Long-Term Efficacy of Treatment Effects After a Kyphosis Exercise and Posture Training Intervention in Older Community-Dwelling Adults: A Cohort Study.
Wendy B Katzman, Neeta Parimi, Amy Gladin and 2 others
PMID 32796410WHAT IT FOUND
3.0 years after a 3-month kyphosis exercise and posture program, kyphosis measured by kyphometer decreased by 1.5 degrees, not different from the change during the program.
Lordosis improved, but several physical function and quality-of-life scores declined.
Key findings
01The primary outcome, kyphometer-measured kyphosis, decreased 1.5 degrees at long-term follow-up, and this change was not statistically different from the 3.8 degree change during the original intervention.
02Lumbar lordosis increased 8.9 degrees at follow-up, a statistically significant change compared with the pre-post intervention change.
03Modified PPT, timed up and go, six minute walk, PROMIS physical function and physical health, and SRS-30 self-image worsened at follow-up significantly more than after the intervention.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 43 of 103 participants returned for follow-up, and the follow-up study was not planned before the original trial. The follow-up visit was added after additional funding was obtained, and radiographs were not done, so long-term radiographic Cobb angle was not measured. Follow-up time varied from 2 to 4 years, so the analysis used a ratio to compare change over different follow-up lengths. The kyphosis change of 1.5 degrees was smaller than the previously reported minimal detectable change of 2.51 degrees. The cohort was healthy, with 95% rating their health as good to excellent, so results may not apply to frailer older adults. Physical activity was self-reported on the PASE, and no actigraphy was used.
The easy way to misread this
Do not read the 1.5 degree kyphosis improvement as proof that the program prevents long-term kyphosis progression. The follow-up was not planned in advance, only 43 of 103 participants returned, radiographs were not obtained, and several physical function and quality-of-life scores worsened. The program included group exercise with light weights, theraband, foam rollers, posture training, a home manual, and independent posture practice, so the contribution of any single component cannot be separated.