The Effect of Exercise Post Vertebral Augmentation In Osteoporotic Patients: A Systematic Review And Meta-Analysis.

This meta-analysis investigated the effects of exercise on visual analogue scale (VAS) and Oswestry disability index (ODI) scores following vertebroplasty or kyphoplasty in osteoporotic fractures. A literature search of PubMed, EMBASE (Elsevier), CiNAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science was conducted from database inception to 6 th October 2022. Eligible studies reported osteoporosis patients over 18 years of age with a diagnosis of at least one vertebral fracture via radiography or clinical assessment. This review was registered in PROSPERO (ID: CRD42022340791). Ten studies met the eligibility criteria (n= 889). VAS scores at baseline were 7.75 (95% CI: 7.54, 7.97, I 2 =76.11%). Following initiation of exercise, VAS scores at the endpoint of 12 months were 1.91 (95% CI: 1.53, 2.29, I 2 =92.69%). ODI scores at baseline were 68.66 (95% CI: 56.19, 81.13, I 2 =85%). Following initiation of exercise, ODI scores at the endpoint of 12 months were 21.20 (95% CI: 14.52, 27.87, I 2 =99.30). A two-arm analysis demonstrated improved VAS and ODI for the exercise group compared to non-exercise control at 6 months (MD=-0.70, 95% CI: -1.08, -0.32, I 2 =87% and MD=-6.48, 95% CI: -7.52, -5.44, I 2 =46% respectively) and 12 months (MD=-0.88, 95% CI: -1.27, -0.49, I 2 =85% and MD=-9.62, 95% CI: -13.24, -5.99, I 2 =93%). Refracture was the only adverse event reported and occurred almost twice as frequently in the non-exercise group than exercise. Exercise rehabilitation post vertebral augmentation is associated with improved pain and functionality, particularly after 6 months of exposure, and may reduce refracture rate. This article is protected by copyright. All rights reserved.