Progressive Early Mobilization and Its Impact on Pain and Function After Lumbar Vertebral Compression Fracture: A Retrospective Study Based on the Oswestry Disability Index

Xingxing Liu, Yuejiao Huang, Yuye Zhang Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of ChinaCorrespondence: Yuye Zhang, Department of Orthopedics, The Second Affiliated Hospital of Soochow University, No. 28 Rehabilitation Lane, High Tech Zone, Suzhou City, Jiangsu, 215004, People’s Republic of China, Email [email protected]: The optimal timing and content of postoperative rehabilitation for elderly patients with osteoporotic vertebral compression fractures (OVCF) remain controversial. This study evaluated whether the addition of a progressive early mobilization protocol to routine care could enhance pain relief, functional recovery, and safety.Methods: This single-center retrospective study included 120 OVCF patients (≥ 60 years) treated surgically from February 2023 to February 2025. Patients were allocated by admission order to routine rehabilitation (control, n=60) or routine care plus progressive early mobilization (observation, n=60). All patients received interventions from the same team over 12 weeks. The progressive protocol included preoperative prone training; turning from 6 hours postoperatively; lower-limb exercises from postoperative days 1– 3; lumbar training from weeks 2– 3; standing and gait training from week 5; and abdominal bracing at week 12. Clinical data were analyzed using t-tests and χ2-tests with SPSS 26.0.Results: The observation group demonstrated significantly shorter length of hospital stay (15.60 ± 2.21 vs. 18.10 ± 2.75 days, P < 0.001), time to first ambulation (14.59 ± 3.66 vs. 17.38 ± 4.20 d, P < 0.001), time to callus formation (23.88 ± 3.25 vs. 27.25 ± 4.10 d, P < 0.001), and time to fracture union (54.85 ± 7.29 vs. 59.68 ± 8.75 d, P < 0.001) compared to controls. The overall treatment efficacy was significantly higher in the observation group (96.67% vs. 91.67%, P = 0.041). Both groups showed significant improvements in VAS and ODI scores from baseline (P < 0.05), with significantly lower scores in the observation group at both 8 and 12 weeks postoperatively (P < 0.05). The complication rate was significantly lower in the observation group (3.33% vs. 13.33%, P = 0.047).Conclusion: The addition of a structured progressive early mobilization program to routine postoperative care may improve pain relief, functional recovery, and safety in elderly patients undergoing surgery for OVCF. These findings suggest that early staged mobilization could be beneficial in this population.Keywords: progressive early mobilization, pain, function, lumbar vertebral compression fracture, retrospective study