Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial.
BACKGROUND
This randomised, single-blind controlled pilot trial aimed 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 randomly 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. Questionnaires 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 Standing 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 Standing 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.


CONCLUSIONS
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.


BACKGROUND
NCT00638768.
Bennell
Kim L
KL
Centre for Health, Exercise & Sports Medicine, Melbourne Physiotherapy School, University of Melbourne, Australia. k.bennell@unimelb.edu.au
Matthews
Bernadette
B
Greig
Alison
A
Briggs
Andrew
A
Kelly
Anne
A
Sherburn
Margaret
M
Larsen
Judy
J
Wark
John
J
D000368:Aged; D001416:Back Pain / Q000534:rehabilitation / Q000628:therapy; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010024:Osteoporosis / Q000534:rehabilitation* / Q000628:therapy*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011788:Quality of Life; D016037:Single-Blind Method; D016103:Spinal Fractures / Q000534:rehabilitation* / Q000628:therapy*; D016896:Treatment Outcome