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Spinal extension exercises prevent natural progression of kyphosis



The angle of kyphosis increases with age with the most rapid increase occurring between 50 and 60 years. The progression of kyphosis was prevented in women ages 50–59 years who performed extension exercises three times a week for one year.


The purpose of this study was to (1) measure the progression of the angle of kyphosis with age and (2) determine whether spinal extension exercises prevent progression of hyperkyphosis in women 50–59 years of age.


Part 1: Cross-sectional study of changes in posture with age, determined by measuring spinal curves in 250 women 30–79 years of age. Part 2: One-year prospective, descriptive analysis of the effect of extension exercises on posture in women 50–59 years of age. Depth of the cervical curve (CD), area under the thoracic curve (TA), and height were measured using a device developed at Kansas University Medical Center. Changes in CD and TA in women compliant with extension exercises were compared to those in non-compliant women.


Kyphosis increases with age in healthy women, with the greatest difference observed between women 50 and 59 years of age. The progression of kyphosis was greater in women who did not perform extension exercises compared to those who performed extension exercises three times per week for 1 year. The difference in change in CD and TA between the two groups was highly significant (CD p = .0001, TA p = .0001).


Kyphosis increases with age in healthy women. In this study the greatest difference in the angle of kyphosis was observed between the fifth and sixth decade. Exercises which strengthen the extensor muscles of the spine can delay the progression of hyperkyphosis in the group included in this study, i.e., women 50–59 years of age.

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The authors wish to thank Deborah VanderVeen, medical student for verifying and organizing data during a research elective, Kathleen Curran, M.S., data manager, for data analysis, and Barry J. Engelken and Heather Gaston, graduate students in physical therapy who verified the reproducibility of the posture board measurements as part of their research to fulfill requirements for a master’s degree. We are indebted to Norman D. Ball (deceased), Dean Emeritus, Casper College, Casper, Wyoming, for advice on using the trapezoid rule for calculating spinal curves.

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Correspondence to B. P. Lukert.

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J. M. Ball has died since this article was written.

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Ball, J.M., Cagle, P., Johnson, B.E. et al. Spinal extension exercises prevent natural progression of kyphosis. Osteoporos Int 20, 481 (2009).

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  • Extension exercises
  • Kyphosis
  • Prevention