Instructional manual for musculoskeletal pain reduction among in-home caregivers of aged individuals: a randomized clinical trial pilot study

Authors

DOI:

https://doi.org/10.21527/2176-7114.2026.51.16753

Keywords:

Caregivers, Health Education, Clinical Trial, Musculoskeletal Pain, Health Promotion

Abstract

Objective: To assess the efficacy of an instructional manual for musculoskeletal pain reduction among in-home caregivers of aged individuals. Method: A randomized clinical trial pilot study with 45 caregivers: 23 in the Control Group and 22 in the Intervention Group. The data were collected between September and December 2021 in a remote fashion. A sociodemographic and health questionnaire was applied, as well as the Nordic Musculoskeletal Questionnaire. The intervention was developed in three stages: Training the caregivers in how to use the instructional manual with self-care guidelines; Training about body postures while providing care to aged individuals; and Weekly follow-up for two months. Pearson's Chi-square test was used for the intergroup comparison, and the statistical software program employed was JAMOVI®. Results: In all, 91.6% of the Intervention Group caregivers presented musculoskeletal pain reduction in the spine and knees. The study has been registered in the Brazilian System for Recording Clinical Trials (Sistema Brasileiro de Registro de Ensaios Clínicos, ReBEC) (RBR-4fvfn2p). Conclusion: When compared to the Control Group, using the instructional manual promoted musculoskeletal pain reduction in the spine and knees in the Intervention Group. It was possible to advise the caregivers about the importance of taking care of themselves in order to provide care to others.

References

1. Francisco PMSB, Assumpção D de, Borim FSA, Yassuda MS, Neri AL. Risco de mortalidade por todas as causas e sua relação com estado de saúde em uma coorte de idosos residentes na comunidade: Estudo FIBRA. Ciênc saúde coletiva. 2021; 26(12): 6153–64. DOI: https://doi.org/10.1590/1413-812320212612.32922020

2. Oliveira AS. Transição demográfica, transição epidemiológica e envelhecimento populacional no Brasil. Hygeia. 2019; 15(32): 69-7. DOI: http://dx.doi.org/10.14393/Hygeia153248614

3. Rebêlo FL, Jucá MJ, Silva CM de A, Santos, AIB, Barbosa JVP. Fatores associados à sobrecarga e qualidade de vida de cuidadores de idosos com demência. Estud interdiscip Envelhec. 2021; 26(2). DOI: https://doi.org/10.22456/2316-2171.107194

4. Gomes NP, Pedreira LC, Nunes SFL, Alvarez AM, Siewert JS, Oliveira LMS de. Musculoskeletal disorders of older adults: an integrative literature review. Rev Bras Enferm. 2021; 74: e20200626. DOI: https://doi.org/10.1590/0034-7167-2020-0626

5. Hasuo H, Shizuma H, Fukunaga M. Factors associated with chronic thoracic spine and low back pain in caregivers of cancer patients. Ann Palliat Med. 2021, 10(2): 1224-36. DOI: 10.21037/apm-20-803

6. Gomes NP, Pedreira LC, Gomes Neto M, Conceição MM da, Sampaio RS, Amorim RF. Cuidadores de pessoas idosas e as condições de trabalho associadas ao cuidado: Caregivers for older people and the working conditions associated with care. Saud Pesq. 2024;17(1):e12239. DOI: https://doi.org/10.17765/2176-9206.2024v17n1.e12239

7. Vaz LCS, Santos KOB, Ferraz DD. Condições de saúde e trabalho entre cuidadores de idosos frágeis. Rev Pesq Fisio. 2018; 8(3); 319-29. DOI: https://doi.org/10.17267/2238-2704rpf.v88i3.197

8. Maia Junior L, Sá SPC, Christovam BP, Domingos AM, Correia DMS, Maia HMSF. Osteomuscular disorders in care of elderly household people: Prevalence and its associated factors. Res., Soc. Dev. 2021; 10(10): e13101018449. DOI: http://dx.doi.org/10.33448/rsd-v10i10.18449

9. Gomes NP, Pedreira LC, Gomes NP, Fonseca EOS, Reis LA dos, Santos AA. Health-related consequences of caring for dependent relatives in older adult caregivers. Rev Esc Enferm USP. 2019; 53: e.03446. DOI: https://doi.org/10.1590/S1980-220X2018002303446

10. Nasreen HE, Tyrrell M, Vikström S, Craftman A, Ahmad SABS, Zin NM, et al. Caregiver burden, mental health, quality of life and self-efficacy of family caregivers of persons with dementia in Malaysia: baseline results of a psychoeducational intervention study. BMC geriatrics. 2024; 24(1):656. DOI: https://doi.org/10.1186/s12877-024-05221-9

11. Santana RF. Gerontological nursing in the care of the elderly in times of COVID-19. In: Batello GVVAT, Guimarães MSA, Pereira IA de C, et al. Caregivers of elderly in pandemic situation: reflections on caring and being cared for. ABEn Magazine. 2020; 19(6): 20-5. [acessado em 20 fev. 2026]. Disponível em: https://www.researchgate.net/publication/344522233_CUIDADORES_DE_IDOSOS_EM_SITUACAO_DE_PANDEMIA_REFLEXOES_SOBRE_O_CUIDAR_E_SER_CUIDADO_Daniella_Pires_Nunes_III

12. Costeira C, Paiva-Santos F, Pais N, Sousa AF, Paiva I, Carvalho DH, et al. Cancer Patients with Chronic Pain and Their Caregivers during COVID-19: A Descriptive Study. Nurs Rep. 2023;13(3):934-45. DOI: 10.3390/nursrep13030082.

13. Sheth K, Lorig K, Stewart A, Parodi JF, Ritter PL. Effects of COVID-19 on Informal Caregivers and the Development and Validation of a Scale in English and Spanish to Measure the Impact of COVID-19 on Caregivers. J Appl Gerontol. 2021;40(3):235-43. DOI: 10.1177/0733464820971511.

14. Biderman A, Carmel S, Amar S, Bachner YG. Care for caregivers- a mission for primary care. BMC Fam Pract. 2021; 22(1): 227. DOI: https://doi.org/10.1186/s12875-021-01579-6

15. Da Silva EC, Maia LRB. Prevenção de dores lombares em cuidadores de idosos. Aracê, [S. l.], 2025; 7(10):e9266. DOI: 10.56238/arev7n10-247

16. Hopewell S, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, et al. CONSORT 2025 statement: updated guideline for reporting randomised trials. Lancet. 2025:S0140-6736(25)00672-5. DOI: 10.1016/S0140-6736(25)00672-5

17. Horn CG, Jensen K, Hartvigsen J, Wekre LL, Skou ST, Folkestad L. Evaluation of the Nordic Musculoskeletal Questionnaire for Measuring Prevalence and the Consequence of Pain in a Danish Adult OI Population: A Pilot Study. Calcif Tissue Int. 2024;115(4):405-12. DOI: 10.1007/s00223-024-01262-9

18. Ceccon RF, Vieira LJE de S, Brasil CCP, Soares KG, Portes V de M, Garcia Júnior CAS, et al. Envelhecimento e dependência no Brasil: características sociodemográficas e assistenciais de idosos e cuidadores. Ciênc saúde coletiva. 2021;26(1):17–26. DOI: https://doi.org/10.1590/1413-81232020261.30352020

19. Camarano AA, Pinheiro L. Cuidar, verbo transitivo : caminhos para a provisão de cuidados no Brasil[internet]. Rio de Janeiro: Ipea, 2023. [acessado em 20 fev. 2026]. Disponível em:https://repositorio.ipea.gov.br/server/api/core/bitstreams/46ded4bb-4ef2-457b-b16b-4f1c124276fa/content

20. Minayo MC de S, Mendonça JMB, Sousa GS de, Pereira TF da S, Mangas RM do N. Políticas de apoio aos idosos em situação de dependência: Europa e Brasil. Ciênc saúde coletiva. 2021Jan;26(1):137–46. DOI: https://doi.org/10.1590/1413-81232020261.30262020

21. Nemcikova M, Katreniakova Z, Nagyova I. Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia. Front Public Health. 2023;11:1104250. DOI: 10.3389/fpubh.2023.1104250

22. Instituto Brasileiro de Geografia e Estatística. Mulheres pretas ou pardas gastam mais tempo em tarefas domésticas, participam menos do mercado de trabalho e são mais afetadas pela pobreza. Agência de Notícias IBGE, 8 mar. 2024. [acessado em 08 mar. 2026]. Disponível em: https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/39358-mulheres-pretas-ou-pardas-gastam-mais-tempo-em-tarefas-domesticas-participam-menos-do-mercado-de-trabalho-e-sao-mais-afetadas-pela-pobreza

23. Romero DE, Maia LR, Muzy J, Andrade N, Szwarcwald CL, Groisman D, et al.. O cuidado domiciliar de idosos com dependência funcional no Brasil: desigualdades e desafios no contexto da primeira onda da pandemia de COVID-19. Cad Saúde Pública. 2022;38(5):e00216821. DOI: https://doi.org/10.1590/0102-311X00216821.

24. Greaney ML, Kunicki ZJ, Drohan MM, Nash CC, Cohen SA. Sleep Quality Among Informal Caregivers During the COVID-19 Pandemic: A Cross-Sectional Study. Gerontol Geriatr Med. 2022;8:23337214211057387. DOI: 10.1177/23337214211057387.

25. Figueiredo LC, Barbosa GC, Monteiro DQ, Martins G, Silva AFO, Ruy LFT, et al. Factors associated with symptoms of physical and emotional burden in informal caregivers of the aged. Rev Bras Enferm. 2022;75(Supl 4):e20210927. DOI: https://doi.org/10.1590/0034-7167-2021-0927.

26. Sahbaz T, Medin-Ceylan C. Gravedad de accidentes cerebrovasculares para determinar síntomas osteomusculares en cuidadores familiares. Rev Latino-Am Enfermagem. 2023;31:e4004. DOI: https://doi.org/10.1590/1518-8345.6725.4004.

27. Terassi M, Bento SR, Rossetti ES, Pavarini SCI, Hortense P. Influência da sobrecarga, estresse e sintomas depressivos na saúde de idosos cuidadores: estudo longitudinal. Esc Anna Nery. 2023;27:e20220437. DOI: https://doi.org/10.1590/2177-9465-EAN-2022-0437pt.

28. De Araújo Freitas Moreira KL, Ábalos-Medina GM, Villaverde-Gutiérrez C, Gomes de Lucena NM, Belmont Correia de Oliveira A, Pérez-Mármol JM. Effectiveness of two home ergonomic programs in reducing pain and enhancing quality of life in informal caregivers of post-stroke patients: A pilot randomized controlled clinical trial. Disabil Health J. 2018;11(3):471-477. DOI: 10.1016/j.dhjo.2018.01.003

29. Nagamine BP, Dantas R da S, Chaves TVP, de Oliveira Penna Chaves CT . The importance of the exercise of strengthening in kinetic chain closed in patellar condromalacy. RSD. 2021; 10(4): e3810413931. DOI: https://doi.org/10.33448/rsd-v10i4.13931

30. Sabo K, Chin E. Self-care needs and practices for the older adult caregiver: An integrative review. Geriatr Nurs. 2021;42(2):570-81. DOI: 10.1016/j.gerinurse.2020.10.013

31. Kojima HJ, Batista MPP, Marques C, Almeida MHM de. Análise dos benefícios do programa “Cuidando de quem cuida” para os cuidadores familiares participantes. Cad Bras Ter Ocup. 2025;33:e3918. DOI: https://doi.org/10.1590/2526-8910

32. Wang J, Liu J, Li L, Man J, Yue S, Liu Z. Effect of education and muscle relaxation program on anxiety, depression and care burden in caregivers of acute stroke survivors: A randomized, controlled study. Medicine (Baltimore). 2021;100(4):e24154. DOI: 10.1097/MD.0000000000024154

33. Aguiar DP, Souza CP de Q, Barbosa WJM, Santos-Júnior FFU, Oliveira AS de. Prevalence of chronic pain in Brazil: systematic review. BrJP. 2021;4(3):257–67. DOI: https://doi.org/10.5935/2595-0118.20210041

34. Dos Santos IN, Pernambuco ML, da Silva AMB, Ruela GA, de Oliveira AS. Association between musculoskeletal pain and telework in the context of the COVID-19 pandemic: an integrative review. Rev Bras Med Trab. 2021;19(3):342-350. DOI: 10.47626/1679-4435-2021-812

35. Indrayani NLD, Buntari NLPIA, Suyasa IGPD, Sutini NK, Duygulu S, Portia V, et al. Empowering Caregivers to Improve Working Posture Management for Preventing Musculoskeletal Injuries in Long Term Care Settings. AMJPM. 2025;5(1):79-86. DOI: https://doi.org/10.53770/amjpm.v5i1.522

36. Figueiredo M do LF, Gutierrez DMD, Darder JJT, Silva RF, Carvalho ML de. Cuidadores formais de idosos dependentes no domicílio: desafios vivenciados. Ciênc saúde coletiva. 2021;26(1):37–46. DOI: https://doi.org/10.1590/1413-81232020261.32462020

37. Alwin J, Karlson BW, Husberg M, Carlsson P, Ekerstad N. Societal costs of informal care of community-dwelling frail elderly people. Scand J Public Health. 2021;49(4):433-40. DOI: 10.1177/1403494819844354

38. Groisman D, Romero D, Andrade ZP, Araújo AB, Araújo GCL, Barros H, et al. Care-Covid: National survey on the working conditions and health of caregivers of the elderly in the pandemic - Key findings [internet]. Rio de Janeiro: EPSJV/ICICT/Fiocruz; 2021 [acessado em 20 fev. 2026]. Disponível em: https://www.oasisbr.ibict.br/vufind/Record/CRUZ_a64532109af9e7654dd02a5812fb279c

39. Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Nota Técnica 22 de 9 de novembro de 2021. O “represamento” do atendimento em saúde no SUS. Rio de Janeiro: Fiocruz/Icict, 2021. 10 p. [acessado em 20 fev. 2026]. Disponível em: https://arca.fiocruz.br/items/66422cbd-17ed-40f0-b054-0f73bd4cde6a

40. Lima AMC, Piagge CSLD, Silva ALO, Robazzi MLCC, Mélo CB, Vasconcelos SC. Educational technologies in the promotion of the health of the elderly. Enferm Foco. 2020;11(4):87-94. DOI: 10.21675/2357-707X.2020.v11.n4.3277

41. Santiago BVM, Oliveira ABG, Silva GMRD, Silva MFD, Bergamo PE, Parise M, et al. Prevalence of chronic pain in Brazil: A systematic review and meta-analysis. Clinics. 2023;78:100209. DOI: 10.1016/j.clinsp.2023.100209

42. Brasil. Ministério da Saúde. Política Nacional de Atenção Básica. Brasília: Ministério da Saúde, 2012. [acessado em 23 fev. 2026]. Disponível em: http://189.28.128.100/dab/docs/publicacoes/geral/pnab.pdf

43. Brasil. Ministério da Saúde. Relatório para a Sociedade: informações sobre recomendações de incorporação de medicamentos e outras tecnologias no SUS. Brasília: Ministério da Saúde, 2021. [acessado em 23 fev. 2026]. Disponível em: https://www.sbglaucoma.org.br/medico/relatorio-para-sociedade-informacoes-sobre-recomendacoes-de-incorporacao-de-medicamentos-e-outras-tecnologias-do-sus/

44. Freitas L de O, Gonçalves JL, Gomes JES, Vinhote JFC, Silva RM da, Vieira LJE de S. Contributions of the physical therapist to primary health care based on multiprofessional residency. Fisioter mov. 2024;37:e37119. DOI: https://doi.org/10.1590/fm.2024.37119

45. Bispo Júnior JP, Almeida ER de. Equipes multiprofissionais (eMulti): potencialidades e desafios para a ampliação da atenção primária à saúde no Brasil. Cad Saúde Pública. 2023;39(10):e00120123. DOI: https://doi.org/10.1590/0102-311XPT120123

Published

2026-10-01

Issue

Section

ORIGINAL ARTICLE

How to Cite

Instructional manual for musculoskeletal pain reduction among in-home caregivers of aged individuals: a randomized clinical trial pilot study. (2026). Revista Contexto & Saúde, 26(51), e16753. https://doi.org/10.21527/2176-7114.2026.51.16753