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Relationship Between Physical Fitness Abilities, Trunk Range of Motion and Kyphosis in Junior High School Students
Abstract
The purpose of the present research was to study the relationship between physical fitness abilities and the level of thoracic kyphosis in junior high school students. The subjects of the present research were 50 junior high school students with a mean and standard deviation of 13.32±0.95 years of age, 50.41±14.25 kg of weight and 155.51±9.38 cm of height, respectively. A Spinal Mouse was used to measure the spinal shape. The strength of erector spine muscles and scapular abductors was measured by a dynamometer. Flexibility of scapular flexors and spinal flexors was measured using the related tests. Descriptive statistics, Pearson correlation coefficient and stepwise multiple regression were applied in order to examine the relationship between the dependent variables and the independent variable at the 0.05 significance level. The results of Pearson correlation test indicated a significant relationship between thoracic kyphosis and all the predictor variables at P#0.05. The results of multiple regression introduced three predictor models and in the third and most important model, strength of erector spine muscles ( = -0.26), flexibility of scapular flexors ($ = -0.25) were found to be the most important predictors of variance in thoracic kyphosis (F = 17.39, P<0.009, R = 0.45). In conclusion, the results of the present research suggested that 3,36 2 decrease in the strength of erector spine muscles and scapular abductors and also decrease in the flexibility of trunk flexors and scapular flexors may increase the level of thoracic kyphosis. INTRODUCTION Kyphosis is one of the one of the malformations of
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EAGAN, M. S., and D. A. SEDLOCK. Kyphosis in active and sedentary postmenopausal women. Med. Sci. Sports Exerc., Vol. 33, No. 5, 2001, pp. 688-695.
Purpose:
This study examined kyphosis in relation to self-reported activity level (sedentary, active) and activity type (weight-bearing land, nonweight-bearing water) in 61 postmenopausal women aged 60-78 yr.
Methods:
Specifically, we measured kyphosis, muscle strength (defined as back extensor (BES) and grip (GS) strength), total calcium intake, body fat, height lost since age 30 (HtLost), current activity level for household, leisure and sport activities and their total, as well as occupational and physical activity history and their total.
Results:
No significant differences (P > 0.05) were found for any variables when subjects were divided into sedentary (N = 18), land (N = 29), and water (N = 14) groups; exercisers (N = 43) and nonexercisers (N = 18); or between the top and bottom tertiles of lifetime active (N = 20) and inactive (N = 20) women. Stepwise multiple regression yielded body fat as the single best predictor of kyphosis accounting for 6.9% of the total variance (P < 0.04) with the resulting equation: kyphosis (degrees) = 22.919 + 0.627*body fat (%) + 0.852*HtLost (cm) + 2.881E-0.03*total calcium intake (mg) (r2 = 0.22, SEE = 7.7). Significant relationships (P < 0.05) included kyphosis with body fat (r = 0.26) and HtLost with age (r = 0.50). Relationships (P < 0.05) regarding muscle strength included: GS and BES with age (r = -0.38, -0.30), HtLost (r = -0.39, -0.36), and occupational activity history (r = 0.28, 0.35), as well as BES with household activity and total activity history (r = 0.28, 0.30). Physical activity history was related (P < 0.05) to current sport, leisure, and total activity history (r = 0.37, 0.42, 0.93, respectively).
Conclusion:
Women who are active when younger seem to be active and stronger as older adults. However, this does not seem to impact kyphosis. The measured variables accounted for a small proportion of kyphosis variance, suggesting that more potent causative factors of this spinal malformation exist.
Cross-sectional.
To determine if thoracic kyphosis was different in older women grouped based on their bone mineral density (BMD) and back extensor strength (BES), and to determine if an association between and these variables exist.
Changes in kyphosis might be related to back extensor weakness in patients with osteoporosis. Disproportionate weakness in back extensor musculature considerably increases the possibility of deformities in the fragile osteoporotic spine.
A total of 189 female subjects 50 to 80 years of age were grouped by their BMD and additionally by their BES. All were evaluated for thoracic kyphosis, maximal isometric strength of the back extensors, and BMD of the lumbar spine and the hip.
There was no significant difference in thoracic kyphosis among all groups. Multivariate analyses of BES and BMD showed that only BES might influence thoracic kyphosis (P = 0.02). There was no correlation between BES and BMD. Statistically significant deficit in BES was observed only between the osteoporotic and osteopenic group (P < 0.05). The importance of BES in maintaining posture was observed when the study population was divided according to their BES level. With respect to thoracic kyphosis and BMD values, there were no statistical differences between strong women (BES more than 60 N) and those with medium BES (BES between 60 and 35 N). But the weakest group (BES less then 35 N) had significantly higher (P < 0.05) mean values of thoracic kyphosis in comparison to strong women (BES more than 60 N) and those with medium BES (BES between 60 and 35 N).
The severity of thoracic kyphosis may be influenced especially by changes in BES. Therefore, provision of strong, natural extrinsic support for the spine seems to be important to decrease the incidence of spinal deformity.
Background: The aetiology of osteoporotic vertebral fracture is multifactorial and may be conceptualised using a systems framework. Previous studies have established several correlates of vertebral fracture including reduced vertebral cross-sectional area, weakness in back extensor muscles, reduced bone mineral density, increasing age, worsening kyphosis and recent vertebral fracture. Alterations in these physical characteristics may influence biomechanical loads and neuromuscular control of the trunk and contribute to changes in subregional bone mineral density of the vertebral bodies.
Methods: This review discusses factors that have received less attention in the literature, which may contribute to the development of vertebral fracture. A literature review was conducted using electronic databases including Medline, Cinahl and ISI Web of Science to examine the potential contribution of trabecular architecture, subregional bone mineral density, vertebral geometry, muscle force, muscle strength, neuromuscular control and intervertebral disc integrity to the aetiology of osteoporotic vertebral fracture.
Interpretation: A better understanding of factors such as biomechanical loading and neuromuscular control of the trunk may help to explain the high incidence of subsequent vertebral fracture after sustaining an initial vertebral fracture. Consideration of these issues may be important in the development of prevention and management strategies.
The main goal of this study is to determining relationship between kyphosis and depression anxiety in athlete and non athlete male students in selected universities of Tehran. 190 athlete and non athlete students of selected universities of Tehran participated at the study. Subjects were randomly selected from three universities (Tehran, Allameh Tabatabaee, faculty of physical education of Islamic Azad University). 190 students selected, then degree of kyphosis of subjects determined by spinal mouse system. A questionnaire disterbuted among subjects. Followed by analyzing data, 106 students selected as kyphotic patricians. To determining relationship between the degree of kyphosis among athletes and no athletes, Person coefficient correlation was used. We also used Fischer Test, for comparison of two groups. Results showed no significant relationship between evidence of kyphosis, depression and anxiety in athlete and non athlete subjects.
The loss of serial sarcomeres which results when muscles are immobilised in a shortened position is accompanied by an increase in the proportion of collagen and an increased muscle stiffness. In order to determine whether it is lack of stretch or lack of contractile activity which is the main factor involved in these changes experiments were carried out using different combinations of immobilisation and electrical stimulation. It was found that the connective tissue accumulation that occurs in inactive muscles can be prevented either by passive stretch or by active stimulation. It was also shown that in muscle that is working over a reduced range there is, as in muscle immobilised in the shortened position, a reduction in serial sarcomeres. In this case, however, there is no concomitant increase in connective tissue, again indicating that contractile activity is important for the maintenance of normal muscle compliance.
Thoracic kyphosis was measured on chest radiographs of 316 "normal" subjects by means of a modification of the Cobb technique for measuring scoliosis. Patients were accepted as "normal" if they had no thoracic or spinal complaints or radiographic abnormalities in the chest including the thoracic spine. A total of 159 males and 157 female subjects 2-77 years old was studied. The relation among age, gender, and kyphosis were determined using least squares fits of first-order linear mathematical models. These results were also used to determine the expected ranges of kyphosis for a "normal" patient of a given age and gender. The degree of kyphosis increased with age and the rate of increase was higher in females than in males. Clinical explanations for this differential increase are discussed.
Aging and osteoporosis have been associated with skeletal changes. Back extensor strengthening exercises are highly recommended for management of back pain, especially back pain related to osteoporosis. To our knowledge, the correlation of thoracic kyphosis, lumbar lordosis, and sacral inclination with back extensor strength, physical activity, and bone mineral density has not been critically studied in healthy, active, estrogen-deficient women. In a study of 65 such women (ages 48-65 yr), back extensor strength, bone mineral density, and physical activity score were evaluated and measured. These factors were then correlated with radiographic factors: (1) vertebral body ratios (anterior/posterior height) calculated for each vertebra from T-4 through L-5; (2) kyphosis index determined by adding the anterior heights of each vertebral body, T-4 through T-12, and then dividing the total by the corresponding sum of the posterior heights of each vertebral body; (3) thoracic kyphosis; (4) lumbar lordosis; and (5) sacral inclination. Back extensor strength had a significant negative correlation with thoracic kyphosis (r = -0.30, P = 0.019) and a positive correlation with lumbar lordosis (r = 0.26, P = 0.048) and sacral inclination (r = 0.34, P = 0.009). However, bone mineral density and physical activity score did not show any significant correlations with the radiographic factors. The results indicate that the stronger the back extensor, the smaller the thoracic kyphosis and the larger the lumbar lordosis and sacral inclination. We conclude that back extensor strength is an important determinant of posture in healthy women. However, prescribing back extensor strengthening exercises alone may also increase lumbar lordosis, which is not desirable.
Nerve compression or musculoskeletal diagnoses require consideration of both the repetitive movements and static postures that may be contributing to the problem. Certain postures and positions assumed at home, at work, and during sleep will have three major influences: (1) directly increasing pressure on nerves at entrapment sites; (2) placing muscles in shortened positions so that adaptive muscle shortening may then secondarily compress nerves; and (3) placing some muscles in elongated and weakened positions, resulting in other muscles being over-used, thus creating the cycle of muscle imbalance. Successful management of the patient with upper extremity pain, paresthesia, and numbness should begin with initial identification of all sites that are contributing to the presenting symptoms. Treatment must then be directed toward the sources of nerve compression and musculoskeletal dysfunction. Upper quadrant symptomatology can be alleviated with an appropriate therapy program, even in the patient with chronic symptoms, but only with patient education, compliance with an exercise program, and behavioral modification at home, work, and during sleep.
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.1,2
Hyperkyphosis may be associated with physical and emotional limitations3–11 and may have multiple precipitants.4,12–14 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.
Cervicothoracic kyphotic deformity may inhibit horizontal gaze function, impede activities of daily living, and induce disabling pain. Eventually, some patients develop a chin-on-chest deformity that limits their ability to eat and drink; in the end stage, a few patients also may have difficulty breathing. Progressive kyphosis can stretch the spinal cord leading to myelopathy with progressive lower extremity spasticity and weakness. Indications for surgery include myelopathy, pain, dysphagia or dyspnea owing to kyphosis, and difficulty maintaining a functional horizontal gaze. Patients with unstable cervicothoracic fractures also require surgical fixation. For these patients, surgical goals include deformity correction with restoration of an acceptable forward gaze, re-establishment of sagittal balance, decompression of the spinal cord (if myelopathic), and stable fixation.
We conducted a systematic review to examine the relationship between osteoporotic vertebral fractures, kyphosis, and pulmonary function. Findings suggest modest but predictable declines in vital capacity related to the degree of kyphosis. However, there were only four studies, and all had significant methodologic limitations. Further high-quality research is needed.
Our objective was to systematically review the extent to which osteoporosis-related vertebral fractures and kyphosis affect pulmonary function.
We used a literature search from 1966 to 2006 (using Medline, EMBASE, and hand searches of references) for studies examining pulmonary function in patients without known lung disease who had vertebral fractures or kyphosis secondary to osteoporosis. Two reviewers independently abstracted data. Heterogeneity precluded formal meta-analysis.
Initial searches yielded 453 articles. After applying eligibility criteria, only four case-control studies of limited quality (e.g., only one study was blinded) remained. Since 1966, only 109 patients (6 men) have been studied. All four studies reported reductions in vital capacity (VC), with values ranging from 68% to 94% of predicted values. This was quantified as a 9% reduction in predicted VC per vertebral fracture in one study. The degree of kyphosis clinically (one study) or radiographically (three studies) correlated with declines in VC; impairments were most notable at kyphotic angles>55 degrees. Statistically significant differences in percent predicted VC were obtained only when arm span or recalled height, rather than measured height, was used (two studies).
Despite conventional teaching, the evidence relating osteoporotic vertebral fractures or kyphosis to pulmonary function is limited. On the basis of available studies, declines in VC secondary to kyphosis seem modest and directly related to the number of vertebral fractures or degree of kyphosis. Future studies need longitudinal follow-up of larger numbers of men and women, appropriate proxies for height, standardized measures for pulmonary function and kyphosis, and efforts to blind outcomes ascertainment.
Greater thoracic kyphosis is associated with increased biomechanical loading of the spine which is potentially problematic in individuals with osteoporotic vertebral fractures. Conservative interventions that reduce thoracic kyphosis warrant further investigation. This study aimed to investigate the effects of therapeutic postural taping on thoracic posture. Secondary aims explored the effects of taping on trunk muscle activity and balance.
Fifteen women with osteoporotic vertebral fractures participated in this within-participant design study. Three taping conditions were randomly applied: therapeutic taping, control taping and no taping. Angle of thoracic kyphosis was measured after each condition. Force plate-derived balance parameters and trunk muscle electromyographic activity (EMG) were recorded during three static standing tasks of 40s duration.
There was a significant main effect of postural taping on thoracic kyphosis (p=0.026), with a greater reduction in thoracic kyphosis after taping compared with both control tape and no tape. There were no effects of taping on EMG or balance parameters.
The results of this study demonstrate that the application of postural therapeutic tape in a population with osteoporotic vertebral fractures induced an immediate reduction in thoracic kyphosis. Further research is needed to investigate the underlying mechanisms associated with this decrease in kyphosis.
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