Exercise Adherence Support Boosts Vertebral Fracture Rehab

Medscape

07-07-2025

TOPLINE:
A tailored exercise adherence intervention integrated into physiotherapy rehabilitation enhanced mobility outcomes in people with vertebral fragility fractures. At 12 months, participants who received adherence support demonstrated better functional mobility and exercise capacity than those who received standard rehabilitation.
METHODOLOGY:
Researchers conducted a randomised controlled trial to evaluate whether adding a tailored, theory-driven adherence support intervention to a standard physiotherapy exercise programme improves outcomes in people with osteoporotic vertebral fragility fractures.
They enrolled 126 participants (mean age, 72.7 years; 83% women) from eight hospitals in England and Wales, all of whom had at least one vertebral fragility fracture confirmed using radiography, X-ray, MRI, or DEXA; had experienced back pain in the past 12 months; and were able to walk 10 m independently.
Participants were randomly assigned to either the control group or the intervention group (n = 63 each), where both received progressive exercise rehabilitation including musculoskeletal assessments, treatment sessions, and a home exercise plan comprising strength, posture, and balance exercises over 4 months.
The intervention group also received an integrated exercise adherence intervention that used a motivational interviewing approach with goal setting and three or more behaviour change techniques.
The primary outcome was the Timed-Up and Go test at 12 months that assessed balance, lower limb function, functional mobility, and fall risk, whereas secondary outcomes included measures of physical functions and self-reported outcomes.
TAKEAWAY:
At the 12-month follow-up, the intervention group demonstrated a faster performance in the Timed-Up and Go test than the control group by 2.1 seconds (P < .01), which was clinically significant.
In the 6-minute walk test that determines functional exercise capacity, the intervention group covered a significantly greater walking distance than the control group (mean difference, 24.5 m; P < .01).
No significant differences were observed between groups in other outcome measures of physical functions including thoracic kyphosis, test of dynamic standing balance, and test of shoulder and back muscle endurance.
No intervention-related serious adverse events or adverse events were reported in either group.
IN PRACTICE:
"The results of this study provide evidence that integrating tailored support for exercise behaviour throughout physiotherapy exercise rehabilitation for people with VFF [vertebral fragility fractures] can help to sustain effects and improve longer-term functional mobility outcomes," the authors wrote.
SOURCE:
This study was led by Karen L. Barker, Oxford University Hospitals NHS Foundation, Oxford, England. It was published online on June 30, 2025, in Osteoporosis International.
LIMITATIONS:
Physiotherapists and participants were necessarily aware of their allocated group. Physiotherapists had differing levels of knowledge and experience of using the motivational interviewing approach.
DISCLOSURES:
This study received support from the Chartered Society of Physiotherapy Charitable Trust. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.