The effect of spinal orthoses on pain, kyphosis angle, balance, fall risk, and quality of life in older adults with hyperkyphosis: A systematic review

Hyperkyphosis, defined as excessive forward thoracic curvature, is associated with pain, impaired balance, increased fall risk, and reduced quality of life in older adults. Spinal orthoses have been proposed as a therapeutic option. This systematic review evaluated their effects on pain, kyphosis angle, balance, fall risk, and quality of life. The protocol was registered in PROSPERO (CRD42024607584) and followed PRISMA 2020 guidelines. Comprehensive searches of PubMed, Web of Science, Scopus, CINAHL, and Cochrane Library up to November 2024 identified 16 eligible studies involving 757 participants and 13 orthosis types. Inclusion criteria covered clinical trials, cohort, cross-sectional, and observational studies in adults ≥60 years with hyperkyphosis, while surgical, pharmacological, and non-hyperkyphotic studies were excluded. Data were synthesized qualitatively, with balance outcomes classified as static or dynamic, and orthoses categorized by design and function. Risk of bias was assessed using PEDro and ROBINS-I. Findings suggest spinal orthoses, particularly semi-rigid devices, may reduce kyphosis angle, alleviate pain, enhance balance, and improve quality of life. Nonetheless, heterogeneity, limited blinding, and non-randomized designs reduce certainty. Further high-quality trials are warranted to strengthen evidence. No funding was received.