The effect of probiotic treatment on elderly patients with distal radius fracture: a prospective double-blind, placebo-controlled randomised clinical trial

Abstract

Probiotic treatment has been shown to improve bone formation, increase bone mass density and prevent bone loss. We aimed to assess the effect of probiotic treatment on functional recovery in elderly patients with a distal radius fracture. A total of 417 elderly patients with an acute distal radius fracture were enrolled in this double-blind placebo-controlled clinical trial. They were randomised to receive skimmed milk containing either a commercial probiotic (Lactobacillus casei Shirota) or placebo daily for a period of 6 months after the fracture. Treatment outcomes were the DASH (disabilities of the arm, shoulder and hand) score, pain, complex regional pain syndrome (CRPS) score, active range of motion and grip strength, all of which were measured on a monthly basis. Throughout the duration of the study, DASH score, pain, CRPS score, wrist flexion and grip strength of patients receiving probiotics exhibited a significantly faster pace of improvement than those on placebo, with treatment outcomes of patients receiving Lactobacillus casei Shirota at month 4 at comparable levels with those of patients receiving placebo at month 6. In elderly patients with a fracture of the distal radius, administration of the probiotic could greatly accelerating the healing process.

Advances and Promises of Nutritional Influences on Natural Bone Repair

“…[111][112][113][114][115][116] However, to date, only one study has reported on the effects of probiotics on fracture healing, which showed that elderly patients with radius fractures who consumed the probiotic Lactobacillus casei Shirota displayed significant improvements in pain and functional outcomes. 117 Though healing was not assessed radiographically, this study sets an intriguing precedent that, when consumed after fracture, probiotics may be a viable strategy to accelerate the healing process thereby leading to improved quality of life. Additional studies are certainly warranted to not only assess whether probiotic supplements can accelerate or enhance bone repair but to also determine the mechanisms by which probiotic manipulation of the gut microbiome can influence the bone repair sequelae (Fig.…”

Probiotics in Gut-Bone Signaling

“…While there currently are several ongoing studies examining probiotic effects on bone health in the elderly, only a few studies have been published to date. In one study, Lactobacillus casei Shirota was given to elderly male and female patients (n=417); after 4 months of treatment these patients showed enhanced fracture healing (distal radius) compared to patients with placebo treatment (Fig 3) [65]. In a similar study, 50 postmenopausal women with osteopenia (50–72 years of age) were randomly assigned to take either GeriLact (7 probiotic bacteria species) or a placebo for 6 months.…”

Immune response of patients with recurrent aphthous stomatitis challenged with a symbiotic

“…The literature has demonstrated that probiotics are capable of controlling pain by modulating the activities of genes involved in nociception such as tryptophan hydroxylase 1 (TPH‐1), cannabinoid receptor 1 (CNR1), and opiate receptor‐like 1 . Clinical trials have showed that treatment with probiotic decrease the dolorous symptomatology in elderly patients with distal radius fracture and in patients with abdominal pain …”