Yoga for Women With Hyperkyphosis: Pilot Study

The thoracic region of the spine is normally kyphotic, or anteriorly concave. Hyperkyphosis, colloquially called “dowager’s hump,” refers to excessive kyphotic curvature; however, there is no criterion standard, nor are there any outcome-based definitions of the condition. A kyphosis angle ≥ 40°—the 95th percentile value for young adults—is currently used to define hyperkyphosis.

Hyperkyphosis may be associated with physical and emotional limitationsand may have multiple precipitants. Yoga could be an optimal intervention for hyperkyphosis in that it may improve physical and emotional functioning as well as combat some of the underlying muscular and biomechanical causes. We conducted a single-arm, nonmasked intervention trial to assess the effects on anthropometric and physical function of yoga among women with hyperkyphosis.

Methods

To be included in the study, which was conducted in Los Angeles during September 2000 to September 2001, women had to meet the following criteria: presence of physician-diagnosed hyperkyphosis, age 60 years or older, absence of angina and uncontrolled lung disease, cleared for participation by primary care physician, and able to pass physical safety tests (e.g., able to rise from the floor to a standing position safely and independently). The intervention involved hatha yoga, a type of yoga incorporating a combination of breathing and movement.

As a means of ensuring the safety of the participants, the study took place in a closely monitored environment involving one-on-one supervision and hands-on adjustments and corrections. The women were divided into 2 separate small classes (n = 11 and n = 10), each of which involved 12 weeks of yoga consisting of twice-weekly 1-hour sessions.

The program included 4 series of poses modified from the classical forms of yoga to accommodate the physical constraints of kyphotic women. More challenging poses were introduced every 3 weeks, and muscles and joints particularly affected by hyperkyphosis (shoulders, spinal erectors, abdominals, neck) were targeted.

Results

At baseline, the mean age of the 21 participants was 75.0 years (range: 63.3–86.0 years). Mean height and mean weight were 156.9 cm and 61.5 kg, respectively. Nine women (43%) had no thoracic or lumbar vertebral fracture, 7 (33%) had at least 1 thoracic fracture (median = 2), and 5 (24%) had both thoracic and lumbar fractures (all of the women with lumbar fractures had at least 1 thoracic fracture).

Nineteen women (90%) completed the study; losses were due to unrelated medical problems. Among those who completed the study, session attendance averaged 80% (range: 52%–96%), and the daily diary completion rate was 100%. There were no adverse events.

Measured height increased and distance from tragus to wall diminished; no changes in kyphometer angle were apparent. Improvements were evident in the case of timed chair stands (faster), the penny test (faster), and functional reach (longer).

In terms of diary entries, 63% of the women reported increased postural awareness/improvement (e.g., “I feel I am standing straighter; because I’m more aware of my posture the more I do yoga, the more I remember to stand and sit correctly” and “I still bend over, but I am catching it more often”), 63% reported improved well-being (e.g., “After class I feel relaxed and peaceful” and “I find [the classes] making me feel better in every way”), and 58% perceived improvements in their physical functioning (e.g., “I really think all the classes that I have attended have helped me with my balance” and “I am feeling more energy, I believe, because of the class”).

Read the article with images and tables:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447294/

 American Journal of Public Health article provided by American Public Health Association