STUDY DESIGN: Longitudinal, repeated-measures study. OBJECTIVE: The aim of this study was to determine changes in sagittal spinal posture in older adults during standing and sitting after a Pilates-based exercise program. SUMMARY OF BACKGROUND DATA: Pilates exercise is purported to improve posture, however, few peer-reviewed articles are available to provide scientific support. Most previous studies were conducted in young dancers, and the effect of Pilates exercise on spinal posture in older adults remained unclear. METHODS: Thirty-four healthy older adults aged over 60 years volunteered for this study. A two-dimensional PEAK Motus motion analysis system was used to measure sagittal spinal angles. Participants were tested on 2 occasions before the exercise program to establish a baseline measure, and undertook a supervised Pilates-based exercise program twice weekly for 10 weeks. Participants were tested on another 2 occasions, immediately after the exercise program, and after a short-term follow-up. RESULTS: Baseline measures in both standing and sitting postures remained unchanged except for the lumbar spine angle in sitting. Immediately after the Pilates-based exercise program, older adults stood with slightly decreased thoracic flexion and sat with slightly increased lumbar extension. No significant differences were found during the follow-up period. CONCLUSION: The individually designed Pilates-based exercise program was feasible for healthy older adults, and the high attendance rate supports the suitability of the exercise program over a long period. Considering the variability of the baseline measure, small improvement was only observed in the thoracic kyphosis during standing. The long-term effect of Pilates exercise requires further investigation.

OBJECTIVES: To assess whether a specifically designed yoga intervention can reduce hyperkyphosis. DESIGN: A 6-month, two-group, randomized, controlled, single-masked trial. SETTING: Community research unit. PARTICIPANTS: One hundred eighteen women and men aged 60 and older with a kyphosis angle of 40 degrees or greater. Major exclusions were serious medical comorbidity, use of assistive device, inability to hear or see adequately for participation, and inability to pass a physical safety screen. INTERVENTION: The active treatment group attended hour-long yoga classes 3 days per week for 24 weeks. The control group attended a monthly luncheon and seminar and received mailings. MEASUREMENTS: Primary outcomes were change (baseline to 6 months) in Debrunner kyphometer-assessed kyphosis angle, standing height, timed chair stands, functional reach, and walking speed. Secondary outcomes were change in kyphosis index, flexicurve kyphosis angle, Rancho Bernardo Blocks posture assessment, and health-related quality of life (HRQOL). RESULTS: Compared with control participants, participants randomized to yoga experienced a 4.4% improvement in flexicurve kyphosis angle (P=.006) and a 5% improvement in kyphosis index (P=.004). The intervention did not result in statistically significant improvement in Debrunner kyphometer angle, measured physical performance, or self-assessed HRQOL (each P>.1). CONCLUSION: The decrease in flexicurve kyphosis angle in the yoga treatment group shows that hyperkyphosis is remediable, a critical first step in the pathway to treating or preventing this condition. Larger, more-definitive studies of yoga or other interventions for hyperkyphosis should be considered. Targeting individuals with more-malleable spines and using longitudinally precise measures of kyphosis could strengthen the treatment effect.