Original research
Family History Influences the Effectiveness of Home Exercise in Older People With Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial

https://doi.org/10.1016/j.apmr.2020.03.019Get rights and content

Highlights

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    Family history of low back pain (LBP) can reduce activity in older people with LBP.

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    Family history may also have a negative influence on pain and self-efficacy.

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    Video game exercises are beneficial for older people without a family history of LBP.

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    Video game exercises have no effect on those with a family history of severe LBP.

Abstract

Objective

To investigate whether a family history of low back pain (LBP) influences patient outcomes and treatment effects following home exercises in older people with chronic LBP.

Design

Secondary analysis of a randomized controlled trial.

Setting

Local community.

Participants

People older than 55 years with chronic LBP (N=60).

Interventions

Participants in the intervention group completed video game exercises for 60 minutes 3 times per week for 8 weeks. Participants in the control group were instructed to maintain their usual levels of activity and care seeking behaviors.

Main Outcomes Measures

Participants indicated whether any of their immediate family members had a history of “any” LBP or “activity-limiting” LBP at baseline. We collected self-reported measures of pain, function, pain self-efficacy, care seeking, physical activity, disability, fear of movement and/or reinjury, and falls efficacy at baseline, 8 weeks, 3 months, and 6 months. We performed regression analyses to determine whether a family history of LBP predicted patient outcomes and moderated the effects of home exercise.

Results

Participants with a family history of any LBP were less likely to be highly active than those without a family history (odds ratio, 0.08; 95% CI, 0.01-0.42; P=.003). Home-based video game exercises led to improvements in function in those without a family history of activity-limiting LBP (β=1.78; 95% CI, 0.56-3.00; P=.006) but not in those with a family history (β=−0.17; 95% CI, −2.56 to 2.21; P=.880) (interaction P=.049). A family history of LBP did not influence the remaining patient outcomes or treatment effects.

Conclusions

A family history of LBP appears to negatively influence physical activity levels in older people with chronic LBP. Further, home-based video game exercises appear to be beneficial for older people with chronic LBP that do not have a family history of LBP.

Section snippets

Design

We conducted a secondary analysis of an RCT comparing a group who performed home-based video game exercises with a control group instructed to maintain usual activity levels (including care-seeking behaviors) in people older than 55 years with chronic LBP (≥3-mo duration). Detailed information regarding trial registration, recruitment and screening procedures, the intervention, feasibility measures, outcome measures, and data collection can be found elsewhere.11,28 All trial procedures were

Results

The mean age of participants was 68 years, and there were 31 women (51.7%). There were 33 (55.0%) and 19 participants (31.7%) reporting at least 1 family member with a history of any LBP and activity-limiting LBP, respectively. Baseline characteristics stratified by a family history of LBP can be found in table 2. Most participants reported that at least 1 of their family members engaged in regular moderate (n=48, 80.0%) or vigorous-intensity physical activity (n=40, 66.7%). Baseline

Discussion

A family history of LBP decreases the likelihood that older people with chronic LBP will engage in high levels of physical activity. Home-based video game exercises are beneficial for improving function in older people without a family history of LBP but not for those with a family history. Further research in this area would have important implications for prescribing home exercise to those likely to respond but also for addressing beliefs and behaviors shared within families that could

Conclusions

A family history of LBP decreases the likelihood of being highly active in older people with chronic LBP. Further, home-based video game exercises are not beneficial for older people with chronic LBP who have a family history of activity-limiting LBP. These preliminary findings highlight that a family history of LBP could influence patient outcomes and modify the effects of home exercise for older people with chronic LBP.

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    • Clinical Trial Registration No.: ACTRN12615000703505.

    Disclosures: none.

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