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Objective. Participation in life situations is a critical aspect of health recognized by the World Health Organization. Guidelines to prevent spreading of COVID-19 place older adults at risk of worsening participation. The purpose of this study was to identify the factors associated with participation during the COVID-19 pandemic among community-dwelling older adults living in Hamilton, Ontario, Canada. Methods. Participants were recruited from identified census dissemination areas in Hamilton. Participants completed surveys either by phone or online during the months of May to August 2020. Measures were organized into factors related to body functions and structures, activities, participation, as well as personal and environmental contextual factors using the International Classification of Functioning, Disability, and Health (ICF) framework. Multivariable regression analysis was conducted to identify factors associated with participation as measured by the Late-Life Disability Instrument's (LLDI) frequency and limitations scales. Results. A total of 272 older adults completed the survey (78 [7.3] years; 70% female). Use of a walking aid, driving status, perceived mental health status, nutrition risk, and physical function explained 48.2% of the variance observed in the LLDI-frequency scale scores. Use of a walking aid, driving status, perceived mental health status, receiving health assistance, and physical function explained 38.5% of the variance observed in the LLDI-limitation scale scores. Conclusion. Results highlighted factors across multiple ICF domains that are associated with participation restriction among a sample of community-dwelling older adults during the pandemic. Participation during the pandemic was greatest in those that were able to walk without needing to use a walking aid, being a licensed and current driver, perceiving good to excellent mental health, and having greater physical function. Impact. Our findings contribute to the literature on older adult participation during lockdowns, restrictions, pandemics, and/or other similar circumstances. Keywords: Community-Dwelling, COVID-19, Driving, Mental Health Participation in Life Situations, Older Adults, Introduction In December 2019, a novel coronavirus named COVID-19 (Coronavirus Disease 2019) was discovered in Wuhan, China. COVID-19 is a respiratory virus that can cause fever, shortness of breath, cough, [...]

Background. The Vain Self-Efficacy Questionnaire (PSEQ) is used by physical therapists in clinical practice and in research. However, current understanding of the PSEQ's measurement properties is incomplete, and investigators cannot be confident that it provides unbiased information on patient self-efficacy. Objective, The aims of this study were: (1) to investigate the scale properties of the PSEQ using Rasch analysis and (2) to determine whether age, sex, pain intensity, pain duration, and pain-related disability bias function of the PSEQ. Design. This was a retrospective study; data were obtained from 3 existing studies. Methods. Data were combined from more than 600 patients with low back pain of varying duration. Rasch analysis was used to evaluate targeting, category ordering, unidimensionality, person fit, internal consistency, and item bias. Results. There was evidence of adequate category ordering, unidimensionality, and internal consistency of the PSEQ. Importantly, there was no evidence of item bias. Limitations. The PSEQ did not adequately target the sample; instead, it targeted people with lower self-efficacy than this population. Item 7 was hardest for participants to endorse, showing excessive positive misfit to the Rasch model. Response strings of misfitting persons revealed older participants and those reporting high levels of disability. Conclusions. The individual items of the PSEQ can be validly summed to provide a score of self-efficacy that is robust to age, sex, pain intensity, pain duration, and disability. Although item 7 is the most problematic, it may provide important clinical information and requires further investigation before its exclusion. Although the PSEQ is commonly used with people with low back pain, of whom the sample in this study was representative, the results suggest it targets patients with lower self-efficacy than that observed in the current sample., Self-efficacy plays a critical role in the management of pain conditions. (1,2) Strong self-efficacy has been found to predict positive treatment outcomes and better prognosis, (3) and weak self-efficacy predicts [...]

Background. Graded activity and graded exposure are increasingly being used in the management of persistent low back pain; however, their effectiveness remains poorly understood. Purpose. The aim of this study was to systematically review randomized controlled trials that evaluated the effectiveness of graded activity or graded exposure for persistent (>6 weeks in duration or recurrent) low back pain. Data Sources. Trials were electronically searched and rated for quality by use of the PEDro scale (values of 0-10). Study Selection. Randomized controlled trials of graded activity or graded exposure that included pain, disability, global perceived effect, or work status outcomes were included in the study. Data Extraction. Outcomes were converted to a scale from 0 to 100. Trials were pooled with software used for preparing and maintaining Cochrane reviews. Results are presented as weighted mean differences with 95% confidence intervals. Data Synthesis. Fifteen trials with 1,684 patients were included. The trials had a median quality score of 6 (range=3-9). Pooled effects from 6 trials comparing graded activity with a minimal intervention or no treatment favored graded activity, with 4 contrasts being statistically significant: mean values (95% confidence intervals) for pain in the short term, pain in the intermediate term, disability in the short term, and disability in the intermediate term were -6.2 (-9.4 to -3.0), -5.5 (-9.9 to -1.0), -6.5 (-10.1 to -3.0), and -3.9 (-7.4 to -0.4), respectively. None of the pooled effects from 6 trials comparing graded activity with another from of exercise, from t trials comparing graded activity with graded exposure, and from 2 trials comparing graded exposure with a waiting list were statistically significant. Limitations. Limitations of this review include the low quality of the studies, primarily those that evaluated graded exposure: the use of various types of outcome measures: and differences in the implementation of the interventions, adding to the heterogeneity of the studies. Conclusions. The available evidence suggests that graded activity in the short term and intermediate term is slightly more effective than a minimal intervention but not more effective than other forms of exercise for persistent low back pain. The limited evidence suggests that graded exposure is as effective as minimal treatment or graded activity for persistent low back pain., Many patients with low back pain (LBP) have concerns that are inadequately explained with a traditional biomedical model. Contemporary approaches have recognized the multifactorial etiology of LBP and the necessity [...]

Background. Previous systematic reviews have concluded that the effectiveness of motor control exercise for persistent low back pain has not been clearly established. Objective. The objective of this study was to systematically review randomized controlled trials evaluating the effectiveness of motor control exercises for persistent low back pain. Methods. Electronic databases were searched to June 2008. Pain, disability, and quality-of-life outcomes were extracted and converted to a common 0 to 100 scale. Where possible, trials were pooled using Revman 4.2. Results. Fourteen trials were included. Seven trials compared motor control exercise with minimal intervention or evaluated it as a supplement to another treatment. Four trials compared motor control exercise with manual therapy. Five trials compared motor control exercise with another form of exercise. One trial compared motor control exercise with lumbar fusion surgery. The pooling revealed that motor control exercise was better than minimal intervention in reducing pain at short-term follow-up (weighted mean difference = -14.3 points, 95% confidence interval [CI] = -20.4 to -8.1), at intermediate follow-up (weighted mean difference = -13.6 points, 95% CI = -22.4 to -4.1), and at long-term follow-up (weighted mean difference = -14.4 points, 95% CI = -23.1 to -5.7) and in reducing disability at long-term follow-up (weighted mean difference = -10.8 points, 95% CI = -18.7 to -2.8). Motor control exercise was better than manual therapy for pain (weighted mean difference = -5.7 points, 95% CI = -10.7 to -0.8), disability (weighted mean difference = -4.0 points, 95% CI = -7.6 to -0.4), and quality-of-life outcomes (weighted mean difference = -6.0 points, 95% CI = -11.2 to -0.8) at intermediate follow-up and better than other forms of exercise in reducing disability at short-term follow-up (weighted mean difference = -5.1 points, 95% CI = -8.7 to -1.4). Conclusions. Motor control exercise is superior to minimal intervention and confers benefit when added to another therapy for pain at all time points and for disability at long-term follow-up. Motor control exercise is not more effective than manual therapy or other forms of exercise., Low back pain (LBP) is one of the main causes of disability, and, despite its high prevalence, the source of pain is not established in the majority of cases and [...]