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Cited by 258Musculoskeletal pain and rehabilitationMindfulness and Compassion InterventionsPain Mechanisms and Treatments

A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial

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Morone, Natalia E., Greco, Carol M., Moore, Charity G., Rollman, Bruce L., Lane, Bridget, Morrow, Lisa A., Glynn, Nancy W., Weiner, Debra K.·2016·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2015.8033PMC PMC6361386
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Abstract

IMPORTANCE: Treatment of chronic low back pain (LBP) in older adults is limited by the adverse effects of analgesics. Effective nonpharmacologic treatment options are needed. OBJECTIVE: To determine the effectiveness of a mind-body program at increasing function and reducing pain in older adults with chronic LBP. DESIGN, SETTING, AND PARTICIPANTS: This single-blind, randomized clinical trial compared a mind-body program (n = 140) with a health education program (n = 142). Community-dwelling older adults residing within the Pittsburgh metropolitan area were recruited from February 14, 2011, to June 30, 2014, with 6-month follow-up completed by April 9, 2015. Eligible participants were 65 years or older with functional limitations owing to their chronic LBP (≥11 points on the Roland and Morris Disability Questionnaire) and chronic pain (duration ≥3 months) of moderate intensity. Data were analyzed from March 1 to July 1, 2015. INTERVENTIONS: The intervention and control groups received an 8-week group program followed by 6 monthly sessions. The intervention was modeled on the Mindfulness-Based Stress Reduction program; the control program, on the "10 Keys" to Healthy Aging. MAIN OUTCOMES AND MEASURES: Follow-up occurred at program completion and 6 months later. The score on the Roland and Morris Disability Questionnaire was the primary outcome and measured functional limitations owing to LBP. Pain (current, mean, and most severe in the past week) was measured with the Numeric Pain Rating Scale. Secondary outcomes included quality of life, pain self-efficacy, and mindfulness. Intent-to-treat analyses were conducted. RESULTS: Of 1160 persons who underwent screening, 282 participants enrolled in the trial (95 men [33.7%] and 187 women [66.3%]; mean [SD] age,74.5 [6.6] years). The baseline mean (SD) Roland and Morris Disability Questionnaire scores for the intervention and control groups were 15.6 (3.0) and 15.4 (3.0), respectively. Compared with the control group, intervention participants improved an additional -1.1 (mean, 12.1 vs 13.1) points at 8 weeks and -0.04 (mean, 12.2 vs 12.6) points at 6 months (effect sizes, -0.23 and -0.08, respectively) on the Roland and Morris Disability Questionnaire. By 6 months, the intervention participants improved on the Numeric Pain Rating Scale current and most severe pain measures an additional -1.8 points (95% CI, -3.1 to -0.05 points; effect size, -0.33) and -1.0 points (95% CI, -2.1 to 0.2 points; effect size, -0.19), respectively. The changes in Numeric Pain Rating Scale mean pain measure after the intervention were not significant (-0.1 [95% CI, -1.1 to 1.0] at 8 weeks and -1.1 [95% CI, -2.2 to -0.01] at 6 months; effect size, -0.01 and -0.22, respectively). CONCLUSIONS AND RELEVANCE: A mind-body program for chronic LBP improved short-term function and long-term current and most severe pain. The functional improvement was not sustained, suggesting that future development of the intervention could focus on durability. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01405716.

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  • Mindfulness-based stress reduction (MBSR) may be an effective treatment option for patients with chronic low back pain.

    “Relevant trials have suggested that MBSR may be an effective treatment option for patients with chronic low back pain [14–16].”

    From Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial (2022) · cites this paper as [16]

    The Methods (Intervention and Overview) describe an eight-week mindfulness program modeled on MBSR, rather than a trial of MBSR itself, in adults aged 65 or older with chronic low back pain. The Conclusions report improvements in pain and short-term physical function and suggest mindfulness has a treatment role for those older adults. This supports the tentative treatment claim, but not its extension to patients with chronic low back pain generally. (LLM, conf=0.84)

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  • In older adults with chronic low back pain, an eight-week MBSR program improved numerical pain ratings and symptom severity relative to an active health education comparison.

    “Morone and colleagues found that an 8-week MBSR program significantly improved numerical pain scale ratings and pain-symptom severity in older adults (i.e., older than 65 years of age) suffering from chronic low back pain when compared to a “very active” pain-related health education group.55”

    From Mindfulness meditation-based pain relief: a mechanistic account (2016) · cites this paper as [55]

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Research works printed but not linked: 1

  1. [1]Institute of Medicine. Relieving Pain inAmerica: A Blueprintfor Transforming Prevention, Care, Education, and Research. Washington, DC: National Academies Press; 2011. 22553896

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Authors
Morone, N. E., Greco, C. M., Moore, C. G., Rollman, B. L., Lane, B., Morrow, L. A., Glynn, N. W., & Weiner, D. K.
Affiliations
  • University of Pittsburgh (US)
  • Carolinas Healthcare System (US)
  • Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Corresponding author
Morone, Natalia E.
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2016-03-01
Volume
176
Issue
3
Pages
329
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2015.8033
PMC
PMC6361386
OpenAlex
W2284879964
Cited by
258
References
36
Citations by year
2026: 13 · 2025: 24 · 2024: 27 · 2023: 18 · 2022: 30 · 2021: 26 · 2020: 32 · 2019: 26 · 2018: 24 · 2017: 24 · 2016: 14
FWCI
23.71
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (R01AG034078)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Keywords
chronic low back pain, older adults, mind-body interventions, mindfulness-based stress reduction, non-pharmacological pain management, functional disability, pain intensity, quality of life, pain self-efficacy, mindfulness, health education, community-dwelling older adults, analgesic side effects, cognitive behavioral therapy, spinal manipulation, acupuncture, Tai Chi
MeSH terms
Aged, Analgesics, Disability Evaluation, Female, Follow-Up Studies, Health Education, Humans, Male, Pain Measurement, Pennsylvania, Psychophysiology, Quality of Life, Surveys and Questionnaires, Single-Blind Method, Treatment Outcome, Low Back Pain, Meditation, Chronic Pain, Mindfulness

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