Effect of Physical Therapy with Combined Resistance Exercises and Vigorous Walking in Older Adult Women with Chronic Non-Specific Pain: A Randomized Controlled Trial

Background: Age-related hormonal changes in older women accelerate bone and muscle loss, leading to postural dysfunction and chronic musculoskeletal pain. This study aimed to evaluate the short-term effects of a physical therapy program combining elastic band exercises and vigorous walking on pain, thoracic mobility, and functional capacity in older adult women. Methods: A multicenter randomized controlled trial was conducted older adult women (60–80 years) with chronic non-specific musculoskeletal pain, allocated to an elastic band plus vigorous walking group (EBWG), a vigorous walking group (VWG), or a control group (CG). A total of 91 participants completed all of the assessments. Outcomes included pressure pain threshold (PPT), self-reported pain (VAS), thoracic mobility (UPC, LWC), functional capacity (5XSTS), and perceived improvement (PGIC), evaluated at baseline, after a 4-week intervention, and at 4-week follow-up. Results: The EBWG demonstrated greater improvements in PPT (+0.66 kg/cm2 at T2), upper chest expansion (+1.00 cm), and 5XSTS performance (−1.7 s) compared to the control group. The VWG showed significant reductions in overall pain (−0.9 points) and lumbar pain (−1.7 points). Improvements in PPT and thoracic mobility in the EBWG exceeded MDC/MCID thresholds, indicating clinically meaningful changes. Vigorous walking alone improved self-reported pain but was less effective than the multicomponent program. Conclusions: A 4-week combined program of elastic band exercises and vigorous walking produced clinically relevant improvements in pain threshold, thoracic mobility, functional capacity, and perceived change compared to walking alone or usual activity. These findings support the clinical utility of short, feasible, multicomponent interventions for managing chronic musculoskeletal pain in older women.