School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan Campus, 1238 Discovery Avenue, Kelowna, BC, V1V 1V9, Canada.
International Collaboration On Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, BC, Canada.
Osteoporos Int. 2023 Jun;34(6):1065-1074. doi: 10.1007/s00198-023-06688-9. Epub 2023 Feb 17.
We identified a knowledge gap in the non-pharmacological and non-surgical management of osteoporotic vertebral fractures.
This international consensus process established multidisciplinary biopsychosocial recommendations on pain, nutrition, safe movement, and exercise for individuals with acute and chronic vertebral fractures.
These recommendations will guide clinical practice and inform interventions for future research.
To establish international consensus on recommendations for the non-pharmacological and non-surgical management of osteoporotic vertebral fractures.
We adopted a five-step modified Delphi consensus process: (1) literature search and content analysis, (2) creation of the survey, (3) selection of the expert panel, (4) first round of the rating process, and (5) second round of the rating process. The first round included 49 statements and eight open-ended questions; the second round included 30 statements. Panelists were asked to rate their agreement with each of the statements using a 9-point scale, with the option to provide further comments. Consensus for each statement was determined by counting the number of panelists whose rating was outside the 3-point region containing the median.
We invited 76 people with degree in medicine, physiotherapy, kinesiology, and experience in the management of osteoporotic vertebral; 31 (41%) and 27 (36%) experts agreed to participate to the first and the second round, respectively. The mean percentage agreement after the first and second rounds was 76.6% ± 16.0% and 90.7% ± 6.5%, respectively. We established consensus on recommendations on pain, early satiety, weight loss, bracing, safe movement, and exercise for individuals with acute and chronic vertebral fractures.
Our international consensus provides multidisciplinary biopsychosocial recommendations to guide the management of osteoporotic vertebral fractures and inform interventions for future research.
制定骨质疏松性椎体骨折非药物和非手术治疗的国际共识推荐意见。
我们采用了五步改良 Delphi 共识过程:(1)文献检索和内容分析,(2)制定调查,(3)选择专家小组,(4)第一轮评分过程,(5)第二轮评分过程。第一轮包括 49 个陈述和 8 个开放式问题;第二轮包括 30 个陈述。要求小组成员使用 9 分制对每个陈述的同意程度进行评分,并可提供进一步的意见。每个陈述的共识是通过计算评分不在包含中位数的 3 分区间内的小组成员人数来确定的。
我们邀请了具有医学、物理治疗、运动学学位和骨质疏松性椎体骨折管理经验的 76 人;31 人(41%)和 27 人(36%)专家分别同意参加第一轮和第二轮。第一轮和第二轮后的平均百分比协议分别为 76.6%±16.0%和 90.7%±6.5%。我们就急性和慢性椎体骨折患者的疼痛、早饱、体重减轻、支具、安全运动和运动制定了共识推荐意见。
我们的国际共识提供了多学科的生物心理社会推荐意见,以指导骨质疏松性椎体骨折的管理,并为未来的研究提供干预措施。