Global Rehabilitation Health Worker Certification: Global Agenda, Local Imperative.

Rehabilitation, seen as a disability-specific service needed only by few of the world's population, has not been prioritized in countries and is under-resourced. A rehabilitation-ready health workforce is potentially the most important resource for improving functioning and the quality of life for the 2.41 billion people worldwide needing this care.

Pain-Related Drug Use Among Older Adults With Activity Limiting Pain Who Received Home Care Services.

Pain is a common problem for patients receiving home care, often limiting mobility and contributing to functional decline. Pharmacological pain management is common, but all drugs bring some risk of side effects and adverse reactions. The opioid epidemic has brought into question analgesic prescribing patterns across all care settings.

The use of pain neuroscience education in older adults with chronic back and/or lower extremity pain.

: Chronic pain due to musculoskeletal disorders is the leading cause of disability among older adults and is associated with a lower quality of life, reduced function, and increased risk of institutionalization. Pain Neuroscience Education (PNE) has demonstrated effectiveness in reducing pain and improving pain self-efficacy in individuals under 60 years of age, but there is a paucity of research examining its use with older adults. If PNE has similar effects in older adults, it has the potential to be a useful non-pharmacological intervention for this population.

Implementing a Pain Self-Management Protocol in Home Care: A Cluster-Randomized Pragmatic Trial.

Objectives: To determine the effectiveness of a cognitive-behavioral pain self-management (CBPSM) protocol delivered by physical therapists (PTs) for use by older adults with activity-limiting pain receiving home care.

Design: A randomized pragmatic trial comparing delivery of the intervention plus usual care with usual care alone.

Setting: Community.

Translating Evidence-Based Protocols Into the Home Healthcare Setting.

Activity-limiting pain is common among older home care patients and pain management is complicated by the high prevalence of physical frailty and multimorbidity in the home care population. A comparative effectiveness study was undertaken at a large urban home care agency to examine an evidence-based pain self-management program delivered by physical therapists (PTs). This article focuses on PT training, methods implemented to reinforce content after training and to encourage uptake of the program with appropriate patients, and therapists' fidelity to the program.

Exercise and Movement-based Therapies in Geriatric Pain Management.

Exercise is often recommended for older adults with pain, but pain itself is often a barrier to increased activity. This article reviews the evidence on the impact of various forms of exercise and related movement therapies on older adults with pain problems. The literature is reviewed with respect to published guidelines.

Pain and Function in Home Care: A Need for Treatment Tailoring to Reduce Disparities?

Objectives: To describe racial/ethnic group differences in pain presentation and the prevalence of psychosocial factors among patients admitted to home health care, and to determine the extent of racial/ethnic group differences in the association of psychosocial factors with pain intensity and pain-related disability.

Methods: We analyzed cross-sectional data on 588 patients with activity-limiting pain admitted to home care for physical therapy. Three psychosocial factors were assessed: depressive symptoms, pain self-efficacy, and health literacy.

Patient age is related to the types of physical therapy interventions provided for chronic low back pain: an observational study.

Study Design: Retrospective analysis of a longitudinal cohort of patients treated for chronic low back pain (CLBP).

Objectives: To determine whether patient age is associated with types of physical therapy interventions received for CLBP.

Background: Advancing age is associated with less positive treatment outcomes in patients with CLBP.

Implementing a cognitive-behavioral pain self-management program in home health care, part 2: feasibility and acceptability cohort study.

Purpose: The prevalence of pain in older adults receiving home health care is high, yet safety concerns for analgesic therapy point to a need for nonpharmacologic approaches to pain management in this population. The purpose of this study was to determine the feasibility and acceptability to physical therapists (PTs) and patients of a cognitive-behavioral pain self-management (CBPSM) program.

Methods: Thirty-one PTs volunteered to participate, completed two 4-hour training sessions, and recruited 21 patients with activity-limited pain who consented to participate in the study.

Implementing a cognitive-behavioral pain self-management program in home health care, part 1: program adaptation.

Background And Purpose: Pain is highly prevalent among older adults receiving home care, contributing to disability, increased health care utilization, nursing home placement, and diminished quality of life. Pain is a particular problem in the home care setting, where current approaches are often inadequate, resulting in persistent high levels of pain and disability in this vulnerable population. Cognitive-behavioral approaches to pain management have demonstrated effectiveness in reducing pain intensity and associated disability but have not been systematically implemented in home health care.

A cognitive-behavioral plus exercise intervention for older adults with chronic back pain: race/ethnicity effect?

This pilot study examined the feasibility and potential efficacy of a self-management program for seniors with chronic back pain and assessed for possible race/ethnicity differences in program impact. Sixty-nine seniors (24 African Americans, 25 Hispanics, and 20 non-Hispanic Whites) enrolled in the 8-wk community-based program. Efficacy outcomes included pain-related disability as measured by the Roland Morris Disability Questionnaire (RMDQ), pain intensity, pain self-efficacy, depressive symptoms, social activity, and functional status.

Preparing to implement a self-management program for back pain in new york city senior centers: what do prospective consumers think?

Objective: Prior to testing the feasibility/potential efficacy of a newly developed self-management pain program for seniors with back pain, this study sought to: 1) determine prospective consumers' prior exposure to self-management pain programs, 2) determine their willingness to participate in the new program, and 3) ascertain perceived barriers/facilitators to program participation.

Design: Cross-sectional survey.

Setting: Six senior centers located in New York City.

Physical therapists' use of cognitive-behavioral therapy for older adults with chronic pain: a nationwide survey.

Background: Increasing evidence supports the use of cognitive-behavioral therapy (CBT) for patients with chronic pain.

Objective: This study determined whether physical therapists incorporate CBT techniques (eg, relaxation, activity pacing) when treating older patients with chronic pain, ascertained their interest in and barriers to using CBT, and identified participant-related factors associated with interest in CBT.

Design: This cross-sectional study used a telephone survey.