096. AMBULATORY ACTIVITIES IN OLDER PEOPLE WITH COMPRESSION VERTEBRAL FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: Older people with vertebral fracture (VF) have worse physical Health Related Quality of Life (HRQoL) than older people without VF, even after accounting for age differences. However, it's not clear exactly what aspect of physical function is impaired in people with osteoporotic VF. Ambulatory activities are one of the most important everyday activities. Further understanding of the effect of fracture on these activities would allow the development of appropriate interventions to improve quality of life. Methods: A comprehensive search was undertaken using the databases of PubMed, EMBASE, MEDLINE and Web of Science, and the grey literature from 1950 to the end of July 2016. Search terms for VF included VF, osteoporotic fracture fragility fracture and spinal fracture. Walking activities were searched using the following terms walking, gait, and movement. Strict inclusion and exclusion criteria were used and only studies that matched VF cases and controls for age and gender were included. Pooled odds ratios (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Results: 12 studies were identified which had investigated the associations between prevalent VF and ambulatory activities, and expressed these as ORs, were included in this meta-analysis. There was a positive association between VF and ambulatory activities for women but not for men [OR 1.27 (95% CI 1.14, 1.42), P<0.001 and (1.09 95% CI 0.91, 1.32), P=0.346, respectively]. Regarding the type of walking-related activities, there was a positive association between prevalent VF and walking two or three blocks on a level surface [1.90 (1.35, 2.66], P<0.001), cycling or walking >30 min/day [1.17 (1.03, 1.34), P=0.016], climbing 10 steps without stopping [2.37 (1.68, 3.36), P<0.001], walking down 10 steps [1.85 (1.05, 3.24] P=0.032), and shopping for groceries or clothes [2.27 (1.43, 3.62), P=0.001]. No association was found for time walking outside (per 1.4 h/day), use of a walking aid, and difficulty standing or walking for two hours. Conclusion: Our study showed that women but not men with VF have more difficulty in ambulatory activities than age matched controls without fracture. This will help physiotherapists to develop more specific programs to improve HRQoL in women with VF.