Physical therapy management of older adults with chronic low back pain

Katja Ehrenbrusthoff, Cormac G. Ryan, Patricia A. Schofield, Denis J. Martin

Research output: Chapter in Book/Report/Conference proceedingChapterResearch

Abstract

Chronic low back pain (CLBP) is common in older adults. Findings from younger patients may not be generalizable to older adults with this condition. Objective: To investigate the evidence from RCTs for the effectiveness of physiotherapeutic interventions on pain and function in older adults with non-specific CLBP. Study group: Studies including older adults (>65years) with non-specific CLBP of >3 month's duration were included. Methods: The Cochrane Back Research Groups' guidelines were used as a methodological template for this systematic review. A literature search of EMBASE, CENTRAL, Medline, AMED, CINAHL and PEDro was performed up to November 2010. Two reviewers assessed the quality of included articles and the evidence for interventions was qualified using the GRADE system. Results: Three moderate quality RCTs were included. They investigated the following: mindfulness meditation, Percutaneous Electrical Nerve Stimulation [PENS], Exercise, and PENS and Exercise combined. Outcome measures for pain and function were reported for the short and medium-term only. There was limited evidence that compared to control/placebo interventions mindfulness meditation, exercise, and PENS combined with exercise have no effect on pain or function in older adults with non-specific CLBP. There was conflicting evidence that PENS compared to placebo is effective for pain and function. Conclusions: This systematic review identified only three studies that have investigated the effect of physiotherapeutic interventions on older adults with CLBP. There was insufficient research upon which to make firm clinical recommendations. Further research is needed on this severely under investigated and growing clinical population, to guide clinical practice.

Original languageEnglish
Title of host publicationPain
Subtitle of host publicationInternational Research in Pain Management
PublisherNova Science Publishers, Inc.
Pages173-188
Number of pages16
ISBN (Electronic)9781629484358
ISBN (Print)9781629484235
Publication statusPublished - 1 Jan 2013

Fingerprint

Transcutaneous Electric Nerve Stimulation
Low Back Pain
Exercise
Mindfulness
Meditation
Pain
Placebos
Research
Therapeutics
Outcome Assessment (Health Care)
Guidelines
Population

Cite this

Ehrenbrusthoff, K., Ryan, C. G., Schofield, P. A., & Martin, D. J. (2013). Physical therapy management of older adults with chronic low back pain. In Pain: International Research in Pain Management (pp. 173-188). Nova Science Publishers, Inc..
Ehrenbrusthoff, Katja ; Ryan, Cormac G. ; Schofield, Patricia A. ; Martin, Denis J. / Physical therapy management of older adults with chronic low back pain. Pain: International Research in Pain Management. Nova Science Publishers, Inc., 2013. pp. 173-188
@inbook{e42799a8a9b443e28e3e01c884c65b78,
title = "Physical therapy management of older adults with chronic low back pain",
abstract = "Chronic low back pain (CLBP) is common in older adults. Findings from younger patients may not be generalizable to older adults with this condition. Objective: To investigate the evidence from RCTs for the effectiveness of physiotherapeutic interventions on pain and function in older adults with non-specific CLBP. Study group: Studies including older adults (>65years) with non-specific CLBP of >3 month's duration were included. Methods: The Cochrane Back Research Groups' guidelines were used as a methodological template for this systematic review. A literature search of EMBASE, CENTRAL, Medline, AMED, CINAHL and PEDro was performed up to November 2010. Two reviewers assessed the quality of included articles and the evidence for interventions was qualified using the GRADE system. Results: Three moderate quality RCTs were included. They investigated the following: mindfulness meditation, Percutaneous Electrical Nerve Stimulation [PENS], Exercise, and PENS and Exercise combined. Outcome measures for pain and function were reported for the short and medium-term only. There was limited evidence that compared to control/placebo interventions mindfulness meditation, exercise, and PENS combined with exercise have no effect on pain or function in older adults with non-specific CLBP. There was conflicting evidence that PENS compared to placebo is effective for pain and function. Conclusions: This systematic review identified only three studies that have investigated the effect of physiotherapeutic interventions on older adults with CLBP. There was insufficient research upon which to make firm clinical recommendations. Further research is needed on this severely under investigated and growing clinical population, to guide clinical practice.",
author = "Katja Ehrenbrusthoff and Ryan, {Cormac G.} and Schofield, {Patricia A.} and Martin, {Denis J.}",
year = "2013",
month = "1",
day = "1",
language = "English",
isbn = "9781629484235",
pages = "173--188",
booktitle = "Pain",
publisher = "Nova Science Publishers, Inc.",
address = "United States",

}

Ehrenbrusthoff, K, Ryan, CG, Schofield, PA & Martin, DJ 2013, Physical therapy management of older adults with chronic low back pain. in Pain: International Research in Pain Management. Nova Science Publishers, Inc., pp. 173-188.

Physical therapy management of older adults with chronic low back pain. / Ehrenbrusthoff, Katja; Ryan, Cormac G.; Schofield, Patricia A.; Martin, Denis J.

Pain: International Research in Pain Management. Nova Science Publishers, Inc., 2013. p. 173-188.

Research output: Chapter in Book/Report/Conference proceedingChapterResearch

TY - CHAP

T1 - Physical therapy management of older adults with chronic low back pain

AU - Ehrenbrusthoff, Katja

AU - Ryan, Cormac G.

AU - Schofield, Patricia A.

AU - Martin, Denis J.

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Chronic low back pain (CLBP) is common in older adults. Findings from younger patients may not be generalizable to older adults with this condition. Objective: To investigate the evidence from RCTs for the effectiveness of physiotherapeutic interventions on pain and function in older adults with non-specific CLBP. Study group: Studies including older adults (>65years) with non-specific CLBP of >3 month's duration were included. Methods: The Cochrane Back Research Groups' guidelines were used as a methodological template for this systematic review. A literature search of EMBASE, CENTRAL, Medline, AMED, CINAHL and PEDro was performed up to November 2010. Two reviewers assessed the quality of included articles and the evidence for interventions was qualified using the GRADE system. Results: Three moderate quality RCTs were included. They investigated the following: mindfulness meditation, Percutaneous Electrical Nerve Stimulation [PENS], Exercise, and PENS and Exercise combined. Outcome measures for pain and function were reported for the short and medium-term only. There was limited evidence that compared to control/placebo interventions mindfulness meditation, exercise, and PENS combined with exercise have no effect on pain or function in older adults with non-specific CLBP. There was conflicting evidence that PENS compared to placebo is effective for pain and function. Conclusions: This systematic review identified only three studies that have investigated the effect of physiotherapeutic interventions on older adults with CLBP. There was insufficient research upon which to make firm clinical recommendations. Further research is needed on this severely under investigated and growing clinical population, to guide clinical practice.

AB - Chronic low back pain (CLBP) is common in older adults. Findings from younger patients may not be generalizable to older adults with this condition. Objective: To investigate the evidence from RCTs for the effectiveness of physiotherapeutic interventions on pain and function in older adults with non-specific CLBP. Study group: Studies including older adults (>65years) with non-specific CLBP of >3 month's duration were included. Methods: The Cochrane Back Research Groups' guidelines were used as a methodological template for this systematic review. A literature search of EMBASE, CENTRAL, Medline, AMED, CINAHL and PEDro was performed up to November 2010. Two reviewers assessed the quality of included articles and the evidence for interventions was qualified using the GRADE system. Results: Three moderate quality RCTs were included. They investigated the following: mindfulness meditation, Percutaneous Electrical Nerve Stimulation [PENS], Exercise, and PENS and Exercise combined. Outcome measures for pain and function were reported for the short and medium-term only. There was limited evidence that compared to control/placebo interventions mindfulness meditation, exercise, and PENS combined with exercise have no effect on pain or function in older adults with non-specific CLBP. There was conflicting evidence that PENS compared to placebo is effective for pain and function. Conclusions: This systematic review identified only three studies that have investigated the effect of physiotherapeutic interventions on older adults with CLBP. There was insufficient research upon which to make firm clinical recommendations. Further research is needed on this severely under investigated and growing clinical population, to guide clinical practice.

UR - http://www.scopus.com/inward/record.url?scp=85060574394&partnerID=8YFLogxK

M3 - Chapter

SN - 9781629484235

SP - 173

EP - 188

BT - Pain

PB - Nova Science Publishers, Inc.

ER -

Ehrenbrusthoff K, Ryan CG, Schofield PA, Martin DJ. Physical therapy management of older adults with chronic low back pain. In Pain: International Research in Pain Management. Nova Science Publishers, Inc. 2013. p. 173-188