Thoracic Kyphosis and Ventilatory Dysfunction in Unselected Older Persons: An Epidemiological Study in Dicomano, Italy

Abstract

OBJECTIVES:To assess whether kyphosis is associated with ventilatory dysfunction in older community dwellers. DESIGN: Cross-sectional study. SETTING: The unselected population of Dicomano, Italy aged !65 years. PARTICIPANTS: A total of 323 nonheart failure participants underwent clinical evaluation for the presence of kyphosis and spirometry. The severity of kyphosis was estimated from the difference between standing stature and knee-height-derived stature and from the occiput-wall distance. MEASUREMENTS: Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and prevalence of obstructive and restrictive ventilatory pattern. RESULTS: The 130 kyphotic participants (40.2%) had an adjusted 2.5 prevalence odds ratio (POR) for dyspnea (95% confidence interval (CI) 5 1.1-5.8). FVC% and FEV1% were lower in the presence of kyphosis (Po.01); their deficit was proportional to kyphosis severity. The ventilatory dysfunction was underestimated when reference spirometric parameters were calculated based on standing stature, compared with knee-height derived stature. Of the kyphotic participants, 56.2%, 26.9%, and 16.9% had spirometric normal, obstructive, and restrictive patterns, respectively. Kyphosis was associated with a restrictive (adjusted POR 5 2.3, 95% CI 5 1.1-4.8; P 5.021) and an obstructive ventilatory pattern (adjusted POR 5 3.3, 95% CI 5 1.7-6.5; Po.001). CONCLUSION: In unselected older persons, kyphosis is associated with dyspnea and ventilatory dysfunction of a restrictive and an obstructive type. Kyphosis should be included in the differential diagnosis of dyspnea and ventilatory dysfunction in the elderly. J Am Geriatr Soc 52: 909-915, 2004.

Relationship between the occiput-wall distance and physical performance in the elderly: a cross sectional study

“…Although it cannot substitute highly accurate clinical measures of kyphosis such as Cobb's angle, OWD has been extensively used in epidemiological studies. It has been associated with depressed mood, postural instability, muscle weakness and disability in older women (2), and may account for a large percentage of the dyspnea and restrictive/ obstructive respiratory dysfunction that often remains unexplained in older persons (3). In the Rancho-Bernardo study, OWD was found to be inversely related to several measures of physical performance, but it was not clear whether osteoporosis mediated this relationship to some extent (4).…”

An 8-week thoracic spine stabilization exercise program improves postural back pain, spine alignment, postural sway, and core endurance in university students:a randomized controlled study

“…Postural back pain and/or low back pain, diminished physical performance, impaired respiratory function, and low quality of life arise as a result of kyphotic posture (7)(8)(9)(10)(11). Moreover, increased thoracic kyphosis has a negative effect on postural stability.…”

Balloon Kyphoplasty for Vertebra Plana with or without Osteonecrosis

“…Vertebral fractures decrease the pulmonary capacity of these patients, [27][28][29] in whom pulmonary disorders are the most common cause of death. [30][31][32][33] This underlines the importance of identifying any osteonecrosis in patients with severe vertebral collapses.…”