The impact of kyphosis on daily functioning.
OBJECTIVE
To determine whether moderate or severe kyphosis is associated with decrements in physical function, especially mobility.


METHODS
Cross-sectional analysis of a cohort study.


METHODS
The Johns Hopkins Functional Status Laboratory, a multidisciplinary, standardized, quantitative assessment center.


METHODS
A total of 231 community-dwelling volunteers aged 59 and older who participated in a 1-day evaluation.


METHODS
Age, gender, self report of physical function, standardized measurement of: kyphosis (both qualitatively clinical criteria and quantitative assessment), time to walk 5 meters (0.1 seconds), and time to climb a flight of stairs (0.1 seconds) at usual pace.


RESULTS
Using multivariate step-wise regression analysis, the presence and severity of kyphosis, measured qualitatively, was independently associated with time to walk 5 meters and to climb a flight of stairs (P = .015, P < .001, respectively), adjusting for moderate-severe scoliosis, heart rate response to exercise, arthritis, vertigo, age, and gender. Similarly, quantitative kyphosis was associated independently with stair climb time (P = .005). Qualitative kyphosis was also associated with difficulty reaching (OR = 2.21 (95% CI: 1.14 to 4.29)) and difficulty performing heavy housework (OR = 1.64 (95% CI: 1.03 to 2.61)), adjusting for prior diagnosis of moderate-severe scoliosis, prior diagnosis of arthritis, age, and gender.


CONCLUSIONS
Kyphosis, by both clinical and quantitative assessment, is associated with diminished function, especially performance of mobility tasks. This association should be verified prospectively. If predictive, the impact of kyphosis on physical function should be considered in osteoporosis prevention and treatment counseling.
Ryan
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SD
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Fried
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LP
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007738:Kyphosis / Q000145:classification* / Q000150:complications; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D012720:Severity of Illness Index