Scaturro Dalila, Rizzo Serena, Sanfilippo Valeria, Giustino Valerio, Messina Giuseppe, Martines Francesco, Falco Vincenzo, Cuntrera Daniele, Moretti Antimo, Iolascon Giovanni, Letizia Mauro Giulia
Department of Oncology and Stomatological Surgical Disciplines, University of Palermo, 90100 Palermo, Italy.
Program in Health Promotion and Cognitive Sciences, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90100 Palermo, Italy.
J Funct Morphol Kinesiol. 2021 Mar 3;6(1):24. doi: 10.3390/jfmk6010024.
Patients with vertebral fragility fractures often experience chronic pain, postural and balance disorders, and poor quality of life (QoL). Although several studies have investigated the role of rehabilitation in severe osteoporosis, the effectiveness of this intervention in patients with multiple vertebral fractures is poorly known. The aim of our longitudinal cohort study is to evaluate the effectiveness of rehabilitation, including postural training, resistance exercises, and visual stabilization exercises, for a 7-week period, on the pain, postural balance, and QoL of subjects with at least two vertebral fragility fractures receiving denosumab and vitamin D. We investigated, before (T0) and after (T1, at 7 weeks) rehabilitation, the following outcome measures on 28 patients: pain (Numerical Rating Scale (NRS)), self-perceived QoL (36-Item Short Form Survey (SF-36) and Mini-Osteoporosis Quality of Life Questionnaire (Mini-OQOL)), dizziness (Dizziness Handicap Inventory (DHI-I)), mobility (Timed-Up and Go (TUG) test), and instrumental posturographic assessment (FreeMed posturography system). At the end of the treatment, improvements of pain and QoL were recorded. Pain relief was highly obtained in patients with more than two vertebral fractures. Moreover, a significant functional improvement (TUG test) was found in those with two vertebral fractures, without any statistically significant change reported for other outcomes. Our findings suggest that combined intervention, including anti-osteoporotic drugs and postural rehabilitation, should be proposed to osteoporotic patients with multiple vertebral fractures.
椎体脆性骨折患者常伴有慢性疼痛、姿势及平衡障碍，生活质量较差。尽管多项研究探讨了康复治疗在重度骨质疏松症中的作用，但该干预措施对多发性椎体骨折患者的有效性仍知之甚少。我们纵向队列研究的目的是评估康复治疗（包括姿势训练、抗阻运动和视觉稳定训练）对至少有两处椎体脆性骨折且正在接受地诺单抗和维生素D治疗的患者在7周内疼痛、姿势平衡和生活质量方面的有效性。我们在康复治疗前（T0）和治疗后7周（T1）对28例患者进行了以下指标的评估：疼痛（数字评定量表（NRS））、自我感知生活质量（36项简明健康调查量表（SF-36）和骨质疏松症生活质量简易问卷（Mini-OQOL））、头晕（头晕残障量表（DHI-I））、活动能力（计时起立行走测试（TUG））以及仪器化姿势分析（FreeMed姿势分析系统）。治疗结束时，记录到疼痛和生活质量有所改善。在有两处以上椎体骨折的患者中疼痛得到了显著缓解。此外，在有两处椎体骨折的患者中发现了显著的功能改善（TUG测试），而其他指标未见统计学上的显著变化。我们的研究结果表明，对于多发性椎体骨折的骨质疏松症患者，应建议采用包括抗骨质疏松药物和姿势康复在内的联合干预措施。
