A Paradigm Shift for Movement-based Pain Assessment in Older Adults: Practice, Policy and Regulatory Drivers.
Staja Q Booker, Keela A Herr, Ann L Horgas
PMID 32948452WHAT IT FOUND
Pain scores at rest may miss pain that limits older adults' movement and function.
This review recommends assessing pain during walking, turning, or daily activities, but these are expert recommendations, not tested interventions.
Key findings
01Single-number pain intensity scales do not capture how pain affects older adults' function, and the Joint Commission now emphasizes function rather than a single number.
02Movement-based pain assessment means asking about pain intensity and interference on function during activities such as walking, turning in bed, deep breathing, coughing, or basic ADLs.
03For older adults unable to self-report, behavior changes during movement may signal pain, and behavioral tools should compare ratings between rest and movement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The article does not report its own methods or results from patients. Many tools discussed have only preliminary evidence, and the article calls for more research before wider use. The article does not fully address pain assessment in older adults with cognitive impairment, which is a major clinical subgroup. Assessing pain during movement may temporarily increase pain, and the article notes this ethical and practical issue needs policy and staff education. The paper focuses on practice, policy, and regulatory drivers, not implementation steps or evidence that policy changes improve care.
Declared interests
The supplied text does not include author conflict declarations. The article metadata lists NIH extramural research support.
The easy way to misread this
Do not read movement-based pain assessment as a proven method for better pain relief or function. The article is a narrative review of existing guidelines and preliminary evidence, and it says more research is needed.