title: Effects of an adapted physical activity program in a group of elderly subjects with flexed posture: clinical and instrumental assessment.
abstract: BACKGROUND
  Flexed posture commonly increases with age and is related to musculoskeletal impairment and reduced physical performance. The purpose of this clinical study was to systematically compare the effects of a physical activity program that specifically address the flexed posture that marks a certain percentage of elderly individuals with a non specific exercise program for 3 months.
  
  
  METHODS
  Participants were randomly divided into two groups: one followed an Adapted Physical Activity program for flexed posture and the other one completed a non-specific physical activity protocol for the elderly. A multidimensional clinical assessment was performed at baseline and at 3 months including anthropometric data, clinical profile, measures of musculoskeletal impairment and disability. The instrumental assessment of posture was realized using a stereophotogrammetric system and a specific biomechanical model designed to describe the reciprocal position of the body segments on the sagittal plane in a upright posture.
  
  
  RESULTS
  The Adapted Physical Activity program determined a significant improvement in several key parameters of the multidimensional assessment in comparison to the non-specific protocol: decreased occiput-to-wall distance, greater lower limb range of motion, better flexibility of pectoralis, hamstrings and hip flexor muscles, increased spine extensor muscles strength. Stereophotogrammetric analysis confirmed a reduced protrusion of the head and revealed a reduction in compensative postural adaptations to flexed posture characterized by knee flexion and ankle dorsiflexion in the participants of the specific program.
  
  
  CONCLUSIONS
  The Adapted Physical Activity program for flexed posture significantly improved postural alignment and musculoskeletal impairment of the elderly. The stereophotogrammetric evaluation of posture was useful to measure the global postural alignment and especially to analyse the possible compensatory strategies at lower limbs in flexed posture.
authors.affiliation: Movement Analysis Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy. benedetti@ior.it
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Benedetti
authors.forename: Lisa
authors.initials: L
authors.lastname: Berti
authors.forename: Chiara
authors.initials: C
authors.lastname: Presti
authors.forename: Antonio
authors.initials: A
authors.lastname: Frizziero
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000222:Adaptation, Physiological / Q000502:physiology; D000368:Aged; D000375:Aging / Q000473:pathology / Q000502:physiology; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D019416:Head Movements / Q000502:physiology; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D018482:Muscle, Skeletal / Q000503:physiopathology; D009468:Neuromuscular Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000379:methods; D011187:Posture / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D013131:Spine / Q000503:physiopathology; D016896:Treatment Outcome