对患有脊柱后凸的老年人进行为期4周的姿势干预后步态的二次分析。
A secondary analysis of gait after a 4-week postural intervention for older adults with hyperkyphosis.
作者信息
Hughes L C, Ellis A L, Rogers H L, Hadley M, Galloway R V
机构信息
Department of Physical Therapy, University of Texas Medical Branch (UTMB), 301 University Blvd, Galveston, TX, 77555, USA.
Present address: Classic Rehabilitation, 2008 L Don Dodson Dr., Bedford, TX, 76021, USA.
出版信息
BMC Musculoskelet Disord. 2025 Feb 11;26(1):136. doi: 10.1186/s12891-025-08330-7.
BACKGROUND
Thoracic hyperkyphosis (HK), common in older adults, has been linked to impairments in physical function, mobility, balance, gait, and falls. Our pilot study used a novel 4-week manual therapy and exercise intervention for HK and showed improved posture and function. This secondary analysis aims to explore 1) the changes in gait parameters after a novel intervention for HK, 2) the correlations between posture and gait variables at baseline, and 3) pre- to post intervention.
METHODS
This secondary analysis uses data from a quasi-experimental, single group pilot study. Participants with HK underwent pre- and post intervention measurements in posture, function, and unique to this secondary analysis, gait parametrics of velocity (V), step length (SL), double limb support (DLS), and step width (SW) using the GAITRite® electronic walkway. Paired t-tests compared pre- and post intervention gait parameters. Pearson correlation coefficients were utilized to investigate correlations between all variables at baseline and in pre- and post intervention change values.
RESULTS
Fourteen women and 8 men (aged 65.9 years ±9.2; range 52 - 90) completed 12 treatments (3 times/week for 4-weeks). Statistically significant improvement (p≤.001) occurred pre- to post for postural measures: height (M=0.73cm ±0.54), Kyphotic index (-2.41 ±2.96), Block (-1.17cm ±1.22), Acromion to table (ATT) (-1.85cm ±1.42), and 3 gait measures: V (M=0.087m/s ±0.09), SL (2.34cm ±2.55), and DLS (- 0.031sec ±0.04). SW improvement was not statistically significant. Block and ATT measures were moderately correlated with V, SL, SW (Block only), and DLS (ATT only) at baseline. Strong correlations were found among V, SL, and DLS at baseline and in pre- to post change scores, but no correlation between change scores of posture and gait.
CONCLUSIONS
This study shows that a clinically practical 4-week PT intervention may benefit older adults with HK by demonstrating improved posture and gait parameters. Further research is warranted.
TRIAL REGISTRATION
This study was retrospectively registered on 16/09/2019 under ClinicalTrials.gov Identifier: NCT04114331.
背景
胸椎后凸（HK）在老年人中很常见，与身体功能、活动能力、平衡、步态及跌倒方面的损伤有关。我们的初步研究采用了一种新颖的为期4周的手法治疗和运动干预来治疗HK，并显示出姿势和功能得到改善。这项二次分析旨在探讨：1）针对HK的新型干预后步态参数的变化；2）基线时姿势与步态变量之间的相关性；3）干预前后的情况。
方法
这项二次分析使用了来自一项准实验性单组初步研究的数据。患有HK的参与者在姿势、功能方面接受了干预前后的测量，并且针对此二次分析，使用GAITRite®电子步道测量了速度（V）、步长（SL）、双支撑（DLS）和步宽（SW）等独特的步态参数。配对t检验比较了干预前后的步态参数。Pearson相关系数用于研究基线时以及干预前后变化值中所有变量之间的相关性。
结果
14名女性和8名男性（年龄65.9岁±9.2；范围52 - 90岁）完成了12次治疗（每周3次，共4周）。姿势测量指标在干预前后有统计学显著改善（p≤.001）：身高（M = 0.73厘米±0.54）、后凸指数（-2.41±2.96）、胸段矢状面垂直轴距离（Block）（-1.17厘米±1.22）、肩峰至桌面距离（ATT）（-1.85厘米±1.42），以及3项步态指标：速度（V）（M = 0.087米/秒±0.09）、步长（SL）（2.34厘米±2.55）和双支撑时间（DLS）（-0.031秒±0.04）。步宽改善无统计学显著意义。基线时，胸段矢状面垂直轴距离和肩峰至桌面距离测量值与速度、步长、步宽（仅胸段矢状面垂直轴距离）和双支撑时间（仅肩峰至桌面距离）中度相关。基线时以及干预前后变化分数中，速度、步长和双支撑时间之间存在强相关性，但姿势和步态的变化分数之间无相关性。
结论
本研究表明，一项临床实用的为期4周的物理治疗干预可能通过改善姿势和步态参数使患有HK的老年人受益。有必要进行进一步研究。
试验注册
本研究于2019年9月16日在ClinicalTrials.gov上进行回顾性注册，标识符为：NCT04114331。
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