Effectiveness of Early Rehabilitation for Vertebral Compression Fractures: A Retrospective Cohort Study

Background and Purpose: Most patients become physically inactive after vertebral compression fracture and thus need help for early mobilization. This study sought to investigate the effect of early rehabilitation on activities of daily living in patients following acute vertebral compression fracture. Methods: We conducted this retrospective cohort study with a hospital-based database created by the Japan Medical Data Center and comprising data from a Diagnosis Procedure Combination survey from more than 100 acute care hospitals across Japan. Data of consecutive inpatients hospitalized because of thoracic and/or lumbar compression fractures from 2014 to 2018 were extracted. We compared characteristics and outcomes between patients who underwent early rehabilitation (early rehabilitation group) and those who did not undergo rehabilitation (no rehabilitation group). The primary outcome measure was Barthel Index improvement. Results: After applying exclusion criteria, a total of 8493 eligible patients with acute vertebral compression fracture were included in this study. The unadjusted data showed significantly greater Barthel Index improvement (72.5% vs 60.3, P < .001) and a higher rate of discharge to home (82.9% vs 77.4, P < .001) among patients in the early rehabilitation group compared with the no rehabilitation group. After adjustment by propensity score analysis, significant between-group differences were found. Conclusion: Early rehabilitation could possibly be a feasible alternative for maintenance of the Barthel Index in patients with acute vertebral compression fracture.

Automated summary

This study investigated the effect of early rehabilitation on activities of daily living in patients following acute vertebral compression fracture. Patients who underwent early rehabilitation showed significantly greater improvement in Barthel Index and a higher rate of discharge to home compared to those who did not undergo rehabilitation. Early rehabilitation could be a feasible alternative for maintaining Barthel Index in patients with acute vertebral compression fracture.