Module D
Module E
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What about changing posture?

Briggs et al.,(2004, 2006) have stated in their research that it is important for therapists’ treatment plans to include specific strengthening modalities to reduce vertebral loading and that interventions aimed at minimizing thoracic kyphosis may do this.

Authors investigating vertebral bone failure under compressive forces have shown that recovery of cancellous bone height is possible following removal of forces (Fyhrie et al., 1994) . The research was conducted in lab conditions with short-term compressive forces of very high loads to vertebral cancellous bone, with a resulting 94% recovery of bone height following removal of the loads. The authors suggest this recovery mechanism inherent with cancellous bone may be the key in allowing a damaged vertebrae/articular joints to regain original shape (and height!) with little loss of function. There hasn’t been conclusive research on long-term osteoporotic fractures with respect to potential recovery of vertebral height through a similar mechanism.

However, it would stand to reason that unloading activities such as active extension, postural correction and/or avoiding/adapting ADLs which are flexion-based, can reduce compressive loads which MAY prevent further fractures.

Research Summary #1

An osteoporotic vertebral fracture may simply be a ‘weak’ vertebral bone being loaded during activities of daily living*

Research Summary #2

Reduction or avoidance of anterior compressive forces in the presence of damaged or at risk vertebrae at the very least prevents further damage.

Briggs, A. M., Greig, A. M., Wark, J. D., Fazzalari, N. L., & Bennell, K. L. (2004). A review of anatomical and mechanical factors affecting vertebral body integrity. Int J Med Sci, 1(3), 170-180.

Briggs, A. M., Wark, J. D., Kantor, S., Fazzalari, N. L., Greig, A. M., & Bennell, K. L. (2006). Bone mineral density distribution in thoracic and lumbar vertebrae: an ex vivo study using dual energy X-ray absorptiometry. Bone, 38(2), 286-288.

Fyhrie, D. P., & Schaffler, M. B. (1994). Failure mechanisms in human vertebral cancellous bone. Bone, 15(1), 105-109.