A novel movement-evoked pain provocation test for older adults with persistent low back pain - safety, feasibility, and associations with self-reported physical function and usual gait speed

Review written by Dr Mariana Wingood info

Key Points

  1. The prevalence of low back pain among older adults is high and associated with disability.
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BACKGROUND & OBJECTIVE

About 150 million older adults globally experience low back pain (LBP), and about 50% report a physical disability (1). Movement-evoked pain (MEP) occurs during and after movement and is associated with reduced physical activity, which can lead to disability. Assessments of MEP occur in parallel with a patient’s movement; thus, it may provide details about the impact of LBP on movement, a factor not evaluated through the two predominant pain measures used in patient care: (1) recalled pain, assessed via questionnaire, and (2) resting pain, assessed while the patient is motionless (2).

Despite the growing literature, clinical relevance, and association to patient-reported outcomes and function, Movement-Evoked Provocation Test for Low Back Pain in Older Adults (MEPLO) has not been evaluated among older adults.

The objective of this study was: (1) to determine whether the MEPLO is safe and feasible, (2) to calculate delta and aggregate MEP scores and characterize within-individual differences for the two scores, and (3) to quantify the association between MEP scores and two disability-associated outcome measures—self-reported physical function and usual gait speed.

About 150 million older adults globally experience low back pain and about 50% report a physical disability.
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These findings highlight the importance of utilizing LBP assessments that incorporate functional movements completed regularly.

METHODS

Participants: 40 community-ambulating adults aged 60-85 who experienced LBP for 3+ months with an average daily LBP pain intensity of at least 40/100 on a 0 to 100 numeric pain rating scale (NPRS; 100 = worst pain imaginable).

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