Mailloux Julie, Finno Mark, Rainville James
Massachusetts School of Professional Psychology, Boston, Massachusetts, USA.
Am J Phys Med Rehabil. 2006 Feb;85(2):120-6. doi: 10.1097/01.phm.0000197580.64079.3d.
Chronic back pain is common in the elderly population and can be treated with exercise. Long-term adherence to exercise recommendations has been documented in adults of <65 yrs of age but not for elderly adults. This study explored exercise behaviors of elderly adults with a history of chronic back pain before and 2 yrs after treatment in an exercise-oriented rehabilitation program.
This study utilized a case series design to survey 126 subjects >65 yrs old who underwent physical therapy during the year 2000 for complaints of chronic low back pain. Of these, 89 (70%) responded to the 2-yr questionnaire. Outcome measures included visual analog scale for pain, Oswestry disability questionnaires, back flexibility and strength, and a questionnaire exploring exercise behaviors. All subjects underwent a 6-wk physical therapy program that consisted of exercise coupled with advice to remain active.
Improvements in flexibility and strength occurred during treatment. Mean Oswestry disability scores (0-100 scale) improved from 32 to 20, and pain scores (0-10 scale) from 5.0 to 3.0 during treatment (P < 0.001) and were maintained at the 2-yr follow-up, regardless of exercise adherence. The percentage of patients who performed at least some exercise increased from 49% before treatment to 72% at the 2-yr follow-up. The changes in disability or pain observed during treatment did not influence exercise compliance. The most frequently stated reasons for nonadherence was that exercise did not help or aggravated pain (33%). For those who exercised regularly, 80% did so because of the health benefits from exercise.
The exercise behaviors of many elderly adults with chronic low back pain can increase after an exercise-oriented spine physical therapy program.
慢性背痛在老年人群中很常见，可通过运动进行治疗。已有文献记载65岁以下成年人能长期坚持运动建议，但老年成年人的情况尚无相关研究。本研究探讨了有慢性背痛病史的老年成年人在以运动为导向的康复项目治疗前及治疗2年后的运动行为。
本研究采用病例系列设计，对2000年因慢性下背痛主诉接受物理治疗的126名65岁以上受试者进行调查。其中，89名（70%）回复了2年随访问卷。结局指标包括疼痛视觉模拟量表、Oswestry功能障碍问卷、背部柔韧性和力量，以及一份探索运动行为的问卷。所有受试者均接受了为期6周的物理治疗项目，该项目包括运动以及保持活动的建议。
治疗期间柔韧性和力量有所改善。治疗期间，Oswestry功能障碍平均评分（0 - 100分制）从32分提高到20分，疼痛评分（0 - 10分制）从5.0分降至3.0分（P < 0.001），且在2年随访时保持不变，无论运动依从性如何。至少进行了一些运动的患者百分比从治疗前的49%增加到2年随访时的72%。治疗期间观察到的功能障碍或疼痛变化并未影响运动依从性。最常提及的不依从原因是运动没有帮助或加重了疼痛（33%）。对于那些经常运动的人，80%这样做是因为运动对健康有益。
许多患有慢性下背痛的老年成年人在以运动为导向的脊柱物理治疗项目后运动行为会增加。
