Relationship between physical function at admission and walking ability at discharge in older adults with vertebral compression fractures: an analysis using propensity score matching

Hosaka, Kodai; Otao, Hiroshi; Nishi, Eri; Imamura, Junpei; Tanaka, Junko; Shibata, Hajime

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Original Article

DOI: https://doi.org/10.4235/agmr.24.0180 [Accepted]
Published online April 16, 2025.

Relationship between physical function at admission and walking ability at discharge in older adults with vertebral compression fractures: an analysis using propensity score matching

Kodai Hosaka^1,2

, Hiroshi Otao³, Eri Nishi¹, Junpei Imamura¹, Junko Tanaka¹, Hajime Shibata¹

¹Kurume Rehabilitation Hospital:1887 Toyoda, Yamamoto-machi Kurume-shi, Fukuoka 839-0827, Japan
²Graduate School of Human Care Sciences, Nishikyushu University, Japan
³Faculty of Rehabilitation Sciences, Nishikyushu University, Japan

Correspondence: Kodai Hosaka,
Email: k.1992.0903.h@gmail.com

Received: 1 December 2024 • Revised: 15 March 2025 • Accepted: 9 April 2025

Abstract

Background
Vertebral compression fractures (VCFs) are common among older adults, with the highest prevalence observed in Japan. These fractures cause pain, reduce quality of life, and increase the need for physical therapy. This study identified key factors at admission that predict walking ability at discharge in patients with VCFs.
Methods
This retrospective cohort study included 143 patients aged ≥65 years with VCFs. VCFs are fractures in which only the anterior column of the vertebral body collapses. The primary variables assessed upon admission included the revised Hasegawa Dementia Scale (HDS-R) score, grip strength, skeletal muscle mass index (SMI), and phase angle (PhA). Propensity score matching was applied to adjust for background factors, after which a logistic regression analysis using a generalized linear model was conducted to determine whether these variables influenced walking ability at discharge.
Results
Significant associations were observed between walking ability at discharge and HDS-R score at admission (p < 0.001, effect size [ES] = 0.42), grip strength (p = 0.027, ES = 0.23), SMI (p = 0.025, ES = 0.23), and PhA (p < 0.001, ES = 0.40). Logistic regression analysis indicated that HDS-R score (odds ratio [OR] = 1.19, p = 0.005) and PhA (OR = 3.21, p = 0.015) during admission significantly predicted walking ability at discharge.
Conclusion
Walking ability at discharge in patients with VCFs can be predicted based on early assessments. In particular, HDS-R score and PhA at admission may serve as key indicators for prognosis in patients with VCFs.

Key Words: body composition, older adults, prognosis, vertebral compression fracture, activities of daily living