Background & Aims
Group-Based Exercise (GBE) in primary health care may be an effective and low-cost intervention for older people with low back pain (LBP). However, this population usually has low adherence to exercise protocols not considering their specific biopsychosocial characteristics. Older people present specific biopsychosocial characteristics that are often overlooked in LBP trials. The aim of the feasibility study was to evaluate adherence to treatment, between-group contamination, satisfaction with treatment, understanding of the information provided by the physiotherapist, and to identify and make changes to the exercise protocol according to older people’s needs.
Methods
This was a feasibility study of a randomised controlled trial (RCT) to investigate the effectiveness of GBE in older people with chronic LBP. Patients (n= 60) aged 60 or over, with chronic LBP (?12 weeks), disability score ?4 out of 25 and pain intensity score ?3 out of 10, referred to primary health care centres in Diamantina/Brazil were included. Serious spinal pathology, radiculopathy, recent spinal surgery, cognitive deficit, and contraindications to exercise were excluded. The baseline assessment included demographic, clinical, functional, cognitive and outcome data of the full RCT. Participants were randomised into two groups: 1- GBE (three weekly sessions of GBE for eight weeks); and 2- control group (waiting list). Feasibility and outcome data were assessed after eight weeks. During the feasibility study, the treatment protocol was adapted according to individual needs. Feasibility outcomes reported by patients were collected using a self-administered form.
Results
The study had a 68% eligibility rate and 100% acceptance (n= 60) of random allocation. Contamination was similar between groups (58.6% and 45.2%). Of the 29 GBE participants, seven withdrew. Of the 22 who completed, adherence was 82.58%. Satisfaction and understanding were high; 100% reported that they would do this treatment again and 81.8% classified the information as very easy to understand. The exercise protocol changed for two reasons: 1- Reduce the risk of falling (participants exercised in pairs, separated according to the risk of falls. Additionally, mat-covered ground was used to GBE); 2- Impossibility of doing exercises lying down (for 5/22.7% of the GBE participants, exercises were adapted to standing or sitting, maintaining the action of the main muscle groups. Of the 17 who did it lying down, 7 preferred another position). Muscle pain was the most common adverse event. One falling during the GBE without damage was reported. The groups were similar for the RCT outcomes.
Conclusions
This study found important insights to adapt exercises to older people with LBP in primary health care centres. We point out difficulties in performing solo exercises and present a solution that can be used in the future RCT.
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Presenting Author
Vinícius Oliveira
Poster Authors
Vinicius Oliveira
PhD
Universidade Federal dos Vales do Jequitinhonha e Mucuri
Lead Author
Hytalo Silva
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Júlio Miranda
Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Camila Melo
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Letícia Fonseca
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Rodrigo Mascarenhas
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Nathalia Veloso
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Whesley Silva
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Alessandra Bastone
Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)
Lead Author
Topics
- Evidence, Clinical Trials, Systematic Review, Guidelines, and Implementation Science