Abstract
BackgroundExercise therapy is commonly prescribed by primary care physicians (PCPs) in the management of chronic musculoskeletal (MSK) pain.AimTo evaluate the clinical effectiveness of a supervised neuromuscular (NM) exercise programme in older people with chronic MSK pain.Design and settingThis was a 12-week, two-arm, randomised controlled trial comparing 6 weeks of supervised NM exercise versus waiting list controls. The authors enrolled 72 participants with chronic MSK pain at seven public primary care clinics.MethodParticipants were randomly allocated in block sizes of 12 to the NM (n = 36) and control groups (n = 36) in a 1:1 ratio. Data were collected at baseline, 6, and 12 weeks. The primary outcome was the Brief Pain Inventory (BPI) pain severity score at 6 weeks post-intervention. Secondary outcomes included the BPI interference score; Pain Self-Efficacy Questionnaire (PSEQ), Short Form Health Survey (SF-12), 7-item Generalised Anxiety Disorder (GAD-7), and 9-item Patient Health Questionnaire (PHQ-9) scores; and functional measurements using the Timed-Up- and-Go test and handgrip strength.ResultsAt 6 weeks, the NM group demonstrated a significantly greater improvement in the BPI pain severity score (between-group difference = −1.27; 95% confidence interval [CI] = −2.08 to −0.45; P<0.01), PSEQ (between-group difference = 6.5; 95% CI = 2.22 to 10.77; P<0.01), and SF-12 physical scores (between-group difference = 3.4; 95% CI = 0.05 to 6.75; P<0.05) compared with the control group. Statistically significant overall trends of improvement were also observed for the BPI interference and PHQ-9 scores.ConclusionNM exercise has the potential to reduce pain and improve self-efficacy and physical function in older people with chronic MSK pain. It can be an option for PCPs in exercise prescriptions.
Highlights
Chronic musculoskeletal (MSK) pain is very common among older patients, with varying impacts on functional, psychological, and social impairment.[1]
NM exercise has the potential to reduce pain and improve self-efficacy and physical function in older people with chronic MSK pain. It can be an option for primary care physicians (PCPs) in exercise prescriptions
Chronic MSK pain is commonly managed in primary care,[5] and accounts for 15%–20% of all annual visits to GPs.[6,7]
Summary
Chronic musculoskeletal (MSK) pain is very common among older patients, with varying impacts on functional, psychological, and social impairment.[1]. Chronic MSK pain is commonly managed in primary care,[5] and accounts for 15%–20% of all annual visits to GPs.[6,7] Medication is the most common treatment modality, with one in five older adults (18%) regularly taking analgesics.[8] Analgesic use is associated with significant side effects; its prescription and consumption are complicated in older people with multiple comorbidities, polypharmacy, and age- and frailty-related changes in pharmacokinetics and pharmacodynamics.[9]. Exercise therapy is commonly prescribed by primary care physicians (PCPs) in the management of chronic musculoskeletal (MSK) pain
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