Neuromuscular exercise for chronic musculoskeletal pain in older people: a randomised controlled trial in primary care in Hong Kong

Br J Gen Pract. 2021 Feb 25;71(704):e226-e236. doi: 10.3399/bjgp20X714053. Print 2021.

Abstract

Background: Exercise therapy is commonly prescribed by primary care physicians (PCPs) in the management of chronic musculoskeletal (MSK) pain.

Aim: To evaluate the clinical effectiveness of a supervised neuromuscular (NM) exercise programme in older people with chronic MSK pain.

Design and setting: This was a 12-week, two-arm, randomised controlled trial comparing 6 weeks of supervised NM exercise versus waiting list controls. The authors enrolled 72 participants with chronic MSK pain at seven public primary care clinics.

Method: Participants were randomly allocated in block sizes of 12 to the NM (n = 36) and control groups (n = 36) in a 1:1 ratio. Data were collected at baseline, 6, and 12 weeks. The primary outcome was the Brief Pain Inventory (BPI) pain severity score at 6 weeks post-intervention. Secondary outcomes included the BPI interference score; Pain Self-Efficacy Questionnaire (PSEQ), Short Form Health Survey (SF-12), 7-item Generalised Anxiety Disorder (GAD-7), and 9-item Patient Health Questionnaire (PHQ-9) scores; and functional measurements using the Timed-Up- and-Go test and handgrip strength.

Results: At 6 weeks, the NM group demonstrated a significantly greater improvement in the BPI pain severity score (between-group difference = -1.27; 95% confidence interval [CI] = -2.08 to -0.45; P<0.01), PSEQ (between-group difference = 6.5; 95% CI = 2.22 to 10.77; P<0.01), and SF-12 physical scores (between-group difference = 3.4; 95% CI = 0.05 to 6.75; P<0.05) compared with the control group. Statistically significant overall trends of improvement were also observed for the BPI interference and PHQ-9 scores.

Conclusion: NM exercise has the potential to reduce pain and improve self-efficacy and physical function in older people with chronic MSK pain. It can be an option for PCPs in exercise prescriptions.

Keywords: aged; chronic musculoskeletal pain; exercise therapy; neuromuscular exercise; pain; randomised controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Exercise Therapy
  • Hand Strength
  • Hong Kong
  • Humans
  • Musculoskeletal Pain* / therapy
  • Primary Health Care
  • Quality of Life