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Family history influences the effectiveness of home-exercise in older people with chronic low back pain: a secondary analysis of a randomised controlled trial
Zadro JR, Shirley D, Nilsen TI, Mork PJ, Ferreira PH
Archives of Physical Medicine and Rehabilitation 2020 Aug;101(8):1322-1331
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate whether a family history of LBP influences patient outcomes and treatment effects following home-exercises in older people with chronic LBP. DESIGN: Secondary analysis of a randomised controlled trial. SETTING: Local community. PARTICIPANTS: People over 55 years old with chronic LBP. INTERVENTIONS: Participants in the intervention group completed video-game exercises for 60 minutes, 3 times per week, for 8 weeks. Participants in the control group were instructed to maintain their usual levels of activity and care seeking behaviours. MAIN OUTCOMES MEASURES: Participants indicated whether any of their immediate family members had a history of 'any' LBP or 'activity-limiting' LBP at baseline. We collected self-reported measures of pain, function, pain self-efficacy, care seeking, physical activity, disability, fear of movement/re-injury, and falls-efficacy at baseline, 8 weeks, 3 months and 6 months. We performed regression analyses to determine whether a family history of LBP predicted patient outcomes and moderated the effects of home-exercise. RESULTS: Participants with a family history of any LBP were less likely to be highly active compared to those without a family history (OR 0.08, 95%CI 0.01 to 0.42, p = 0.003). Home-based video-game exercises led to improvements in function in those without a family history of activity-limiting LBP (beta 1.78 95%CI 0.56 to 3.00, p = 0.006), but not in those with a family history (beta -0.17 95%CI -2.56 to 2.21, p = 0.880) (interaction p = 0.049). A family history of LBP did not influence the remaining patient outcomes or treatment effects. CONCLUSION: A family history of LBP appears to negatively influence physical activity levels in older people with chronic LBP. Further, home-based video-game exercises appear to be beneficial for older people with chronic LBP that do not have a family history of LBP.

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