Assessment of thoracic kyphosis using the flexicurve for individuals with osteoporosis

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Thoracic kyphosis is one of the manifestations of spinal osteoporosis. Since kyphosis is associated with patient symptoms and is a risk factor for loss of function, it would be beneficial to have simple, noninvasive measurement techniques that can be applied in clinical practice. The purpose of this study was to assess the test-retest reliability of the measurement of thoracic kyphosis using the flexicure ruler in individuals with osteoporosis. Twenty-six females (mean age, 67 yr) diagnosed with osteoporosis had measurements of kyphosis taken in standing by aligning a flexible drafting ruler before and after a 12-week exercise program. The time period was chosen to be consistent with the duration of a physiotherapy intervention. Measures of kyphosis height (cm), length (cm), and an index of kyphosis (height/length) were recorded. Data analysis (intraclass correlation coefficients [ICC]) indicated that the reliability between the trials of the measurement of kyphosis height (0.89) and index of kyphosis (0.93) were high; however, the reliability estimate of kyphosis length was less with an ICC value of (0.54). This study supports the use of the flexicure ruler for the measurement of kyphosis in elderly women with osteoporosis based on reliability outcomes and the fact that it is noninvasive, inexpensive, and easy to use in a clinical setting. The measurement of kyphosis may be used to determine the response to a therapeutic intervention and in monitoring kyphotic progression.




Yanagawa, T. L., Maitland, M. E., Burgess, K., Young, L., & Hanley, D. (2000). Assessment of thoracic kyphosis using the flexicurve for individuals with osteoporosis. Hong Kong Physiotherapy Journal, 18(2), 53–57.

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