A comparison of the effectiveness of three types of trunk orthoses on the balance performance of older people with osteoporotic hyperkyphosis: A cross-over study

Background: Orthotic immobilization is an early treatment for osteoporotic vertebral fracture at the hyperkyphotic thoracic spine.

Objective: This exploratory study compared the immediate impact of three types of trunk orthoses on the balance parameters of older people with osteoporosis hyperkyphosis.

Methods: Twenty older people (aged 60-65 years) with osteoporosis kyphosis and a history of falls participated in a pilot cross-over study. Four randomized comparisons were carried out, including either soft, semi-rigid, and rigid trunk orthoses worn on the participants compared to "no orthosis" as the control condition. Kyphosis angle, Forward Reach Test, Timed Up and Go test, and postural stability during standing on a force plate were recorded and compared between study conditions using one-way repeated measures analysis of variance test.

Results: All orthoses significantly reduced the kyphosis angle (p < 0.01). None of the orthoses has a significant change in the Timed Up and Go test (p > 0.01). Rigid orthosis significantly reduced the forward reach compared to "no orthosis" (p = 0.003, 95% CI: 1.08-6.3 cm). None of the orthosis induced a significant change in postural sway velocity in anteroposterior and mediolateral directions compared to the control condition (p > 0.01).

Conclusion: These findings suggest that using rigid orthosis in older people with osteoporosis hyperkyphosis reduces the balance performance.