Performance and metabolic evaluation in primiparous beef cows under grazing at different breeding ages.

We aimed to evaluate the metabolic and performance differences in primiparous Nellore cows, which became pregnant at 14 or 24-mo old. Thirty-eight cows with 202 ± 5 days of gestation were divided into two treatments according to breeding age: 14 or 24-mo. Cows were evaluated for body weight (BW), body condition score (BCS), carcass characteristics, milk yield, calves's performance, and blood characteristics. The animals were managed in eight paddocks under continuous grazing and evaluated from 90 d before parturition until 240 d after calving. We observed an interaction between breeding age and time (P < 0.01) for cow BW. Both breeding age categories experienced BW loss during parturition, with a concurrent decrease in BCS. However, following their first calving, the BW of 24-mo cows remained stable (P > 0.05), whereas 14-mo cows exhibited a gradual recovery in BW after parturition (P < 0.05). Milk yield was greater in 24-mo animals (P < 0.01), but decreased with increasing milking days (p < 0.05) for both groups. The weight gain calves from the heifers bred at 24-mo was greater (P < 0.01), which reflected in greater BW at weaning. The beta-hydroxybutyrate (ß-OHB) concentration was greater before calving and a marked decrease after parturition (P < 0.05). The 24-mo cows had greater blood ß-OHB (P < 0.01) at prepartum and 30 days after calving. Blood progesterone was greater in 24-mo cows (P > 0.05). Primiparous beef cows that conceive at either 14 or 24-months of age exhibit distinct nutritional requirements and metabolic profiles. Notably, cows that conceive at 24-months of age have the advantage of weaning heavier calves and displaying a more consistent reproductive cycle following their first calving than cows that conceive at 14-months.

Association of Musculoskeletal Pain With Sedentary Behavior in Public School Teachers: The Role of Habitual Physical Activity.

BACKGROUND: Sedentary behavior has been associated with musculoskeletal pain in school teachers. However, our hypothesis is that physical activity practice could mitigate this association. AIM: The aim of this study was to investigate the relationship of musculoskeletal pain with high screen-based sedentary behavior among public school teachers and whether physical activity could mitigate this relationship. METHOD: A sample of 246 teachers from 13 public schools were assessed (45.0 ± 10.4 years, 76.0% of women). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire, screen-based sedentary behavior was measured considering the sum of screen time in television, computer, and smartphone/tablet, and physical activity using the Baecke habitual physical activity questionnaire. Binary logistic regression was used to verify the associations between high screen-based sedentary behavior and musculoskeletal pain in school teachers (Model 1-unadjusted; Model 2-adjusted by age, sex, and socioeconomic status; Model 3-variables of Model 2 + adjusted by physical activity). RESULTS: High screen-based sedentary behavior was associated with pain in neck (odds ratio = 2.09; 95%confidence interval = 1.08-4.04), upper back (odds ratio = 2.21; 95%confidence interval = 1.07-4.56), and low back (odds ratio = 1.91; 95%confidence interval = 1.00-3.65). However, after inserting the variables, including physical activity, these associations were mitigated. CONCLUSIONS: High screen-based sedentary behavior was associated with musculoskeletal pain in public school teachers. However, this relationship was mitigated after the inclusion of confounding variables, including physical activity.

Association Between Domain-Specific Physical Activity and Chronic Low Back Pain in Community-Dwelling Older Adults: A Cross-Sectional Study.

To investigate the association between physical activity (PA) domains and chronic low back pain (LBP) in older adults. A cross-sectional study where sociodemographic, behavioral, and health variables; PA; and presence of chronic LBP were collected. Higher scores of PA defined the "more active" participants. Binary logistic regression was used to test the association between PA domains and chronic LBP. A total of 516 participants were included. The mean age was 71.8 (95% confidence interval, CI, [71.1, 72.5]) years, and 29%, 27%, 25%, and 31% were identified as "more active" in the household, sports, leisure-time, and total PA domains, respectively. "More active" participants in sports (odds ratio = 0.62, 95% CI [0.40, 0.97]), leisure-time (odds ratio = 0.54, 95% CI [0.35, 0.85]) and total (odds ratio = 0.60, 95% CI [0.39, 0.92]) PA domains were less likely to report chronic LBP. High levels of sports, leisure-time, and total PA were inversely associated with chronic LBP.

Bidirectional Association Between Sleep Quality and Low Back Pain in Older Adults: A Longitudinal Observational Study.

OBJECTIVE: To investigate the bidirectional relationship by determining whether baseline sleep quality predicts pain intensity and whether baseline pain intensity predicts sleep quality in older individuals with chronic low back pain (LBP). DESIGN: A prospective longitudinal cohort study with a 6-month follow-up period. SETTING: Community. PARTICIPANTS: Older adults with LBP aged 60 years or older (N=215). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Data collection occurred at baseline and at 6 months. Pain intensity and sleep quality were measured in both time points of assessment using the numeric pain rating scale (range, 0-10) and the Pittsburg Sleep Quality Index. At baseline, we also collected information on demographic anthropometric variables, cognitive status, depression, and comorbidities. Multivariable linear regression analyses adjusted for potential covariates were performed. RESULTS: A total of 215 individuals with LBP were recruited. Poor sleep quality at baseline predicted high pain intensity at 6 months (ß coefficient, 0.18; 95% confidence interval [CI], 0.07-0.30). High pain intensity at baseline predicted poor sleep quality 6 months later (ß coefficient, 0.14; 95% CI, 0.01-0.26). CONCLUSION: Our findings give some support to the bidirectional relationship between pain and sleep quality in older individuals with LBP. This bidirectional relationship may be used as prognostic information by clinicians when managing patients with LBP.

Effectiveness of brief patient information materials for promoting correct beliefs about imaging and inevitable consequences of low back pain: A randomised controlled trial.

OBJECTIVE: To investigate what format for providing patient information (i.e. written summary, infographic or video animation) is most effective for promoting correct beliefs about imaging and inevitable consequences of low back pain (LBP). DESIGN: Randomised controlled trial. SETTING/PATIENTS: One hundred and fifty-nine patients with non-specific LBP were recruited from outpatient physiotherapy clinics. INTERVENTION: Participants were randomised to receive patient information in one of three formats: video animation, infographic or written summary. Patients were allowed to read or watch the materials for up to 20 min. MEASUREMENTS: Outcome were assessed before and immediately after the intervention. The primary outcome was the Back Beliefs Questionnaire. The secondary outcome was beliefs about imaging for LBP assessed by two questions. RESULTS: All 159 patients completed the study. Our findings revealed no difference between groups for the Back Beliefs Questionnaire. Correct beliefs about imaging were more likely with the infographic than the video animation (Question 1- Odds Ratio [OR] = 3.9, 95% confidence interval [CI]: 1.7, 8.7; Question 2- OR = 6.8, 95%CI: 2.7, 17.2) and more likely with the written summary than the video animation (Question 1- OR = 3.3, 95%CI: 1.5, 7.4; Question 2- OR = 3.7, 95%CI: 1.6, 8.5). No difference between infographic and written summary formats were reported for the questions assessing LBP imaging beliefs. CONCLUSION: The three materials were equally effective in improving patient's general beliefs about LBP care. However, the traditional written summary or infographic formats were more effective than the video animation format for improving beliefs about imaging for LBP.

New triazole-substituted triterpene derivatives exhibiting anti-RSV activity: synthesis, biological evaluation, and molecular modeling.

Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infections in infants. Currently, ribavirin, a nucleoside analog containing a 1,2,4-triazole-3-carboxamide moiety, is a first-line drug for its treatment, however, its clinical use has been limited due to its side effects. Here, we designed two new nitroaryl-1,2,3-triazole triterpene derivatives as novel anti-RSV drugs. Their anti-RSV and cytotoxic activity were evaluated in vitro, RSV protein F gene effects by RT-PCR and molecular modeling with inosine monophosphate dehydrogenase (IMPDH) were performed. Compound 8 was the best performing compound, with an EC50 value of 0.053 µM, a TI of 11160.37 and it inhibited hRSV protein F gene expression by approximately 65%. Molecular docking showed a top-ranked solution located in the same region occupied by crystallographic ligands in their complex with IMPDH. The results obtained in this study suggest that compound 8 might be a new anti-RSV candidate.

Cellular compartments challenged by membrane photo-oxidation.

The lipid composition impacts directly on the structure and function of the cytoplasmic as well as organelle membranes. Depending on the type of membrane, specific lipids are required to accommodate, intercalate, or pack membrane proteins to the proper functioning of the cells/organelles. Rather than being only a physical barrier that separates the inner from the outer spaces, membranes are responsible for many biochemical events such as cell-to-cell communication, protein-lipid interaction, intracellular signaling, and energy storage. Photochemical reactions occur naturally in many biological membranes and are responsible for diverse processes such as photosynthesis and vision/phototaxis. However, excessive exposure to light in the presence of absorbing molecules produces excited states and other oxidant species that may cause cell aging/death, mutations and innumerable diseases including cancer. At the same time, targeting key compartments of diseased cells with light can be a promising strategy to treat many diseases in a clinical procedure called Photodynamic Therapy. Here we analyze the relationships between membrane alterations induced by photo-oxidation and the biochemical responses in mammalian cells. We specifically address the impact of photosensitization reactions in membranes of different organelles such as mitochondria, lysosome, endoplasmic reticulum, and plasma membrane, and the subsequent responses of eukaryotic cells.

Taurine supplementation in conjunction with exercise modulated cytokines and improved subcutaneous white adipose tissue plasticity in obese women.

Interventions that can modulate subcutaneous white adipose tissue (scWAT) function, such as exercise training and nutritional components, like taurine, modulate the inflammatory process, therefore, may represent strategies for obesity treatment. We investigated the effects of taurine supplementation in conjunction with exercise on inflammatory and oxidative stress markers in plasma and scWAT of obese women. Sixteen obese women were randomized into two groups: Taurine supplementation group (Tau, n = 8) and Taurine supplementation + exercise group (Tau + Exe, n = 8). The intervention was composed of daily taurine supplementation (3 g) and exercise training for 8 weeks. Anthropometry, body fat composition, and markers of inflammatory and oxidative stress were determined in plasma and scWAT biopsy samples before and after the intervention. We found that, although taurine supplementation increased taurine plasma levels, no changes were observed for the anthropometric characteristics. However, Tau alone decreased interleukin-6 (IL-6), and in conjunction with exercise (Tau + Exe), increased anti-inflammatory interleukins (IL-15 and IL10), followed by reduced IL1ß gene expression in the scWAT of obese women. Tau and Tau + Exe groups presented reduced adipocyte size and increased connective tissue and multilocular droplets. In conclusion, taurine supplementation in conjunction with exercise modulated levels of inflammatory markers in plasma and scWAT, and improved scWAT plasticity in obese women, promoting protection against obesity-induced inflammation. TRN NCT04279600 retrospectively registered on August 18, 2019.

Nutritional performance and metabolic characteristics of cattle fed tropical forages with protein and starch supplementation.

Effects of protein supplementation, with and without starch supplementation, on nutritional performance and metabolic characteristics of cattle fed low- and medium-quality tropical forages were evaluated using 4 cannulated steers distributed according to a 4 × 4 Latin square. Experimental periods were divided into two subperiods. In the first subperiod, two animals received low-quality hay and two animals received medium-quality. Supplementation schemes were evaluated in the second subperiod: low-quality hay with protein (300 g of crude protein - CP/d); low-quality hay with protein (300 g CP/d) and starch (225 g/d); medium-quality hay with protein (300 g CP/d); and medium-quality hay with protein (300 g CP/d) and starch (225 g/d) supplementation. Without supplementation, medium-quality forage provided higher intake, digestibility, nitrogen balance (NB) and efficiency of nitrogen utilization (EFNU). Comparing subperiods, supply of supplements depressed medium-quality forage intake, but did not affect low-quality forage intake. Supplementation increased NB, EFNU and serum concentration of IGF1 in animals fed low-quality forage. Protein supplementation increases nitrogen retention in animals, an effect attributed mainly to anabolic stimuli. However, this effect is more prominent when animals are fed low-quality forages. No positive impact on animal metabolism was obtained with combination of supplemental protein and starch.

Characteristics Associated With People With Chronic Low Back Pain Meeting Physical Activity Guidelines and Recommendations for Sedentary Behavior: A Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to identify factors associated with meeting physical activity guidelines and sedentary recommendations in people with chronic low back pain (LBP). METHODS: This was a cross-sectional study including 171 people with chronic LBP. Trained assessors collected information regarding demographic, anthropometric, and clinical data. Physical activity levels and sedentary time were objectively measured using a tri-axial accelerometer. Participants were classified as being physically active (ie, performing at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week) and sedentary (ie, more than 8 hours of time spent in sedentary activities per day). Multivariable logistic regression analyses were used to determine the association of being physically active or sedentary with the range of demographic, anthropometric and clinical variables. RESULTS: Our results showed that although lower body mass index (odds ratio [OR] = 0.91; 95% CI: 0.85-0.98) and higher self-reported levels of leisure time physical activity (OR = 3.46; 95% CI: 1.94-6.15) were associated with being physically active, lower self-reported levels of physical activity at work (OR = 0.56; 95% CI: 0.39-0.81) was associated with being sedentary. CONCLUSION: Our findings showed that, in people with LBP, lower body mass index and higher levels of leisure time physical activity may be important factors for identifying those physically active. In contrast, lower levels of physical activity at work may be considered when identifying sedentary people with LBP. Future studies should consider these factors when designing interventions aiming to promote physical activity and decrease sedentary behavior in this population.

Co-occurrence of Chronic Musculoskeletal Pain and Cardiovascular Diseases: A Systematic Review with Meta-analysis.

OBJECTIVE: To determine the magnitude of the association between cardiovascular disease and chronic musculoskeletal pain. DESIGN: Systematic review with meta-analysis. METHODS: A comprehensive search was performed in five electronic databases. Population-based studies reporting the prevalence of cardiovascular diseases in adults stratified by chronic musculoskeletal pain status were considered eligible. Two independent reviewers performed the screening of the records following the inclusion criteria, extracted data, and evaluated the risk of bias of the included studies using an assessment tool of risk of bias for observational studies. In addition, we assessed the overall quality of evidence using an adaptation of the GRADE approach for prognosis. RESULTS: Twenty studies were included in this review. There was high-quality evidence that people with chronic musculoskeletal pain are 1.91 times more likely to report having a cardiovascular disease compared with those without chronic musculoskeletal pain (risk ratio = 1.91, 95% confidence interval = 1.64-2.21). CONCLUSIONS: Our findings demonstrated associations between chronic musculoskeletal pain and any cardiovascular diseases. Future studies are still warranted to better understand the association between chronic musculoskeletal pain and the specific types of cardiovascular diseases.

Effects of active video games on children and adolescents: A systematic review with meta-analysis.

OBJECTIVE: To investigate the effectiveness of active video games (AVGs) on obesity-related outcomes and physical activity levels in children and adolescents. DESIGN: Systematic review with meta-analysis. METHODS: Literature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity-related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models. RESULTS: Twelve studies were considered eligible for this review. Included studies mostly reported outcome data at short-term (less or equal than three months) and intermediate-term follow-up (more than 3 months, but <12 months). AVGs were more effective than no/minimal intervention in reducing BMI/zBMI at short-term (SMD = -0.34; 95% CI: -0.62 to -0.05) and intermediate-term follow-up (SMD = -0.36; 95% CI: -0.01 to -0.71). In addition, AVGs were more effective in reducing body weight compared with no/minimal intervention at intermediate-term follow-up (SMD = -0.25; 95% CI: -0.46 to -0.04). Regarding physical activity levels, AVGs were not more effective compared with minimal intervention at short-term and intermediate-term follow-up. CONCLUSIONS: Our review identified that AVGs were better than minimal intervention in reducing BMI and body weight, but not for increasing physical activity in young people.

Effect of interventions using physical activity trackers on physical activity in people aged 60 years and over: a systematic review and meta-analysis.

BACKGROUND: Older people are at high risk of physical inactivity. Activity trackers can facilitate physical activity. We aimed to investigate the effect of interventions using activity trackers on physical activity, mobility, quality of life and mental health among people aged 60+ years. METHODS: For this systematic review, we searched eight databases, including MEDLINE, Embase and CENTRAL from inception to April 2018. Randomised controlled trials of interventions that used activity trackers to promote physical activity among people aged 60+ years were included in the analyses. The study protocol was registered with PROSPERO, number CRD42017065250. RESULTS: We identified 23 eligible trials. Interventions using activity trackers had a moderate effect on physical activity (23 studies; standardised mean difference (SMD)=0.55; 95% CI 0.40 to 0.70; I2=86%) and increased steps/day by 1558 (95% CI 1099 to 2018 steps/day; I2=92%) compared with usual care, no intervention and wait-list control. Longer duration activity tracker-based interventions were more effective than short duration interventions (18 studies, SMD=0.70; 95% CI 0.47 to 0.93 vs 5 studies, SMD=0.14; 95% CI -0.26 to 0.54, p for comparison=0.02). Interventions that used activity trackers improved mobility (three studies; SMD=0.61; 95% CI 0.31 to 0.90; I2=10%), but not quality of life (nine studies; SMD=0.09; 95% CI -0.07 to 0.25; I2=45%). Only one trial included mental health outcomes and it reported similar effects of the activity tracker intervention compared with control. CONCLUSIONS: Interventions using activity trackers improve physical activity levels and mobility among older people compared with control. However, the impact of activity tracker interventions on quality of life, and mental health is unknown.

Taurine supplementation increases irisin levels after high intensity physical training in obese women.

BACKGROUND: Irisin is a myokine/adipokine that under stimulus of physical exercise is able to improve thermogenic capacity in adipose tissue. Likewise, taurine supplementation has demonstrated similar effects on energy metabolism. Therefore, we hypothesized that taurine supplementation combined with physical training may induce an increase in irisin concentrations, optimizing energy metabolism in obese individuals. OBJECTIVE: To evaluate if taurine supplementation associated with a high intensity physical training program increases irisin levels in obese women. METHODS: double-blind study with 22 obese women (BMI 32.4 ±â€¯2.0 kg/m2, 36.6 ±â€¯6.4 years and sedentary) who were randomly divided into two groups, control group (GC, n = 14), exercised and supplemented with placebo (3 g of starch), and taurine group (GTAU, n = 8), exercised and supplemented with taurine (3 g). The subjects performed high intensity physical training, Deep Water Running (DWR), for 8 weeks, 3 times/week, for 50 min per training session, at 70-85% maximum heart rate. Resting metabolic rate (RMR) was evaluated by indirect calorimetry, body composition by deuterium oxide, plasma taurine by HPLC, plasma irisin by Multiplex Kit, and food consumption by food records. The results were analyzed by an ANOVA two way repeated measures mixed model, with the Sidak post hoc (p < 0.05). RESULTS: No changes were observed in body composition. DWR increased RMR independent of supplementation (p < 0.001) and irisin levels (pg/mL) showed a significant difference only in the GTAU in 1 h after exercise (p < 0.001). CONCLUSION: DWR associated with taurine supplementation resulted in increased plasma irisin concentrations after physical training in obese adult women.

Association Between Clinical Tests Related to Motor Control Dysfunction and Changes in Pain and Disability After Lumbar Stabilization Exercises in Individuals With Chronic Low Back Pain.

OBJECTIVE: To investigate whether clinical tests used to detect motor control dysfunction can predict improvements in pain and disability in patients with chronic nonspecific low back pain (LBP) who have undergone an 8-week lumbar stabilization exercise program. STUDY DESIGN: A prospective cohort study. SETTING: Outpatient physical therapy university clinic. PARTICIPANTS: Seventy people with chronic nonspecific LBP were recruited, and 64 completed the exercise program (N=64). INTERVENTIONS: The lumbar stabilization program was provided twice a week for 8 weeks. MAIN OUTCOME MEASURES: Pain intensity (11-point numerical rating scale) and disability (Roland Morris Disability Questionnaire) and clinical tests, such as the Deep Muscle Contraction (DMC) scale, Clinical Test of Thoracolumbar Dissociation (CTTD), and Passive Lumbar Extension (PLE) test. Univariate and multivariate linear regression models were used in the prediction analysis. RESULTS: Mean changes in pain intensity and disability following the 8-week stabilization program were -3.8 (95% confidence interval [CI], -3.2 to -4.4) and -7.4 (95% CI, -6.3 to -8.5), respectively. Clinical test scores taken at baseline did not predict changes in pain and disability at 8-week follow-up. CONCLUSION: Our findings revealed that the DMC scale, CTTD, PLE test, clinical tests used to assess motor control dysfunction, do not predict improvements in pain and disability in patients with chronic nonspecific LBP following an 8-week lumbar stabilization exercise program.

Physical training, UCP1 expression, mitochondrial density, and coupling in adipose tissue from women with obesity.

BACKGROUND: Exercise training may improve energy expenditure, thermogenesis, and oxidative capacities. Therefore, we hypothesized that physical training enhances white adipose tissue mitochondrial oxidative capacity from obese women. OBJECTIVE: To evaluate mitochondrial respiratory capacity, mitochondrial content, and UCP1 gene expression in white adipose tissue from women with obesity before and after the physical training program. METHODS: Women (n = 14, BMI 33 ± 3 kg/m2 , 35 ± 6 years, mean ± SD) were submitted to strength and aerobic exercises (75%-90% maximum heart rate and multiple repetitions), 3 times/week during 8 weeks. All evaluated subjects were paired, before and after training for resting metabolic rate (RMR), substrate oxidation (lipid and carbohydrate) by indirect calorimeter, deuterium oxide body composition, and aerobic maximum velocity (Vmax ) test. At the beginning and at the ending of the protocol, abdominal subcutaneous adipose tissue was collected to measure the mitochondrial respiration by high-resolution respirometry, mitochondrial content by citrate synthase (CS) activity, and UCP1 gene expression by RT-qPCR. RESULTS: Combined physical training increased RMR, lipid oxidation, and Vmax but did not change body weight/composition. In WAT, exercise increased CS activity, decreased mitochondrial uncoupled respiration and mRNA of UCP1. RMR was positively correlated with fat-free mass. CONCLUSION: Physical training promotes an increase in mitochondrial content without changing tissue respiratory capacity, a reduction in mitochondrial uncoupling degree and UCP1 mRNA expression in WAT. Finally, it improved the resting metabolic rate, lipid oxidation and physical performance, independent of the body changing free, or fat mass in obese women.

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-Based Interventions Using Electronic Feedback May Be Ineffective in Reducing Pain and Disability in Patients With Chronic Musculoskeletal Pain: A Systematic Review With Meta-Analysis.

OBJECTIVE: To investigate the effectiveness of physical activity-based interventions using electronic feedback in reducing pain and disability compared to minimal or no interventions in patients with chronic musculoskeletal pain. DATA SOURCES: The following electronic databases were searched: EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Web of Science, Physiotherapy Evidence Database, and main clinical trial registers. STUDY SELECTION: Randomized controlled trials investigating the effect of physical activity interventions using electronic feedback (eg, physical activity monitors) on pain and disability compared to minimal or no interventions in adults with chronic musculoskeletal pain were considered eligible. DATA EXTRACTION: Pooled effects were calculated using the standardized mean difference (SMD), and the Grading of Recommendations Assessment, Development and Evaluation system was used to assess the overall quality of the evidence. DATA SYNTHESIS: Four published randomized controlled trials and 4 registered unpublished randomized controlled trials were included. At short-term follow-up, pooled estimations showed no significant differences in pain (2 trials: n=116; SMD=-.50; 95% confidence interval, -1.91 to 0.91) and disability (2 trials: n=116; SMD=-.81; 95% confidence interval, -2.34 to 0.73) between physical activity-based interventions and minimal interventions. Similarly, nonsignificant results were found at intermediate-term follow-up. According to Grading of Recommendations Assessment, Development and Evaluation, the overall quality of the evidence was considered to be of low quality. CONCLUSIONS: Our findings suggest that physical activity-based interventions using electronic feedback may be ineffective in reducing pain and disability compared to minimal interventions in patients with chronic musculoskeletal pain. Clinicians should be cautious when implementing this intervention in patients with chronic musculoskeletal pain.

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.

Fear of Movement Is Not Associated With Objective and Subjective Physical Activity Levels in Chronic Nonspecific Low Back Pain.

OBJECTIVES: To assess the association of physical activity measures, derived with an accelerometer and a self-reported questionnaire, with fear of movement in patients with chronic nonspecific low back pain (LBP) and to investigate the association between disability and fear of movement in this population. DESIGN: Cross-sectional study. SETTING: Outpatient physical therapy university clinics. PARTICIPANTS: Patients (N=119) presenting with nonspecific LBP of >3 months' duration. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physical activity levels measured objectively with an accelerometer (ie, counts per minute, time spent in moderate-to-vigorous and light physical activity per day, number of steps per day, and number of 10-minute bouts of moderate-to-vigorous physical activity per day) and subjectively with a self-reported questionnaire (Baecke Physical Activity Questionnaire); fear of movement (Tampa Scale of Kinesiophobia); pain (11-point numerical rating scale); disability (Roland Morris Disability Questionnaire); and depression (Beck Depression Inventory). The associations were examined with correlational, univariate, and multivariable linear regression analyses. RESULTS: None of the objective physical activity measures were associated with fear of movement. The apparent association of self-reported physical activity levels with fear of movement (correlational analyses: r=-.18; P<.05; univariate regression analyses: ß=-.04; 95% confidence interval [CI], -.07 to -.01; P=.04) was not confirmed in multivariable analyses. Fear of movement was consistently associated with disability in both correlational (r=.42; P<.01) and multivariable (ß=.21; 95% CI, .11-.31; P<.001) analyses. CONCLUSIONS: Our data support one aspect of the fear-avoidance model-that higher fear of movement is associated with more disability-but not the aspect of the model linking fear of movement with inactivity.