Is mindfulness-based stress reduction program effective in improving function and reducing pain in older adults with chronic low back pain (LBP)?
Date of publication of the randomized controlled trial: March 2016
Design
Randomized controlled trial (RCT).
Participants
282 community-dwelling older adults (mean age: 74.5 years, male %: 33.7%) who were 65 years or older with functional limitations owing to their chronic LBP (≥11 points on the Roland and Morris Disability Questionnaire) and chronic pain (duration ≥3 months) of moderate intensity.
Intervention
The intervention group received an 8-week group program followed by 6 monthly sessions. The intervention was modeled on the mindfulness-based stress reduction program.
Comparator
Comparison 1: 8-week mindfulness-based stress reduction program versus 8-week health education program.
Major Outcomes
Outcome 1: Functional limitations owing to LBP measured by scoring on the Roland and Morris Disability Questionnaire (RMDQ). Higher scores indicated higher degree of disability;
Outcome 2: Pain level measured with the Numeric Pain Rating Scale (NRS). Higher scores indicated worse pain.
Settings
This trial was performed in an outpatient setting.
Comparison    Mindfulness-based stress reduction program versus health education program
Main Results
Compared to health education program, mindfulness-based stress reduction program had shown significant impact on reducing functional limitation in patients with chronic LBP (mean difference(MD): -1.1, 95% Cl: Not reported). The difference in pain level between groups did not reach statistical significance (p=0.08).
Comparison: Mindfulness-based stress reduction program versus health education program among older adults with chronic LBP
Outcomes No. of studies (Total number of participants) Mean score (SD)/ No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 1 (282) 12.1/140 13.1/142 Not applicable as there is only 1 study. -1.1 (Not reported) 0.01 Moderate
2 1 (282) Not reported Not reported Not applicable as there is only 1 study. Not reported 0.08 Low
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    Mindfulness-based stress reduction program versus health education program
Main Results
Compared to health education program, mindfulness-based stress reduction program had shown significant impact on reducing functional limitation in patients with chronic LBP (mean difference(MD): -1.1, 95% Cl: Not reported). The difference in pain level between groups did not reach statistical significance (p=0.08).
Comparison: Mindfulness-based stress reduction program versus health education program among older adults with chronic LBP
Outcomes 1 2
No. of studies (Total number of participants) 1 (282) 1 (282)
Mean score (SD)/ No. of participants Intervention 12.1/140 Not reported
Comparator 13.1/142 Not reported
MD (95% CI) -1.1 (Not reported) Not reported
p value 0.01 0.08
Overall quality of evidence* Moderate Low
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to the 8-week health education program, the mindfulness-based stress reduction program of the same length significantly improves the functional limitation of patients owing to chronic LBP. For Outcome 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. For Outcome 2, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/26903081
The synopsis is based on the following article:
Morone NE, Greco CM, Moore CG, Rollman BL, Lane B, Morrow LA, et al. A mind-body program for older adults with chronic low back pain: a randomized clinical trial. JAMA Internal Medicine. 2016 Mar 1;176(3):329-37.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.