Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: a randomized controlled trial

Abstract

Sara Cederbom,1 Suzanne G Leveille,2–4 Astrid Bergland11Faculty of Health Sciences, Department of Physiotherapy, OsloMet – Oslo Metropolitan University, Oslo, Norway; 2Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA; 3Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; 4Department of Medicine, Harvard Medical School, Boston, MA, USAPurpose: The aim of the study was to evaluate the effects of an intervention, based on a behavioral medicine approach in physical therapy (BMPI), on pain-related disability and physical performance as well as on pain severity, pain catastrophizing, physical activity levels, falls efficacy, and health-related quality of life (HRQL) by comparing the effects to standard care.Patients and methods: The study was a pragmatic randomized controlled trial with a two-group design and included measurements preintervention and postintervention and a 12-week follow-up. In total, 105 older adults, aged >75 years with chronic musculoskeletal pain living alone at home and dependent on formal care to manage their everyday lives, were included in the study. All statistical analyses were performed using an intention to treat approach.Results: The intervention, based on a behavioral medicine approach, compared to usual care, had a positive effect on pain-related disability, pain severity, level of physical activity, HRQL, management of everyday life, and self-efficacy.Conclusion: BMPI can be a suitable evidence-based intervention for community-dwelling older adults, even for those who are very old and frail. BMPI can support and promote an active aging and “age in place” for the target population, which is currently the main goal of all interventions in this field.Keywords: active aging, behavior change, exercise, pain management, physical therapy, self-efficacy

Keywords

• active aging
• behavior change
• exercise
• pain management
• physical therapy
• self-efficacy