Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, BE-1090 Brussels, Belgium.
J Rehabil Med. 2010 Feb;42(2):129-35. doi: 10.2340/16501977-0486.
To explore the feasibility and effects of rehabilitation using manual mobilization of the thoracic spine in elderly female patients with osteoporosis.
Forty-eight postmenopausal patients with osteoporosis (age 76 -/+ 7 years) were randomly assigned to 3 months rehabilitation (18 sessions including manual mobilization, taping and exercises, n = 29) or control (wait-list, n = 19). The primary outcome was thoracic kyphosis degree (Spinal-Mouse). Secondary outcomes were back pain (visual analogue scale) and quality of life (Qualeffo-41). Explanatory outcomes were compliance with rehabilitation, complications, and patients' and therapists' perceptions regarding the rehabilitation programme.
Thoracic kyphosis improved significantly following rehabilitation compared with controls (intention-to-treat analysis, p = 0.017); and in patients who were compliant with rehabilitation (n = 15) compared with those who were non-compliant (p = 0.002) and controls (p = 0.001). Mental health worsened slightly in the rehabilitation group (p = 0.029), but not significantly compared with controls. Neither patients nor physical therapists reported serious adverse effects.
Three months of rehabilitation with manual mobilization can attenuate thoracic kyphosis in elderly patients with osteoporosis. Its impact on back pain and quality of life remains unclear and needs further investigation.
探索手法胸椎活动度康复对老年女性骨质疏松症患者的可行性和效果。
将 48 名绝经后骨质疏松症患者（年龄 76 +/- 7 岁）随机分为 3 个月康复组（18 次治疗，包括手法、贴扎和运动，n = 29）或对照组（等候名单，n = 19）。主要结局指标为胸椎后凸角度（脊柱鼠标）。次要结局指标为背痛（视觉模拟评分）和生活质量（Qualeffo-41）。解释性结局指标为康复依从性、并发症以及患者和治疗师对康复方案的看法。
与对照组相比，康复组的胸椎后凸角度显著改善（意向治疗分析，p = 0.017）；与不依从康复的患者（n = 15）相比，依从康复的患者（p = 0.002）和对照组（p = 0.001）的胸椎后凸角度也显著改善。康复组的心理健康状况略有恶化（p = 0.029），但与对照组相比无显著差异。患者和物理治疗师均未报告严重不良事件。
3 个月的手法胸椎活动度康复可以减轻老年骨质疏松症患者的胸椎后凸角度。其对背痛和生活质量的影响尚不清楚，需要进一步研究。
