Systematic Review of Postural Assessment in Individuals With Obstructive Respiratory Conditions: MEASUREMENT AND CLINICAL ASSOCIATIONS.
OBJECTIVE
Changes in posture in individuals with an obstructive respiratory disease have been reported, but the extent of these deviations and their clinical significance is not well understood. This study aimed to systematically review the literature of the skeletal structural alignment in children and adults with an obstructive respiratory disease, describe the measurement techniques used, and determine the clinical relevance of any alternations.


METHODS
Observational cohort or cross-sectional studies of postural assessment were identified, with 2 reviewers independently assessing study quality.


RESULTS
A total of 18 studies were included, 12 in cystic fibrosis (CF), 5 in asthma, and 1 in chronic obstructive pulmonary disease (COPD). The overall quality assessment rating was 12.6 out of 16. Increased thoracic kyphosis or scoliosis was found in both children and adults with CF. Increased shoulder protraction and elevation were evident in asthma and COPD, although changes in spinal curvature were variable. The clinical impact of postural changes was diverse, with an inconsistent influence on lung function. A mix of methods was applied for postural assessment.


CONCLUSIONS
Skeletal structural malalignment appears to be present in some individuals with an obstructive respiratory disease, although the extent of alterations and its clinical impact is variable. Photogrammetry is used to provide a comprehensive assessment of posture in these populations.
Department of Respiratory Medicine, West Park Healthcare Centre (Drs Lee, Brooks, and Goldstein), Department of Physical Therapy, University of Toronto (Drs Lee, Brooks, and Goldstein), and Department of Medicine, University of Toronto (Dr Goldstein), Toronto, Ontario, Canada.
Annemarie L
AL
Lee
Karl
K
Zabjek
Roger S
RS
Goldstein
Dina
D
Brooks
D001249:Asthma / Q000150:complications / Q000503:physiopathology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000503:physiopathology; D064887:Observational Studies as Topic; D011187:Posture / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012600:Scoliosis / Q000150:complications / Q000503:physiopathology