Validity and reliability of a thoracic kyphotic assessment tool measuring distance of the seventh cervical vertebra from the wall.
Pipatana Amatachaya, Sawitree Wongsa, Thanat Sooknuan and 4 others
PMID 30931031WHAT IT FOUND
A C7-to-wall distance tool was dependable and agreed with Flexicurve kyphosis angle in older people with thoracic kyphosis.
Physical therapists, village health volunteers, and caregivers could use it to assess severity and walking endurance.
Key findings
01In 21 participants, the C7-to-wall distance had excellent reliability when used by a physical therapist, a village health volunteer, and a caregiver, with agreement scores (ICC) greater than 0.90 and p < 0.001.
02In 158 older adults, the C7-to-wall distance correlated with Flexicurve kyphosis angle at r = 0.902 and p < 0.001.
03In groups of 48 participants per severity category, more severe kyphosis by C7-to-wall distance was associated with shorter 6-minute walk distance, p < 0.001.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included older adults with structural thoracic kyphosis and a body mass index between 18.5 kg/m2 and 29.9 kg/m2, and it excluded people who used walking devices or had pain, inflammation, scoliosis, leg length discrepancy, or upper back masses, so it may not apply to patients with those features. The tested measurement used the KypDist tool, not ordinary rulers, so the results do not confirm that a simple C7-to-wall measurement with a ruler has the same accuracy. The Flexicurve was used as the reference standard, and the authors note its shape can change when removed from the spine and its landmarks can be hard to identify, especially in overweight or obese people. The study was cross-sectional, so it cannot show that kyphosis caused reduced walking endurance or that the tool tracks change over time. The comparison between moderate and severe kyphosis had low explanatory power, and lifestyle or comorbidities were not considered.
Declared interests
The authors declared that they have no conflicts of interest.
The easy way to misread this
Do not conclude that the KypDist tool directly measures thoracic kyphosis or that it has been shown to monitor change over time. It measures C7-to-wall distance, was validated against Flexicurve, and the study was cross-sectional.