Risk of falls in Brazilian elders with and without low back pain assessed using the Physiological Profile Assessment: BACE study.
Nayza M B Rosa, Bárbara Z Queiroz, Renata A Lopes and 3 others
PMID 27683833WHAT IT FOUND
Older Brazilian adults with low back pain had a moderate fall-risk score, while those without pain had a mild score.
They also reported more falls, swayed more, reacted slower and had weaker thigh muscles.
Key findings
01Elders with low back pain had a higher PPA fall-risk score (1.6) than elders without low back pain (0.5), indicating moderate versus mild risk.
02More elders with low back pain fell in the last 12 months (57.3%) than elders without low back pain (34.6%).
03The pain group had greater postural sway, slower reaction time and lower quadriceps strength, while vision and proprioception did not differ.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study compared groups at one time, so it cannot show that low back pain caused the higher fall-risk scores or falls. Participants were recruited by convenience, and many high-risk conditions were excluded, including cognitive dysfunction, vestibular disorders, neurological disease, recent lower-limb surgery or fracture, and wheelchair or bedridden status, so results may not apply to frailer elders. Falls and low back pain were partly self-reported, and fall history was collected retrospectively, which can introduce recall bias. The pain group had more comorbidities and more depressive symptoms than the control group, and the paper does not show whether these differences explain the higher fall risk. Trunk muscle strength was not measured, so the study cannot assess a possible direct contribution of low back pain to trunk control.
The easy way to misread this
Do not conclude that low back pain causes falls or that treating it will reduce them. This was a cross-sectional comparison, and the pain group also had more comorbidities and depressive symptoms, so other factors may explain the difference.