Chronic Pain Characteristics and Gait in Older Adults: The MOBILIZE Boston Study II.
Elisa F Ogawa, Ling Shi, Jonathan F Bean and 5 others
PMID 31634443WHAT IT FOUND
Older adults with multisite pain walked slower and with more variability than those with no pain, regardless of whether they were performing a concurrent mental task.
Pain distribution, not the addition of a cognitive challenge, drove the gait deficits.
Key findings
01Participants with multisite pain had slower gait speed and poorer performance across most gait measures compared to those with single-site or no pain.
02The reduction in gait performance caused by chronic pain was comparable to the reduction seen when healthy participants added a difficult cognitive task to their walking.
03Selective attention partially mediated the relationship between pain and gait, suggesting a cognitive pathway rather than solely a mechanical one.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot prove that pain caused the gait changes; it could be that poor mobility leads to pain. The participants were very old (mean age 84), so results may not apply to younger older adults (e.g., 65-75). 52 participants did not complete the gait assessment, and those who dropped out were older and had more pain and disability, potentially biasing the sample toward healthier individuals. Pain was self-reported and defined by location and duration, not by specific diagnoses or severity scales, which may obscure differences between types of pain.
Declared interests
No potential conflicts of interest were reported by the authors. The study was supported by the National Institute on Aging (N.I.H., Extramural).
The easy way to misread this
Do not conclude that adding a cognitive task to gait training is harmful or ineffective for patients with pain. The study found that dual-task costs were similar across groups, meaning patients with pain can still handle cognitive loads, but their starting point (baseline gait) is already worse. It does not mean pain and cognitive load do not interact; it means pain's effect on gait is already substantial without the extra load.