Good posture means keeping the three natural curves of the spine in balanced alignment. When viewed from the side, a normal spine curves slightly forward in the neck or cervical area, slightly backwards in the upper back or thoracic segment of the spine, and slightly forward in the lower back or lumbar region. The back’s natural curves depend on strong and flexible muscles along with healthy hip, knee and ankle joints to make it possible to maintain good posture in any position and during movement.  Kyphosis in the thoracic spine means an exaggerated deviation from the thoracic spine’s normal backward curve. In addition, the normal curvature in the cervical and lumbar regions may be reduced contributing to an over-all “pitched forward posture”. Hyperkyphosis, or forward leaning posture, is commonly observed among older adults. Initially thought to be primarily a consequence of osteoporotic fractures, recent studies have demonstrated that many older adults who are most affected by hyperkyphosis do not have vertebral fractures. Other conditions associated with excessive curvature include degenerative joint disease, decreased physical functioning, sedentary lifestyle, and impaired pulmonary function.

While prior research has demonstrated that abnormal postural changes alter the fundamental characteristics of balance and gait, the association between hyperkyphosis and increased risk of falling had not been studied.

A study of 1,900 older adults revealed that 31.6% exhibited hyperkyphosis and twice as many men were hyperkyphotic.  Their hyperkyphosis was also was more severe than that of the women.  The participants reported falls in which 33% reported a serious injury such as fracture.  Women were more likely to fall, but when adjusting for hyperkyphotic posture the men with moderate hyperkyphosis were at greatest risk for injury in a fall.

The study did not address how hyperkyphotic posture might influence the biomechanics of falling.  The study does provide support for including postural exercises in balance training programs to prevent or delay the progression of hyperkyphosis.

*Taken from CT Collaboration for Fall Prevention; by Mary E. Tinetti, MD

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