Biopsychosocial Characteristics, Using a New Functional Measure of Balance, of an Elderly Population with CLBP

Abstract

This study examined the biopsychosocial characteristics of chronic low back pain (CLBP) in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older). A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly) was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH)-developed Patient-Reported Outcome Measurement Information System (PROMIS) was also part of this comprehensive evaluation. Two demographically-matched groups of elderly participants were evaluated: one with CLBP (n = 24); and the other without (NCLBP, n = 24). Results revealed significant differences in most of these measures between the two groups, further confirming the importance of using a biopsychosocial approach for future studies of pain and postural control in the elderly.

Fatores biopsicossociais associados com a incapacidade em idosos com dor lombar aguda: estudo BACE-Brasil

“…Previous data that indicate the influence of health status on LBP disability are consistent with this result 9,46 . However, it is essential to note that the available literature on LBP in the general population has shown meaningful participation of psychological and social issues in detriment of clinical and biological issues [18][19][20]37,44 . This is also evident in this study since several biological factors did not show a significant association with disability.…”

“…The scientific literature highlights the importance of the biopsychosocial model in the approach of LBP in the general population [17][18][19][20] . However, on the association of biopsychosocial factors with disability in LBP patients are still limited.…”

“…The few available data point to the influence of physical, psychological and socio-environmental factors on self-reported disability in adults with acute LBP 19 . In older adults, the only study available on the biopsychosocial and LBP model showed an association of negative biopsychosocial aspects with worse functional results and recommended the use of the biopsychosocial approach in future research on LBP in older adults 18 .…”

The biopsychosocial approach and considerations involved in chronic pain

“…Lee et al reported that CLBP patients performed significantly worst in every aspect of postural control compared to older patients not suffering from chronic pain [52] . Similarly, a study conducted by Hulla et al examined biopsychosocial measures in older adults affected by CLBP compared to match (age, gender, education, and exercise engagement) non-CLBP counterparts [53] . The study revealed that older adults with CLBP associated with worse scores on conditions related to postural control and fall risk; and CLBP individuals suffered from greater pain intensity, fatigue, sleep disturbance, and lower levels of perceived physical function than their non-CLBP matched counterparts.…”

The Chronic Low Back Pain Epidemic in Older Adults in America

“…Risk factors, such as anxiety, cognitive deficiencies, depression, declining vision, decreased physical activity, weakening neuromuscular factors, osteoarthritis, and increased psychotropic medication and diuretic consumption, can all contribute to sustaining a fall-related injury [8][9][10]. A study conducted by Hulla et al provided an example of new important issues of chronic pain and "fall-risk, " by revealing that older adults with CLBP performed more poorly in balance-activities and various psychosocial dimensions, relative to their demographically-matched counterparts without CLBP [11]. Relatedly, in regards to exercise in aiding in the management of chronic pain in the older-adult population, a study by Stubbs et al demonstrated that adequate exercise can have an influence in reducing falls in older adults by enhancing psychosocial and physical functioning [12].…”