Are the KypDisT and conventional C7WD are practical, valid, reliable, and effectiveness of the tools to discriminate the functional ability impairments relating to kyphosis when compare with gold standard (Cobb's method), and compare among physical therapy, VHS and caregiver?

1. To further develop an innovation to measure kyphosis using distance from the wall, a Kyphosis wall distance tool (KypDisT).

2. investigate validity of the measurements in terms of 2.1 Concurrent validity of conventional C7WD and KypDisT as compared to a gold standard (Cobb's method).

   2.2 Discriminative ability of conventional C7WD and KypDisT on functional abilities in elderly with different severity of kyphosis.

3. To investigate the reliability of the measurements in terms of 3.1 Test-retest reliability of conventional C7WD and KypDisT. 3.2 Reliability of conventional C7WD and KypDisT comparing among physical therapy, VHS and caregiver.

4. To explore the distance to indicate risk of spinal fracture to indicate a risk of spinal fracture.

Inclusion Criteria:

• Community-dwelling elderly with different degrees of kyphosis,
• Aged at least 60 years
• Body mass index between 18.5-29.9 kg/m2
• OWD >0 cm.

Exclusion Criteria:

• Present signs and symptoms that may affect participation in the study, i.e. unstable medical condition, pain or inflammation in the joints of the lower extremity (pain scale > 5), having sequelae of neurological deficits
• Unable to understand and follow a simple command used in the study.

Elderly who live community-dwelling with different degrees of kyphosis, aged at least 60 years with a body mass index between 18.5-29.9 kg/m2 and OWD >0 cm. (Wongsa et al., 2012). However, elderly are excluded if they present signs and symptoms that may affect participation in the study, i.e. unstable medical condition, pain or inflammation in the joints of the lower extremity (pain scale > 5), having sequelae of neurological deficits, and unable to understand and follow a simple command used in the study.