PDF(Pubmed)
Abstract：
BACKGROUND: Osteoporotic vertebral fractures affect a large number of older adults OBJECTIVES: Systematically review evidence of the benefits and harms of non-surgical and non-pharmacological management of people with osteoporotic vertebral fractures compared with standard care (control); and evaluate the benefits and harms of non-surgical and non-pharmacological management of people with osteoporotic vertebral fractures compared with an alternative non-pharmacological, non-invasive intervention.
METHODS: Systematic review and meta-analysis of randomized controlled trials. Five electronic databases (CINAHL, EMBASE, MEDLINE, PUBMED, and COCHRANE) were searched. Eligible trials included participants with primary osteoporosis and at least one vertebral fracture diagnosed on radiographs, with treatment that was non-surgical and non-pharmacological involving more than one session.
RESULTS: Twenty randomized controlled trials were included with 2083 participants with osteoporotic vertebral fractures. Exercise, bracing, multimodal therapy, electrotherapy, and taping were investigated interventions. Meta-analyses provided low certainty evidence that exercise interventions compared to no exercise were effective in reducing pain in patients with osteoporotic vertebral fractures (mean difference (MD)= 1.01; 95% confidence interval (CI): 0.08, 1.93), and low certainty evidence that rigid bracing intervention compared with no bracing was effective in reducing pain in patients with osteoporotic vertebral fractures (MD= 2.61; 95%CI: 0.95, 4.27). Meta-analyses showed no differences in harms between exercise and no exercise groups. No health-related quality of life or activity improvements were demonstrated for exercise interventions, bracing, electrotherapy, or multimodal interventions.
CONCLUSIONS: Exercise and rigid bracing as management for patients with osteoporotic vertebral fractures may have a small benefit for pain without increasing risk of harm.
BACKGROUND: PROSPERO registration number CRD42012002936.
METHODS: Systematic review and meta-analysis of randomized controlled trials. Five electronic databases (CINAHL, EMBASE, MEDLINE, PUBMED, and COCHRANE) were searched. Eligible trials included participants with primary osteoporosis and at least one vertebral fracture diagnosed on radiographs, with treatment that was non-surgical and non-pharmacological involving more than one session.
RESULTS: Twenty randomized controlled trials were included with 2083 participants with osteoporotic vertebral fractures. Exercise, bracing, multimodal therapy, electrotherapy, and taping were investigated interventions. Meta-analyses provided low certainty evidence that exercise interventions compared to no exercise were effective in reducing pain in patients with osteoporotic vertebral fractures (mean difference (MD)= 1.01; 95% confidence interval (CI): 0.08, 1.93), and low certainty evidence that rigid bracing intervention compared with no bracing was effective in reducing pain in patients with osteoporotic vertebral fractures (MD= 2.61; 95%CI: 0.95, 4.27). Meta-analyses showed no differences in harms between exercise and no exercise groups. No health-related quality of life or activity improvements were demonstrated for exercise interventions, bracing, electrotherapy, or multimodal interventions.
CONCLUSIONS: Exercise and rigid bracing as management for patients with osteoporotic vertebral fractures may have a small benefit for pain without increasing risk of harm.
BACKGROUND: PROSPERO registration number CRD42012002936.
摘要：
背景：骨质疏松性椎骨骨折影响大量老年人目的：系统地回顾与标准治疗（对照）相比，非手术和非药物治疗骨质疏松性椎骨骨折患者的益处和危害的证据；并评估与替代非药物治疗相比，非手术和非药物治疗骨质疏松性椎骨骨折患者的益处和危害。非侵入性干预。
方法：随机对照试验的系统评价和荟萃分析。五个电子数据库(CINAHL，EMBASE,MEDLINE,pubmed,和COCHRANE)进行了搜索。符合条件的试验包括原发性骨质疏松症和至少一个在X光片上诊断出的椎骨骨折的参与者。非手术和非药物治疗涉及多个疗程。
结果：20项随机对照试验纳入2083例骨质疏松性椎体骨折患者。锻炼,支撑,多模式疗法,电疗,和录音进行了干预调查。荟萃分析提供了低确定性证据，表明与不进行运动相比，运动干预可有效减轻骨质疏松性椎体骨折患者的疼痛（平均差异（MD）=1.01；95％置信区间（CI）：0.08，1.93），和低确定性证据表明，刚性支撑干预与无支撑相比，可有效减轻骨质疏松性椎体骨折患者的疼痛（MD=2.61;95CI：0.95,4.27）。荟萃分析显示，运动组和不运动组之间的危害没有差异。运动干预没有表现出与健康相关的生活质量或活动改善，支撑,电疗,或多模式干预。
结论：运动和刚性支撑作为骨质疏松性椎体骨折患者的治疗可能对疼痛有很小的益处，而不会增加伤害风险。
背景：PROSPERO注册号CRD42012002936。
方法：随机对照试验的系统评价和荟萃分析。五个电子数据库(CINAHL，EMBASE,MEDLINE,pubmed,和COCHRANE)进行了搜索。符合条件的试验包括原发性骨质疏松症和至少一个在X光片上诊断出的椎骨骨折的参与者。非手术和非药物治疗涉及多个疗程。
结果：20项随机对照试验纳入2083例骨质疏松性椎体骨折患者。锻炼,支撑,多模式疗法,电疗,和录音进行了干预调查。荟萃分析提供了低确定性证据，表明与不进行运动相比，运动干预可有效减轻骨质疏松性椎体骨折患者的疼痛（平均差异（MD）=1.01；95％置信区间（CI）：0.08，1.93），和低确定性证据表明，刚性支撑干预与无支撑相比，可有效减轻骨质疏松性椎体骨折患者的疼痛（MD=2.61;95CI：0.95,4.27）。荟萃分析显示，运动组和不运动组之间的危害没有差异。运动干预没有表现出与健康相关的生活质量或活动改善，支撑,电疗,或多模式干预。
结论：运动和刚性支撑作为骨质疏松性椎体骨折患者的治疗可能对疼痛有很小的益处，而不会增加伤害风险。
背景：PROSPERO注册号CRD42012002936。
