Back pain, postural balance and quality of life in vertebral fragility fractures: a prospective cohort study

Abstract

Osteoporosis is characterized by poor bone quality, reduced bone mass and and increased risk of fragility fractures. Vertebral fragility fracture can result in chronic pain, postural and balance disorders and poor quality of life (QoL). The purpose of this longitudinal cohort study was to assess the effectiveness of two months of rehabilitation in patients with at least two vertebral fragility fractures receiving vitamin D and denosumab. In 28 patients, we studied the following measures of outcome before (T0) and after (T1) an eight-week rehabilitation programme: pain (Numerical Rating Scale), QoL (36-Item Short Form Survey and Mini-Osteoporosis Quality of Life Questionnaire), vertigo (Dizziness Handicap Inventory, Italian version), mobility (Timed-Up and Go, TUG test) and instrumental posturographic assessment (posturography system). At the end of the treatment improvements in pain and QoL were recorded in all the patients. Pain reduction was recorded in patients with more than two vertebral fractures. In addition, functional improvement (TUG test) was found in those with two vertebral fractures. Our results suggest that combined intervention, including anti-osteoporosis drugs (denosumab, vitamin D) and postural rehabilitation, should be proposed to osteoporotic patients with multiple fragility vertebral fractures. KEY WORDS: Osteoporosis, postural balance, pain, quality of life.