Musculoskeletal Pain in Family Caregivers: Does a Therapeutic Physical Program in Primary Care Work? A Randomized Controlled Trial

Effects of physical exercise in reducing caregivers burden: a systematic review

Background and aim

Caring for someone can be physically and psychologically demanding, predisposing caregivers to muscle injuries, fatigue, exhaustion, depression, anxiety, and burnout. The literature suggests several approaches to reducing caregiver burden, one of which is physical exercise. The aim of this systematic review was to analyze the effectiveness of exercise-based programs or muscle relaxation in reducing caregiver burden and stress among family caregivers.

Method

A systematic literature review was conducted following the PRISMA guidelines. The search was performed in the Web of Science, Cochrane Library and Scopus databases and through the EBSCOhost aggregator (CINAHL Plus, MEDLINE, and SportDiscus). Studies were selected based on the PICOD acronym.

Results

Eleven randomized controlled trials (RCTs) and two other experimental studies were included. The reviewed programs encompassed aerobics, strengthening, and muscle relaxation exercises, delivered by various professionals in diverse settings, such as caregivers' homes, gyms, and hospital environments. Although the programs varied in type, duration, and structure, the majority of the studies demonstrated positive effects on caregivers' physical and psychological well-being, along with reductions in burden and stress.

Conclusion

The results suggest that physical exercise interventions are effective in reducing caregiver burden and stress, while also enhancing overall well-being. Future strategies should emphasize the importance of raising awareness among caregivers about adopting healthy lifestyles, with a particular focus on regular physical activity, as a means of relaxation and self-care. To maximize the effectiveness of these interventions, incorporating flexible, home-based components and engaging multidisciplinary teams could enhance accessibility, adherence, and impact.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023446129, PROSPERO 2023 CRD42023446129.

Joint Pain and Leisure-Time Physical Activity: Cross-Sectional Findings From the Cardiovascular Health Study

Background

Joint pain is common and limits leisure-time physical activity (LTPA) in older adults. However, some older adults with pain are also physically active. Psychosocial factors that may indicate external engagement (such as social network) and internal drive (such as feeling able to "get going") are emerging as predictors of LTPA and may explain why some older adults with pain are physically active.

Methods

We investigated the cross-sectional association of psychosocial factors with LTPA (kcal/week) in adults over the age of 64 with pain in their back, hips, knees and/or feet from the Cardiovascular Health Study. Psychosocial factors included: social network score from the Lubben Social Network scale and three questions from the Center of Epidemiologic Studies Depression Scale (CES-D): perceived effort, difficulty getting going, and trouble concentrating. Separate multivariable ordinal regression models estimated the association between these indicators and LTPA, while controlling for demographics and other contributors of LTPA: number of medications, number of pain sites, body mass index, gait speed, digit substitution symbol test, brain white matter hyperintensities, and mood.

Results

Among 902 participants (65% female, 14% Non-White) with joint pain and complete data, higher social network score, and no self-reported "difficulty getting going" were associated with higher levels of LTPA, independent of covariates. Associations with perceived effort or trouble concentrating were not statistically significant.

Conclusions

Our research suggests that some older adults with pain are physically active and psychosocial factors related to external engagement and internal drive might be important targets to support LTPA. Studies should investigate the role of psychosocial states on LTPA among older adults with pain.

Impact Statement

We certify that this work is novel.The potential impact of this research on clinical care includes the following: Resiliency factors such as psychosocial factors may be more important targets to promote leisure-time physical activity in older adults with pain than specific pain reduction strategies.

Effectiveness of care provided by an itinerant community caregiver in reducing the burden and violence of family caregivers of impaired elderly in Rio de Janeiro, Brazil: A randomized clinical trial

INTRODUCTION

The aging population and the rise in chronic diseases are linked to a higher number of elderly individuals with impairments. These individuals often depend on family caregivers for basic daily activities, which can impose a significant burden and increase the risk of violence against them.

OBJECTIVE

To assess the effectiveness of itinerant community caregivers (ICC) in reducing burden, depression and risk of violence among family caregivers of impaired elderly (FCIE), while also increasing their social support.

METHODS

Randomized controlled trial with 38 pairs of elderly people and their caregivers. For six months, twice a week, the ICC spent three hours with the elderly, completing tasks given by the FCIE. The primary outcomes were reduction of at least one level in the burden, and or in the risk of violence against the elderly. The secondary outcomes were a decrease in depressive symptoms and/or an increase in social support. Multiple log binomial regression models were used to assess the relationship between the predictors and the response variables.

RESULTS

In the FCIE group, most individuals providing care were women who spent over 16 hours each day in the task of caring for the impaired elderly, with most falling between the ages of 41 and 60. Over half of them were children of the elderly participants. In the intervention group, there was a significant decrease in the likelihood of violence against the elderly, with a 10-fold reduction. However, other endpoints did not present significant changes.

CONCLUSION

The involvement of an ICC in the care of impaired elderly can contribute to reducing domestic violence by FCIE.

Physical pain among family caregivers to older adults: A scoping review of the literature

BACKGROUND AND OBJECTIVES

Scholarship on the health of family caregivers to older adults continues to expand. Although existing research suggests that many family caregivers experience pain, which impacts their ability to perform caregiving tasks and is associated with care recipients' unmet needs, the scope of research on family caregivers' pain remains poorly characterized. We conducted a scoping review of research on pain among family caregivers to older adults to characterize existing evidence and identify knowledge gaps.

METHODS

We searched multiple databases spanning from January 2012 to July 2023, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (e.g., study design/methodology, pain measurement, caregiver pain type, and major findings).

RESULTS

We identified 46 eligible studies conducted in the United States (n = 19) and internationally (n = 27). Studies often focused on caregivers for older adults with specific health conditions, such as cancer (n = 11), dementia (n = 8), or stroke (n = 3). The most commonly employed pain measure was a single-item dichotomous question about pain (n = 16), followed by a visual numeric or visual analog scale (n = 11). Nine studies (five randomized controlled trials) reported on five caregiver pain management interventions, including yoga/exercise programs and caregiver education programs.

DISCUSSION

Existing research on family caregivers' pain offers an important foundation. However, more robust research designs are necessary. We identify possibilities for future studies in addition to opportunities for systematic investigations to support the family caregivers being relied upon to care for the increasing number of older adults.

Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis

BACKGROUND

Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately.

OBJECTIVE

To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone.

METHOD

A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline.

RESULTS

A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD =-2.02 (95% CI =-2.71 to -1.33; p< 0.001), the disability variable with SMD =-1.14 (95% CI =-1.63 to -0.65; p< 0.001), and the kinesiophobia variable with SMD =-1.8 (95% CI =-2.54 to -1.05; p< 0.001).

CONCLUSION

Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manner.