Physiotherapy post Vertebral Fragility Fracture: A Scoping Review

Abstract

Background

The incidence of vertebral fragility fractures (VFF) is rising, placing a major burden on individuals and health systems. No comprehensive picture of the research regarding physiotherapy exists for this patient cohort.

Objectives

This scoping review aims to summarise the research regarding Physiotherapy post VFF, the type of physiotherapy interventions employed and outcome measures utilised.

Design

Scoping review, adhering to the Joanna Briggs Institute guidelines. Databases searched were PubMed, PEDro, CINAHL, CochraneEmbase from 2005 to November 2021. Grey literature searching was conducted using ProQuest and Open Grey. A narrative summary of data was compiled to describe the current evidence regarding physiotherapy post VFF.

Study Selection

Articles were included if they related to Physiotherapy interventions delivered to patients with VFF in any setting.

Data Synthesis

A narrative synthesis was conducted.

Results

Thirteen studies were included with five randomised control trials, three pilot RCTs, two qualitative studies, one cross-sectional survey of clinicians, one cohort study and one prospective comparative study. Interventions most commonly reported were exercise, education or manual therapy. A large diversity of outcome measures was utilised most commonly in the spinal deformity, physical performance and balance, pain and quality of life domains.

Conclusion

Findings of this scoping review indicate the limited evidence to guide physiotherapists in the management of patients with VFF. The most commonly explored physiotherapy interventions were exercise, manual therapy and education. A diversity of outcome measures is utilised. Research is urgently needed, including high quality clinical trials with representative populations and studies exploring physiotherapy practice and the experience of patients with VFF.

Contribution of the Paper

  • To the authors’ knowledge, this is the first scoping review of the literature about physiotherapy post vertebral fragility fracture.
  • This review gives an important overview of: study designs and extent of research regarding physiotherapy; type of physiotherapy interventions employed, outcome measures utilised and summary of response to physiotherapy interventions post vertebral fragility fracture.
  • This review has value for both physiotherapy clinicians and researchers. The need for more high quality research to inform the clinical management of the growing VFF patient cohort has been highlighted.