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

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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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“42,44,45,47,48,50 Two of the studies only reported between-group differences (they were signi ﬁ cant) but did not report on within-group change.”
BackgroundMethodInfluential
Telehealth Mindfulness-Based Interventions for Chronic Pain
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“As a matter of fact, trials that used an active control group often reported smaller or null effect on participants' well‐being and/or quality of life.(45) This could be due not only to the non‐specific effect, but that both MBSR and the active control were able to improve well‐being to a similar extent.”
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Complementary and Integrative Health Approaches Offered in the Veterans Health Administration: Results of a National Organizational Survey
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Mindfulness Meditation in the Treatment of Chronic Pain
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Self-citation
Can Mindfulness-Based Training Improve Positive Emotion and Cognitive Ability in Chinese Non-clinical Population? A Pilot Study
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Biopsychosocial Profiles and Functional Correlates in Older Adults with Chronic Low Back Pain: A Preliminary Study
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Self-citation
Effectiveness of pharmacological and non-pharmacological therapy on pain intensity and disability in older people with chronic nonspecific low back pain: a systematic review with meta-analysis
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The Effects of Combined Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation and Mindfulness Meditation for Chronic Low Back Pain: A Pilot Study
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Addressing Chronic Pain Disparities Between Black and White People: A Narrative Review of Socio-Ecological Determinants
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Guided Mindfulness Meditation for Pain Control After Septorhinoplasty: A Randomized-Controlled Pilot Study
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MethodSelf-citation
Auricular Point Acupressure Smartphone Application to Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial
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Randomized Trial of a Low-Literacy Chronic Pain Self-Management Program: Analysis of Secondary Pain and Psychological Outcome Measures
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Income as a Predictor of Self-Efficacy for Managing Pain and for Coping With Symptoms Among Patients With Chronic Low Back Pain
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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: Morone, Natalia E.
Greco, Carol M.
Rollman, Bruce L.
Glynn, Nancy W.
Weiner, Debra K.
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: bronze
doi.org
Locations: JAMA Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (R01AG034078)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Physiology (medical) › 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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A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial

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