International consensus on the non-pharmacological and non-surgical management of osteoporotic vertebral fractures

Matteo Ponzano^{1

2}, N Tibert³, S Brien⁴, L Funnell⁴, J C Gibbs⁵, H Keller^{3

6}, J Laprade⁷, S N Morin⁸, A Papaioannou⁹, Z Weston^{10

11}, T H Wideman¹², L M Giangregorio^{3

6}

Affiliations

¹ School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan Campus, 1238 Discovery Avenue, Kelowna, BC, V1V 1V9, Canada. matteo.ponzano@ubc.ca.
² International Collaboration On Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, BC, Canada. matteo.ponzano@ubc.ca.
³ Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2T0G6, Canada.
⁴ Canadian Osteoporosis Patient Network, Osteoporosis Canada, 201 - 250 Ferrand Dr, Toronto, ON, M3C 3G8, Canada.
⁵ Department of Kinesiology and Physical Activity, McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A0G4, Canada.
⁶ Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada.
⁷ Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, M5S, Canada.
⁸ Department of Medicine, McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A0G4, Canada.
⁹ Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S4L8, Canada.
¹⁰ Canadian Society for Exercise Physiology (CSEP), Ottawa, Canada.
¹¹ Wilfrid Laurier University, 75 University Ave W, Waterloo, ON, N2L3C5, Canada.
¹² School of Physical & Occupational Therapy, McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A0G4, Canada.

PMID: 36799981
DOI: 10.1007/s00198-023-06688-9

International consensus on the non-pharmacological and non-surgical management of osteoporotic vertebral fractures

Matteo Ponzano et al. Osteoporos Int. 2023 Jun.

. 2023 Jun;34(6):1065-1074.

doi: 10.1007/s00198-023-06688-9. Epub 2023 Feb 17.

Authors

Matteo Ponzano^{1

2}, N Tibert³, S Brien⁴, L Funnell⁴, J C Gibbs⁵, H Keller^{3

6}, J Laprade⁷, S N Morin⁸, A Papaioannou⁹, Z Weston^{10

11}, T H Wideman¹², L M Giangregorio^{3

6}

Affiliations

¹ School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan Campus, 1238 Discovery Avenue, Kelowna, BC, V1V 1V9, Canada. matteo.ponzano@ubc.ca.
² International Collaboration On Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, BC, Canada. matteo.ponzano@ubc.ca.
³ Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2T0G6, Canada.
⁴ Canadian Osteoporosis Patient Network, Osteoporosis Canada, 201 - 250 Ferrand Dr, Toronto, ON, M3C 3G8, Canada.
⁵ Department of Kinesiology and Physical Activity, McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A0G4, Canada.
⁶ Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada.
⁷ Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, M5S, Canada.
⁸ Department of Medicine, McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A0G4, Canada.
⁹ Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S4L8, Canada.
¹⁰ Canadian Society for Exercise Physiology (CSEP), Ottawa, Canada.
¹¹ Wilfrid Laurier University, 75 University Ave W, Waterloo, ON, N2L3C5, Canada.
¹² School of Physical & Occupational Therapy, McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A0G4, Canada.

PMID: 36799981
DOI: 10.1007/s00198-023-06688-9

Erratum in

Publisher Correction: International consensus on the non-pharmacological and non-surgical management of osteoporotic vertebral fractures.
Ponzano M, Tibert N, Brien S, Funnell L, Gibbs JC, Keller H, Laprade J, Morin SN, Papaioannou A, Weston Z, Wideman TH, Giangregorio LM. Ponzano M, et al. Osteoporos Int. 2023 Jun;34(6):1139. doi: 10.1007/s00198-023-06717-7. Osteoporos Int. 2023. PMID: 37036475 No abstract available.

Abstract

We identified a knowledge gap in the non-pharmacological and non-surgical management of osteoporotic vertebral fractures.

Main results: This international consensus process established multidisciplinary biopsychosocial recommendations on pain, nutrition, safe movement, and exercise for individuals with acute and chronic vertebral fractures.

Significance: These recommendations will guide clinical practice and inform interventions for future research.

Purpose: To establish international consensus on recommendations for the non-pharmacological and non-surgical management of osteoporotic vertebral fractures.

Methods: We adopted a five-step modified Delphi consensus process: (1) literature search and content analysis, (2) creation of the survey, (3) selection of the expert panel, (4) first round of the rating process, and (5) second round of the rating process. The first round included 49 statements and eight open-ended questions; the second round included 30 statements. Panelists were asked to rate their agreement with each of the statements using a 9-point scale, with the option to provide further comments. Consensus for each statement was determined by counting the number of panelists whose rating was outside the 3-point region containing the median.

Results: We invited 76 people with degree in medicine, physiotherapy, kinesiology, and experience in the management of osteoporotic vertebral; 31 (41%) and 27 (36%) experts agreed to participate to the first and the second round, respectively. The mean percentage agreement after the first and second rounds was 76.6% ± 16.0% and 90.7% ± 6.5%, respectively. We established consensus on recommendations on pain, early satiety, weight loss, bracing, safe movement, and exercise for individuals with acute and chronic vertebral fractures.

Conclusion: Our international consensus provides multidisciplinary biopsychosocial recommendations to guide the management of osteoporotic vertebral fractures and inform interventions for future research.

Keywords: Education; Fragility fractures; Osteoporosis; Rehabilitation; Spine.

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References

1. Nevitt MC (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793 - PubMed - DOI
1. Ettinger B et al (2009) Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res 7:449–456 - DOI
1. Griffith JF (2015) Identifying osteoporotic vertebral fracture. Quant Imaging Med Surg 5:11
1. Fink HA et al (2003) Disability after clinical fracture in postmenopausal women with low bone density: the fracture intervention trial (FIT). Osteoporos Int 14:69–76 - PubMed - DOI
1. Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005 - PubMed - DOI

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International consensus on the non-pharmacological and non-surgical management of osteoporotic vertebral fractures

Affiliations

International consensus on the non-pharmacological and non-surgical management of osteoporotic vertebral fractures

Authors

Affiliations

Erratum in

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

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