The effects of Hyperkyphosis on Balance and Fall Risk in older adults: A Systematic Review

Introduction

Hyperkyphosis, a common spinal curvature in older adults, is linked to impaired balance and increased fall risk. Despite affecting up to 40 % of those over 60, its impact on fall risk is unclear due to inconsistent research. This systematic review aims to clarify the relationship between hyperkyphosis and balance in older adults.

Methods

This systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO (registration number: CRD42024590745). Studies published up to September 2024 were included if they involved older adults (≥60 years) with hyperkyphosis and examined the relationship between hyperkyphosis and balance or fall risk. Observational studies with cross-sectional, cohort, or case-control designs were considered. A comprehensive search of PubMed, Web of Science, Scopus, CINAHL, and the Cochrane Library was conducted using a combination of relevant MeSH terms and keywords. Two reviewers independently screened studies for eligibility, extracted data, and assessed quality using the STROBE checklist, resolving discrepancies through discussion.

Results

This systematic review included 19 studies on the impact of hyperkyphosis on balance and fall risk in adults aged 60 and above. Quality assessment revealed varied methodological rigor. Hyperkyphosis was measured using diverse methods like Cobb angle and flexicurve ruler. Findings showed significant impairments in static and dynamic balance, assessed through tests such as the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Fall rates ranged from 24 % to,64 %, with many resulting in injuries.

Conclusion

This review highlights hyperkyphosis significantly impairs balance and increases fall risk in older adults. Hyperkyphosis is linked to reduced postural stability and a higher incidence of falls, emphasizing the need for targeted interventions to improve balance and reduce fall risk in this population.

Clinical relevance

Hyperkyphosis impairs balance and raises fall risk in older adults, highlighting the need for targeted interventions to enhance stability and prevent falls. Early identification and management of hyperkyphosis can improve mobility and quality of life in this population.