Physical Activity for the Treatment of Chronic Low Back Pain in Elderly Patients: A Systematic Review

Abstract

Chronic low back pain (CLBP) affects nearly 20–25% of the population older than 65 years, and it is currently the main cause of disability both in the developed and developing countries. It is crucial to reach an optimal management of this condition in older patients to improve their quality of life. This review evaluates the effectiveness of physical activity (PA) to improve disability and pain in older people with non-specific CLBP. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. Individual risk of bias of single studies was assessed using Rob 2 tool and ROBINS-I tool. The quality of evidence assessment was performed using GRADE analysis only in articles that presents full data. The articles were searched in different web portals (Medline, Scopus, CINAHL, EMBASE, and CENTRAL). All the articles reported respect the following inclusion criteria: patients > 65 years old who underwent physical activities for the treatment of CLBP. A total of 12 studies were included: 7 randomized controlled trials (RCT), 3 non-randomized controlled trials (NRCT), 1 pre and post intervention study (PPIS), and 1 case series (CS). The studies showed high heterogeneity in terms of study design, interventions, and outcome variables. In general, post-treatment data showed a trend in the improvement for disability and pain. However, considering the low quality of evidence of the studies, the high risk of bias, the languages limitations, the lack of significant results of some studies, and the lack of literature on this argument, further studies are necessary to improve the evidences on the topic.

Association of low back pain with muscle weakness, decreased mobility function, and malnutrition in older women: A cross-sectional study

“…The malnutrition risk that was represented by lower serum hemoglobin levels in older adults was related to decreased mobility function. A systematic review highlighted that physical activity can decrease chronic LBP and improve disability in older patients [ 10 ]. The relationship of malnutrition with decreased mobility may also affect the presence of LBP in older adults.…”

“…Therefore, exercise and physical activity are recommended to decrease LBP and disability [10,11,18,40]. However, not all treatments options normally indicated for the young population can be applied to the older population, because they have muscle weakness, osteoporosis, and other musculoskeletal pain and dysfunction in the extremities [10][11][12][13]18]. Adherence and motivation are also important for exercise therapy for older patients [9].…”

“…In a systemic review, Hayden et al [ 8 ] reported that among various types of exercise therapies for chronic LBP, strengthening exercises were the most effective for improving physical functions. For older patients with chronic LBP, compliance with performing necessary exercise and the motivation to exercise are generally limited [ 9 , 10 ]. Unfortunately, research of exercise for chronic LBP has frequently focused on the working population and has excluded the older population due to age-related co-morbidities [ 10 – 12 ].…”

“…For older patients with chronic LBP, compliance with performing necessary exercise and the motivation to exercise are generally limited [ 9 , 10 ]. Unfortunately, research of exercise for chronic LBP has frequently focused on the working population and has excluded the older population due to age-related co-morbidities [ 10 – 12 ]. A significant number of older patients with chronic LBP are unable to continue their recommended exercise regimen because they have pain, deformities, and/or loss of flexibility in the spine and extremities and because of muscle weakness [ 12 , 13 ].…”

The Effects of Workplace Interventions on Low Back Pain in Workers: A Systematic Review and Meta-Analysis

“…Non-specific low back pain (LBP) is a common worldwide disorder with a significant impact on productivity, work ability, and quality of life [ 1 ]. Indeed, LBP is characterized by persisting pain, muscle weakness, reduction of physical activity [ 2 ], and sleep disorders, which have serious consequences on a person’s quality of life by limiting daily life and work activities [ 3 ]. The etiopathogenesis of nonspecific LBP is multifactorial including lifestyle risk factors (i.e., excess weight) [ 4 ] but also, according to the type of job, several occupational risk factors such as manual handling of heavy loads, awkward and prolonged postures (i.e., sustained sedentary work), whole-body mechanical vibrations, and work-related stress (i.e., psychosocial factors) [ 5 ].…”