Slower upper extremity function in older adults with hyperkyphosis negatively impacts the 6-min walk test

Yoshimi Fukuoka; Wendy B Katzman; Amy Gladin; Nancy E Lane; Deborah M Kado; Yoo Jung Oh

doi:10.1186/s12891-022-05455-x

Slower upper extremity function in older adults with hyperkyphosis negatively impacts the 6-min walk test

BMC Musculoskelet Disord. 2022 May 28;23(1):505. doi: 10.1186/s12891-022-05455-x.

Authors

Yoshimi Fukuoka¹, Wendy B Katzman², Amy Gladin³, Nancy E Lane⁴, Deborah M Kado⁵, Yoo Jung Oh⁶

Affiliations

¹ Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, N631, San Francisco, CA, 94143, USA. Yoshimi.fukuoka@ucsf.edu.
² Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, 94158, USA.
³ San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, 94118, USA.
⁴ Center for Musculoskeletal Health, School of Medicine, University of California at Davis, Davis, CA, 95616, USA.
⁵ Department of Medicine, Stanford University School of Medicine, Stanford, CA and Geriatric Research Education and Clinical Center (GRECC), Veterans Health Administration, Palo Alto, CA, 94304, USA.
⁶ Department of Communication, University of California Davis, Davis, CA, 95616, USA.

Abstract

Background: Approximately 30% to 40% of older adults have hyperkyphosis, defined as excessive curvature of the thoracic spine. Hyperkyphosis is associated with increased morbidity and mortality. This study aimed to determine whether hyperkyphosis (Cobb's angle) and upper extremity tasks were independently associated with the 6-min walk test (6MWT) in community-dwelling older adults with hyperkyphosis.

Methods: In this cross-sectional study, we studied 71 women and 28 men aged 60-87 from the study of hyperkyphosis, exercise, and function trial (SHEAF) who had kyphosis, 3 timed upper extremity tasks and the 6MWT assessed at their baseline visit. We used standing lateral spine radiographs and a standardized protocol for thoracic kyphosis (T4-T12) to measure Cobb angle of kyphosis. In addition, 3 activity of daily living (ADL) extremity tests (putting on and removing a laboratory coat, picking up a penny from the floor, and lifting a 7-lb. book to a shelf) were used.

Results: The mean ± SD age was 70.1 ± 6.1 years. The mean ± SD Cobb angle of kyphosis was 57.4 ± 12.5 degrees. On average ± SD, the participants walked 504.8 ± 84.2 m in 6 min and took 2.4 ± 2.2 prescription medications. The mean ± SD height was 164.7 ± 8.5 cm, weight was 68.7 ± 13.1 kg, and BMI was 25.2 ± 4.0 kg/m². Multivariate regression revealed that age, height, upper extremity book lift task, and the number of prescribed medications were significant predictors of performance on the 6MWT (p < 0.05).

Conclusions: While kyphosis was not associated with the 6MWT, timed tests of upper extremity function indicated that upper body dynamics can affect walking performance. In addition, sociodemographic factors and the number of prescribed medications were significant contributing factors to the 6MWT in older adults with mild to moderate hyperkyphosis. These results illustrate multifactorial influences on physical performance and the need for an integrated and targeted approach in helping older hyperkyphotic adults maintain healthy physical functioning as they age.

Keywords: 6-min walk test; Cobb angle; Hyperkyphosis; Kyphosis; Older adults; Physical function; Upper extremity task.

MeSH terms

Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Kyphosis*
Male
Middle Aged
Spine
Upper Extremity
Walk Test

Abstract

MeSH terms

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