Thoracic kyphosis comparison between a patient with chronic obstructive pulmonary disease and a healthy individual by flexicurve method
DOI:
https://doi.org/10.590/1809-2950/14468822032015Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction, air entrapment and pulmonary hyperinflation. These pathophysiological factors can compromise the diaphragmatic mobility, causing deformities in the thoracic cavity and consequently increasing the angle of the thoracic curvature. We compared the angle of the thoracic curvature between COPD patients and healthy individuals by the flexicurve method. Thirty-seven patients with COPD and 37 healthy individuals participated in the study. All subjects performed the following evaluations: anthropometry, spirometry, and measurement of the thoracic curvature angle. The data were analyzed and treated with descriptive analysis such as mean and standard deviation. The Shapiro-Wilk test was used to verify the normality of the data. The Student's t-test was used to compare the thoracic curvature angle of patients with COPD with healthy individuals. The significance level adopted was 5%. The mean age of the COPD group was 65.70±7.91 years, body mass index (BMI) of 26.73±5.34kg/m2, and FEV1(expected %) of 50.65±19.08, showing moderate obstruction degree. Healthy individuals showed an average of 7.27±62.49 years, BMI of 26.97±3.55kg/m² and FEV1(expected %) of 94.05±0 9.44. We did not observe any significant difference between patients with COPD and healthy individuals in the thoracic curvature angle: 56.67±11.31 and 55.42±9.61 degrees, respectively (p=0.61). The flexicurve method proved to be a useful and practical tool for assessing the thoracic kyphosis, and it also identified no difference between the thoracic curvature of COPD patients with moderate obstruction and of healthy individuals.Downloads
References
Saiiari A, Khodayarib B, Bostanic M. Relation between
Increasing spinal curve and anxiety. P - Soc Behav Sci.
;30:2246-8.
Nishiwaki Y, et al. Association of thoracic kyphosis with
subjective poor health, functional activity and blood pressure
in the community-dwelling elderly. Environ Health Prev Med.
;12(6):246-50.
Schneider DL, von Müller D, Barrtet-Connor E, Sartoris DJ
. Kyphosis does not equal vertebral fractures: the Rancho
Bernardo study. J Rheumatol. 2004;31:747-52.
Hinman MR. Comparision of thoracic kyphosis and
postural stiffness in younger and older women. Spine J.
;4(4):413-7.
Goh S, Price RI, Leedman PJ, Singer KP. The relative influence
of vertebral body and intervertebral disc shape on thoracic
kyphosis. Clin Biomech. 1999;14:439-48.
Mika A, Unnithan VB, Mika P. Differences in thoracic kyphosis
and in back muscle strength in women with bone loss due to
osteoporosis. Spine. 2005;30:241-6.
Birnbaum K, Siebert CH, Hinkelmann J, Prescher A, Niethard
FU. Correction of kyphotic deformity before and after
transection of the anterior longitudinal ligament: a cadaver
study. Arch Orthop Trauma Surg. 2001;121:142-7.
Kado DM, Christianson L, Palermo L, Smith-Bidman R,
Cummings SR, Greendale GA. Comparing a supine radiologic
versus standing clinical measurement of kyphosis in older
women: the fracture Intervention Trial. Spine. 2006;31:463-7.
Pachioni CAS, Ferrante JA, Panissa TSD, Ferreira DMA,
Ramos D, Moreira GL, et al. Avaliação postural em pacientes
com doença pulmonar obstrutiva crônica. Fisioter Pesqui,
São Paulo. 2011;18(4):341-5.
Oliveira, PC. Apresentações clínicas da DPOC. Pulmão RJ.
;22(2):15-8.
Soares SMTP, Carvalho CRR. Intolerância ao exercício em
pacientes com doença pulmonar obstrutiva crônica. Rev
Ciênc Méd. 2009;18(3):143-51.
Martinez FJ, Couser JI, Celli BR. Factors influencing
ventilatory muscle recruitment in patients with chronic
airflow obstruction. Am Rev Respir Dis. 1990;142:276-82.
Kado DM, Prenovost K, Crandall C. Narrative review:
hyperkyphosis in older persons. Ann Intern Med.
;147(5):330-8.
Di Bari M, Chiarlone M, Matteuzzi D, Zacchei S, Pozzi C,
Bella V, et al.. Thoracic kyphosis and ventilatory dysfunction
in unselected older person: an epidemiological study in
Dicomano, Italy. J Am Geriatr Soc. 2004;52(6):909-15.
Ryan SD, Fried LP. The impact of kyphosis on daily
functioning. J Am Geriatr Soc. 1997;45(12):1479-86.
Takahashi T, Ishida K, Hirose D, Nagano Y, Okumiya K,
Nishinaga M. et al. Trunk deformity is associated with
a reduction in outdoor activities of daily living and life
satisfaction in community-dwelling older people. Osteoporos
Int. 2005;16:273-9.
Kado DM, Huang MH, Karlamangia AS, Barrett-Connor E,
Greendale GA. Hyperkyphotic posture predicts mortality in
older community-dwelling men and women: a prospective
study. J Am Geriatr Soc. 2004;52(10):1662-7.
Dias CS, Kirkwood RN, Parreira VF, Sampaio RF. Orientation
and position of the scapula, head and kyphosis thoracic
in male patients with COPD. Summer. Can J Resp Ther.
;45(2):30-4.
Barrett E, McCreesh K, Lewis J. Reliability and validity of nonradiographic methods of thoracic kyphosis measurement: A
systematic review. Manual Ther. 2014;19:10-7.
Chen Y. Vertebral centroid measurement of lumbar
lordosis compared with the Cobb technique. Spine.
;24(17):1786-90.
Doody MM, Lonstein JE, Stovall M, Hacker DG, Luckyanov
N, Land CEal. Breast cancer mortality after diagnostic
radiography: findings from the U.S. Scoliosis Cohort Study.
Spine. 2000;25(16):2052-63.
Teixeira FA, Carvalho GA. Confiabilidade e validade das
medidas da cifose torácica através do método flexicurva. Rev
Bras Fisioter. 2007;11(3):199-204.
Greendale GA; Nili NS, Huang MH, Seeger L, Karlamangia AS.
The reliability and validity of three non-radiological measures
of thoracic kyphosis and their relations to the standing
radiological Cobb angle. Osteoporos Int. 2011;22:1897-905.
Oliveira TS, Candotti CT, la Torre M, Pelinson PPT, Furlanetto
TS, Kutchak FM, Loss JF. Validity and reproducibility of the
measurements obtained using the flexicurve instrument
to evaluate the angles of thoracic and lumbar curvatures
of the spine in the sagittal plane. Rehab Res Practice.
;(2012):1-9.
Leroux MA, et al. A noninvasive anthropometric technique for
measuring kyphosis and lordosis. Spine. 2000;25:1689-94.
Global initiative for chronic obstructive lung disease
(GOLD). Global Strategy for the diagnosis, management
and prevention of chronic pulmonary disease. http://www.
goldcopd.org/Guidelines/guidelines-resources.html, 2013.
World Health Organization. WHO Obesity Technical Report
Series. Obesity: preventing and managing the global epidemic.
Report of a World Health Organization Consultation. Geneva:
World Health Organization. 2000;284:256.
Miller MR. Series “ATS/ERS task force: Standardisation of
lung function testing”. Standardisations of spirometry. Eur
Respir J. 2005;26:319-38.
Pereira CA, Sato T, Rodrigues SC. New reference values for
forced spirometry in white adults in Brazil. J Bras Pneumol.
;33:397-406.
Bandeira FM, Delíno FC, Carvalho GA, Valduga R.
Comparação entre a cifose torácica de idosos sedentários e
praticantes de atividade física pelo método flexicurva. Rev
Bras Cineantropom Desempenho Hum. 2010;12(5):381-6.
Baraúna M.A., et al. Validade e confiabilidade intra-indivíduo
do cifolordômetro na avaliação da convexidade torácica. Rev
Bras Fisiot. 2005;9 (3):319-25.
Tillotson KM, Burton AK. Noninvasive measurement of
lumbar sagital mobility: an assessment of the flexicurve
technique. Spine. 1991;16:29-33.
Loubresse CG, Vialle R, Wolff S. Cyphoses pathologiques
Pathological kyphosis. EMC-Rhumatologie Orthopédie.
;294-334.
Libby D, et al. Acute respiratory failure in scoliosis or kyphosis.
Am J Med. 1982;73(4):532-8.
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