Evidence map›Paper›PMID 28689306›Full record

Trial reportOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017

Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial.

W B Katzman, E Vittinghoff, F Lin, A Schafer, R K Long, S Wong, A Gladin, B Fan, B Allaire, D M Kado and 1 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01751685 (Study of Hyperkyphosis, Exercise and Function-SHEAF), which is not on this map. Cited by 55 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 4 pooled it
8.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01751685 nacompletednot on this map

Study of Hyperkyphosis, Exercise and Function-SHEAF

TypeinterventionalSponsorUniversity of California, San FranciscoRan2013 to 2019Enrolled99ConditionsKyphosisArmsKyphosis-specific spinal strengthening exercises, Control
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 4 syntheses or guidelines pooled it, 125 citations in OpenAlex.

  1. Effect of Therapeutic Exercise on the Management of Hyperkyphosis in Adolescence and Young Adulthood: A Systematic Review.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025
    Pooled it
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  8. Physiotherapy rehabilitation for osteoporotic vertebral fracture-a randomised controlled trial and economic evaluation (PROVE trial).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
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  12. The psychometric properties of the Dubousset Functional Test in patients with thoracic hyperkyphosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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  17. Who benefits from home-based exercise for adult spinal deformity? A prospective multicenter study on clinical and radiographic predictors.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

W B KatzmanUniversity of California, 1500 Owens Street, San Francisco, CA, 94158, USA. Wendy.Katzman@ucsf.edu.
E VittinghoffUniversity of California, 550 16th. Street, San Francisco, CA, 94158, USA.
F LinUniversity of California, 550 16th. Street, San Francisco, CA, 94158, USA.
A SchaferUniversity of California, 4150 Clement St, San Francisco, CA, 94121, USA.
R K LongUniversity of California, 550 16th. Street, San Francisco, CA, 94143, USA.
S WongUniversity of California, 1500 Owens Street, San Francisco, CA, 94158, USA.
A GladinKaiser Permanente Northern CA, San Francisco Medical Center, 1635 Divisadero Street, Suite 300, San Francisco, CA, 94115, USA.
B FanUniversity of California, 400 Parnassus Avenue, San Francisco, CA, 94117, USA.
B AllaireBeth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.
D M KadoUniversity of California, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
N E LaneUniversity of California, 4625 Second Avenue, Suite 2000, Sacramento, CA, 95616, USA.
University of California, San Francisco · USUniversity of California System · USBeth Israel Deaconess Medical Center · USKaiser Permanente San Francisco Medical Center · USSan Francisco VA Health Care System · USUniversity of California, San Diego · US

Funding

Engaging University of California Stakeholders for Biorespository ResearchUL1TR000004 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$78.0M
Sex Differences in response to an exercise for hyperkyphosisP50AR063043 · NIAMS · UNIVERSITY OF CALIFORNIA AT DAVIS · PI KATZMAN, WENDY BETH · 2012 to 2017
$5.7M
Study of Hyperkyphosis, Exercise and Function - SHEAFR01AG041921 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KATZMAN, WENDY BETH · 2012 to 2016
$2.4M
NIAMS NIH HHS P50 AR063043NIA NIH HHS R01 AG041921
6 · The paper itself

Abstract

A 6-month randomized controlled trial of spine-strengthening exercise and posture training reduced both radiographic and clinical measures of kyphosis. Participants receiving the intervention improved self-image and satisfaction with their appearance. Results suggest that spine-strengthening exercise and postural training may be an effective treatment option for older adults with hyperkyphosis.

introductionThe purpose of the present study is to determine in a randomized controlled trial whether spine-strengthening exercises improve Cobb angle of kyphosis in community-dwelling older adults.

methodsWe recruited adults ≥60 years with kyphosis ≥40° and enrolled 99 participants (71 women, 28 men), mean age 70.6 ± 0.6 years, range 60-88, with baseline Cobb angle 57.4 ± 12.5°. The intervention included group spine-strengthening exercise and postural training, delivered by a physical therapist, 1-h, three times weekly for 6 months. Controls received four group health education meetings. The primary outcome was change in the gold standard Cobb angle of kyphosis measured from standing lateral spine radiographs. Secondary outcomes included change in kyphometer-measured kyphosis, physical function (modified Physical Performance Test, gait speed, Timed Up and Go, Timed Loaded Standing, 6-Min Walk), and health-related quality of life (HRQoL) (PROMIS global health and physical function indexes, SRS-30 self-image domain). ANCOVA was used to assess treatment effects on change from baseline to 6 months in all outcomes.

resultsThere was a -3.0° (95% CI -5.2, -0.8) between-group difference in change in Cobb angle, p = 0.009, favoring the intervention and approximating the magnitude of change from an incident vertebral fracture. Kyphometer-measured kyphosis (p = 0.03) and SRS-30 self-esteem (p < 0.001) showed favorable between-group differences in change, with no group differences in physical function or additional HRQoL outcomes, p > 0.05.

conclusionsSpine-strengthening exercise and posture training over 6 months reduced kyphosis compared to control. Our randomized controlled trial results suggest that a targeted kyphosis-specific exercise program may be an effective treatment option for older adults with hyperkyphosis. TRIAL REGISTRATION NUMBER AND NAME OF TRIAL REGISTER: ClinicalTrials.gov; identifier NCT01751685.

Indexed as

AgedAged, 80 and overExercise TherapyFemaleHumansKyphosisMaleMiddle AgedMuscle StrengthPatient SatisfactionPostureQuality of LifeRadiographySpineTreatment OutcomeAgingClinical trialsExerciseRadiologySkeletal muscle

Identifiers

PMID28689306
PMCPMC5873977
OpenAlexW2728920776

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.