K Kuss1, A Becker2, S Quint3, C Leonhardt2. 1. Department of General Practice/Family Medicine, Philipps University Marburg, Germany. Electronic address: kuss@staff.uni-marburg.de. 2. Department of General Practice/Family Medicine, Philipps University Marburg, Germany. 3. Department of Medical Psychology, Philipps University Marburg, Germany.
Abstract
BACKGROUND: Although there are many special exercise-based therapy approaches for the working population suffering chronic low back pain, similar programmes for older individuals are rare. OBJECTIVES: To summarise all evaluated physical therapy approaches, and assess the effects on older people with chronic low back pain. DATA SOURCES: Medline, CINAHL, Cochrane, Embase, PEDro, PsychINFO and Psyndex. STUDY SELECTION/ELIGIBILITY: Age≥65 years, subacute or chronic non-specific low back pain of ≥6weeks' duration, and a physical therapy approach. STUDY APPRAISAL AND SYNTHESIS METHODS: Study selection, data extraction, and assessment of methodological quality and clinical relevance were performed independently by two reviewers. As there were only a few controlled trials and wide heterogeneity in observation periods and outcome measures, pooling of data was not feasible. Therefore, the results are presented descriptively. RESULTS: In total, nine studies were included; six related to mixed physiotherapy modalities, one related to strength training, and two related to endurance training. Low-quality evidence suggests that physical therapy modalities are associated with a small-to-moderate reduction in pain and a small improvement in function. LIMITATIONS: The results must be interpreted with caution due to poor methodological quality. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: Few studies have been performed in this highly relevant and growing age group. It is not possible to recommend one particular modality or programme; as such, prescriptions should reflect patients' preferences and local conditions. Further research of higher methodological quality is needed urgently.
BACKGROUND: Although there are many special exercise-based therapy approaches for the working population suffering chronic low back pain, similar programmes for older individuals are rare. OBJECTIVES: To summarise all evaluated physical therapy approaches, and assess the effects on older people with chronic low back pain. DATA SOURCES: Medline, CINAHL, Cochrane, Embase, PEDro, PsychINFO and Psyndex. STUDY SELECTION/ELIGIBILITY: Age≥65 years, subacute or chronic non-specific low back pain of ≥6weeks' duration, and a physical therapy approach. STUDY APPRAISAL AND SYNTHESIS METHODS: Study selection, data extraction, and assessment of methodological quality and clinical relevance were performed independently by two reviewers. As there were only a few controlled trials and wide heterogeneity in observation periods and outcome measures, pooling of data was not feasible. Therefore, the results are presented descriptively. RESULTS: In total, nine studies were included; six related to mixed physiotherapy modalities, one related to strength training, and two related to endurance training. Low-quality evidence suggests that physical therapy modalities are associated with a small-to-moderate reduction in pain and a small improvement in function. LIMITATIONS: The results must be interpreted with caution due to poor methodological quality. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: Few studies have been performed in this highly relevant and growing age group. It is not possible to recommend one particular modality or programme; as such, prescriptions should reflect patients' preferences and local conditions. Further research of higher methodological quality is needed urgently.
Authors: J Megan Sions; Peter C Coyle; Teonette O Velasco; James M Elliott; Gregory E Hicks Journal: Arch Phys Med Rehabil Date: 2016-08-30 Impact factor: 3.966