TY - JOUR
T1 - Adherence to a community-based exercise program is a strong predictor of improved back pain status in older adults
T2 - An observational study
AU - Hicks, Gregory E.
AU - Benvenuti, Francesco
AU - Fiaschi, Valentino
AU - Lombardi, Bruna
AU - Segenni, Luciana
AU - Stuart, Mary
AU - Pretzer-Aboff, Ingrid
AU - Gianfranco, Gensini
AU - Macchi, Claudio
PY - 2012/3
Y1 - 2012/3
N2 - Objectives: To identify factors that were predictive of improved pain status among older adults with chronic back pain participating in the Adaptive Physical Activity (APA) program and to identify factors that were predictive of adherence to APA. Methods: An observational cohort study of 392 older adults (ages 50 to 88) with chronic back pain participating in APA for 12 months. APA was a community-based group exercise program given for 1-hour, twice weekly, in local gyms. Primary outcome measures were improved pain based on a global rating of change evaluation and adherence to the APA program (defined as participation in >75% of exercise sessions). Potential predictor variables were entered into multivariate logistic regression models to determine the most accurate set of variables for predicting improved pain and adherence. Results: Presence of depressive symptoms, poor self-rated health and adherence to APA were the best predictors of improved pain status, with adherence being the strongest predictor [odds ratio: 13.88 (95% confidence interval: 8.17, 23.59)]. Better physical function, longer pain duration, and positive rating of the trainer were all positively associated with adherence to APA; whereas poor self-rated health and further distance from the gym were inversely associated. Conclusions: Given that adherence to APA is the key predictor of improved back pain, future efforts should focus on strategies to improve adherence. Our data suggest that enhanced training of exercise trainers, development of separate classes for people with different functional levels, and use of psychosocial interventions to reduce health pessimism and depression may be potential targets for improving adherence.
AB - Objectives: To identify factors that were predictive of improved pain status among older adults with chronic back pain participating in the Adaptive Physical Activity (APA) program and to identify factors that were predictive of adherence to APA. Methods: An observational cohort study of 392 older adults (ages 50 to 88) with chronic back pain participating in APA for 12 months. APA was a community-based group exercise program given for 1-hour, twice weekly, in local gyms. Primary outcome measures were improved pain based on a global rating of change evaluation and adherence to the APA program (defined as participation in >75% of exercise sessions). Potential predictor variables were entered into multivariate logistic regression models to determine the most accurate set of variables for predicting improved pain and adherence. Results: Presence of depressive symptoms, poor self-rated health and adherence to APA were the best predictors of improved pain status, with adherence being the strongest predictor [odds ratio: 13.88 (95% confidence interval: 8.17, 23.59)]. Better physical function, longer pain duration, and positive rating of the trainer were all positively associated with adherence to APA; whereas poor self-rated health and further distance from the gym were inversely associated. Conclusions: Given that adherence to APA is the key predictor of improved back pain, future efforts should focus on strategies to improve adherence. Our data suggest that enhanced training of exercise trainers, development of separate classes for people with different functional levels, and use of psychosocial interventions to reduce health pessimism and depression may be potential targets for improving adherence.
KW - adherence
KW - back pain
KW - exercise
KW - older adults
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U2 - 10.1097/AJP.0b013e318226c411
DO - 10.1097/AJP.0b013e318226c411
M3 - Article
C2 - 21750458
AN - SCOPUS:84857041857
VL - 28
SP - 195
EP - 203
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
SN - 0749-8047
IS - 3
ER -