAHL, and PEDro databases were searched through 2021 for studies that included measures of thoracic hyperkyphosis and physical function with extractable data for women older than 60 years. Studies were excluded if they were qualitative, case reports, case series, ecological studies, reviews, or were not published in English. The study quality and risk of bias were assessed using checklists from the National Heart, Lung, and Blood Institute. Data were synthesized using Cohen's d effect size and 95% confidence interval (CI), and random-effects models were used for the meta-analyses.
Three cohort and 22 cross-sectional studies of fair to good quality met the inclusion criteria. Eight studies reporting single-group data showed a moderate association between greater kyphosis angles and lower physical function ( d = -0.57; 95% CI -0.73, -0.40). Fourteen studies reporting 2-group data showed a large negative effect on physical function for groups with greater kyphosis angles ( d = -1.16; 95% CI -1.53, -0.78). Three studies that reported multivariate data also tended to show negative associations between physical function and hyperkyphosis. Limitations include a relative lack of causal evidence; confirming causation requires additional longitudinal studies. Studies have assessed various physical function categories, including strength, gait, and balance. Future studies could determine the categories of function most affected so that preventive interventions could target hyperkyphosis appropriately.
Hyperkyphosis was associated with lower physical function in older women. Three cohort studies suggest that greater kyphosis angles may predict greater loss of physical function over time. These results imply that therapies that help to minimize hyperkyphosis may help preserve function in older women.
胸椎后凸过大可能会对老年人的身体功能产生不利影响，但相关文献存在分歧，且可能受到性别差异的干扰。本系统评价和荟萃分析旨在研究老年女性胸椎后凸过大与身体功能之间的关联。
检索了Scopus、ISI科学网、考克兰图书馆、PubMed、CINAHL和PEDro数据库截至2021年的研究，纳入那些包含胸椎后凸过大测量指标和身体功能指标且有60岁以上女性可提取数据的研究。如果研究为定性研究、病例报告、病例系列、生态学研究、综述或非英文发表，则将其排除。使用美国国立心肺血液研究所的清单评估研究质量和偏倚风险。数据采用Cohen's d效应量和95%置信区间（CI）进行综合分析，荟萃分析采用随机效应模型。
三项队列研究和22项质量中等至良好的横断面研究符合纳入标准。八项报告单组数据的研究显示，更大的后凸角度与更低的身体功能之间存在中度关联（d = -0.57；95% CI -0.73，-0.40）。十四项报告两组数据的研究显示，后凸角度更大的组对身体功能有较大的负面影响（d = -1.16；95% CI -1.53，-0.78）。三项报告多变量数据的研究也倾向于显示身体功能与胸椎后凸过大之间存在负相关。局限性包括相对缺乏因果证据；证实因果关系需要更多的纵向研究。研究评估了各种身体功能类别，包括力量、步态和平衡。未来的研究可以确定受影响最大的功能类别，以便预防性干预能够适当地针对胸椎后凸过大问题。
胸椎后凸过大与老年女性较低的身体功能相关。三项队列研究表明，更大的后凸角度可能预示着随着时间的推移身体功能会有更大的丧失。这些结果意味着，有助于尽量减少胸椎后凸过大的治疗方法可能有助于保持老年女性的功能。
