The effect of elderly-specific spinal orthoses on muscle function and kyphosis angle in elderly subjects: systematic review and meta-analysis

Abstract

Purpose

Age-related postural hyper-kyphosis is an exaggerated anterior curvature of the thoracic spine, that impairs balance and increases the risk of falls and fractures in elderly subjects. Our objectives are to review the effect of elderly-specific spinal orthoses on muscle function and kyphosis angle in this subjects.

Materials and Methods

We searched PubMed, Scopus, ISI web of Knowledge, ProQuest and Cochrane library to identify relevant studies that assessed efficacy of spinal orthoses on muscle function and kyphosis angle of elderly subjects with elderly with hyper-kyphosis. Quality assessment was implemented using the Downs and Black scale.

Results

Results for 709 individuals were described in 18 articles which 12 studies involved RCT. There was significant difference for kyphosis angle after use of orthosis of 148 participants (SMD: −3.79, 95% CI −7.02 to −0.56, p < 0.01). Except one study, all of studies showed significantly increased on the back muscle strength when the participants wore the spinal orthosis and this effect was significantly better in long-term follow up (MD: 84.73; 95% CIs, 23.24 to 146.23; p < 0.01). In the outcome of pain, the efficacy brought by orthosis was large and significant (SMD: −1.66; 95% CIs, −2.39 to 0.94; p < 0.01).

Conclusions

Spinal orthosis may be an effective treatment for elderly hyper-kyphosis. However, the small number, and heterogeneity of the included studies, indicate that higher-quality studies should be conducted to verify the effectiveness and orthosis in hyper-kyphosis.

IMPLICATIONS FOR REHABILITATION

• Age-related postural hyper kyphosis is an exaggerated anterior curvature of the thoracic spine, that impairs balance and increases the risk of falls and fractures in elderly subjects.

• Based on the findings of this review, elderly specific spinal orthoses may be recommended as effective device for elderly hyper kyphotic subjects.

• Spinal orthoses prescription is important for health practitioners to consider when planning treatment.

Keywords:

• Spinal orthoses
• orthosis
• elderly
• kyphosis angle
• muscle strength
• muscle function
• cobb angle
• pain

Disclosure statement

The authors declare they have no conflicts of interest or competing interests.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.