Family History Influences the Effectiveness of Home Exercise in Older People With Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial

Joshua R Zadro; Debra Shirley; Tom I L Nilsen; Paul J Mork; Paulo H Ferreira

doi:10.1016/j.apmr.2020.03.019

Family History Influences the Effectiveness of Home Exercise in Older People With Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial

Arch Phys Med Rehabil. 2020 Aug;101(8):1322-1331. doi: 10.1016/j.apmr.2020.03.019. Epub 2020 May 4.

Authors

Joshua R Zadro¹, Debra Shirley², Tom I L Nilsen³, Paul J Mork⁴, Paulo H Ferreira²

Affiliations

¹ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia. Electronic address: joshua.zadro@sydney.edu.au.
² Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia.
³ Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
⁴ Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.

PMID: 32376326
DOI: 10.1016/j.apmr.2020.03.019

Abstract

Objective: To investigate whether a family history of low back pain (LBP) influences patient outcomes and treatment effects following home exercises in older people with chronic LBP.

Design: Secondary analysis of a randomized controlled trial.

Setting: Local community.

Participants: People older than 55 years with chronic LBP (N=60).

Interventions: Participants in the intervention group completed video game exercises for 60 minutes 3 times per week for 8 weeks. Participants in the control group were instructed to maintain their usual levels of activity and care seeking behaviors.

Main outcomes measures: Participants indicated whether any of their immediate family members had a history of "any" LBP or "activity-limiting" LBP at baseline. We collected self-reported measures of pain, function, pain self-efficacy, care seeking, physical activity, disability, fear of movement and/or reinjury, and falls efficacy at baseline, 8 weeks, 3 months, and 6 months. We performed regression analyses to determine whether a family history of LBP predicted patient outcomes and moderated the effects of home exercise.

Results: Participants with a family history of any LBP were less likely to be highly active than those without a family history (odds ratio, 0.08; 95% CI, 0.01-0.42; P=.003). Home-based video game exercises led to improvements in function in those without a family history of activity-limiting LBP (β=1.78; 95% CI, 0.56-3.00; P=.006) but not in those with a family history (β=-0.17; 95% CI, -2.56 to 2.21; P=.880) (interaction P=.049). A family history of LBP did not influence the remaining patient outcomes or treatment effects.

Conclusions: A family history of LBP appears to negatively influence physical activity levels in older people with chronic LBP. Further, home-based video game exercises appear to be beneficial for older people with chronic LBP that do not have a family history of LBP.

Keywords: Aged; Exercise; Low back pain; Medical history taking; Rehabilitation; Video games.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Chronic Pain / rehabilitation*
Exercise
Exercise Therapy / methods*
Female
Humans
Low Back Pain / rehabilitation*
Male
Medical History Taking*
Middle Aged
Pain Measurement
Patient Acceptance of Health Care / statistics & numerical data
Patient Compliance
Physical Functional Performance
Treatment Outcome
Video Games

Associated data

ANZCTR/ACTRN12615000703505