THE IMPACT OF KYPHOSIS ON DAILY FUNCTIONING

OBJECTIVES: To determine whether moderate or severe kyphosis is associ ated with decrements in physical function, especially mobility. DESIGN : Cross-sectional analysis of a cohort study. SETTING: The Johns Hopki ns Functional Status Laboratory, a multidisciplinary, standardized, qu antitative assessment center. PARTICIPANTS: A total of 231 community-d welling volunteers aged 59 and older who participated in a 1-day evalu ation. MEASUREMENTS: Age, gender, self report of physical function, st andardized measurement of: kyphosis (both qualitatively clinical crite ria and quantitative assessment), time to walk 5 meters (0.1 seconds), and time to climb a flight of stairs (0.1 seconds) at usual pace. RES ULTS: Using multivariate step-wise regression analysis, the presence a nd severity of kyphosis, measured qualitatively, was independently ass ociated with time to walk 5 meters and to climb a flight of stairs (P = .015, P < .001, respectively), adjusting for moderate-severe scolios is, heart rate response to exercise, arthritis, vertigo, age, and gend er. Similarly, quantitative kyphosis was associated independently with stair climb time (P = .005). Qualitative kyphosis was also associated with difficulty reaching (OR = 2.21 (95%CI: 1.14 to 4.29)) and diffic ulty performing heavy housework (OR = 1.64 (95%CI: 1.03 to 2.61)), adj usting for prior diagnosis of moderate-severe scoliosis, prior diagnos is of arthritis, age, and gender. CONCLUSION: Kyphosis, by both clinic al and quantitative assessment, is associated with diminished function , especially performance of mobility tasks. This association should be verified prospectively. If predictive, the impact of kyphosis on phys ical function should be considered in osteoporosis prevention and trea tment counseling.