Methods of Postural Assessment used in Hyperkyphotic Elders: A Narrative Review

Abstract

Background and objective: Aging is a natural process and associated changes in posture, mainly at the spine lead to complications in functional independence and quality of life. The aim of this review is to identify existing measuring tools used to measure hyperkyphotic posture in the elderly population. Methods: Electronic databases were searched from January 2001 to December 2021, with different combinations of keywords, “thoracic kyphosis” or “hyperkyphosis” or “kyphotic posture” or hyperkyphotic posture” or “flexed posture” or “spinal curve” and “assessment”, “measurement” or “instrument” or “equipment” and “elderly” or “older adults” or “elders”. Studies were selected based on inclusion and exclusion criteria. Results: Four thousand one hundred sixty-six studies were obtained from electronic databases. After the removal of 3227 duplicate studies, twenty-six relevant studies were selected from 939 unique studies. Radiographic measurement, Flexicurve ruler, Debrunner kyphometer, Gravity-dependent inclinometer, occiput to wall distance (OTW), tragus to wall distance (TWD), and spinal mouse were used for hyperkyphotic measurement. The radiographic method and Flexicurve showed very high reliability. The block method and flexicurve are widely used methods for assessing hyperkyphotic posture in older adults. Conclusion: Postural assessment methods showed variability in defining criteria for hyperkyphosis in the elderly population. Flexicurve and block methods can be used as non-invasive methods for the early detection of hyperkyphosis. In the future, more measurement tools should be developed for the measurement of kyphosis, that are cost-effective, with excellent reliability and validity.