nature-based intervention for chronic pain in older people

Conditions: Chronic Disease; Chronic Pain (Back / Neck); Older Adults (65 Years and Older)

Summary: the goal of this clinical trial is to learn if a nature-based intervention program has positive effects on the physical and psychosocial health in a group of older participants with chronic non-specific lower back pain. the main questions it aims to answer are: will the program improve: * the physical outcomes such as mobility, strength and balance? * the psychosocial health outcomes? participants will: * be assessed before and after the program; * participate in one session per week of the intervention.

nonspecific chronic low back pain is defined as persistent pain located between the lower ribs and the gluteal fold, with no identifiable pathoanatomical cause. it is associated with decreased quality of life, mental well-being, increased work absenteeism, and represents a significant economic burden for both individuals and the healthcare system. in the scientific literature, physical activity remains the primary recommended intervention. recently, nature-based interventions have also been explored as a potential multidisciplinary ally for the management of chronic pain. the objective of this study is to examine the effects of outdoor physical activity (i.e. walking, general back mobility and strengthening) combined with other nature interventions (i.e. shinrin-yoku, meditation, gardening and pain education) in a group of older adults living with chronic non-specific lower back pain. the intervention will consist of an 8-week group program, conducted once a week for 2 hours. a total of 15 participants will take part in the program to evaluate its impact on both physical and mental health. data collection will include both quantitative and qualitative measures. quantitative outcomes will assess pain disability, quality of life, kinesiophobia (fear of movement), fear of falling, pain catastrophisation, pain beliefs, well-being, depression, nature connectedness, and physical function through standardized tests (e.g., 5 times sit to stand test), postural control, and gait patterns. statistical analyses will be performed to compare pre- and post-intervention outcomes, as well as to explore associations between clinical variables, using spss software. qualitative data will be collected through individual interviews conducted before and at the end of the program to provide a richer understanding of participants' experiences of pain and perceived effects of the program. interview transcripts will be analyzed using nvivo software. it is anticipated that this type of intervention will have positive effects for this population and may be considered a promising rehabilitation approach for the management of chronic low back pain in older adults.

Eligibility criteria:
inclusion criteria: * aged 65 years + * having low back pain for 3 months or more * being able to walk independently * mental state \>25/30 in the mmse questionnaire * frailty score \<3/5 (fried criterias) exclusion criteria: * presenting other severe musculoskeletal, cardiovascular, or neurological conditions, or systemic diseases (e.g., cancer).

Keywords: aging chronic pain non-specific low back pain nature-based interventions falls forest bathing shinrin-yoku social nature connectedness functionning physical activity mindfulness meditation rehabilitation postural control strength quality of life balance