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老年患者脊柱后凸对平衡及跌倒风险的影响:一项系统综述

The effects of Hyperkyphosis on Balance and Fall Risk in older adults: A Systematic Review.

作者信息

Gasavi Nezhad Zeinab, A Gard Steven, Arazpour Mokhtar

机构信息

Neuromusculoskeletal Rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IRAN; Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Department of Orthotics and Prosthetics, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Northwestern University Prosthetics Orthotics Center, Dept. of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Chicago, IL, United States; Jesse Brown VA Medical Center, Chicago, IL, United States.

出版信息

Gait Posture. 2025 May;118:154-167. doi: 10.1016/j.gaitpost.2025.02.005. Epub 2025 Feb 12.

Abstract

INTRODUCTION

Hyperkyphosis, a common spinal curvature in older adults, is linked to impaired balance and increased fall risk. Despite affecting up to 40 % of those over 60, its impact on fall risk is unclear due to inconsistent research. This systematic review aims to clarify the relationship between hyperkyphosis and balance in older adults.

METHODS

This systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO (registration number: CRD42024590745). Studies published up to September 2024 were included if they involved older adults (≥60 years) with hyperkyphosis and examined the relationship between hyperkyphosis and balance or fall risk. Observational studies with cross-sectional, cohort, or case-control designs were considered. A comprehensive search of PubMed, Web of Science, Scopus, CINAHL, and the Cochrane Library was conducted using a combination of relevant MeSH terms and keywords. Two reviewers independently screened studies for eligibility, extracted data, and assessed quality using the STROBE checklist, resolving discrepancies through discussion.

RESULTS

This systematic review included 19 studies on the impact of hyperkyphosis on balance and fall risk in adults aged 60 and above. Quality assessment revealed varied methodological rigor. Hyperkyphosis was measured using diverse methods like Cobb angle and flexicurve ruler. Findings showed significant impairments in static and dynamic balance, assessed through tests such as the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Fall rates ranged from 24 % to,64 %, with many resulting in injuries.

CONCLUSION

This review highlights hyperkyphosis significantly impairs balance and increases fall risk in older adults. Hyperkyphosis is linked to reduced postural stability and a higher incidence of falls, emphasizing the need for targeted interventions to improve balance and reduce fall risk in this population.

CLINICAL RELEVANCE

Hyperkyphosis impairs balance and raises fall risk in older adults, highlighting the need for targeted interventions to enhance stability and prevent falls. Early identification and management of hyperkyphosis can improve mobility and quality of life in this population.

摘要

引言

脊柱后凸是老年人常见的脊柱弯曲,与平衡能力受损和跌倒风险增加有关。尽管在60岁以上人群中发病率高达40%,但由于研究结果不一致,其对跌倒风险的影响尚不清楚。本系统评价旨在阐明老年人脊柱后凸与平衡能力之间的关系。

方法

本系统评价遵循PRISMA 2020指南,并在PROSPERO上注册(注册号:CRD42024590745)。纳入截至2024年9月发表的研究,研究对象为患有脊柱后凸的老年人(≥60岁),并探讨脊柱后凸与平衡能力或跌倒风险之间的关系。考虑采用横断面、队列或病例对照设计的观察性研究。使用相关医学主题词和关键词组合,对PubMed、Web of Science、Scopus、CINAHL和Cochrane图书馆进行全面检索。两名评审员独立筛选研究的 eligibility,提取数据,并使用STROBE清单评估质量,通过讨论解决差异。

结果

本系统评价纳入了19项关于脊柱后凸对60岁及以上成年人平衡能力和跌倒风险影响的研究。质量评估显示方法学严谨性各不相同。脊柱后凸采用多种方法测量,如Cobb角和柔性曲线尺。研究结果表明,通过定时起立行走测试(TUG)和伯格平衡量表(BBS)等测试评估,静态和动态平衡存在显著损害。跌倒率从24%到64%不等,许多跌倒导致受伤。

结论

本综述强调脊柱后凸显著损害老年人的平衡能力并增加跌倒风险。脊柱后凸与姿势稳定性降低和跌倒发生率较高有关,强调需要针对性干预措施来改善该人群的平衡能力并降低跌倒风险。

临床意义

脊柱后凸损害老年人的平衡能力并增加跌倒风险,凸显了针对性干预措施以增强稳定性和预防跌倒 的必要性。早期识别和管理脊柱后凸可改善该人群的活动能力和生活质量。

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