Age-related Hyperkyphosis: Difference between revisions
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- breathing (in more severe cases)<br> | - breathing (in more severe cases)<br> | ||
== Differential Diagnosis | == Differential Diagnosis<sup>1</sup> == | ||
Nowadays we have different reliable methods helping us to diagnose an hyperkphosis. The gold-standard orthopedic technique for assessment of thoracic kyphosis is standing lateral spine radiographs. The Cobb’s angle of kyphosis is calculated from perpendicular lines drawn on a standard thoracic spine radiograph: a line extends through the superior endplate of the vertebral body, marking the beginning of the thoracic curve (usually at T4), and the inferior endplate of the vertebral body, marking the end of the thoracic curve (usually at T12). While this method is the gold-standard, it is limited by the need for radiography.<br>Other acceptable ways to diagnose a hyperkyphosis are the Debrunner kyphometer and the flexicurve ruler. <br> | |||
== Diagnostic Procedures == | == Diagnostic Procedures == |
Revision as of 08:10, 26 June 2013
Original Editors
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Search Strategy[edit | edit source]
The information you will find below is based on articles found on PubMed by using the keywords: age-related hyperkyphosis, hyperkyphotic posture, elderly hyperkyphosis, rehabilitation hyperkyphosis.
Definition/Description1,2[edit | edit source]
An age-related hyperkyphosis can be described as an exaggerated dorsal curvature of the thoracic spine. It can lead to mobility impairments (such as decreased mobility), and it increases the risks of falling and of fractures. A thoracic hyperkyphosis is associated with advancing age, low bone density, muscle weakness and degenerative disk diseases. An age-related hyperkyphosis can have an impact on the basic functioning and daily living (especially performance of mobility tasks). That’s why its diagnostic is important, research of the risk factors, the possible consequences and surely its treatment/rehab.
Clinically Relevant Anatomy1,2
[edit | edit source]
As thoracic kyphosis increases, there are also changes in the normal sagittal plane alignment that may cause pain and risk of dysfunction in the shoulder and pelvic girdle and over the entire length of the spine. Forward head posture, scapula protraction, reduced lumbar lordosis, and decreased standing height are often associated with hyperkyphosis. The result of these postural changes is the flexion bias around the hip and shoulder joints that increases and can interfere with normal joint mechanics and movement patterns.
Epidemiology /Etiology1,2,3[edit | edit source]
Hyperkyphosis is a widely recognized condition and it commonly affects the elderly population. Current studies estimate its prevalence among older adults at 20% to 40% 2
A lot of factors can increase de risk of having an age-related hyperkyphosis:1
• Vertebral fractures: the bone mineral density decrease with the age. It’s the most notable cause but it may explain only about 42-48% of the hyperkyphosis variance. It has been shown that 2/3 from those with an accentuated hyperkyphosis had no underlying fracture.3
• Osteoporosis
• Degenerative disc disease
• Muscle weakness: most of studies confirm its related with spinal extensor muscle weakness.
• Decreased mobility: decrease of spinal extension by aging
• Sensory deficits: a loss of postural control because of a deficit in the somatosensory, vestibular, visual system ( occurring by aging)
• Poor habitual posture
• Ligament degeneration²
All these factors occur with aging.
Characteristics/Clinical Presentation1,3,5[edit | edit source]
In most cases the hyperkyphosis is gradual over time and you may not have recognized it.
But in case of a sudden increased kyphosis there could be more severe causes and health problems.
When hyperkyphosis is present, people could have difficulties with
- getting up from a chair, out of bed, or out of the bathtub
- Walking (more slowly)
- Feeling "off-balance," and/or losing your balance, or almost falling
- Feeling more tired than usual (fatigue)
- breathing (in more severe cases)
Differential Diagnosis1[edit | edit source]
Nowadays we have different reliable methods helping us to diagnose an hyperkphosis. The gold-standard orthopedic technique for assessment of thoracic kyphosis is standing lateral spine radiographs. The Cobb’s angle of kyphosis is calculated from perpendicular lines drawn on a standard thoracic spine radiograph: a line extends through the superior endplate of the vertebral body, marking the beginning of the thoracic curve (usually at T4), and the inferior endplate of the vertebral body, marking the end of the thoracic curve (usually at T12). While this method is the gold-standard, it is limited by the need for radiography.
Other acceptable ways to diagnose a hyperkyphosis are the Debrunner kyphometer and the flexicurve ruler.
Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
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Medical Management
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Physical Therapy Management
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Key Research[edit | edit source]
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Resources
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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