Should physical activity recommendation depend on state of low back pain?

The association of physical activity and sedentary behaviour with low back pain disability trajectories: A prospective cohort study

BACKGROUND

Multiple factors influence the recovery process of low back pain (LBP). The identification and increased knowledge of risk factors might contribute to a better understanding of the course of LBP.

OBJECTIVES

To investigate the association of habitual physical activity (PA) and sedentary behaviour (SB), measured at baseline, with disability trajectories in adults with LBP.

METHODS

A prospective cohort study where habitual PA levels were measured using the Short QUestionnaire to ASsess Health enhancing physical activity (SQUASH), SB was calculated as average sedentary hours per day, and LBP disability using the Oswestry Disability Index (ODI). Participants completed the questionnaires at one and a half, three, six, and twelve months. Linear mixed models were estimated to describe the association of habitual PA levels SB measured at baseline with disability trajectories. Other predictors were gender, education level, age, pain, number of previous episodes of LBP, and duration of LBP.

RESULTS

Habitual SB measured at baseline in adults (n = 347) with LBP were not associated with disability trajectories. For PA, participants with one metabolic equivalent of task (MET) hour per day above average recovered 0.04 [95% CI 0.004 to 0.076] points on the ODI per month faster than participants with an average amount of MET hours per day.

CONCLUSIONS

Habitual SB was not associated with LBP disability trajectories over a one-year follow-up. High levels of habitual PA at baseline were associated with improved recovery in LBP disability trajectory, but the finding is not clinically relevant.

High Intensity Training to Treat Chronic Nonspecific Low Back Pain: Effectiveness of Various Exercise Modes

High-intensity training (HIT) improves rehabilitation outcomes such as functional disability and physical performance in several chronic disorders. Promising results were also found in chronic nonspecific low back pain (CNSLBP). However, the impact of different exercise modes on HIT effectiveness in CNSLBP remains unclear. Therefore, this study evaluated the effectiveness of various HIT exercise modes and compared differences between these modes, on pain intensity, disability, and physical performance, as a therapeutic intervention for persons with CNSLBP. In a randomized comparative trial, consisting of a 12-week program, persons with CNSLBP were divided into four HIT groups, i.e., cardiorespiratory interval training coupled with either general resistance training, core strength training, combined general resistance and core strength training, or mobility exercises. Before and after the program, the Numeric Pain Rating Scale (NPRS), Modified Oswestry Disability Index (MODI), and Patient Specific Functioning Scale (PSFS) were recorded, and a cardiopulmonary exercise test (VO₂max, cycling time) and isometric trunk strength test (maximum muscle torque) were performed. Eighty participants (mean age: 44.0 y, 34 males) were included. Improvements were found within all groups after the HIT programs and ranged from −39 to −57% on the NPRS, +27 to +64% on the MODI, +38 to +89% on the PSFS, +7 to +14% on VO₂max, and +11 to +18% on cycling time. No differences between groups were found. High-intensity cardiorespiratory interval training improves CNSLBP rehabilitation outcomes when performed with other HIT exercise modes or mobility exercises. Hence, when setting up an exercise therapy program in CNSLBP rehabilitation, various HIT modes can be considered as therapy modalities.

Lower back pain at workplace: prevalence and risk factors

Objective — analysis of lower back pain (LBP) prevalence and risk factors for its development in employees with different conditions at their workplace, depending on their age, length of service, occupational factors, and physical activity. Material and Methods — As a result of a simultaneous cross-sectional study, 3300 employees with different conditions at their workplace were examined. To study the relationships between LBP prevalence and risk factors, we used the results of employees’ survey and physical examination, along with the data on their physical activity and working conditions. Results — The workplace posture was the most common production-related risk factor for developing LBP. The second most common risk factor was the weight of the load being lifted and carried, followed by general vibration at a workplace. The least significant factor was a bending motion. According to our data, LBP prevalence in all observation groups was increasing with both age and length of employment. Over 50% of those working in hazardous conditions at the age of 50 yo and higher had LBP. Low physical activity at a workplace led to a statistically significant increase in the chances of LBP emergence. Conclusion — In employees without exposure to harmful risk factors in the form of physical exertion and general vibration, the prevalence of LBP was significantly lower than in workers in harmful working conditions. The combined effect of static and dynamic physical activities at a workplace had a more pronounced negative impact on workers’ health. Low physical activity was a significant risk factor for LBP development.

Leisure-time physical activity and absenteeism

Regular physical activity has a significant impact on health. There is scientific evidence for prescription of exercise in the treatment of at least 26 different chronic non-communicable diseases. Furthermore, it has an indirect role in the preservation of work capacity. The aim of this study was to review the published results of research on the relationship between leisure-time PA and absenteeism due to sickness. Medline database was searched using the keywords "leisuretime physical activity AND (sick leave OR sickness absence OR absenteeism)". Fifteen studies were included in the final analysis. A negative correlation between leisure-time PA and absenteeism due to sickness in working population was determined in 11 studies. The results support the inclusion of PA promotion in the programmes intended to reduce absenteeism prevalence, the latter being an important public health issue.