Are Older Adults with Chronic Musculoskeletal Pain Less Active than Older Adults Without Pain? A Systematic Review and Meta-Analysis

Abstract

Objective. To compare the overall levels of physical activity of older adults with chronic musculoskeletal pain and asymptomatic controls.Review Methods. A systematic review of the literature was conducted using a Cochrane methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses statement. Major electronic databases were searched from inception until December 2012, including the Cochrane Library, CINAHL, EBSCO, EMBASE, Medline, PubMed, PsycINFO, and the international prospective register of systematic reviews. In addition, citation chasing was undertaken, and key authors were contacted. Eligibility criteria were established around participants used and outcome measures focusing on daily physical activity. A meta-analysis was conducted on appropriate studies.Results. Eight studies met the eligibility criteria, four of these reported a statistically lower level of physical activity in the older adult sampl e with chronic pain compared with the asymptomatic group. It was possible to perform a nonheterogeneous meta-analysis on five studies. This established that 1,159 older adults with chronic pain had a significantly lower level of physical activity (-0.20, confidence interval 95% = -0.34 to -0.06, p = 0.004) compared with 576 without chronic pain.Conclusion. Older adults with chronic pain appear to be less active than asymptomatic controls. Although this difference was small, it is likely to be clinically meaningful. It is imperative that clinicians encourage older people with chronic pain to remain active as physical activity is a central nonpharmacological strategy in the management of chronic pain and is integral for healthy aging. Future research should prioritize the use of objective measurement of physical activity.

Effects of a Multicomponent Home-Based Physical Rehabilitation Program on Mobility Recovery After Hip Fracture: A Randomized Controlled Trial

“…This result is in line with earlier studies showing that musculoskeletal pain is among the major reasons for low physical activity in older populations (Ashe et al 2009, Stubbs et al 2013. In the present study, the participants with internal fixation reported more pain and perceived more walking difficulties than patients with hemiarthroplasty or total hip replacement (I).…”

The relationship between perceived promotion of autonomy/dependence and pain-related disability in older adults with chronic pain: the mediating role of self-reported physical functioning

“…More importantly, it does not provide information about actual/observed physical functioning concerning mobility, agility or strength to accomplish physical tasks. Indeed, perceived physical functioning might be poorly linked to real activity levels (Stubbs et al, 2013). In future research, physical functioning should also be assessed using observational measures.…”

“…Indeed, the prevalence of chronic pain is known to increase with age (e.g., Blyth et al, 2001;Johannes et al, 2010) and musculoskeletal chronic pain (in muscles, ligaments, tendons and/or bones) is one of the most prevalent pain conditions among older adults (e.g., Miranda et al, 2012). Furthermore, in this particular age group, chronic pain is often associated with depression, sleep disturbances, avoidance of social interactions and decreased physical activity (e.g., Lee, et al, 2015;Mort & Philip, 2014;Stubbs et al, 2013;Zimmerman, et al, 2015). Also, chronic (musculoskeletal) pain often strongly interferes with older adults' performance of their daily activities (Helme & Gibson, 1997;Mobily et al, 1994;Reyes-Gibby et al, 2002;Thomas et al, 2004); in other words, it is often associated with high levels of pain-related disability (e.g., Cleeland, 2009;Tait, et al, 1990).…”

“…Thus increasing supportive behaviors that promote functional autonomy rather than functional dependence. Indeed, such supportive behaviors may even help promote older adults' physical activity, which is an important non-pharmacological strategy for managing chronic pain in older adults (e.g., Haneweer, et al, 2009;Hendrick et al, 2011;Stubbs et al, 2013). responses to social support actions may depend on the extent to which these actions address their needs or preferences (e.g., Maisel & Gable, 2009).…”

Estudo comparativo dos efeitos biopsicossociais de dois programas de atividade física para idosas em Moçambique

“…O fortalecimento musculoesquelético por meio da AF expressa-se através da melhoria da DMO, do conteúdo mineral ósseo, da mudança no estilo de vida (autonomia e independência) mesmo reconhecendo o impacto das enfermidades que o acompanham (STUBBS et al, 2013). No caso da DMO que está em constante perda com o avanço da idade, estudos mostram que a AF aumenta de forma gradual e lenta a DMO durante a adolescência e isso repercute na qualidade da saúde óssea na idade adulta (TINETTI, 2003;STUBBS et al, 2013).…”