10:06 a.m., Sept. 4, 2008----Gregory Hicks, an assistant professor of physical therapy at UD, recently received a National Institutes of Health grant of $420,750 to study low back pain in older adults.

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Classified as exploratory/developmental, the grant will enable Hicks, along with University co-investigators Tara Manal, director of the Department of Physical Therapy, and Lynn Snyder-Mackler, Alumni Distinguished Professor of Physical Therapy, to collect and track data from 62 elderly patients with chronic low back pain over a six-month period. It will also, Hicks anticipates, help to determine the best course of treatment for chronic low back in older adults.

“This is the first exercise-based intervention specifically for older adults with chronic low back pain,” Hicks said, “because inclusion criteria for most studies usually stipulates that patients be between 18 and 50 or 18 and 55. We don't know that much at all about treating non-specific back pain in the elderly, largely because people over the age of 55 are excluded from most studies on low back pain.”

Hicks added that having treatment plans in place designed specifically for the elderly will be all the more important as Baby Boomers begin to age, en masse.

“There are so many issues in older adults that have largely been ignored--chronic low back pain being one--that this seemed like an area that could use some attention,” he said. “Things change quite a bit in the elderly, so a condition that you'd treat one way in a younger population might need a different approach in an older adult, but many healthcare practitioners don't choose to go into geriatric medicine, because it's not as financially remunerative or as 'sexy' as other disciplines. There aren't enough geriatric practitioners to care for an aging population in many states, Delaware being one.”

To address this concern, Hicks will study local individuals from 65 to 85 years old who suffer from chronic low back pain. Participants will be randomly divided into two treatment groups--one that centers on traditional low back pain treatment regimens and one that incorporates newer, more experimental methods--and data from each group will be carefully tracked and compared using magnetic resonance imaging, rehabilitative ultrasound imaging as well as measures of pain and functional performance.

“The study will be a randomized trial comparing two potential physical therapy interventions, with one intervention using treatments such as massage, heat modalities and flexibility exercises, while the other intervention will use treatments such as neuromuscular electrical stimulation and strengthening exercises,” Hicks said.

“What we're ultimately interested in doing is improving function, because a big issue in older adults with low back pain is functional decline,” he said, adding that ramifications of decreased function include depression, increased isolation and dependence on others, and gradual debilitation.

“While we hope to show a reduction in pain, our main goal is to improve function,” Hicks said, “because that is ultimately what's so critical to overall quality of life and longevity.”

Hicks added that because low back pain is so common in so many older adults, sufferers often take it as a natural part of the aging process. “One of the things we've found in our research is that older adults with low back pain don't seek care for it, even if they seek care for other conditions,” he said. “Part of what I'm trying to do is change the mentality of that, and to let [sufferers] know that they don't just have to accept it.”

Hicks, who taught at the University of Maryland and completed a post-doctoral fellowship at the National Institute on Aging before joining UD in February 2007, learned that he'd secured the grant in August. He will begin recruiting participants for the study in the fall. Interested candidates can reach him by e-mail at [ghicks@udel.edu].

Article by Becca Hutchinson
Photo by Kathy Atkinson