Restricted activity and persistent pain following motor vehicle collision among older adults: a multicenter prospective cohort study

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  • Platts-Mills, Timothy
    • Affiliation: School of Medicine, Department of Emergency Medicine
  • Nicholson, Robert J
    • Affiliation: School of Medicine, Department of Emergency Medicine
  • Richmond, Natalie L
    • Affiliation: School of Medicine, Department of Emergency Medicine
  • Patel, Kushang V
    • Other Affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA, USA
  • Simonsick, Eleanor M
    • Other Affiliation: Intramural Research Program, National Institute on Aging, 251 Bayview Boulevard, Suite 100, Baltimore, MD, USA
  • Domeier, Robert M
    • Other Affiliation: Department of Emergency Medicine, Saint Joseph Mercy Health System, 5301 McAuley Drive, Ypsilanti, MI, USA
  • Swor, Robert A
    • Other Affiliation: Department of Emergency Medicine, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI, USA
  • Hendry, Phyllis L
    • Other Affiliation: Department of Emergency Medicine, University of Florida College of Medicine Jacksonville, 1515 SW Archer Road, Gainesville, FL, USA
  • Peak, David A
    • Other Affiliation: Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA
  • Rathlev, Niels K
    • Other Affiliation: Department of Emergency Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, USA
  • Jones, Jeffrey S
    • Other Affiliation: Department of Emergency Medicine, Spectrum Health – Butterworth Campus, 100 Michigan St. NE, 49503 Grand Rapids, MI, USA
  • Lee, David C
    • Other Affiliation: Department of Emergency Medicine, North Shore University Hospital, 300 Community Dr, Manhasset, NY, USA
  • Weaver, Mark
    • Affiliation: School of Medicine, Department of Medicine
  • Keefe, Francis J
    • Other Affiliation: Department of Psychiatry, Duke University, Durham, 17 Chapel Drive, Durham, NC, USA
  • McLean, Samuel A
    • Affiliation: School of Medicine, Department of Anesthesiology
Abstract
  • Abstract Background Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain. Methods We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer “yes” to the question, “during the past two weeks, have you stayed in bed for at least half a day?”, and 3) by the answer “yes” to the question, “during the past two weeks, have you cut down on your usual activities as compared to before the accident?” We examined relationships between each definition of restricted activity and pain severity, pain interference, and functional capacity at 6 months with adjustment for confounders. Results Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32). In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01). In adjusted analyses, both decreased PASE score and cutting down on activity were associated with functional capacity at 6 months, but only decreased PASE score was associated with increased ADL difficulty at 6 months (0.70 vs. -0.01, p = 0.02). Conclusions Among older adults experiencing MVC, those reporting bed rest or reduced activity 6 weeks after the collision reported higher pain and pain interference scores at 6 months. More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.
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  • Article
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  • In Copyright
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  • Platts-Mills et al.
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  • English
Bibliographic citation
  • BMC Geriatrics. 2016 Apr 19;16(1):86
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  • BioMed Central

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