Spinal deformity has an important and measurable impact on physical function and health-related quality of life (HRQoL), particularly in older adults. Deformity in the sagittal plane has the largest impact on clinical health status of older adults, increasing pain, and compromising gait speed, functional reach, balance, self- image, and satisfacfion with life in general. Hyperkyphosis is an important cause of sagittal plane malalignment and has been associated with poor health outcomes, including falls, fractures, activities of daily living (ADL) disability, and mortality. Higher prevalence of hyperkyphosis has been reported.among females versus males, 28% versus 14%, respectively. Hyperkyphosis is accompanied by spinal muscle weakness17- 19 that may be modifiable with exercise. Sex differences in muscle strength may differentially affect the severity of hyperkyhosis and modify the response to exercise. Currently, there are few evidence-based treatments targeted to reduce hyperkyhosis and no proven exercise interventions that reduce hyperkyphosis and delay funcfional decline and disability. The primary hypothesis of project IV is that interventions that reduce hyperkyphosis by improving spinal muscle strength will also delay functional decline and disability, and could, therefore, have significant public health benefits. No study examining the impact of exercise to improve hyperkyphosis has determined whether treatment effects differ according to sex. This project proposes a paradigm where physical function can be improved in an exercise intervention targeted at reducing hyperkyphosis, which may reduce associated disability. Pilot work conducted by the project research team suggests that the approach is feasible and potentially effective. Project IV proposes a randomized controlled trial comparing a 12-week high-intensity spinal strengthening exercise intervenfion and home exercise pracfice to a control stretching intervenfion in community-dwelling males and females 55- 80 years old with hyperkyphosis. All primary and secondary outcomes will be compared between the exercise and the control group after 12-weeks. The long-term goal is to develop intervenfions to delay funcfional decline and physical disability in older males and females and to identify those who would most benefit from interventions.

Public Health Relevance

Exercise intervenfions targeted at increasing funcfion in older adults often neglect posture and spinal muscle weakness. No study examining the impact of exercise to improve hyperkyphosis has determined whether treatment effects differ according to sex. The aims of Project IV propose a paradigm where physical function can be improved in an exercise intervention targeted at reducing hyperkyphosis, which may reduce associated disability.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Specialized Center (P50)
Project #
5P50AR063043-02
Application #
8544788
Study Section
Special Emphasis Panel (ZRG1-EMNR-Q)
Project Start
2013-09-01
Project End
2017-08-31
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
2
Fiscal Year
2013
Total Cost
$53,971
Indirect Cost
Name
University of California Davis
Department
Type
DUNS #
047120084
City
Davis
State
CA
Country
United States
Zip Code
95618
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