Exercise therapy and bracing in patients with osteoporotic compression vertebral fractures

Abstract

Osteoporotic vertebral fractures (VF) have a negative impact on quality of life within a year after injury. A recent-onset vertebral body compression fracture in the presence of osteoporosis (OP) is generally accompanied by acute back pain, hypokinesia, and a reduction in daily physical and social activities, further leading to social isolation. Rehabilitation measures are of particular importance to restore quality of life in OP patients, especially in the people who have a history of fractures. Exercise therapy is the mainstay of management in patients with OP and VF; however, pain and limited mobility can be a barrier to exercises. Competent bracing is a method that can assist in reducing pain in VF, stabilizing the spine, and increasing motor activity. The use of an orthosis not only improves quality of life, but also gives an opportunity to take physical exercises. Semi-rigid and elastic corsets are preferable to rigid structures that are less convenient to use and associated with a large number of undesirable phenomena. Wearing a brace continuously (with its obligatory taking off overnight) is rational for 6-8 weeks. Above this period, there is an increased risk of muscle atrophy. It is acceptable to longer use orthoses situationally, if there is a need to be in an upright position, during long walks, trips, or physical exercises.