Evaluation Of The Effectiveness Of A Chronic Pain Management Intervention With Older Adults

2006 ◽  
Author(s):  
Erin A. BAKER
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management ◽  
Management Intervention

scholarly journals Acceptability and Effects of Commercially Available Activity Trackers for Chronic Pain Management Among Older African American Adults

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e68-e78 ◽  
Author(s):  
Mary R Janevic ◽  
Varick Shute ◽  
Susan L Murphy ◽  
John D Piette
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African American ◽  
Pain Management ◽  
Feasibility Trial ◽  
Chronic Pain Management ◽  
Step Counts ◽  
African American Adults ◽  
Activity Trackers ◽  
Wearable Activity Trackers

Abstract Background Wearable activity trackers may facilitate walking for chronic pain management. Objective We assessed the acceptability of a commercially available tracker and three alternative modes of reporting daily steps among older adults in a low-income, urban community. We examined whether using the tracker (Fitbit ZipTM) was associated with improvements in functioning and activity. Design Randomized controlled pilot and feasibility trial. Subjects Fifty-one African American adults in Detroit, Michigan, aged 60 to 85 years, with chronic musculoskeletal pain (28 in the intervention group, 23 controls). Methods Participants completed telephone surveys at baseline and eight weeks. Intervention participants wore trackers for six weeks, alternately reporting daily step counts via text messages, automated telephone calls, and syncing (two weeks each). We used multimethods to assess satisfaction with trackers and reporting modalities. Adherence was indicated by the proportion of expected days on which valid step counts were reported. We assessed changes in pain interference, physical function, social participation, walking frequency, and walking duration. Results More than 90% of participants rated trackers as easy to use, but some had technical or dexterity-related difficulties. Text reporting yielded 79% reporting adherence vs 69% each for automated calls and syncing. Intervention participants did not show greater improvement in functioning or walking than controls. Conclusions With appropriate support, wearable activity trackers and mHealth reporting for chronic pain self-care are feasible for use by vulnerable older adults. Future research should test whether the effects of trackers on pain-related outcomes can be enhanced by incorporating behavior change strategies and training in evidence-based cognitive-behavioral techniques.

scholarly journals Levels of physical activity in people with chronic pain

2017 ◽  
Vol 73 (1) ◽  
Author(s):  
Romy Parker ◽  
Emma Bergman ◽  
Anelisiwe Mntambo ◽  
Shannon Stubbs ◽  
Matthew Wills
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Pain Management ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Control Group ◽  
Chronic Pain Management ◽  
Pain Group ◽  
Cross Sectional ◽  
Management Intervention

Background: People who suffer from chronic pain are thought to have lower levels of physical activity compared to healthy individuals. However, there is a lack of evidence concerning levels of physical activity in South Africans with chronic pain. Objectives: To compare levels of physical activity in a South African sample of people with chronic pain compared to matched controls. Methods: A cross-sectional study was conducted with 24 participants (12 with chronic pain and 12 in the control group matched for age, gender and residential area). Convenience sampling was used. The participants with chronic pain (12) were identified from the Groote Schuur Hospital, Chronic Pain Management Clinic (CPMC) waiting list and had not yet received any chronic pain management intervention. Healthy matched controls were selected from volunteers in the community. With the desired alpha level set at 0.05 and the power at 0.9, 45 participants were required to detect a minimum of a 50 per cent difference between groups in levels of physical activity as measured in steps per day using pedometers. The international physical activity questionnaire (IPAQ) and the brief pain inventory (BPI) were used as measures of physical activity and pain. Objective indicators of physical activity that were used included the 6-minute walk test (6MWT), repeated sit-to-stand test (RSST), 7 days of pedometry and body mass index (BMI). Results: The chronic pain group performed significantly worse on the 6MWT (335 m [30–430] vs 680 m [430–795]; U = 0.5; p < 0.01) and on the RSST (17.9 s [11.83–105] vs 7.85 s [5.5–11.5]; U = 0; p < 0.01). The chronic pain group also had significantly lower scores on pedometry (mean daily: 2985.1 [32.8–13785.4] vs 6409.4 [4207.1–15313.6]; U = 35; p < 0.03). The BMI for the chronic pain group was significantly higher than matched controls (29.36 kg/m2 [18.94–34.63] vs 22.16 kg/m2 [17.1–30.86]; U = 34; p < 0.03). Conclusion: Participants with chronic pain had a reduced capacity for physical activity. The pedometry results illustrate a range of maladaptive strategies adopted by those with chronic pain. The majority of people with chronic pain appear to avoid physical activity leading to greater disability as a result of immobility and muscle atrophy. However, a small subgroup appears to ignore their pain and push themselves physically despite their pain. This perseverance behaviour leads to further pain as a consequence of muscle and joint overuse. Both maladaptive behavioural responses result in further sensitisation of the central nervous system. The method used to target physical activity in these patients should be considered in treatment planning, specifically for physiotherapy.

scholarly journals Chronic Pain Management Among Older Adults: A Scoping Review

2019 ◽  
Vol 5 ◽  
pp. 237796081987425
Author(s):  
Ampicha Nawai
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Outcome Measures ◽  
Scoping Review ◽  
Roy Adaptation Model ◽  
Chronic Pain Management ◽  
Adaptation Model

Chronic pain is a significant problem for older adults. The effect of chronic pain on older people’s quality of life needs to be described and identified. For a decade, the Roy Adaptation Model has been used extensively to explain nursing phenomena and guide nursing research in several settings with several populations. The objective of this study was to use the Roy Adaptation Model to describe chronic pain and present a systematic scoping review of the literature about the middle-range theory of chronic pain among older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses model guided a scoping review search method. A literature search was undertaken using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Ovid, and ProQuest. The search terms were “chronic pain,” “pain management,” “older adult,” “Roy Adaptation Model,” and “a scope review.” The search included articles written in English published for the period of 2004–2017. All articles were synthesized using concepts of Roy’s Adaptation Model. Twenty-two studies were considered for the present review. Twenty-one articles were reports of quantitative studies, and one was a report of a qualitative study. Two outcome measures were found in this systematic scoping review. The primary outcomes reported in all articles were the reduction of pain due to interventions and an increase in coping with chronic pain. The secondary outcome measures reported in all studies were the improvement of physical function, quality of life, sleep disturbance, spiritual well-being, and psychological health related to pain management interventions among older adults. Many interventions of all studies reported improvement in chronic pain management among older adults. However, to improve chronic pain management, nurses need to understand about nursing theories, the context which instruments work, and develop empirical instruments based on the conceptual model.

scholarly journals Acceptance and Commitment Therapy and Exercise: Can They Help Older Adults Manage Chronic Pain?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 289-290
Author(s):  
Dara K Y Leung ◽  
Annabelle P C Fong ◽  
Wai-Wai Kwok ◽  
Angie K Y Shum ◽  
Tianyin Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Acceptance And Commitment Therapy ◽  
Physical Functioning ◽  
Psychological Flexibility ◽  
Chronic Pain Management ◽  
Pain Acceptance ◽  
Acceptance And Commitment ◽  
Body Strength

Abstract Chronic pain is common among older adults and affects their physical and psychological well-being. While exercise can reduce pain and promote physical functions, psychological interventions may enhance pain management by addressing the psychosocial contributors to the prolonged pain. Acceptance and Commitment Therapy (ACT) is a psychological intervention that emphasizes on psychological flexibility, values, and mindfulness. This approach may be particularly helpful in dealing with chronic pain, where symptoms can be beyond one’s control. This single group pre-post study investigated the feasibility and efficacy of an intervention combining ACT and exercise for chronic pain management in older adults. The intervention consisted of 16 sessions delivered over eight weeks. ACT and exercises were modified according to the individual’s capability when needed. Clinical outcomes regarding pain severity and interference, pain acceptance, value of life, depression, anxiety, and physical functioning were assessed. Twenty-four older adults attended all sessions and completed the assessments. Preliminary results showed that, while participants experienced similar level of pain after the intervention, they reported less pain interference on mood and enjoyment of life, and improved chronic pain acceptance, pain self-efficacy, success at living their values, committed action, depressive symptoms, physical functioning in the lower body strength, aerobic and endurance, agility and dynamic balance, and upper body strength (all p&lt;.050). This study lends support to the feasibility of a combined ACT and exercise intervention for chronic pain management in older adults. The efficacy of ACT may not be directly on reducing pain, but on increased psychological flexibility to co-live with pain.

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