Hyperkyphotic measures using distance from the wall: validity, reliability, and distance from the wall to indicate the risk for thoracic hyperkyphosis and vertebral fracture
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C7WD is a practical, valid, and reliable measure that could clearly indicate a risk of hyperkyphosis and vertebral fracture in the elderly. The findings might be particularly of use in regions difficult to access radiology or for the determination of those who need further invasive radiologic examination and therapy.
To investigate psychometric properties of the 7th cervical vertebra wall distance (C7WD) to determine the risk of thoracic hyperkyphosis and spinal fracture, as compared to a standard radiologic Cobb’s method.
Community-dwelling elderly (n = 104), aged at least 60 years with occiput-wall distance > 0 cm, were assessed for their C7WD using rulers and a specially developed tool for an accurate perpendicular distance from C7 to the wall: infrared-gun kyphosis wall distance tool (IG-KypDisT). The first 15 participants were also involved in the reliability tests by a healthcare professional, village health volunteer, and caregiver. Within 7 days, all participants were at a hospital to complete a lateral plain radiograph (Cobb’s method).
Outcomes of C7WD had excellent correlation to the Cobb angles (r = 0.87 for rulers and r = 0.92 for IG-KypDisT), with excellent reliability when used by all three raters (ICC3,3 = 0.85–0.99). The C7WD of at least 7.5 and 9.5 cm had the best diagnostic properties to determine the risk of thoracic hyperkyphosis and vertebral fracture, respectively.
C7WD is valid and reliable with good diagnostic properties for thoracic hyperkyphosis and vertebral fracture. The findings confirm the use of C7WD using traditional ruler-based method as a practical tool to screen and monitor severity of thoracic hyperkyphosis in clinics and communities. In addition, the measurement using the IG-KypDisT provided accurate data that can be saved for further analysis; it is therefore suggested for research settings. The findings would promote the standardization of hyperkyphosis measurements in various settings.
KeywordsRound back Dowager’s hump Assessment Spinal fracture Cobb angle
The researchers sincerely thank Miss Arpassanan Wiyanad and Miss Pakwipa Chokphukiao for their contribution in data collection. In addition, the researchers are thankful for contribution and funding support from the Research and Researcher for Industries or RRi (Grant No. 5770I0039), Faculty of Engineering and Architecture, Rajamangala University of Technology Isan, Nakhon Ratchasima, and the Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Thailand.
Compliance with ethical standards
All procedures of the study were in accordance with the standards of the Ethics Committee for Human Research (HE581446). Eligible participants completed a written informed consent form before participation in this study.
Conflicts of interest
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