Musculoskeletal Pain in Family Caregivers: Does a Therapeutic Physical Program in Primary Care Work? A Randomized Controlled Trial

Abstract

Background: Family caregivers play a crucial role in the overall healthcare system and in our society. The elderly population is significantly increasing, which creates a high demand for family caregivers. Few studies have investigated the impact of caregiving on musculoskeletal pain or proposed an active approach for dealing with it. Objectives: To determine and characterize musculoskeletal pain in female family caregivers (FFCs) and assess the effects of adding a therapeutic exercise program to a family caregiver care program (FCCP) on the quality of life, physical conditions, and psychological well-being of FFCs. Methods: A multicenter randomized controlled clinical trial was conducted with 68 FFCs recruited in two public healthcare areas. The intervention and control groups received the same conventional FCCP for 6 h across 4 sessions. The intervention group received an additional 36 sessions of physical therapeutic exercise (PTE) program over 12 weeks. Results: All caregivers reported having pain in particular locations. Lower back pain and neck pain were the locations most frequently cited, with a prevalence of 69.4% and 56.7%, respectively. In total, 80% of participants presented moderate pain intensity. The intervention group showed a significant decrease in the intensity of the pain (p < 0.001), as well as in anxiety, depression, subjective burden perception (p < 0.01), and quality-of-life variables, including MCS (mental component summary) (p < 0.05) and PCS (physical component summary) (p < 0.001). Conclusions: A PTE program improved the musculoskeletal pain of FFCs in a clinically relevant way. The caregivers who improved the most were those who initially presented the most intense pain, had the greatest levels of disability, and had the lowest quality of life.

Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis

“…The average score of all articles on the PEDro scale was 6.9 points, which is considered a good methodological quality [44] (Table 1). The overall risk of bias was low in eight articles [29,31,33,35,36,37,40,41], in four articles was some concerns [30,34,38,39] and in four articles was high [28,32,42,43] (Fig. 2).…”

“…In the analysis of methodological quality using the Jadad scale, 11 articles obtained four or more points [28,29,30,31,32,33,34,35,36,37,38], four articles obtained three points [39,40,41,42], and only one obtained two points [43]. The most common methodological shortcoming was the absence of blinding.…”

“…A total of 1,814 participants with NBP took part in the 16 studies. Two articles [29,40] analyzed back pain in all regions, ten studies analyzed [28,30,31,32,33,34,39,41,42,43] it specifically in the lumbar region, four papers [35,36,37,38] analyzed it specifically in the cervical region and none of them analyzed it specifically in the thoracic region. The average age was 49 years and 74.9% of the participants were women (Table 3).…”

“…The most common exercises were yoga [32,42,43], stabilization exercises [28,29,30], motor control exercises [31,34,35,36,39,41], and strength and stretch trunk exercises [29,31,34,37,38,40]. On the other hand, the most common education topics were ergonomics [35,36,38,43], health guidance [29,33,34], pain neuroscience education [36,39,41] and cognitive The confidence interval is small but not all articles calculate the optimal sample size.…”

“…Out of the analyzed studies, 14 of them [28,29,31,32,33,34,35,36,37,38,39,40,41,43] analyzed the pain variable. The analysis was divided into two subgroups: exercise therapy plus health education versus isolated exercise therapy or isolated health education.…”