Effects of a 10-week exercise intervention on thoracic kyphosis, pulmonary function, endurance, back extensor strength, and quality of life in women with osteoporosis
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An estimated 10 million women in the United States have osteoporosis. Pronounced kyphosis of the thoracic spine is one of the most common clinical manifestations of spinal osteoporosis, with one quarter of all women over the age of 60 developing vertebral deformities as a consequence of spinal osteoporosis. Kyphotic posture can result in mid-back pain, impaired pulmonary function, decreased back extensor strength, diminished aerobic capacity, functional disability, and decreased quality of life in women with osteoporosis. The purpose of this study was to examine the effects of a 10-week home exercise program on thoracic kyphosis, pulmonary function, 6-minute walk distance, back extensor muscle strength, and "quality of life" in women with osteoporosis. Forty-four women with densitometric diagnosis of osteoporosis in the spine and an index of kyphosis ≥ 13 completed the study. Index of kyphosis, forced vital capacity, peak expiratory flow, maximum inspiratory pressure, 6-minute walk test, back extensor strength, and quality of life measurements were performed. Twenty-three participants (experimental group) performed an exercise program comprising of 8 strengthening exercises performed three sessions per week, over a 10-week period. Twenty-one participants served as the control group. A MANOVA comparing index of kyphosis, peak expiratory flow, forced vital capacity, maximum inspiratory pressure, 6-minute walk test and back extensor strength for pre and post test measurements by exercise and control group, revealed a significant group by time interaction. Univariate tests (ANOVAs) exposed a significant group by time interaction for index of kyphosis and back extensor strength. Subsequent post-hoc tests revealed a significant improvement in index of kyphosis and back extensor strength in the exercise group, but no improvement in the control group. The results of the Wilcoxon Signed Ranks test for Osteoporosis Targeted Quality of Life survey scores, pre- and post-intervention, revealed that neither group was significantly different before and after the 10-week intervention. This study showed that a home-based exercise program was feasible, safe, and effective for significantly reducing thoracic kyphosis and significantly strengthening the supportive back extensor muscles in postmenopausal women with osteoporosis.