Pain-Reducing Effects of Physical Therapist-Delivered Interventions

A Systematic Review of Randomized Trials among Older Adults with Dementia

Rogelio A. Coronado, Hannah E. Albers, Jessica L. Allen, Rebecca G. Clarke, Victoria A. Estrada, Corey B. Simon, Rebecca Galloway, Steven Fisher

Research output: Contribution to journalReview article

Abstract

Background and Purpose: Pain is common among older adults with dementia. There are nonpharmacological options for managing pain in this population. However, the effects of physical therapist-delivered interventions have not been summarized. The purpose of this systematic review was to summarize the literature on physical therapist-delivered interventions in randomized trials for reducing pain among older adults with dementia. Methods: A systematic search of MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science was conducted for randomized trials of pain management in individuals 60 years or older with medically diagnosed dementia of any severity. Included studies addressed the effects of nonpharmacological physical therapist-delivered interventions on pain outcomes. Pain outcomes included patient or caregiver self-report, observational or interactive measures. Independent reviewers extracted relevant data and assessed methodological quality using the PEDro scale. Results and Discussion: Three studies (total = 222 participants; mean age range = 82.2-84.0 years; 178 [80.2%] females) met inclusion criteria. PEDro scores ranged from 4 to 8/10. Interventions included passive movement and massage. Pain outcomes included the observational measures Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC), Pain in Advanced Dementia (PAINAD), and Doloplus-2 Scale. Passive movement did not show better results when compared with no treatment, while massage showed pain-reducing effects in 1 study compared with no treatment. Conclusions: The evidence supporting pain-reducing physical therapy interventions for patients with dementia is limited. There is a clear gap in knowledge related to evidence-based physical therapy for managing pain in this population. Future studies should examine active physical therapist-delivered interventions and utilize interactive pain measures.

Original languageEnglish (US)
JournalJournal of Geriatric Physical Therapy
DOIs
StatePublished - Jan 1 2019

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Physical Therapists
Dementia
Pain
Massage
Aptitude
Pain Measurement
Pain Management
Therapeutics
Checklist
PubMed
MEDLINE
Self Report
Caregivers
Population

Keywords

  • cognition disorders
  • dementia
  • exercise
  • massage
  • pain
  • physical therapy modalities

ASJC Scopus subject areas

  • Rehabilitation
  • Geriatrics and Gerontology

Cite this

Pain-Reducing Effects of Physical Therapist-Delivered Interventions : A Systematic Review of Randomized Trials among Older Adults with Dementia. / Coronado, Rogelio A.; Albers, Hannah E.; Allen, Jessica L.; Clarke, Rebecca G.; Estrada, Victoria A.; Simon, Corey B.; Galloway, Rebecca; Fisher, Steven.

In: Journal of Geriatric Physical Therapy, 01.01.2019.

Research output: Contribution to journalReview article

Coronado, Rogelio A. ; Albers, Hannah E. ; Allen, Jessica L. ; Clarke, Rebecca G. ; Estrada, Victoria A. ; Simon, Corey B. ; Galloway, Rebecca ; Fisher, Steven. / Pain-Reducing Effects of Physical Therapist-Delivered Interventions : A Systematic Review of Randomized Trials among Older Adults with Dementia. In: Journal of Geriatric Physical Therapy. 2019.
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