No abstract

No abstract

Objectives To evaluate the psychometric properties of two commonly used low back pain (LBP) disability questionnaires in a sample solely comprising community-dwelling older adults. Design Single-group repeated measures design. Setting Four continuing care retirement communities in Maryland and in Virginia. Participants Convenience sample of 107 community-dwelling men and women (71.9%) aged 62 years or older with current LBP. Outcome Measures All participants completed modified Oswestry Disability (mOSW) and Quebec Back Pain Disability (QUE) questionnaires, as well as the Medical Outcomes Survey Short-Form 36 questionnaire at baseline. At follow-up, 56 participants completed the mOSW and the QUE for reliability assessment. Results Test–retest reliability of the mOSW and QUE were excellent with intraclass correlation coefficients of 0.92 (95% confidence interval [CI]: 0.86, 0.95) and 0.94 (95% CI: 0.90, 0.97), respectively. Participants with high pain severity and high levels of functional limitation had higher scores on the mOSW (P < 0.0001) and QUE (P < 0.001) scales than other participants, which represents good construct validity for both scales. The threshold for minimum detectable change is 10.66 points for the mOSW and 11.04 points for the QUE. Both questionnaires had sufficient scale width to accurately measure changes in patient status. Conclusions It appears that both questionnaires have excellent test–retest reliability and good construct validity when used to evaluate LBP-related disability for older adults with varying degrees of LBP. Neither questionnaire appears to have superior psychometric properties; therefore, both the Oswestry and Quebec can be recommended for use among geriatric patients with LBP.

Objectives To assess the feasibility of a trial to evaluate a trunk muscle training program augmented with neuromuscular electrical stimulation (TMT+NMES) for the rehabilitation of older adults with chronic LBP and to preliminarily investigate whether TMT+NMES could improve physical function and pain compared with a passive control intervention. Methods We conducted a single-blind, randomized feasibility trial. Patients aged 60-85 years were allocated to TMT+NMES (n=31) or a passive control intervention (n=33), consisting of passive treatments, i.e. heat, ultrasound and massage. Outcomes assessed 3-months and 6-months post-randomization included Timed Up and Go Test, gait speed, pain and LBP-related functional limitation. Results Feasibility was established by acceptable adherence (>/= 80%) and attrition (<20%) rates for both interventions. Both groups had similar, clinically important reductions in pain of greater than 2 points on a numeric pain rating scale during the course of the trial. But, only the TMT+NMES group had clinically important improvements in both performance-based and self-reported measures of function. In terms of the participants' global rating of functional improvement at 6-months, the TMT+NMES group improved by 73.9% and the passive control group improved by 56.7% compared to baseline. The between-group difference was 17.2% (95%CI: 5.87-28.60) in favor of TMT+NMES. Discussion It appears that a larger randomized trial investigating the efficacy of trunk muscle training augmented with NMES for the purpose of improving physical function in older adults with chronic LBP is warranted.