Su P.-Y.1, Yang R.-S.2,3, Hsu W.-L.1,4
1National Taiwan University, Department of Physical Therapy, Taipei, Taiwan, 2National Taiwan University, College of Medicine, Deparment of Orthopedics, Taipei, Taiwan, 3National Taiwan University Hospital, Deparment of Orthopedics, Taipei, Taiwan, 4National Taiwan University Hospital, Physical Therapy Center, Taipei, Taiwan
Background: Older adults with osteoporosis/osteopenia are often suffered from thoracic kyphosis, which may lead to change of movement pattern, poor balance performance, less activities, increased fear of falling, risk of falls, and increase the risk of osteoporotic vertebral compression fractures. Back extensor and core muscle training exercise is often used to correct the kyphotic posture. However, studies have shown that people with slumped posture may develop compensatory movement strategy, such as lumbar hyperlordosis which can cause low back pain, increase disc loading and compression or shearing force on the vertebral body. Therefore, the use of real-time biofeedback of muscle activity might help people recruit the correct muscle during exercise training.
Purpose: This study is to determine the effect of back extensor and core muscle biofeedback exercises on forward reaching performance and spinal curvature in women with osteoporosis and osteopenia.
Methods: Seven women with osteoporosis or osteopenia (age: 63.14±5.92 years; height: 158.24±4.84 cm; weight: 53.90±5.04 kg) participated in this study. Forward reaching performance was evaluated in standing using a motion analysis system with 10 cameras (Vicon Bonita, UK). Spherical reflective markers were placed to participants metacarpal head of right middle finger to measure the reaching distance and velocity, which were calculated in MatLab (The MathWorks Inc., Natick, MA). Spinal curvature was measured by Spinal-Mouse® (Idiag, Volkerswill, Switzerland) under neutral upright, flexion and extension posture in standing. Participants received a 6-week biofeedback training focused on the back extensor and core muscle exercises for 2 sessions per week, 30 minutes per session.
Results: After the 6-week biofeedback training, the thoracic spine curvature in extension posture became more kyphotic (p=0.052). The mobility of the thoracic spine in upright which was indicated by the neutral to extension and neutral to flexion movement also improved (p=0.027 and 0.062, respectively). Moreover, both of the functional forward reach distance (p=0.019) and peak velocity (p=0.041) were significantly increased.
Conclusion(s): Back extensor and core muscle biofeedback exercises might improve thoracic spinal mobility for extension to upright and flexion to extension movement in women with osteoporosis and osteopenia. The curvature of thoracic spine under extension posture and functional forward reach performance are also improved.
Implications: The results suggest that the 6-week back extensor and core muscle biofeedback exercises might improve the spinal curvature and functional balance performance in women with osteoporosis and osteopenia. This may decrease the risk of osteoporotic vertebral compression fractures and falls.
Funding acknowledgements: This study was supported by the National Health Research Institutes (NHRI-EX105-10218EC).
Topic: Older people
Ethics approval: This study was approved by the National Taiwan University Hospital Research Ethics Committee (201204059RIC).
All authors, affiliations and abstracts have been published as submitted.
