A comparison of two short education programs for improving low back pain-related disability in the elderly: a cluster randomized controlled trial.
METHODS
Cluster randomized clinical trial.


OBJECTIVE
To assess the effectiveness of 2 minimal education programs for improving low back pain (LBP)-related disability in the elderly.


BACKGROUND
No education program has shown effectiveness on low back pain (LBP)-related disability in the elderly.


METHODS
A total of 129 nursing homes (6389 residents) in northern Spain were invited to participate in the study. The actual participants were 12 nursing homes randomly assigned to 3 groups and 661 subjects. An independent physician gave a 20-minute talk with slide projections summarizing the content of the Back Book (active management group), the Back Guide (postural hygiene group), and a pamphlet on cardiovascular health (controls). Disability was measured with the Roland-Morris questionnaire (RMQ). Blind assessments were performed before the intervention, and 30 and 180 days later. The effect of the intervention on disability was estimated by generalized mixed linear random effects models.


RESULTS
Mean age of participants ranged between 79.9 and 81.2 years. Disability improved in all groups, but at the 30-day assessment the postural education group showed an additional improvement of 1.1 (95% confidence interval, 0.2-1.9), RMQ points and at the 180-day assessment the active education group an additional improvement of 2.0 (95% confidence interval, 0.6-3.4). In the subset of subjects with LBP when entering the study, postural education had no advantages over controls, while an additional improvement of 3.0 (95% confidence interval, 1.5- 4.5) RMQ points at the 180-day assessment was observed in the active education group.


CONCLUSIONS
In institutionalized elderly, the handing out of the Back Book supported by a 20-minute group talk improves disability 6 months later, and is even more effective in those subjects with LBP.
Kovacs
Francisco
F
Departamento Científico, Fundación Kovacs, Palma de Mallorca, Spain. kovacs@kovacs.org
Abraira
Víctor
V
Santos
Severo
S
Díaz
Elena
E
Gestoso
Mario
M
Muriel
Alfonso
A
Gil del Real
María Teresa
MT
Mufraggi
Nicole
N
Noguera
Juan
J
Zamora
Javier
J
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control* / Q000523:psychology*; D008297:Male; D009735:Nursing Homes; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods* / Q000458:organization & administration; D011187:Posture; D011788:Quality of Life; D011795:Surveys and Questionnaires