Study of Hyperkyphosis, Exercise and Function (SHEAF)

This study incorporates a dynamic exercise intervention to improve physical function in persons with hyperkyphosis, more commonly known as stooped posture. This five-year project will enroll 100 subjects throughout the grant period in waves of 20.  This randomized controlled trial of a 6-month kyphosis-specific exercise intervention will determine the effects of a targeted kyphosis-specific exercise intervention on kyphosis and physical function. Secondary outcomes of physical function and quality life will also be investigated, and mediating pathways of change in kyphosis and function will be explored. Our findings will be directly applicable in physical therapy practice and determine the merits of kyphosis-specific exercise interventions.

Wendy Katzman, P.T., D.P.T.Sc., O.C.S.
Principle Investigator - SHEAF
Project Leader - SCOR Project 4
Associate Professor
Department of PT & Rehabilitation Science
UC San Francisco
wendy.katzman@ucsfmedctr.org

Nancy E. Lane, M.D.
Co-Investigator - SHEAF
Endowed Professor of Medicine and Rheumatology
Director: Musculoskeletal Diseases of Aging Research Group
Co-Director: Building Interdisciplinary Research Careers in Women's Health (BIRCWH)
Co-Director: Center for Translational Research in Osteoarthritis
UC Davis
nancy.lane@ucdmc.ucdavis.edu

Background

Investigator developed intervention protocol (Kyphosis-specific spinal strengthening exercises) of targeted spine exercises during our pilot study based upon the literature and clinical experience. We standardized the protocol with a written script and a video. Each exercise session will be preceded by light aerobic activity, ended with cool-down and stretching the neck, chest and all extremities. All participants will be carefully monitored to ensure that all exercises will be performed slowly, with correct body alignment and technique to minimize risk of injury.

Specific Aims

The aims of this study are to determine if the exercise intervention improves kyphosis, physical function and health related quality of life. The ultimate goal of this investigation is to improve physical function in older persons that suffer from hyperkyphosis through an evidence-based exercise intervention.

Significance

The experimental interventions will be provided in small groups meeting three sessions per week for 6 months. At baseline and 6 months after the intervention, we will measure kyphosis, physical function, spine muscle strength and density, and quality of life. We will assess the effect of the intervention on the co-primary outcomes of kyphosis, modified Physical Performance Test (PPT) and gait speed measured as change over 6 months. We will also assess the effect of the intervention on secondary outcomes of physical function and health-related quality of life, measured as change in Timed Up and Go, Timed Loaded Standing, Six-Minute Timed Walk, the Scoliosis Research Society SRS-30, PROMISe Global Health and physical function and PACE questionnaires. Furthermore, we will investigate whether changes in kyphosis, spinal muscle strength and/or density mediate the effect of the intervention on change in physical function. After the 6-month intervention, both groups will continue their usual activity and we will assess the durability of the effects of the intervention at 1-year follow-up.

"Hyperkyphosis: Are we destined to stoop with aging? Translating research into clinical practice"
February 18, 2015, SCOR Science Exchange, UC Davis
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Age-Related Hyperkyphosis: Are We Destined to Stoop With Aging?”                      February 7, 2015. American Physical Therapy Association Combined Sections Meeting, Indianapolis,Indiana                                                                                                                         Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

"Sex Differences in Kyphosis and Response to Treatments"
August 1, 2014, AAOS/CORR/ORS/CMH-UCD/SWHR Musculoskeletal Sex Difference Throughout the Lifespan Research Symposium, Rosemont, Ill
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

"Kyphosis: Causes, Consequences, Treatment"
July 24, 2014, 11th Annual Osteoporosis: New Insights in Research, Diagnosis and Clinical Care, UCSF, San Francisco, CA.
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Take steps to improve posture
July 16, 2014, San Francisco Jewish Community Center
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

The Art of Aging Gracefully Resource Fair – on Posture Screening
April 10, 2014, Jewish Community Center, San Francisco
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Healthy Bones Fight Fracture with Fitness
January 29, 2014, University of California Television (UCTV): http://www.youtube.com/watch?v=BixyHtp_fjI
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Take steps to improve your posture"
September 16, 2013, Carlisle Retirement Home, San Francisco
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

"Are HIV-infected women at greater risk for hyperkyphosis?"
September 13, 2013, Women’s HIV Study, University of California, San Francisco
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Bone Health
May 9, 2013, UC Davis TV (Health Education TV)
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Steps to improve your posture
May 6, 2013, Jewish Community Center of SF
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Causes, consequences and treatments for hyperkyphosis
May 4, 2013, UCSF/SFSU Graduation Program in Physical Therapy Research Symposium-Keynote speaker
Wendy Katzman, PT, DPTSc, OCS, Physical Therapy and Rehabilitation Science, UCSF

Don’t stand as straight and tall as you used to?

Take steps to improve your posture!

Researchers at UC San Francisco are offering two research studies that investigate the effects of exercise on stooped posture, known as hyperkyphosis. Studies are open to both men and women and meet to exercise in a small group led by a physical therapist.

You may be eligible to participate if you:

  • Are 60 years or older
  • Have noticed you don’t stand as straight and tall as you used to
  • Can walk at least a ¼ block without using a cane or walker
  • Do not have any chronic medical condition that may prevent you from participating in an exercise program

There is no cost to participate. Transportation and parking vouchers for visits are available.

SCOR Kyphosis Project:

The purpose of this study is to learn about the effects of specific spinal muscle strengthening exercises on kyphosis. We will also investigate the differences in the effects of exercise between men and women.

  • Exercise groups meet for one-hour, twice a week for 3 months.
  • Groups will meet at the UC San Francisco Osher Center
  • Participants who completed the SCOR study will receive a $50 gift card.

To find out if you are eligible for this study, call 415-514-6776.

SHEAF Study:

The purpose of this study is to learn about the effects of specific spinal muscle strengthening exercises as compared to usual care on hyperkyphosis, physical function, muscle strength and quality of life. Eligible participants will be randomly assigned to the strengthening group or the usual care control group.

  • Exercise groups will meet for a one-hour, 3 days a week for 6 months.
  • Groups will meet at the PhysFit Health and Wellness Center at the UC San Francisco Mission Bay Campus
  • Participants who complete the SHEAF study will receive a $100 gift card.

To find out if you are eligible for this study, call 415-514-6776.