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Behavioural medicine intervention in older adults

...Is there any effect on pain, global health and behaviour?

Chronic pain is a common condition around the world and represents a public health issue. Described as pain lasting three or more months despite treatments and medications provided, it affects 62 percent of people over 75 years old.

Pain in relation to musculoskeletal conditions is the most common type of chronic pain. Its consequences can be devastating, such as poor global health, poor physical function, disabilities, higher risks of falling, fear of movement and catastrophising, anxiety, social isolation, poor quality of life, et cetera. In older adults, chronic pain is even more associated with risk of increasing disability, less movement, sedentarity and frailty.

While physical activity has been identified in the literature as a way for older people with chronic pain to maintain the possibility to perform daily activities, a behavioural medicine approach in physiotherapy (BMPT) has also been developed and recommended as an evidence based intervention for middle-aged adults suffering from chronic pain.

The intervention is based on a biopsychosocial approach. This is particularly relevant here, as pain is a multidimensional experience. It aims at modifying behaviour of people in order to reach goals associated with disabilities directly affecting daily life. Built on the basis of each patient, it takes into consideration all the dimensions involved in such context – i.e., medical, physical, behavioural, cognitive, psychological, environmental and social.

Although this specific BMPT was found efficient to improve the level of physical activity, self-efficacy for exercise and management of pain of everyday life among older women, additional research is necessary to further assess the level of evidence.

Therefore, the present study investigated the effects of a BMPT on pain related disability and physical function as well as on pain severity, pain-related beliefs, physical activity levels, falls efficacy, and health-related quality of life. This was found as a suitable intervention for older adults, even for those who are very old and frail.

 
 

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