Activating therapy modalities in older individuals with chronic non-specific low back pain: a systematic review

Kuss, Katrin; Becker, Annette; Quint, Sabine; Leonhardt, Corinna

doi:10.1016/j.physio.2015.04.009

Cited by 30 publications

(18 citation statements)

References 38 publications

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“…intramuscular fat, BMI), is particularly relevant given that older adults with chronic LBP demonstrate only small improvements in physical function with conservative interventions. 39 There exists evidence that trunk rehabilitation programs result in increased CSA 40 and while preliminary, there also exists evidence that trunk exercises may also improve muscle quality 41 . Specifically, Woodham et al 41 reported that two young patients with chronic LBP who performed multifidi-focused exercises had reduced intramuscular fat.…”

Section: Discussionmentioning

confidence: 99%

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Sions

Coyle

Velasco

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective The purpose of this study was to determine if multifidi size and/or intramuscular fat were associated with self-reported and performance-based physical function in older adults with and without chronic LBP. Design Case-control study Setting Individuals participated in a standardized evaluation in a clinical laboratory and underwent magnetic resonance imaging (MRI) of the lumbar spine at a nearby facility. Patient Sample A volunteer sample of 106 community-dwelling older adults, aged 60-85 years, with (n=57) and without (n=49) chronic LBP were included in this secondary data analysis. Intervention Average right-left, L5 multifidi relative, i.e. total, cross-sectional area (rCSA); muscle-fat infiltration index (MFI), i.e. a measure of intramuscular fat; and relative muscle cross-sectional area (rmCSA), i.e. total CSA minus intramuscular fat CSA, were determined from MRIs. Linear regression modeling was performed with physical function measures as the dependent variables. Age, sex, and body mass index were entered as covariates. The main effects of L5 multifidi MFI and rmCSA, as well as their interaction with group assignment, were compared as independent variables. Main Outcome Measures Short Form-36 Health Survey Physical Functioning subscale (SF-36 PFS), Timed Up and Go (TUG), gait speed, and fast stair descent performance. Results Interaction terms between L5 multifidi MFI and group assignment were found to be significant contributors to the variance explained in all physical function measures (p≤.012). Neither the main effect, nor the interaction with group assignment for L5 multifidi rmCSA, significantly contributed to the variance explained in any of the physical function measures (p>.012). Conclusions Among older adults with chronic LBP of at least moderate intensity, L5 multifidi muscle composition, but not size, may help to explain physical function.

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Section: Discussionmentioning

confidence: 99%

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Sions

Coyle

Velasco

et al. 2017

Archives of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Growing evidence has indicated that some, but not all, conservative treatments can benefit older people with LBP [255, 256]. While the efficacy of various physiotherapy modalities in treating older people with LBP remains controversial [256], a recent meta-analysis has highlighted that Tai Chi, a mind-body exercise therapy, is an effective intervention for older patients with chronic pain (including LBP, osteoarthritis, fibromyalgia, and osteoporotic pain) as compared to education or stretching [255]. Importantly, in addition to pain relief, various systematic reviews on Tai Chi have revealed promising outcomes in improving balance [257], fear of falling [258], lower limb strength [259], physical function [260], hypertension [261], cognitive performance [262], and depression [263] in seniors as compared to no treatment or usual care.…”

Section: Introductionmentioning

confidence: 99%

Low back pain in older adults: risk factors, management options and future directions

2017

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Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions. Existing evidence suggests that prevalence rates of severe and chronic LBP increase with older age. As compared to working-age adults, older adults are more likely to develop certain LBP pathologies (e.g., osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis). Importantly, various age-related physical, psychological, and mental changes (e.g., spinal degeneration, comorbidities, physical inactivity, age-related changes in central pain processing, and dementia), as well as multiple risk factors (e.g., genetic, gender, and ethnicity), may affect the prognosis and management of LBP in older adults. Collectively, by understanding the impacts of various factors on the assessment and treatment of older adults with LBP, both clinicians and researchers can work toward the direction of more cost-effective and personalized LBP management for older people.

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“…The authors summarized that exercise alleviates pain intensity and promotes functional improvement within 8 weeks. Kuss et al [ 34 ] also performed a systematic review and suggested that physical therapy is associated with a slight-to-moderate decrease in pain intensity and improvement in functions of elderly people with chronic and nonspecific LBP. However, Kuss et al [ 34 ] included studies on multidimensional physiotherapy approaches, such as mixed physiotherapy interventions of exercise, electrotherapy, and cognitive behavioral therapy.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Strengthening Exercises for the Elderly with Low Back Pain to Improve Symptoms and Functions: A Systematic Review

2016

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Objective. To determine the effect of strengthening exercises for older people with low back pain (LBP). Methods. This study is a systematic review of experimental study which evaluated the evidence regarding exercises for older people with LBP by using EBSCO Academic Search Premier, EBSCO EconLit, Science Direct, PUBMED, and PEDro from 2006 to 2016. Search strategy for each database was conducted by using keywords such as “low back pain”, “older people”, and “strengthening exercise”. Boolean operators were used to combine keywords and manual exclusion was conducted to verify studies which met the inclusion criteria. The articles reviewed were evaluated and critically appraised by using PEDro scale and SPSS version 20 was used to analyze the data. Results. Three articles were found regarding strengthening exercise for older people with LBP whereas one study was conducted on multicomponent exercise. The mean, standard deviation, and variance of the PEDro score of all the studies were 5.67, 2.33, and 1.528, respectively. Overall, the qualities of all studies reviewed were fair. Two articles showed significant results when compared to control group (p < 0.05). Conclusions. Strengthening exercise is a beneficial treatment for older people with LBP in reducing pain intensity, disability, and improved functional performances.

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Activating therapy modalities in older individuals with chronic non-specific low back pain: a systematic review

Cited by 30 publications

References 38 publications

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Low back pain in older adults: risk factors, management options and future directions

Effectiveness of Strengthening Exercises for the Elderly with Low Back Pain to Improve Symptoms and Functions: A Systematic Review

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