Occupational Physical Activity Was Associated With Disability Levels at 6-Month Follow-Up of Patients With Chronic Nonspecific Low Back Pain: A Prospective Cohort Study.

BACKGROUND: Physical activity plays an important role in the prognosis of chronic low back pain (LBP); however, whether physical activity predicts pain intensity and disability remains unknown. This study investigated whether objective and subjective physical activity measures predict pain intensity and disability levels 6 months later in patients with chronic LBP. METHODS: Patients with chronic LBP seeking care at 2 outpatient physiotherapy clinics were recruited. At baseline assessment, we collected anthropometric/sociodemographic data, duration of symptoms, pain intensity, disability, and physical activity (accelerometer and questionnaire). After 6 months, we reassessed pain and disability. Multivariable regression analyses were performed to investigate the association of physical activity measures with pain and disability at follow-up. RESULTS: A total of 179 patients with chronic LBP were included. High occupational physical activity at baseline predicted disability at 6-month follow-up (B = 1.22; 95% confidence interval, 0.21 to 2.21) after controlling for age and baseline disability, meaning that for every 1-point increase in occupational physical activity, disability increased on average by 1.22 point. The remaining physical activity measures showed no association with pain intensity or disability at follow-up. CONCLUSION: Higher perceived levels of occupational physical activity predicted higher disability levels at 6-month follow-up in patients with chronic LBP.

Assessment of aerobic fitness in individuals with and without nonspecific chronic low back pain: a pilot study.

Aerobic fitness assessment in patients with low back pain (LBP) may help clinicians to plan how to progress the aerobic training. This was a pilot study designed to evaluate the performance of people with LBP on two different aerobic fitness tests performed on a treadmill and to compare the measure of aerobic fitness between people with LBP and healthy individuals. Ten people with LBP and 10 healthy individuals underwent two aerobic fitness protocols, the modified Bruce and maximum incremental test protocols, performed on a treadmill. Data collected during the protocols were: oxygen consumption, heart rate (HR), blood lactate concentration, respiratory quotient, rating of perceived exertion response, and pain intensity. Independent t-test and two-way analysis of variance were used respectively to assess difference between groups characteristics and physiological responses to the protocols. Our results showed that both groups were similar with regards to age (P = 0.839) or HRrest (P = 0.730) but the LBP group showed higher BMI compared to the healthy group (P = 0.031). Regarding the performance of both groups on the aerobic fitness tests, the only significant difference was reported for respiratory quotient which showed a main effect of test (P = 0.015) with higher values favoring the modified Bruce over the incremental test. Our study showed that most people with LBP are able to perform and tolerate both aerobic fitness tests but no significant differences between people with LBP and healthy individuals on both protocols were reported.

Association of perceived physical overload at work with pain and disability in patients with chronic non-specific low back pain: a 6-month longitudinal study.

BACKGROUND: Physical overload at work has been described as a risk factor for the development of low back pain. However, few studies have investigated the prognostic value of perceived physical overload at work in patients with chronic low back pain. OBJECTIVE: To investigate the association of perceived physical overload at work with pain and disability over a period of 6 months in patients with chronic non-specific low back pain. METHODS: Patients with chronic LBP seeking physiotherapy care were considered eligible. Clinical data collected were: pain intensity, disability, fear of movement, depression and perceived physical overload at work. Linear regression analyses were used to investigate the association of perceived physical workload at work at baseline with pain intensity and disability at 6-month follow-up. The total score and the score for each category of the physical overload at work questionnaire were analyzed separately. RESULTS: Ninety-two patients with chronic low back pain were included in the analysis. The subcategories of the physical overload questionnaire were not significantly associated with pain intensity at 6-month follow-up. However, age, disability at baseline and perceived physical overload related to postures of the trunk (B = -0.60 95% CI - 1.18 to - 0.02) and related to positions of the arms (B = 2.72 95% CI 0.07 to 5.37) were significantly associated with disability at 6-month follow-up. CONCLUSION: Although perceived physical overload at work was not associated with pain intensity in patients with chronic LBP at 6-month follow-up, we identified a significant association between perceived physical overload related to postures of the trunk and positions of the arms with disability at 6-month follow-up. These slides can be retrieved under Electronic Supplementary Material.

Physical activity as a prognostic factor of pain intensity and disability in patients with low back pain: A systematic review.

BACKGROUND AND OBJECTIVE: Identifying factors that influence the course of low back pain (LBP) is important to help clinicians to identify those patients at higher risk of non-recovery. The objective of this systematic review was to investigate the prognostic role of physical activity in the course of LBP. DATABASES AND DATA TREATMENT: Literature searches were conducted in five electronic databases from their inception to February 2018. Prospective cohort studies investigating the influence of any type of physical activity in people with LBP were considered eligible. The primary outcomes were pain intensity and disability. Two independent reviewers extracted the data and assessed the methodological quality of the included studies. Results were stratified according to participants' symptoms duration at baseline. RESULTS: Twelve studies were considered eligible for this review. Of these, six included patients with chronic LBP, four studies did not specify the patients' duration of symptoms, one study included patients with acute LBP, and one study included patients with subacute LBP. Included studies were heterogeneous in terms of physical activity assessment, outcomes, follow-up duration, and statistical methods, therefore, pooling of results was not performed. We found limited evidence to support the prognostic role of physical activity in the course of LBP. CONCLUSIONS: Our review identified limited evidence supporting physical activity as a prognostic factor in LBP. Future cohort studies are needed to clarify the strength and importance of this association. SIGNIFICANCE: Despite recent research in the area, this systematic review shows that there is low quality evidence that physical activity may not be a prognostic factor for predicting pain and disability in patients with LBP.

Physical activity and disability measures in chronic non-specific low back pain: a study of responsiveness.

OBJECTIVES:: To compare the responsiveness of disability measures with physical activity measures in patients with chronic low back pain (CLBP) undergoing a course of physical therapy treatment. DESIGN:: This is a prospective cohort study with two-month follow-up. SUBJECTS:: A total of 106 patients presenting with non-specific CLBP of more than three months duration were recruited. MAIN MEASURES:: Disability measures investigated were Quebec Back Pain Disability Scale and Roland Morris Disability Questionnaire. Physical activity measures analyzed include the Baecke Habitual Physical Activity Questionnaire and objective measures derived from an accelerometer (i.e. total time spent in moderate-to-vigorous and light physical activity, number of steps and counts per minute). Disability and physical activity measures were collected at the baseline and after eight weeks of treatment. For the responsiveness analyses, effect size (ES) and standardized response mean (SRM) were calculated. Correlations between the change in disability and physical activity measures were calculated. RESULTS:: Responsiveness for disability measures was considered to be large with ESs ranging from -1.03 to -1.45 and SRMs ranging from -0.99 to -1.34, whereas all physical activity measures showed values lower than 0.20. Changes in disability measures did not correlate with changes in physical activity measures (correlation coefficients ranged from -0.10 to 0.09). CONCLUSION:: Disability measures were responsive after a course of physical therapy treatment in patients with CLBP. The lack of responsiveness in the physical activity measures might be due to the inability of these measures to detect change over time or the use of an intervention not designed to increase physical activity levels.