Feasibility of a Physical Therapy Intervention on Older Adults With Hyperkyphosis or Forward Head Posture

NCT04114331 | Completed

• 1 other identifier: 15-0098
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

The original intent was to use a manual therapy and therapeutic exercise intervention with older patients with pneumonia post-hospitalization. It was hypothesized that the physical therapy intervention would have a positive impact on posture, physical function, pulmonary function, gait, quality of life, and ultimately readmission. This patient population was found to be not feasible to recruit and the study target population was expanded to include older community dwelling adults with pneumonia, chronic obstructive pulmonary disease (COPD), or hyperkyphosis.

Conditions

Pneumonia; COPD; Hyperkyphosis; Postural, Thoracic Kyphosis

Keywords

forward head posture

Outcome Measures

Primary Outcomes (4)

• Posture, as measured by change in height

  Height in cm

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Posture, as measured by change in kyphotic index

  kyphotic index = (thoracic width/thoracic height) \*100 as measured from flexicurve tracing. A flexible ruler is molded to the posterior spine from C7 to the lumbosacral interspace. Ruler is placed on paper and traced. Measures of the thoracic width and height are taken in centimeters.

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Posture, as measured by change in block test

  height of blocks (measured in cm) under the head with participant supine

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Posture, visual change in digital photos

  Digital photo in standing anterior and side views as well as supine view

  through study completion (4 weeks) and one time follow-up at an average of 6 months

Secondary Outcomes (9)

• Function as a change in Timed Up and Go speed

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Function as a change in Functional Reach test

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Function as a change in the Short Physical Performance Battery (SPPB) score

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Function and Gait as a change in the 2 Minute Walk Test (2MWT)

  through study completion (4 weeks) and one time follow-up at an average of 6 months

• Function and patient perception as change in the Patient Specific Functional Scale (PSFS)

  through study completion (4 weeks) and one time follow-up at an average of 6 months

Other Outcomes (1)

• Weight

  through study completion (4 weeks) and one time follow-up at an average of 6 months

Study Arms (1)

Manual therapy and exercise

EXPERIMENTAL

The intervention (3 times a week for 4 weeks, for a total of 12 sessions) consisted primarily of manual therapy (soft tissue and joint mobilization) followed by therapeutic exercises (muscular control and coordination). Manual therapy: Joint mobilizations (Grades I-V) to cervical spine, thoracic spine and ribs Soft tissue mobilization to the pectoralis, scaleni, upper traps, thoracolumbar fascia, erector spinae, and suboccipital musculature Therapeutic exercises: Strengthening of mid and lower traps, lats, glut med, and glut max. Active \& passive stretching of thoracic and lumbar rotation, hip flexors, and plantarflexors. The treating therapists agreed on a protocol with treatment individualized to each patient.

Other: Manual therapy and exercise

Interventions

Manual therapy and exercise OTHER

Manual therapy consisting of soft tissue and joint mobilization to gain mobility. Therapeutic exercise was active motion and resisted motion to gain motor control and motor coordination in the new range.

Manual therapy and exercise

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• at least 50 years of age
• hyperkyphosis, forward head posture, pneumonia, or chronic obstructive pulmonary disease (COPD)
• community dwelling
• self report of ability to walk 10 feet or greater with or without an assistive device
• ability to perform informed consent
• ability to transport to research facility
• ability to read and write in English or Spanish

You may not qualify if:

• Inability to perform informed consent
• Inability to follow directions
• Inability to perform transfers, sit, and stand independently
• Inability to ambulate 10 feet or more with or without an assistive device
• Inability to perform pulmonary function testing
• Inability to fully participate in testing and measures
• Inability to fully participate in the intervention
• Severe claustrophobia
• Unable to tolerate physical touch
• Morbid obesity (BMI greater than 40)
• History of prior lung disease such as cancer or transplant
• History of comorbidity that would affect lung function such as neuromuscular disease (ALS, MS), collagen disease (SLE), cardiovascular disease (CHF), or musculoskeletal disease with an autoimmune component (Ankylosing Spondylosis, RA).
• A prior discharge within 30 days of hospitalization for pneumonia or COPD
• Discharge against medical advice

Sponsors & Collaborators

• The University of Texas Medical Branch, Galveston: lead

Study Sites (1)

School of Health Professions at the University of Texas Medical Branch

Galveston, Texas, 77555-1144, United States

Location

Related Publications (2)

• Hughes LC, Ellis AL, Rogers HL, Hadley M, Galloway RV. A secondary analysis of gait after a 4-week postural intervention for older adults with hyperkyphosis. BMC Musculoskelet Disord. 2025 Feb 11;26(1):136. doi: 10.1186/s12891-025-08330-7.

  PMID: 39934800 DERIVED

• Hughes LC, Galloway RV, Fisher SR. Feasibility of a 4-Week Manual Therapy and Exercise Intervention on Posture and Function in Community-Dwelling Older Adults: A Pilot Study. J Geriatr Phys Ther. 2022 Jul-Sep 01;46(3):151-160. doi: 10.1519/JPT.0000000000000360. Epub 2022 Aug 5.

  PMID: 35939663 DERIVED

MeSH Terms

Conditions

Pneumonia; Pulmonary Disease, Chronic Obstructive; Kyphosis

Interventions

Musculoskeletal Manipulations; Exercise

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Spinal Curvatures; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Lynne C Hughes, PhD, PT

  University of Texas

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 16, 2019
• First Posted: October 3, 2019
• Study Start: February 26, 2018
• Primary Completion: April 18, 2019
• Study Completion: December 20, 2019
• Last Updated: February 5, 2020

Record last verified: 2019-08

Locations

US (1)