Family History Influences the Effectiveness of Home Exercise in Older People With Chronic Low Back Pain: A Secondary Analysis of a Randomized Controlled Trial


      • Family history of low back pain (LBP) can reduce activity in older people with LBP.
      • Family history may also have a negative influence on pain and self-efficacy.
      • Video game exercises are beneficial for older people without a family history of LBP.
      • Video game exercises have no effect on those with a family history of severe LBP.



      To investigate whether a family history of low back pain (LBP) influences patient outcomes and treatment effects following home exercises in older people with chronic LBP.


      Secondary analysis of a randomized controlled trial.


      Local community.


      People older than 55 years with chronic LBP (N=60).


      Participants in the intervention group completed video game exercises for 60 minutes 3 times per week for 8 weeks. Participants in the control group were instructed to maintain their usual levels of activity and care seeking behaviors.

      Main Outcomes Measures

      Participants indicated whether any of their immediate family members had a history of “any” LBP or “activity-limiting” LBP at baseline. We collected self-reported measures of pain, function, pain self-efficacy, care seeking, physical activity, disability, fear of movement and/or reinjury, and falls efficacy at baseline, 8 weeks, 3 months, and 6 months. We performed regression analyses to determine whether a family history of LBP predicted patient outcomes and moderated the effects of home exercise.


      Participants with a family history of any LBP were less likely to be highly active than those without a family history (odds ratio, 0.08; 95% CI, 0.01-0.42; P=.003). Home-based video game exercises led to improvements in function in those without a family history of activity-limiting LBP (β=1.78; 95% CI, 0.56-3.00; P=.006) but not in those with a family history (β=−0.17; 95% CI, −2.56 to 2.21; P=.880) (interaction P=.049). A family history of LBP did not influence the remaining patient outcomes or treatment effects.


      A family history of LBP appears to negatively influence physical activity levels in older people with chronic LBP. Further, home-based video game exercises appear to be beneficial for older people with chronic LBP that do not have a family history of LBP.


      List of abbreviations:

      LBP (low back pain), RAPA (Rapid Assessment of Physical Activity), RCT (randomized controlled trial)
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