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Effectiveness of a Physical Activity Intervention for Pre-frail Older Adults With Chronic Pain.

Not Applicable
Completed
Conditions
Chronic Pain
Frailty
Old Age; Debility
Interventions
Other: Usual care
Other: Physical Activity Program
Registration Number
NCT04045535
Lead Sponsor
Gerencia de Atención Primaria, Madrid
Brief Summary

The purpose of this investigation is to evaluate the effectiveness of a multicomponent structured physical exercise program for adults aged 65 years or more, classified as pre-frail and with chronic pain to improve the Perceived Health Related Quality of Life, compared with usual care.

Detailed Description

Design: Randomized controlled, pragmatic clinical trial with two groups and 3 months follow-up.

Unit of randomization: Patient. Unit of analysis: Patient. Setting: A Primary Health Care Center in the Spanish Autonomous Community of Madrid.

Population: Pre-frail patients aged 65 years or more with chronic pain. Intervention: Multicomponent structured physical exercise program. Control group: Usual care. Variables: Perceived Health Related Quality of Life (EuroQol 5D-5L), Pain Intensity (Visual Analogue Scale), Frailty (SHARE-Frailty Index), Physical Performance (Short Physical Performance Battery, SPPB), Depression (Yesavage).

Analysis: Mean change differences after 3 months in EQ5D dimensions between groups with CI 95%. Mean differences or proportion differences will be calculated according to variable characteristics between groups with appropriate statistical test.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Clinical record of Chronic Pain by International Classification of Primary Care (ICPC) Code A01.
  • Being classified as pre-frail by SHARE-FI questionnaire.
  • Informed consent
Exclusion Criteria
  • Housebound patients
  • Institutionalized patients
  • Not living in the area of the investigation
  • Dependence for bADL
  • Not being fluent in Spanish
  • Severe mental illness or cognitive disorder

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual careUsual careUsual clinical care based on current clinical practice guidelines.
Intervention groupPhysical Activity ProgramIntervention with nurse and patients
Intervention groupUsual careIntervention with nurse and patients
Primary Outcome Measures
NameTimeMethod
Perceived Health Related Quality of LifeChange from baseline at 2 and 5 months

Quality of life assessed by EuroQol 5 Dimen (EQ5D-5L) Scale. It consist on a Quality Index (Range 0-1) calculated from scores of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) with value for Spain set and a Visual Analog Scale (Range 0: Worst possible health-100: Best possible health).

Secondary Outcome Measures
NameTimeMethod
Frailty StatusChange from baseline at 2 and 5 months

Frailty Status assessed by SHARE-FI (Survey of Health, Ageing and Retirement Frailty Index). It consists on summarizing the response to 5 criteria (exhaustion, weight loss, weakness, slowness and low active) in a discreet factor (DFS). Scores are different for men and women.

Women: If predicted DFS \< 0.31, NON-FRAIL; If predicted DFS \< 2.13, PRE-FRAIL; If predicted DFS \< 6, FRAIL Men: If predicted DFS \< 1.21, NON-FRAIL; If predicted DFS \< 3.00, PRE-FRAIL; If predicted DFS \< 7, FRAIL

Physical PerformanceChange from baseline at 2 and 5 months

Assessed by Short Physical Performance Battery (SPPB). It evaluates balance, walk speed and sitting and standing in a chair. Each Item is scored 0-4 points. Yielding a total between 0 (worst physical performance ) and 12 (best physical performance).

Satisfaction with the interventionAt 2 months

Assessed with Client Satisfaction Questionnaire (CSQ-8). It consist on 8 questions (four ranged 4: most satisfaction-1: least satisfaction and four ranged 1: most satisfaction -4 least satisfaction)

Pain IntensityChange from baseline at 2 and 5 months

Pain Intensity was assessed by McGill Pain Questionnaire's Visual Analog Scale (VAS). It consists on a 100mm horizontal line in which patient points the intensity of his pain. It is measured from left to right. Left side of the line (0 millimeters, mm) means "no pain" and it is the minimum score and right side of the line (100mm) means "pain as worst as you can imagine" and it is maximum score. Lower punctuation meana better outcomes.

Basic Activities of Daily Living (bADL)Change from baseline at 2 and 5 months

Assessed by Barthel Scale. It assesses the help needed with ten variables: feeding, bathing, grooming, dressing, urinary incontinence, faecal incontinence, toilet use, transfers bed to chair, mobility and climbing stairs. (Range: 0: Full Dependence - 100: Independence for bADL).

DepressionChange from baseline at 2 and 5 months

Assessed by ultra-short Yesavage Scale (Geriatric Depression Scale, GDS-5). It consist on 5 questions of the GDS-15 questionnaire (Range:0-5. Cutpoint for depression: 2).

Number of meetings attendedAt 2 months

Number of meetings attended by the participants from intervention group.

FallsAt 2 months and at 5 months

Number of falls during the follow-up process

Trial Locations

Locations (1)

Gerencia de Atención Primaria, Madrid

🇪🇸

Madrid, Comunidad De Madrid, Spain

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