Association of early physical activity time with pain, activities of daily living, and progression of vertebral body collapse in patients with vertebral compression fractures.

BACKGROUND

Physical activity can reduce pain and improve the ability to perform daily activities in patients with acute low back pain (LBP) due to various non-specific causes. The association between physical activity during the early phase of acute vertebral compression fractures (VCFs) and rehabilitation outcomes is unknown.

AIM: The aim of this study was to investigate the effects of early physical activity time (EPAT) on pain following acute VCFs, recovery of the ability to perform activities of daily living (ADLs), and progression of fractured vertebral body collapse.

DESIGN

Observational study.

SETTING

Inpatient clinic.

POPULATION: Sixty-nine patients with acute VCFs being treated conservatively at Nagasaki Memorial Hospital.

METHODS

Physical activity was evaluated as the activity time corresponding to 1.8-8.3 metabolic equivalent activities measured by a motion-sensor during the first week after admission; it was defined as EPAT. The verbal rating scale (VRS) (0-4) at rest and during standing and walking and motor functional independence measure (mFIM) were assessed at weeks 0 (baseline), 2, and 4. Loss of vertebral height was measured in week 4. Mini-mental state examinations, trail making test part-A (TMT-A), and geriatric depression scale-15 were administered at baseline. Patients were divided into active (N.=35) and sedentary (N.=34) groups according to their median EPAT value during the first week.

RESULTS

The completion times for TMT-A and mFIM scores at baseline as well as the relative functional gains of mFIM from baseline to week 2 or 4 were significantly associated with EPAT. VRS at rest and during standing and walking were not significantly different between the groups at week 2 and 4. Loss of vertebral height was not significantly different between the groups.

CONCLUSIONS

EPAT in patients with acute VCF is associated with the recovery of the ability to perform ADLs. However, EPAT is associated with neither pain reduction nor progression of fractured vertebral body collapse.

CLINICAL REHABILITATION IMPACT: This observational study indicates that physical activity in the early acute phase of VCF is associated with better recovery from acute VCF and would be an important factor for short-term recovery.