<p>Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: a randomized controlled trial</p>

Abstract

Purpose The aim of the study was to evaluate the effects of an intervention, based on a behavioral medicine approach in physical therapy (BMPI), on pain-related disability and physical performance as well as on pain severity, pain catastrophizing, physical activity levels, falls efficacy, and health-related quality of life (HRQL) by comparing the effects to standard care. Patients and methods The study was a pragmatic randomized controlled trial with a two-group design and included measurements preintervention and postintervention and a 12-week follow-up. In total, 105 older adults, aged >75 years with chronic musculoskeletal pain living alone at home and dependent on formal care to manage their everyday lives, were included in the study. All statistical analyses were performed using an intention to treat approach. Results The intervention, based on a behavioral medicine approach, compared to usual care, had a positive effect on pain-related disability, pain severity, level of physical activity, HRQL, management of everyday life, and self-efficacy. Conclusion BMPI can be a suitable evidence-based intervention for community-dwelling older adults, even for those who are very old and frail. BMPI can support and promote an active aging and “age in place” for the target population, which is currently the main goal of all interventions in this field.

<p>Pain Intensity and Functional Outcomes for Activities of Daily Living, Gait and Balance in Older Adults Accessing Outpatient Rehabilitation Services: A Retrospective Study</p>

“…46 In a study investigating the effect of a behavioral medicine approach of physical therapy that addresses physical function and psychosocial factors for older adults with chronic pain, it was noted that such a program resulted in a greater decrease in pain severity, as well as greater improvements in physical activity, health-related quality of life and self-efficacy in the intervention group, compared to the control group. 47 Interestingly, and similar to the results in the present study, both persons in the intervention and control group demonstrated significant improvements in physical function. 47 In the present study, the functional gains measured for gait, balance and functional autonomy following outpatient rehabilitation were not associated with initial pain levels.…”

“…47 Interestingly, and similar to the results in the present study, both persons in the intervention and control group demonstrated significant improvements in physical function. 47 In the present study, the functional gains measured for gait, balance and functional autonomy following outpatient rehabilitation were not associated with initial pain levels. The changes in the values of the outcome measures between T1 and T2 were similar between the groups.…”

“…67 A behavioral medicine physical therapy intervention in older adults with chronic pain resulted in significantly increased self-efficacy in relation to goal behavior to improve function and physical activities. 47 Taken together, these observations suggest that alternative mechanisms, which are independent of motor learning and presumably unaffected by pain levels, could be involved in the functional improvements found within the present study.…”

“…However, addressing pain in older adults remains important to improve quality of life and increase physical activity. 47…”

Implementing a behavioral medicine approach in physiotherapy for patients with musculoskeletal pain: a scoping review

“…Studies that contributed to the results were from Australia, 51 Ireland, 40 Norway, 9 , 10 , 56 , 57 Sweden, 4 , 6 , 8 , 19 , 23 , 28 , 34 , 35 , 42 , 43 , 45 , 49 the United Kingdom, 27 , 58 and the United States. 3 , 44 …”