Mind–Body Intervention for Chronic Pain Benefits Adults 50 and Older
Key findings
- This secondary analysis of a randomized feasibility trial is the first to examine whether there are age differences in the effects of a mind–body program designed for chronic pain
- 82 adults were assigned to one of two 10-week, 90-minute programs for increasing walking: one used time-based goals and in the other, a step count was reinforced with Fitbit; the intervention also included mindfulness and cognitive behavioral skills
- Adults aged 50 and older demonstrated greater improvements in performance-based physical function, measured by the six-minute walk test, compared with their younger counterparts
- The older group also reported greater decreases in pain intensity during activity from baseline to the three-month follow-up assessment
- Mind–body interventions may offer benefit for chronic pain management across the lifespan
In 2020, Massachusetts General Hospital researchers reported on the first mind–body intervention designed to increase physical function, measured in multiple ways, in people with chronic pain. Their proof-of-concept trial published in JMIR Formative Research showed significant improvements in physical function and pain during activity whether or not the participant used a Fitbit device.
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Lisa R. LaRowe, PhD, a clinical psychologist and researcher at the Mongan Institute Center for Aging and Serious Illness, Jafar Bakhshaie, MD, PhD, a research staff psychologist in the Center for Health Outcomes and Interdisciplinary Research (CHOIR) in the Department of Psychiatry, Ana-Maria Vranceanu, PhD, a staff psychologist and founding director of CHOIR, and Jonathan Greenberg, PhD, a research staff psychologist in CHOIR, recently conducted a secondary analysis of the trial to examine whether participant age affected the results.
In the Journal of Pain Research, they report that adults ≥50 years old derived the same benefits as younger adults on two measures and benefited significantly more than younger adults on two others, pain and performance-based physical function.
Methods
The study included 82 adults, recruited from July 2018 to September 2019, who had reported nonmalignant pain for more than three months. They were randomly assigned to one of two 10-week, 90-minute programs focused on increasing walking: one used time-based goals and in the other a step count was reinforced with a Fitbit device. The intervention also included skills such as mindfulness and changing pain-related thoughts.
One week before beginning treatment and about one week after completion, participants completed four measures:
- Self-report of pain intensity with activity, using a numeric rating scale (0–10)
- Self-report of physical function, using the World Health Organization Disability Assessment Schedule 2.0
- Daily step count, recorded via actigraphy during all waking hours for 7 days
- 6-minute walk test
Three months after completing the intervention, participants repeated the self-report measures.
Participant Characteristics
66% of participants were female and 57% were age 50 or older. The mean age was 62 in the older group (range, 50–79) and 38 in the younger group (range, 21–49).
The older and younger groups didn't differ in other sociodemographic characteristics, but baseline pain during activity was significantly higher in the older group.
Age Differences in Treatment Effects
Both groups improved significantly on the following measures, and participants ages 50 and older demonstrated even greater benefit than the younger group:
- 6-minute walk test from baseline to immediately after treatment (β, 17.77; P=0.03)
- Pain during activity from baseline to 3 months (β, −0.66; P=0.03)
No age differences were observed on the other measures.
Implications for Clinical Practice
Older adults often face substantial barriers to chronic pain management, such as sedentary behavior and multimorbidity. Even so, this trial suggests older adults can achieve meaningful benefit from a mind–body intervention. In fact, since older adults may have more room for improvement in physical activity and function-related outcomes than their younger counterparts, they may derive greater benefit.
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