Acute-phase rehabilitation for osteoporotic vertebral fractures: current evidence from scoping review

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Abstract
Study Design: Scoping review.Purpose: To map and summarize current evidence on acute-phase rehabilitation in patients with osteoporotic vertebral fractures (OVFs), with particular emphasis on intervention characteristics, safety, and clinical effectiveness.Overview of Literature: Existing reviews on osteoporotic vertebral compression fractures have predominantly focused on pharmacological or bracing strategies, whereas evidence regarding rehabilitation in the acute phase remains limited.Methods: A literature search was performed using PubMed, Google Scholar, and the Physiotherapy Evidence Database to identify studies published between January 2015 and December 2025. Eligible studies included patients with vertebral compression fractures or OVFs who underwent rehabilitation or exercise-based interventions within 4 weeks of symptom onset. Extracted data were narratively synthesized.Results: This review identified 1,034 records and included seven studies. The included studies were heterogeneous in design and enrolled between 34 and 40,743 participants. In most studies, rehabilitation was initiated within 2 weeks of onset, with several studies reporting initiation within 3 days of admission. Early initiation of rehabilitation within 3 days was associated with greater improvements in the Barthel index (BI) (p <0.001). Longer daily rehabilitation duration was associated with BI gains of 7.28–10.24 points. Provision of rehabilitation through the week, including weekends, was linked to higher BI scores at discharge (B =3.92, p <0.001) and reduced readmission rates (odds ratio, 0.907; p =0.008). No serious adverse events were reported.Conclusions: Acute-phase rehabilitation for patients with OVF appears to be safe and may contribute to improved functional recovery and favorable clinical outcomes, particularly when initiated within 2 weeks of onset and preferably within the first 3 days. Further prospective studies are warranted to establish the optimal rehabilitation program during the acute phase.

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