PTOTCohortJournal of geriatric physical therapy (2001)2023

A Clinical Measure of Trunk Neuromuscular Function Predicts Falling in Older Adults With Chronic Low Back Pain.

Patrick J Knox, Jenifer M Pugliese, Ryan T Pohlig and 3 others

PMID 36827686

WHAT IT FOUND

Older adults with chronic low back pain who show aberrant lumbopelvic movements during forward bending have a 24.9% higher risk of falling for each additional movement observed.

Screening for these movements can help identify patients at higher fall risk beyond standard factors.

Key findings

01Each additional aberrant lumbopelvic movement observed at baseline was associated with a 24.9% increase in fall risk over one year.

02Participants with three aberrant movements fell significantly more than those with none.

03Aberrant movements predicted falls independently of age, sex, BMI, pain intensity, prior falls, anxiolytic use, hip osteoarthritis signs, and dynamic balance performance.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study is observational, so it cannot prove that aberrant movements cause falls. Participants with missing data had worse pain, balance, and more aberrant movements than those with complete data, which may have biased the results toward the null. The sample consisted of community-dwelling adults who could walk with at most a single-point cane, so findings may not apply to more severely impaired populations. Fall data relied on self-reported monthly calendars, which can be subject to recall bias or non-compliance.

Declared interests

The authors declared no conflicts of interest. The study was funded by the National Institute on Aging (grant number not specified in text, but typical for this type of NIH-funded work).

The easy way to misread this

Do not assume that treating the aberrant movements will directly reduce fall risk. This study shows an association, not causation, and did not test an intervention. Additionally, the presence of these movements does not mean the patient has a specific neurological disorder, as they were excluded from the study.

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