This systematic review aimed to summarize the evidence regarding the potential association between frailty and LBP in older adults.
Medline, Embase, CINAHL, and SPORTDiscus were searched from the inception until November 2023 to identify relevant citations. Two independent reviewers screened each identified abstract or full-text article. Relevant data were extracted by two independent reviewers, and risk of bias assessments were performed using different tools based on the study design (cross-sectional, case-control, or cohort). The quality of evidence was evaluated using the Grading of Recommendations Assessments, Development and Evaluation (GRADE).
A total of 1,690 citations were identified for screening. After screening the full-text articles, six cross-sectional studies and one prospective studies were included. These studies were published in Brazil, China, Japan, South Korea, Thailand, and the USA. Three cross-sectional studies were found to have low or moderate risk of bias, while one prospective study had a high risk of bias. The low-quality evidence from the cross-sectional studies suggested a significant association between the presence of LBP and frailty. Additionally, there was low-quality evidence indicating that higher LBP intensity was related to the presence of frailty. However, this association disappeared after accounting for potential confounders. Furthermore, there was low-quality evidence suggesting that older women with higher baseline intensity of LBP had a greater likelihood of transitioning from no frailty to pre-frailty, or from pre-frailty to the frailty stage during a 12-month follow-up.
Preliminary evidence suggests a potential association between the presence or severity of LBP and frailty in older adults. However, further high-quality research is warranted to validate this association while considering other potential mediators and moderators.
While low back pain (LBP) and frailty are common among older adults, physiotherapists should be particularly vigilant with patients experiencing LBP, as they may be at increased risk of developing frailty. Effective pain management can enhance mobility and activity levels, potentially reducing the likelihood of frailty in the future.
lived experiences
systematic review
