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Yoga Decreases Kyphosis in Senior Women and Men with Adult-Onset Hyperkyphosis: Results of a Randomized Controlled Trial
Gail A. Greendale, MD * , Mei-Hua Huang, DrPH * , Arun S. Karlamangla, PhD, MD * , Leanne Seeger, MD † , and Sybil Crawford, PhD ‡
From the Divisions of *Geriatrics and †Musculoskeletal Radiology, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, and ‡Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Address correspondence to Gail A. Greendale, Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095. E-mail: ggreenda@mednet.ucla.edu
Copyright Journal compilation 2009 The American Geriatrics Society/Blackwell Publishing
ABSTRACT
OBJECTIVES: To assess whether a specifically designed yoga intervention can reduce hyperkyphosis.
DESIGN: A 6-month, two-group, randomized, controlled, single-masked trial.
SETTING: Community research unit.
PARTICIPANTS: One hundred eighteen women and men aged 60 and older with a kyphosis angle of 40° or greater. Major exclusions were serious medical comorbidity, use of assistive device, inability to hear or see adequately for participation, and inability to pass a physical safety screen.
INTERVENTION: The active treatment group attended hour-long yoga classes 3 days per week for 24 weeks. The control group attended a monthly luncheon and seminar and received mailings.
MEASUREMENTS: Primary outcomes were change (baseline to 6 months) in Debrunner kyphometer-assessed kyphosis angle, standing height, timed chair stands, functional reach, and walking speed. Secondary outcomes were change in kyphosis index, flexicurve kyphosis angle, Rancho Bernardo Blocks posture assessment, and health-related quality of life (HRQOL).
RESULTS: Compared with control participants, participants randomized to yoga experienced a 4.4% improvement in flexicurve kyphosis angle (P=.006) and a 5% improvement in kyphosis index (P=.004). The intervention did not result in statistically significant improvement in Debrunner kyphometer angle, measured physical performance, or self-assessed HRQOL (each P>.1).
CONCLUSION: The decrease in flexicurve kyphosis angle in the yoga treatment group shows that hyperkyphosis is remediable, a critical first step in the pathway to treating or preventing this condition. Larger, more-definitive studies of yoga or other interventions for hyperkyphosis should be considered. Targeting individuals with more-malleable spines and using longitudinally precise measures of kyphosis could strengthen the treatment effect.
Gail A. Greendale, MD * , Mei-Hua Huang, DrPH * , Arun S. Karlamangla, PhD, MD * , Leanne Seeger, MD † , and Sybil Crawford, PhD ‡
From the Divisions of *Geriatrics and †Musculoskeletal Radiology, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, and ‡Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Address correspondence to Gail A. Greendale, Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095. E-mail: ggreenda@mednet.ucla.edu
Copyright Journal compilation 2009 The American Geriatrics Society/Blackwell Publishing
ABSTRACT
OBJECTIVES: To assess whether a specifically designed yoga intervention can reduce hyperkyphosis.
DESIGN: A 6-month, two-group, randomized, controlled, single-masked trial.
SETTING: Community research unit.
PARTICIPANTS: One hundred eighteen women and men aged 60 and older with a kyphosis angle of 40° or greater. Major exclusions were serious medical comorbidity, use of assistive device, inability to hear or see adequately for participation, and inability to pass a physical safety screen.
INTERVENTION: The active treatment group attended hour-long yoga classes 3 days per week for 24 weeks. The control group attended a monthly luncheon and seminar and received mailings.
MEASUREMENTS: Primary outcomes were change (baseline to 6 months) in Debrunner kyphometer-assessed kyphosis angle, standing height, timed chair stands, functional reach, and walking speed. Secondary outcomes were change in kyphosis index, flexicurve kyphosis angle, Rancho Bernardo Blocks posture assessment, and health-related quality of life (HRQOL).
RESULTS: Compared with control participants, participants randomized to yoga experienced a 4.4% improvement in flexicurve kyphosis angle (P=.006) and a 5% improvement in kyphosis index (P=.004). The intervention did not result in statistically significant improvement in Debrunner kyphometer angle, measured physical performance, or self-assessed HRQOL (each P>.1).
CONCLUSION: The decrease in flexicurve kyphosis angle in the yoga treatment group shows that hyperkyphosis is remediable, a critical first step in the pathway to treating or preventing this condition. Larger, more-definitive studies of yoga or other interventions for hyperkyphosis should be considered. Targeting individuals with more-malleable spines and using longitudinally precise measures of kyphosis could strengthen the treatment effect.
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