The process of creating and disseminating exercise programs by physical therapists for older adults with chronic back pain

Review written by Dr Mariana Wingood info

Key Points

  1. Management of chronic back pain (CBP) should incorporate the biopsychosocial model, clinical expertise, and physical activity prescribed in addition to therapeutic exercise.
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BACKGROUND & OBJECTIVE

Physical activity (PA) guidance and prescriptions are recommended for the management of chronic back pain (CBP) (1). For patients with CBP, the benefits of performing regular PA include reduced disability, psychological distress, and reduced risk of multiple chronic diseases and mortality (2). These health benefits are even greater among aging adults who are undergoing age-related changes such as a decrease in strength, balance, and endurance (3).

Despite the growing literature about physical activity's benefits, about 27.5% of adults above the age of 50 reported no leisure-time PA in the last month (4). These percentages are even lower among older adult patients with CBP. Physical therapists are in an ideal position to help address these low levels of physical activity. Yet, only 30-66% of physical therapists incorporate regular physical activity prescriptions into their clinical practice (5,6).

The clinical reasoning that goes into deciding to prescribe physical activity is not well understood. Therefore, the purpose of this study was to understand the process physical therapists undertake when creating and disseminating exercise programs for older adults with CBP.

Physical activity prescriptions are recommended for the management of chronic back pain.
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Meeting goals was not always related to eliminating pain. Instead, goals were attained by improving function and participating in meaningful activities.

METHODS

Participants: Nine outpatient physical therapists treating individuals aged 65 years and older with CBP lasting three or more months.

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