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01-06-2016 | Imaging (T Lang and F Wehrli, Section Editors)

The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management

Authors: Hossein Mokhtarzadeh, Dennis E. Anderson

Published in: Current Osteoporosis Reports | Issue 3/2016

Abstract

This review examines the current evidence for associations between vertebral fractures (VFx), the most common type of fracture in older adults, and trunk muscles, which are intimately tied to spinal loading and function. Individuals with prevalent VFxs have more fat infiltration in the trunk muscles, lower trunk extension strength, and altered muscle activation patterns. However, no longitudinal studies have examined whether assessment of trunk muscle can contribute to prediction of fracture risk. A few studies report that exercise interventions targeting the trunk muscles can reduce the risk of VFx, improve trunk strength and endurance in patients who have had a VFx, and reduce the risk of falling, a common cause of VFx, but the quality of evidence is low. Trunk muscles likely have an important role to play in prediction, prevention, and management of VFx, but additional longitudinal studies and randomized controlled trials are needed to clarify this role.

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Barker KL, Javaid MK, Newman M, Minns Lowe C, Stallard N, Campbell H, et al. Physiotherapy rehabilitation for osteoporotic vertebral fracture (PROVE): study protocol for a randomized controlled trial. Trials. 2014;15(1):22. This paper presents the protocol for an ongoing RCT of 600 people with clinically diagnosed VFxs to study the effectiveness of exercise-based physiotherapy (including spine extensor and stabilization exercises), a manual therapy-based physiotherapy, or usual care. The primary outcomes will be Quality of Life and trunk muscle endurance (i.e. TLS) test outcomes at 1 year, and importantly incident VFx and falls will also be assessed, providing needed information on safety and whether these interventions may help in VFx prevention.CrossRefPubMedPubMedCentral

85.•

Giangregorio LM, Thabane L, Adachi JD, Ashe MC, Bleakney RR, Braun EA, et al. Build better bones with exercise: protocol for a feasibility study of a multicenter randomized controlled trial of 12 months of home exercise in women with a vertebral fracture. Phys Ther. 2014;94(9):1337–52. This paper presents the protocol for a pilot multicenter RCT recruiting 160 women aged ≥65 years with a prevalent VFx, examining the effect of an exercise intervention group compared with controls receiving equal attention but no exercise advice. The intervention involves personalized and progressive exercises (at least three times a week) targeting lower limb strength, balance, posture, upper extremity strength and endurance Trunk extensor muscle endurance (via TLS test) will be assessed at two study sites. Importantly incident VFx and falls will also be assessed, providing needed information on safety and whether the intervention may help in VFx prevention.CrossRefPubMedPubMedCentral

Title: The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management
Authors: Hossein Mokhtarzadeh
Dennis E. Anderson
Publication date: 01-06-2016
Publisher: Springer US
Published in: Current Osteoporosis Reports / Issue 3/2016
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI: https://doi.org/10.1007/s11914-016-0305-4

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The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management

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Keynote webinar | Spotlight on medication adherence

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Abstract

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