The Effect of Exercise Training on Individuals With Osteoporotic Vertebral Fracture: A Randomized Controlled Trial

BACKGROUND AND PURPOSE: Osteoporotic vertebral fractures significantly impair physical function and quality of life; however, evidence regarding the long-term effects of exercise interventions remains inconclusive. This study aimed to evaluate the effects of exercise training on pain, quality of life, physical performance, depression, kinesiophobia, and sleep quality in individuals with osteoporotic vertebral fractures. METHODS: In this single-centre, open-label randomized controlled trial (unblinded), 48 participants with osteoporotic vertebral fractures were randomly allocated (1:1) to an intervention group (n = 24) or a control group (n = 24). Forty-four participants (intervention: 23, control: 21) completed the study. The intervention group received individually supervised, 40-minute exercise sessions twice weekly for 12 weeks, focusing on spinal extensor, postural, lower-extremity strengthening, and balance exercises. Resistance progressed from body weight to external resistance based on individual tolerance, and balance tasks progressed from static to dynamic, with missed sessions rescheduled within the same week. The control group continued usual activities. Pain was assessed using the Short Form McGill Pain Scale, quality of life with the QUALEFFO-41 questionnaire, physical performance with the 6-minute walk test, depression with the Beck Depression Scale (BDS), disability with the Oswestry Disability Index (ODI), and kinesiophobia with the Tampa Kinesiophobia Scale (TKS). Sleep quality and sleepiness were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). RESULTS: Compared with the control group, the intervention group demonstrated significantly greater improvements in VAS pain (mean difference: -1.24, 95% CI: -1.59 to -0.89; p < 0.05) and 6-minute walk distance (38.94 m, 95% CI: 29.59 to 48.28; p < 0.05). Significant improvements favoring the intervention group were also observed for depression (BDS: -4.52, 95% CI: -6.51 to -2.54; p < 0.05), disability (ODI: -2.63, 95% CI: -4.13 to -1.12; p < 0.05), and kinesiophobia (TKS: -10.81, 95% CI: -13.50 to -8.12; p < 0.05) as well as the QUALEFFO-41 total score (p < 0.05). No statistically significant between-group differences were found for sleep quality (PSQI; p = 0.057) or daytime sleepiness (ESS; p = 0.210). DISCUSSION: A 12-week structured exercise program appears to provide superior benefits in reducing pain and improving functional capacity, depression, and kinesiophobia compared with usual care. These findings suggest that such exercise protocols can be effectively integrated into rehabilitation plans for participants with osteoporotic vertebral fractures, though some elements such as sleep quality may require further investigation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05521724 (Registered: August 24, 2022). Ethical approval: Hasan Kalyoncu University Ethics Committee (Approval No: 2021/011; February 17, 2021).