The association between hyperkyphosis and physical function in geriatric outpatients with frailty

Why This Matters

Frailty in older adults is strongly associated with functional decline, falls, and loss of independence. Hyperkyphosis is common in this population but is often overlooked as a modifiable contributor to function. This study examines whether spinal posture is independently associated with measurable functional impairment in frail older adults.

What the Research Found

This study evaluated 337 geriatric outpatients (mean age 80) to determine whether hyperkyphosis is associated with physical function in a frail population. Hyperkyphosis was defined using multiple methods, including Cobb angle, occiput-to-wall distance, and block measurement.

Key Findings:

  • Hyperkyphosis was highly prevalent, ranging from 43% to 84% depending on measurement method
  • Hyperkyphosis was independently associated with:
    • Slower Timed Up and Go (TUG) performance (OR 3.86)
    • Lower Berg Balance Scale scores (OR 9.42)
  • No significant association was found with:
    • Short Physical Performance Battery (SPPB)
    • Hand grip strength
  • Associations were strongest when hyperkyphosis was measured using the blocks method

Findings suggest posture is linked specifically to balance and mobility, rather than global strength

Clinical Takeaways

    • Recognize that hyperkyphosis is highly prevalent in frail older adults and may be underrecognized
    • Be aware that hyperkyphosis is independently associated with impaired mobility and balance (TUG and Berg Balance Scale)
    • Consider incorporating simple screening methods (e.g., occiput-to-wall distance or block method) into routine assessment
    • Understand that posture may affect function differently than strength—mobility and balance may be more impacted than grip strength

Where Collaborative Spine Care May Support This

Manual medicine and conservative spine care approaches may help address spinal alignment, mobility, and proprioception—factors that could influence balance and functional performance in frail older adults.

Reference

Koelé MC, van der Velde N, van Campen JPCM, van Haelst SAE, Willems HC. The association between hyperkyphosis and physical function in geriatric outpatients with frailty. Arch Osteoporos. 2026;21(1):21.
DOI: 10.1007/s11657-025-01619-z
PubMed: https://pubmed.ncbi.nlm.nih.gov/41505012/