Improving Functional Ability and Quality of Life in Older Adults With Chronic Low Back Pain: A Randomized Controlled Trial.

Abstract

Chronic low back pain (CLBP) significantly affects older adults' quality of life and functional abilities. Self-management programs formatted using the 5A model (Assess, Advise, Agree, Assist, and Arrange) have been proven effective in empowering patients to manage chronic diseases. The present study evaluated the effect of implementing a self-management program based on the 5A model on reducing functional disability and improving the quality of life of older adults with CLBP. This single-blind randomized controlled trial investigated the effectiveness of the 5A approach of self-management for CLBP in older adults. Sixty-four participants were recruited from specialized clinics affiliated with Abadan University of Medical Sciences, Iran, between February and April 2023. Participants were randomly allocated to an intervention group (receiving the 5A program) or a control group. Study outcomes included functional disability assessed using the Oswestry Disability Questionnaire, and quality of life measured with the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. These measures were administered at baseline, 4, and 8 weeks following the intervention. There was no significant difference in functional disability and quality of life between the intervention and control groups before the intervention. After the intervention, a significant difference was observed in both functional disability or quality of life between the two groups (p < .001). The results also revealed a significant improvement in the means of functional disability and the quality of life at 4 and 8 weeks after the intervention implementation in the intervention group (p < .001). Findings from this study demonstrate that a 5A-based self-management program can effectively mitigate functional disability and enhance the quality of life in older adults with nonspecific CLBP. These results suggest that nurses can employ this supportive, nonpharmacological approach to manage CLBP in this population.