***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the effect of back-strengthening exercise on posture in 60 healthy estrogen-deficient women . DESIGN The 60 study subjects were r and omly assigned to either an exercise or a control group , and various factors were assessed at time of enrollment in the study and at 2-year follow-up . MATERIAL AND METHODS The 32 women in the exercise group were instructed in progressive back-strengthening exercises , whereas the 28 women in the control group had no exercise prescription and were asked to continue their usual physical and dietary activities . At baseline and 2-year follow-up examinations ,  back extensor strength  was measured with a strain-gauge dynamometer , and lateral roentgenograms of the thoracic and lumbar areas of the spine were obtained to measure the angles of thoracic kyphosis , lumbar lordosis , and sacral inclination . The changes in radiographic measurements and back extensor strength were analyzed statistically . RESULTS Back extensor strength increased significantly in both the exercise and the control groups , but no radiographic measurements were significantly different between these groups . The significant increase in back extensor strength in both groups of healthy women suggested that the original grouping did not accurately reflect the amount of exercise . Thus , the 60 subjects were reclassified for comparison on the basis of increase in back extensor strength--27 with more than or equal to the mean increase of 21.1 kg and 33 with less than 21.1 kg . Furthermore , each of these groups of subjects was subdivided on the basis of degree of thoracic kyphosis . Among the subjects with substantial thoracic kyphosis , those with a significant increase in back extensor strength had a significant decrease in thoracic kyphosis ( -2.8 + /- 4.2 degrees ; P = 0.041 ) , whereas those with a small increase in strength had a nonsignificant increase in thoracic kyphosis ( 1.8 + /- 5.3 degrees ) . The increase in back extensor strength did not seem to affect mild degrees of kyphosis . CONCLUSION Increasing the back extensor strength in healthy estrogen-deficient women helps decrease thoracic kyphosis BACKGROUND Greater thoracic kyphosis is associated with increased biomechanical loading of the spine which is potentially problematic in individuals with osteoporotic vertebral fractures . Conservative interventions that reduce thoracic kyphosis warrant further investigation . This study aim ed to investigate the effects of therapeutic postural taping on thoracic posture . Secondary aims explored the effects of taping on trunk muscle activity and balance . METHODS Fifteen women with osteoporotic vertebral fractures participated in this within-participant design study . Three taping conditions were r and omly applied : therapeutic taping , control taping and no taping .  Angle of thoracic kyphosis was measured after each condition . Force plate-derived balance parameters and trunk muscle electromyographic activity ( EMG ) were recorded during three static st and ing tasks of 40s duration . RESULTS There was a significant main effect of postural taping on thoracic kyphosis ( p=0.026 ) , with a greater reduction in thoracic kyphosis after taping compared with both control tape and no tape . There were no effects of taping on EMG or balance parameters . CONCLUSIONS The results of this study demonstrate that the application of postural therapeutic tape in a population with osteoporotic vertebral fractures induced an immediate reduction in thoracic kyphosis . Further research is needed to investigate the underlying mechanisms associated with this decrease in kyphosis OBJECTIVES To determine the association between hyperkyphotic posture and rate of mortality and cause-specific mortality  in older persons . DESIGN Prospect i ve cohort study . SETTING Rancho Bernardo , California . PARTICIPANTS Subjects were 1,353 participants from the Rancho Bernardo Study who had measurements of kyphotic posture made at an osteoporosis visit between 1988 and 1991 . MEASURES  Kyphotic posture  was measured as the number of 1.7-cm blocks that needed to be placed under the participant 's head to achieve a neutral head position when lying supine on a radiology table . Demographic and clinical characteristics and health behaviors were assessed at a clinic visit using st and ard question naires .  Participants were followed for an average of 4.2 years , with mortality and cause of death confirmed using review of death certificates . RESULTS Hyperkyphotic posture , defined as requiring one or more blocks under the occiput to achieve a neutral head position while lying supine , was more common in men than women ( 44 % in men , 22 % of women , P<.0001 ) . In age- and sex-adjusted analyses , persons with hyperkyphotic posture had a 1.44 greater rate of mortality ( 95 % confidence interval (CI)=1.12 - 1.86 , P=.005 ) . In multiply adjusted models , the increased rate of death associated with hyperkyphotic posture remained significant ( relative hazard=1.40 , 95 % CI=1.08 - 1.81 , P=.012 ) . In cause-specific mortality analyses , hyperkyphotic posture was specifically associated with an increased rate of death due to atherosclerosis . CONCLUSION Older men and women with hyperkyphotic posture have higher mortality rates Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Currently available therapeutic options for the correction of osteoporotic posture changes are not effective . Rigid or semi-rigid orthoses are only applicable in the early phase after vertebral body fractures , and the knowledge about the efficacy of flexible spinal orthoses is limited . Therefore , the present study is aim ed at investigating the efficacy of a flexible spinal orthosis without any stabilizing components in terms of posture improvement . Forty women aged ( 65.9 ± 8.4 years ) with a proven osteoporosis ( DXA ≤ −2.5 ) were r and omized to receive either of three treatment regimens : ( i ) Orthosis ( Thämert Osteomed ) with paravertebral/lumbosacral air chamber pads ( as commercially available ) ; ( ii ) The same orthosis without air chamber pads ; and ( iii ) Placebo body stocking . Measurements were performed with a 3D real-time ultrasound topometry system ( Zebris ® CMS 70 ) . The posture correction was substantially and significantly more marked in the first group ( 38 % of the maximally possible intentional erection ) as compared to the second ( 21 % ) and third group ( 13 % ) . The orthosis with air chamber pads causes a clinical ly meaningful trunk support in patients with osteoporotic posture changes . Since the device contains no rigid stabilizing elements , the change in posture is considered to be a result of muscle activation due to sensomotor stimulation by the air chamber pads Background This r and omised , single-blind controlled pilot trial aim ed to determine the effectiveness of a physiotherapy program , including exercise and manual therapy , in reducing impairments and improving physical function and health-related quality of life in people with a history of painful osteoporotic vertebral fracture . Methods 20 participants were r and omly allocated to an intervention ( n = 11 ) or control ( n = 9 ) group . The intervention group attended individual sessions with an experienced clinician once a week for 10 weeks and performed daily home exercises with adherence monitored by a self-report diary . The control group received no treatment . Blinded assessment was conducted at baseline and 11 weeks . Question naires assessed self-reported changes in back pain , physical function , and health-related quality of life . Objective measures of thoracic kyphosis , back and shoulder muscle endurance ( Timed Loaded St and ing Test ) , and function ( Timed Up and Go test ) were also taken . Results Compared with the control group , the intervention group showed significant reductions in pain during movement ( mean difference ( 95 % CI ) -1.8 ( -3.5 to -0.1 ) ) and at rest ( -2.0 ( -3.8 to -0.2 ) ) and significantly greater improvements in Qualeffo physical function ( -4.8 ( -9.2 to -0.5 ) ) and the Timed Loaded St and ing test ( 46.7 ( 16.1 to 77.3 ) secs ) . For the perceived change in back pain over the 10 weeks , 9/11 ( 82 % ) participants in the intervention group rated their pain as ' much better ' compared with only 1/9 ( 11 % ) participants in the control group . Conclusion Despite the modest sample size , these results support the benefits of exercise and manual therapy in the clinical management of patients with osteoporotic vertebral fractures , but need to be confirmed in a larger sample .Trail registration This controlled trial was design ed to investigate the influence of  osteoporosis-related kyphosis ( O-K ) on falls . Twelve community-dwelling women with O-K ( Cobb angle , 50–65 ° measured from spine radiographs ) and 13 healthy women serving as controls were enrolled . Mean age of the O-K group was 76 years ( ±5.1 ) , height 158 cm ( ±5 ) , and weight 61 kg ( ±7.9 ) , and mean age of the control group was 71 years ( ±4.6 ) , height 161 cm ( ±3.8 ) , and weight 66 kg ( ±11.7 ) .  Quantitative isometric strength data were collected . Gait was monitored during unobstructed level walking and during stepping over an obstacle of four different heights r and omly assigned ( 2.5 % , 5 % , 10 % , and 15 % of the subject ’s height ) . Balance was objective ly assessed with computerized dynamic posturography consisting of the sensory organization test . Back extensor strength , grip strength , and all lower extremity muscle groups were significantly weaker in the O-K group than the control group ( P < 0.05 ) , except right ankle plantar flexors ( P = 0.09 ) . There was a significant difference in the anteroposterior and mediolateral displacements and velocities . The O-K subjects had less anteroposterior displacement , greater mediolateral displacement , reduced anteroposterior velocity , and increased mediolateral velocity compared with controls for all conditions of unobstructed and obstructed level walking . Obstacle height had a significant effect on all center-of-mass variables . The O-K subjects had significantly greater balance abnormalities on computerized dynamic posturography than the control group ( P = 0.002 ) . Data show that thoracic hyperkyphosis on a background of reduced muscle strength plays an important role in increasing body sway , gait unsteadiness , and risk of falls in osteoporosis Background Flexed posture commonly increases with age and is related to musculoskeletal impairment and reduced physical performance . The purpose of this clinical study was to systematic ally compare the effects of a physical activity program that specifically address the flexed posture that marks a certain percentage of elderly individuals with a non specific exercise program for 3 months . Methods Participants were r and omly divided into two groups : one followed an Adapted Physical Activity program for flexed posture and the other one completed a non-specific physical activity protocol for the elderly .  A multidimensional clinical assessment was performed at baseline and at 3 months including anthropometric data , clinical profile , measures of musculoskeletal impairment and disability . The instrumental assessment of posture was realized using a stereophotogrammetric system and a specific biomechanical model design ed to describe the reciprocal position of the body segments on the sagittal plane in a upright posture . Results The Adapted Physical Activity program determined a significant improvement in several key parameters of the multidimensional assessment in comparison to the non-specific protocol : decreased occiput-to-wall distance , greater lower limb range of motion , better flexibility of pectoralis , hamstrings and hip flexor muscles , increased spine extensor muscles strength . Stereophotogrammetric analysis confirmed a reduced protrusion of the head and revealed a reduction in compensative postural adaptations to flexed posture characterized by knee flexion and ankle dorsiflexion in the participants of the specific program . Conclusion The Adapted Physical Activity program for flexed posture significantly improved postural alignment and musculoskeletal impairment of the elderly . The stereophotogrammetric evaluation of posture was useful to measure the global postural alignment and especially to analyse the possible compensatory strategies at lower limbs in flexed posture An extensive and growing number of review s of the published literature demonstrate that health research publications have frequent deficiencies . Of particular concern are poor reports of r and omised trials , which make it difficult or impossible for readers to assess how the research was conducted , to evaluate the reliability of the findings , or to place them in the context of existing research evidence . As a result , published reports of trials often can not be used by clinicians to inform patient care or to inform public health policy , and the data can not be included in systematic review s. Reporting guidelines are design ed to identify the key information that research ers should include in a report of their research . We describe the history of reporting guidelines for r and omised trials culminating in the CONSORT Statement in 1996 . We detail the subsequent development and extension of CONSORT and consider related initiatives aim ed at improving the reliability of the medical research literature OBJECTIVES To assess whether a specifically design ed yoga intervention can reduce hyperkyphosis . DESIGN A 6-month , two-group , r and omized , 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 comorbid 
    Output:
    
The adherence reported across studies suggests that exercise is an acceptable intervention for individuals with age-related hyperkyphosis .