The Library
Physiotherapy rehabilitation for osteoporotic vertebral fracture—a randomised controlled trial and economic evaluation (PROVE trial)
Tools
Barker, K. L., Newman, M., Stallard, Nigel, Leal, J., Lowe, C. M., Javaid, M. K., Noufaily, Angela, Hughes, T., Smith, D., Gandhi, V., Cooper, C. and Lamb, S. E. (2020) Physiotherapy rehabilitation for osteoporotic vertebral fracture—a randomised controlled trial and economic evaluation (PROVE trial). Osteoporosis International, 31 . pp. 277-289. doi:10.1007/s00198-019-05133-0 ISSN 0937-941X.
|
PDF
WRAP-physiotherapy-rehabilitation-osteoporotic-vertebral-fracture-Stallard-2019.pdf - Accepted Version - Requires a PDF viewer. Download (1345Kb) | Preview |
Official URL: http://dx.doi.org/10.1007/s00198-019-05133-0
Abstract
Summary
The trial compared three physiotherapy approaches: manual or exercise therapy compared with a single session of physiotherapy education (SSPT) for people with osteoporotic vertebral fracture(s). At 1 year, there were no statistically significant differences between the groups meaning there is inadequate evidence to support manual or exercise therapy.
Introduction
To evaluate the clinical and cost-effectiveness of different physiotherapy approaches for people with osteoporotic vertebral fracture(s) (OVF).
Methods
>Prospective, multicentre, adaptive, three-arm randomised controlled trial. Six hundred fifteen adults with back pain, osteoporosis, and at least 1 OVF participated. Interventions: 7 individual physiotherapy sessions over 12 weeks focused on either manual therapy or home exercise compared with a single session of physiotherapy education (SSPT). The co-primary outcomes were quality of life and back muscle endurance measured by the QUALEFFO-41 and timed loaded standing (TLS) test at 12 months.
Results
At 12 months, there were no statistically significant differences between groups. Mean QUALEFFO-41: − 1.3 (exercise), − 0.15 (manual), and − 1.2 (SSPT), a mean difference of − 0.2 (95% CI, − 3.2 to 1.6) for exercise and 1.3 (95% CI, − 1.8 to 2.9) for manual therapy. Mean TLS: 9.8 s (exercise), 13.6 s (manual), and 4.2 s (SSPT), a mean increase of 5.8 s (95% CI, − 4.8 to 20.5) for exercise and 9.7 s (95% CI, 0.1 to 24.9) for manual therapy. Exercise provided more quality-adjusted life years than SSPT but was more expensive. At 4 months, significant changes above SSPT occurred in endurance and balance in manual therapy, and in endurance for those ≤ 70 years, in balance, mobility, and walking in exercise.
Conclusions
Adherence was problematic. Benefits at 4 months did not persist and at 12 months, we found no significant differences between treatments. There is inadequate evidence a short physiotherapy intervention of either manual therapy or home exercise provides long-term benefits, but arguably short-term benefits are valuable.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RM Therapeutics. Pharmacology | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
Library of Congress Subject Headings (LCSH): | Exercise therapy, Osteoporosis, Osteoporosis -- Treatment, Manipulation (Therapeutics), Spine -- Wounds and injuries -- Treatment, Musculoskeletal system -- Wounds and injuries -- Physical therapy | ||||||||
Journal or Publication Title: | Osteoporosis International | ||||||||
Publisher: | Springer London Ltd | ||||||||
ISSN: | 0937-941X | ||||||||
Official Date: | February 2020 | ||||||||
Dates: |
|
||||||||
Volume: | 31 | ||||||||
Page Range: | pp. 277-289 | ||||||||
DOI: | 10.1007/s00198-019-05133-0 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | This is a post-peer-review, pre-copyedit version of an article published in Osteoporosis International. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00198-019-05133-0 | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Copyright Holders: | International Osteoporosis Foundation and National Osteoporosis Foundation 2019 | ||||||||
Date of first compliant deposit: | 20 November 2019 | ||||||||
Date of first compliant Open Access: | 12 November 2020 | ||||||||
RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year