Topics in Geriatrics: Volume 4
Topics in Geriatrics: Volume 4

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Instructional Video: Kypholordosis Measurement Using a Flexible Curve

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Customer Testimonial: After watching the Kypholordosis Instructional Video, I ordered 6 of the 24" flexible curves. I will be using them in the clinic and at school (in the PT program) to show the students. I wish I knew about it years ago so I could have been taking objective measurements of patients. Subjectively, patients who have been consistent with their home exercise program seem to have decreased kyphosis but I've never been able to measure and document. I want students to learn this technique early and use it throughout their career. -Valerie Lapena, PT, GCS Los Angeles, CA Instructor: Carleen Lindsey, PT, MSc, GCS

It is our privilege to present you with this teaching disc on the flexible curve measurement of kypholordosis, produced by the American Physical Therapy Association, Academy of Geriatric Physical Therapy, Osteoporosis Special Interest Group.

Physical therapy interventions for treatment of impaired spinal posture need to be determined through the use of evidence-based evaluation procedures. Utilization of the flexible curve procedure is an efficient and cost effective method for obtaining valid and reproducible objective measurements of individuals with kypholordosis.

Milne and Lauder's hallmark studies sampled 513 men and women between the ages of 20 and 80 who had lateral radiographs performed in community hospitals. Flexible curve tracings performed the same day were highly correlated with the wedging index of T6 through T12 vertebral bodies, wherein the sum of the anterior height was divided by the posterior height of T6 through T12.

Chow et al defined the kyphotic index (KI) as 100 times the maximum horizontal distance (TW) divided by the vertical length (TL) of the upper back curve. The researchers determined that in a sample of 50 to 60 year old postmenopausal women, clinical kyphosis was clearly evident when the value of KI was 13 or greater.

In Arnold's reliability study, 20 women were tested by the same physical therapist on 3 visits and by 2 therapists on the last visit. Intra-rater and inter-rater reliability for height, forward head position, and the flexible curve ruler were all very good to excellent (ICC = .86-.99).

A reliability study by Lundon et al used repeated random measurements involving three observers and 26 subjects in two subgroups (11 healthy backs and 13 rounded backs). Measurements of thoracic kyphosis were obtained using the DeBrunner's kyphometer and the flexible curve ruler. The intrarater and interrater reliability of and between each method was compared, using radiographic films obtained in the sagittal plane. Data analysis showed no significant difference in the reliability of the kyphometer, flexible curve, or radiographs in the measurement of thoracic kyphosis.

References provided upon request.

$5 from the sale of each video will be donated to the Geriatric Fund in the PT Foundation. Visit to read about making a donation to the PT Foundation, and please consider specifying that your money should go to the Geriatric Fund!

Price List:
$25.00: Geriatrics Member
$35.00: APTA Member
$50.00: Non-Member

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