The global approach to rehabilitation following an osteoporotic fragility fracture: A review of the rehabilitation working group of the International Osteoporosis Foundation (IOF) committee of scientific advisors

Abstract

Purpose To conduct a review of the current state of the evidence for rehabilitation strategies post-fragility fracture. Methods Narrative review conducted by the Rehabilitation Working Group of the International Osteoporosis Foundation Committee of Scientific Advisors characterizing the range of rehabilitation modalities instrumental for the management of fragility fractures. Results Multi-modal exercise post-fragility fracture to the spine and hip is strongly recommended to reduce pain, improve physical function, and improve quality of life. Outpatient physiotherapy post-hip fracture has a stronger evidence base than outpatient physiotherapy post-vertebral fracture. Appropriate nutritional care after fragility fracture provides a large range of improvement in morbidity and mortality. Education increases understanding of osteoporosis which in turn increases utilization of other rehabilitation services. Education may improve other health outcomes such as pain and increase a patient's ability for self-advocacy. Conclusion Rehabilitation interventions are inter-reliant, and research investigating the interaction of exercise, nutrition, and other multi-modal therapies may increase the relevance of rehabilitation research to clinical care.

Healing of Vertebral Compression Fractures in the Elderly after Percutaneous Vertebroplasty—An Analysis of New Bone Formation and Sagittal Alignment in a 3-Year Follow-Up

“…We analyzed the long-term effects of vertebroplasty up to 3 years postoperatively. This might provide some values regarding decision-making and health education between patients with osteoporotic vertebral compression fractures and treating physicians [15]. New bone formation after PVP was observed in previous studies; however, it was only a small sample without a between-group comparison with and without new bone formation [12].…”

Multidisciplinary Care of a Vertebral Fracture in a Patient with Hematopoietic Stem Cell Transplant: Safety Appropriateness in Interventional Pain Management and Rehabilitation Considerations

“…Thoracolumbar bracing may be an option for reducing pain and preventing excessive forward flexion, particularly if there is an acute VF. Multi-modal exercise and nutritional programs after a fragility fracture of the spine have been shown to improve function and QoL and have been shown to offer improved morbidity and mortality [ 7 , 8 , 9 , 10 , 25 ].…”

Post-fracture care program in Egypt: merging subsequent fracture prevention and improving patients’ outcomes—an initiative by the Egyptian Academy of Bone Health

“…Meta-analyses and systematic reviews and of progressive resistance training, balance exercise, and structured supervised exercise interventions all revealed moderate to large positive results in physical function compared to controls in people post-hip fracture liaison rehabilitation, while on the other hand, home based exercise therapy has mixed outcome [53]. Future studies in different communities are still needed to determine which type of exercise program are cost effective especially in a community like Egypt where the elderly have less admission to senior homes, more chance of family support, lower economic status and difficult transportation that limit their chance to have the type of structured supervised exercise in medical facilities.…”