Group-based exercise reduces pain and disability and improves other outcomes in older people with chronic non-specific low back pain: the ESCAPE randomised trial

Abstract

Question: In older people with chronic non-specific low back pain (CNSLBP), what is the effect of a group-based exercise protocol compared with a waitlist control on pain intensity, disability, global perceived effect, frequency of falls, fear of falling and physical activity?

Design: Randomised trial with concealed allocation and intention-to-treat analysis.

Participants: One hundred and twenty people aged ≥ 60 years with CNSLBP.

Interventions: Participants were allocated to undertake 1-hour group exercise sessions, three times per week for 8 weeks or to a waitlist control.

Outcome measures: The primary outcomes were pain intensity and disability. Secondary outcomes were the global perceived effect, frequency of falls, fear of falling and physical activity level. Data were collected at baseline, 8 weeks, 5 months and 12 months after randomisation.

Results: Compared with control, group-based exercise reduced pain intensity on a 0-to-10 scale (MD -2.0, 95% CI -2.8 to -1.3) and disability on the 0-to-24 Roland-Morris Disability Questionnaire (MD -3.4, 95% CI -4.7 to -2.1). Group-based exercise also led to higher ratings of global perceived effect sustained through to 12 months and higher levels of physical activity at week 8. The effect on fear of falling was clearly negligible.

Conclusion: Group-based exercise has long-term benefits for pain intensity, disability and global perceived effect, with at least a short-term benefit for physical activity. Group-based exercise can be safely implemented in primary healthcare settings to manage CNSLBP in older people.

Registration: RBR-9j5pqs.

Keywords: Group exercise; Low back pain; Older people; Primary health care; Randomized controlled trial.