The Burden of Prevalent Vertebral Fractures is Negatively Associated with Functional Outcome in Women with Hip Fracture

Monaco, Marco Di; Vallero, Fulvia; Monaco, Roberto; Franza, G.; Tappero, Rosa

doi:10.1097/phm.0b013e31820174e8

Cited by 11 publications

(16 citation statements)

References 24 publications

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“…The effects of an MPP have been studied more frequently in populations where the BMI does not reach levels of obesity. These results are comparable to those of previous studies in which intra-group differences were observed [11,12]. In the primary outcome variable (disability measured by RMQ), the values obtained after 8 weeks of intervention with an MPP were highly significant; the decreasing disability levels observed here were similar to those obtained from previous trials, i.e., -8.74 (95% CI: -11.67 to -2.86) noted by us was comparable to 5.2 (95% CI 3.6 to 6.7) [11], 3.9 (95% CI 2.0 to 5.8) [9] and 3.0 (SD: ±4.8) [10].…”

Section: Discussionsupporting

confidence: 91%

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Obesity effect on a multimodal physiotherapy program for low back pain suffers: patient reported outcome

Cuesta‐Vargas

Gónzalez-Sánchez

2013

Journal of Occupational Medicine and Toxicology

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BackgroundSeveral studies have linked obesity to the increased likelihood of lower back pain, but there are no studies focussing on the effectiveness of a multimodal physiotherapy programme (MPP) in obese subjects who suffer from chronic non-specific lower back pain (CNLBP). The aim of this study was to compare the effectiveness of an MPP in obese (G1) (body mass index (BMI):≥30) and non-obese (G2) (BMI:<30) patients with CNLBP.MethodsA quasi-experimental study with pre- and post-intervention evaluations of an MPP (lasting 8 weeks) was conducted on obese and non-obese patients with CNLBP. A total of 53 people were included in the study: G1, composed of 19 patients (10 men and 9 women) with a BMI of 33.75 and a mean age of 52.94 years, and G2, composed of 34 patients (18 men and 16 women) with a mean age of 49.19 years and an average BMI of 25.56. All patients were measured to calculate pre-intervention (baseline) and post-intervention (8 weeks) changes in disability (RMQ) and health related quality of life in physical and mental health component state of SF12 and quality of life (EQ-5D and EQ-VAS).ResultsPost-intervention, non-obese group shown significant high improve than obese group in disability (RMQ: 4.00), physical component state of SF-12: (-7.26) and quality of life (EQ-VAS.: -10.49).ConclusionsIn patients with CNLBP, a BMI more than or equal to 30 minimises the effects of an MPP lasting 8 weeks.

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Section: Discussionsupporting

confidence: 91%

“…The combination of MT, TE and HE interventions on lower back pain has been shown to be effective in subjects with normal BMI [11,12], displaying improvements in pain, functional ability and general health [11,12]. …”

Section: Introductionmentioning

confidence: 99%

Obesity effect on a multimodal physiotherapy program for low back pain suffers: patient reported outcome

Cuesta‐Vargas

Gónzalez-Sánchez

2013

Journal of Occupational Medicine and Toxicology

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“…In fact, most previous studies reported similar functional outcomes in both fracture types at 6 months and at 1 year [19]. Moreover, our data seem to be in agreement with the study by Di Monaco et al [28] who reported that SDI was negatively associated with functional outcomes in elderly women with hip fracture admitted consecutively to a rehabilitation hospital. It is possible that the positive association between functional outcomes and levels of SDI could be due to an increased probability of trochanteric hip fracture in patients with an elevated SDI, since trochanteric hip fractures are characterized by a slower recovery.…”

Section: Discussionsupporting

confidence: 82%

“…In this study, 54.7 % of women with hip fracture presented vertebral fractures; however, this high prevalence is lower with respect to other similar studies carrying out spinal radiography in women with hip fracture, which reported vertebral fracture prevalence ranging from 65 to 75 % [10,27,28]. On the contrary, the study by Tosteson et al [29] reported a slightly lower prevalence, but in this latter study, spinal fracture prevalence was derived from anamnesis and clinical records only.…”

Section: Discussioncontrasting

confidence: 49%

The assessment of vertebral fractures in elderly women with recent hip fractures: the BREAK Study

et al. 2012

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Summary This study aimed to evaluate the prevalence of vertebral fractures in elderly women with a recent hip fracture. The burden of vertebral fractures expressed by the Spinal Deformity Index (SDI) is more strictly associated with the trochanteric than the cervical localization of hip fracture and may influence short-term functional outcomes. Introduction This study aimed to determine the prevalence and severity of vertebral fractures in elderly women with recent hip fracture and to assess whether the burden of vertebral fractures may be differently associated with trochanteric hip fractures with respect to cervical hip fractures. Methods We studied 689 Italian women aged 60 years or over with a recent low trauma hip fracture and for whom an adequate X-ray evaluation of spine was available. All radiographs were examined centrally for the presence of any vertebral deformities and radiological morphometry was performed. The SDI, which integrates both the number and the severity of fractures, was also calculated. Results Prevalent vertebral fractures were present in 55.7 % of subjects and 95 women (13.7 %) had at least one severe fracture. The women with trochanteric hip fracture showed higher SDI and higher prevalence of diabetes with respect to those with cervical hip fracture, p00.017 and p00.001, respectively. SDI, surgical menopause, family history of fragility fracture, and type2 diabetes mellitus were independently associated with the risk of trochanteric hip fracture. Moreover, a higher SDI was associated with a higher percentage of postsurgery complications (p00.05) and slower recovery (p<0.05). Conclusions Our study suggests that the burden of prevalent vertebral fractures is more strictly associated with the trochanteric than the cervical localisation of hip fracture and that elevated values of SDI negatively influence short term functional outcomes in women with hip fracture.

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“…Two studies suggested that SDI may be an accurate tool for vertebral fracture prediction and that baseline SDI was predictive of the 3-year incidence of subsequent vertebral fracture [16], [17]. Recently, the SDI has been found to be negatively associated with functional outcome in women with hip fracture admitted consecutively to a rehabilitation hospital [18]. This is in line with histological data showing that microarchitectural deterioration is proportionally worse in women with increasing severity of vertebral fractures [19].…”

Section: Introductionmentioning

confidence: 53%

Recognition of Morphometric Vertebral Fractures by Artificial Neural Networks: Analysis from GISMO Lombardia Database

Eller-Vainicher

Chiodini

Santi³

et al. 2011

PLoS ONE

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BackgroundIt is known that bone mineral density (BMD) predicts the fracture's risk only partially and the severity and number of vertebral fractures are predictive of subsequent osteoporotic fractures (OF). Spinal deformity index (SDI) integrates the severity and number of morphometric vertebral fractures. Nowadays, there is interest in developing algorithms that use traditional statistics for predicting OF. Some studies suggest their poor sensitivity. Artificial Neural Networks (ANNs) could represent an alternative. So far, no study investigated ANNs ability in predicting OF and SDI. The aim of the present study is to compare ANNs and Logistic Regression (LR) in recognising, on the basis of osteoporotic risk-factors and other clinical information, patients with SDI≥1 and SDI≥5 from those with SDI = 0.MethodologyWe compared ANNs prognostic performance with that of LR in identifying SDI≥1/SDI≥5 in 372 women with postmenopausal-osteoporosis (SDI≥1, n = 176; SDI = 0, n = 196; SDI≥5, n = 51), using 45 variables (44 clinical parameters plus BMD). ANNs were allowed to choose relevant input data automatically (TWIST-system-Semeion). Among 45 variables, 17 and 25 were selected by TWIST-system-Semeion, in SDI≥1 vs SDI = 0 (first) and SDI≥5 vs SDI = 0 (second) analysis. In the first analysis sensitivity of LR and ANNs was 35.8% and 72.5%, specificity 76.5% and 78.5% and accuracy 56.2% and 75.5%, respectively. In the second analysis, sensitivity of LR and ANNs was 37.3% and 74.8%, specificity 90.3% and 87.8%, and accuracy 63.8% and 81.3%, respectively.ConclusionsANNs showed a better performance in identifying both SDI≥1 and SDI≥5, with a higher sensitivity, suggesting its promising role in the development of algorithm for predicting OF.

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The Burden of Prevalent Vertebral Fractures is Negatively Associated with Functional Outcome in Women with Hip Fracture

Abstract: The burden of prevalent vertebral fractures is negatively associated with functional outcome in women with hip fracture.

Cited by 11 publications

References 24 publications

Obesity effect on a multimodal physiotherapy program for low back pain suffers: patient reported outcome

Obesity effect on a multimodal physiotherapy program for low back pain suffers: patient reported outcome

The assessment of vertebral fractures in elderly women with recent hip fractures: the BREAK Study

Recognition of Morphometric Vertebral Fractures by Artificial Neural Networks: Analysis from GISMO Lombardia Database

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