Content area
Full Text
The thoracic region of the spine is normally kyphotic, or anteriorly concave. Hyperkyphosis, colloquially called "dowager's hump," refers to excessive kyphotic curvature; however, there is no criterion standard, nor are there any outcome-based definitions of the condition. A kyphosis angle >= 40 deg-the 95th percentile value for young adults-is currently used to define hyperkyphosis.1,2
Hyperkyphosis may be associated with physical and emotional limitations 3-11 and may have multiple precipitants.4,12-14 Yoga could be an optimal intervention for hyperkyphosis in that it may improve physical and emotional functioning as well as combat some of the underlying muscular and biomechanical causes. We conducted a single-arm, nonmasked intervention trial to assess the effects on anthropometric and physical function of yoga among women with hyperkyphosis.
METHODS
To be included in the study, which was conducted in Los Angeles during September 2000 to September 2001, women had to meet the following criteria: presence of physician-diagnosed hyperkyphosis, age 60 years or older, absence of angina and uncontrolled lung disease, cleared for participation by primary care physician, and able to pass physical safety tests (e.g., able to rise from the floor to a standing position safely and independently). The intervention involved hatha yoga, a type of yoga incorporating a combination of breathing and movement.
As a means of ensuring the safety of the participants, the study took place in a closely monitored environment involving one-on-one supervision and hands-on adjustments and corrections. The women were divided into 2 separate small classes (n= 11 and n= 10), each of which involved 12 weeks of yoga consisting of twice-weekly 1 -hour sessions.
The program included 4 series of poses modified from the classical forms of yoga to accommodate the physical constraints of kyphotic women. More challenging poses were introduced every 3 weeks, and muscles and joints particularly affected by hyperkyphosis (shoulders, spinal erectors, abdominals, neck) were targeted. Figure 1 briefly summarizes the 4 series and illustrates an example of 1 pose from each.
Anthropometric outcomes, assessed at baseline and follow-up by 1 of the investigators (A.M.) by means of standard protocols, were (1) height without shoes (measured with a stadiometer), (2) distance from tragus to wall (a measure of forward curvature), and (3) Debrunner kyphometer angle (an estimate of degree of thoracic spinal curvature; higher values...
