TY - JOUR
T1 - Pain-Reducing Effects of Physical Therapist-Delivered Interventions
T2 - A Systematic Review of Randomized Trials among Older Adults with Dementia
AU - Coronado, Rogelio A.
AU - Albers, Hannah E.
AU - Allen, Jessica L.
AU - Clarke, Rebecca G.
AU - Estrada, Victoria A.
AU - Simon, Corey B.
AU - Galloway, Rebecca V.
AU - Fisher, Steve R.
N1 - Funding Information:
1Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. 2Department of Physical Therapy, The University of Texas Medical Branch, Galveston. 3Division of Physical Therapy, Department of Orthopaedic Surgery, Duke University, Durham, North Carolina. At the time this article was developed, Dr Coronado was supported by an NIH K12 Rehabilitation Research Career Development Program grant (HD055929) at the University of Texas Medical Branch. The authors declare no conflicts of interest. Address correspondence to: Rogelio A. Coronado, PT, PhD, Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, 1215 21st Ave South, MCE-South, Ste 4200, Nashville, TN 37232 (rogelio. coronado@vumc.org). The Decision Editor was Robert Wellmon. Copyright © 2019 Academy of Geriatric Physical Therapy, APTA.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - cognition disorders
KW - dementia
KW - exercise
KW - massage
KW - pain
KW - physical therapy modalities
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U2 - 10.1519/JPT.0000000000000235
DO - 10.1519/JPT.0000000000000235
M3 - Review article
C2 - 30998563
AN - SCOPUS:85068568784
VL - 43
SP - 159
EP - 169
JO - Journal of Geriatric Physical Therapy
JF - Journal of Geriatric Physical Therapy
SN - 1539-8412
IS - 3
ER -