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- Issue 71
- A novel movement-evoked pain provocation test…
A novel movement-evoked pain provocation test for older adults with persistent low back pain - safety, feasibility, and associations with self-reported physical function and usual gait speed
Key Points
- The prevalence of low back pain among older adults is high and associated with disability.
BACKGROUND & OBJECTIVE
About 150 million older adults globally experience low back pain (LBP), and about 50% report a physical disability (1). Movement-evoked pain (MEP) occurs during and after movement and is associated with reduced physical activity, which can lead to disability. Assessments of MEP occur in parallel with a patient’s movement; thus, it may provide details about the impact of LBP on movement, a factor not evaluated through the two predominant pain measures used in patient care: (1) recalled pain, assessed via questionnaire, and (2) resting pain, assessed while the patient is motionless (2).
Despite the growing literature, clinical relevance, and association to patient-reported outcomes and function, Movement-Evoked Provocation Test for Low Back Pain in Older Adults (MEPLO) has not been evaluated among older adults.
The objective of this study was: (1) to determine whether the MEPLO is safe and feasible, (2) to calculate delta and aggregate MEP scores and characterize within-individual differences for the two scores, and (3) to quantify the association between MEP scores and two disability-associated outcome measures—self-reported physical function and usual gait speed.
These findings highlight the importance of utilizing LBP assessments that incorporate functional movements completed regularly.
METHODS
Participants: 40 community-ambulating adults aged 60-85 who experienced LBP for 3+ months with an average daily LBP pain intensity of at least 40/100 on a 0 to 100 numeric pain rating scale (NPRS; 100 = worst pain imaginable).