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Restricted activity and persistent pain following motor vehicle collision among older adults: a multicenter prospective cohort study.

Platts-Mills TF, Nicholson RJ, Richmond NL, Patel KV, Simonsick EM, Domeier RM, Swor RA, Hendry PL, Peak DA, Rathlev NK, Jones JS, Lee DC, Weaver MA, Keefe FJ, McLean SA - BMC Geriatr (2016)

Bottom Line: Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32).In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01).More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, University of North Carolina, 170 Manning Dr, Chapel Hill, NC, USA. tplattsm@med.unc.edu.

ABSTRACT

Background: Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain.

Methods: We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer "yes" to the question, "during the past two weeks, have you stayed in bed for at least half a day?", and 3) by the answer "yes" to the question, "during the past two weeks, have you cut down on your usual activities as compared to before the accident?" We examined relationships between each definition of restricted activity and pain severity, pain interference, and functional capacity at 6 months with adjustment for confounders.

Results: Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32). In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01). In adjusted analyses, both decreased PASE score and cutting down on activity were associated with functional capacity at 6 months, but only decreased PASE score was associated with increased ADL difficulty at 6 months (0.70 vs. -0.01, p = 0.02).

Conclusions: Among older adults experiencing MVC, those reporting bed rest or reduced activity 6 weeks after the collision reported higher pain and pain interference scores at 6 months. More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of screening, enrollment, and follow-up
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Fig1: Flow diagram of screening, enrollment, and follow-up

Mentions: Of 389 eligible patients, 180 (46.2 %) consented to participate and 164 had complete physical activity data in the ED. Sociodemographic characteristics of the individuals who declined participation were similar to those of study participants: most were white (73.0 % vs. 81.1 %), female (58.1 % vs. 61.6 %), and had a similar median age (73 vs. 70). Among the 164 participants with complete physical activity data, 150 (of 164, 91.5 %) completed the 6 week follow-up, and 147 (89.6 %) completed the 6 month follow-up (Fig. 1). Study participants were white (81.1 %), female (61.6 %), aged 65–74 (67.7 %), drivers (78.7 %), and reported moderate (28.9 %) or severe (51.6 %) pain at the time of the ED interview (Table 1). Most reported an overall pre-MVC pain severity of less than 4 (61.0 %), had no ADL difficulty prior to the MVC (80.5 %), and slept an average of 7 or more hours per day (63.5 %). The majority of participants characterized the damage to their vehicle as severe (68.3 %) and considered the MVC life-threatening (53.1 %).Fig. 1


Restricted activity and persistent pain following motor vehicle collision among older adults: a multicenter prospective cohort study.

Platts-Mills TF, Nicholson RJ, Richmond NL, Patel KV, Simonsick EM, Domeier RM, Swor RA, Hendry PL, Peak DA, Rathlev NK, Jones JS, Lee DC, Weaver MA, Keefe FJ, McLean SA - BMC Geriatr (2016)

Flow diagram of screening, enrollment, and follow-up
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837524&req=5

Fig1: Flow diagram of screening, enrollment, and follow-up
Mentions: Of 389 eligible patients, 180 (46.2 %) consented to participate and 164 had complete physical activity data in the ED. Sociodemographic characteristics of the individuals who declined participation were similar to those of study participants: most were white (73.0 % vs. 81.1 %), female (58.1 % vs. 61.6 %), and had a similar median age (73 vs. 70). Among the 164 participants with complete physical activity data, 150 (of 164, 91.5 %) completed the 6 week follow-up, and 147 (89.6 %) completed the 6 month follow-up (Fig. 1). Study participants were white (81.1 %), female (61.6 %), aged 65–74 (67.7 %), drivers (78.7 %), and reported moderate (28.9 %) or severe (51.6 %) pain at the time of the ED interview (Table 1). Most reported an overall pre-MVC pain severity of less than 4 (61.0 %), had no ADL difficulty prior to the MVC (80.5 %), and slept an average of 7 or more hours per day (63.5 %). The majority of participants characterized the damage to their vehicle as severe (68.3 %) and considered the MVC life-threatening (53.1 %).Fig. 1

Bottom Line: Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32).In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01).More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, University of North Carolina, 170 Manning Dr, Chapel Hill, NC, USA. tplattsm@med.unc.edu.

ABSTRACT

Background: Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain.

Methods: We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer "yes" to the question, "during the past two weeks, have you stayed in bed for at least half a day?", and 3) by the answer "yes" to the question, "during the past two weeks, have you cut down on your usual activities as compared to before the accident?" We examined relationships between each definition of restricted activity and pain severity, pain interference, and functional capacity at 6 months with adjustment for confounders.

Results: Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32). In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01). In adjusted analyses, both decreased PASE score and cutting down on activity were associated with functional capacity at 6 months, but only decreased PASE score was associated with increased ADL difficulty at 6 months (0.70 vs. -0.01, p = 0.02).

Conclusions: Among older adults experiencing MVC, those reporting bed rest or reduced activity 6 weeks after the collision reported higher pain and pain interference scores at 6 months. More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.

No MeSH data available.


Related in: MedlinePlus