Abstract
BACKGROUND
Low back pain (LBP) is one of the world's most prevalent health issues. Patients with
LBP experience various intensities and durations of symptoms, which can lead to distinctive
course patterns commonly described as symptom trajectories.
PURPOSE
This study aimed to investigate the association between different amounts of physical
activity and sedentary behavior and the trajectory of LBP, in people with a lifetime
history of LBP.
STUDY DESIGN
The study involved a secondary analysis of observational longitudinal data collected
from the AUstralian Twin low BACK pain (AUTBACK) study.
METHODS
A total of 329 individual twins met the inclusion criteria for analysis. Latent Class
Growth Analysis was used to identify distinct patterns of LBP and select the primary
outcome (probability of having a severe LBP trajectory, 0%–100%). Linear regression
models were used to investigate the association between different amounts of physical
activity or sedentary behavior at baseline, and the probability of having a severe
LBP trajectory. Results were expressed as β coefficients and 95% confidence intervals
(CI).
RESULTS
Moderate-to-vigorous intensity physical activity was significantly associated with
the probability of having a severe LBP trajectory (unadjusted β -0.0276; 95%CI -0.0456 to -0.0097, p=.003). For every 1-minute increase in moderate-to-vigorous
intensity physical activity per week, there was a 2.8%-point reduction in a participant's
probability of having a severe LBP trajectory. No significant associations were identified between sedentary behavior or light intensity
physical activity, and the probability of having a severe LBP trajectory.
CONCLUSIONS
In people with a lifetime history of LBP, engagement in higher volumes of moderate
to vigorous intensity physical activity at baseline was associated with a lower probability
of developing a severe trajectory of LBP over 1 year.
Keywords
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References
- A systematic review of the global prevalence of low back pain.Arthritis Rheum. 2012; 64: 2028-2037
- Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017.Ann Transl Med. 2020; 8: 299
- The trend in total cost of back pain in The Netherlands in the period 2002 to 2007.Spine (Phila Pa 1976). 2011; 36: 1050-1058
- The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients.Eur Spine J. 2005; 14: 337-345
- Healthcare costs due to low back pain in the emergency department and inpatient setting in Sydney, Australia.Lancet Reg Health West Pac. 2021; 7100089
National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. 2020; Available at: https://www.nice.org.uk/guidance/NG59/chapter/Recommendations#non-invasive-treatments-for-low-back-pain-and-sciatica.
- The association between physical activity and low back pain: a systematic review and meta-analysis of observational studies.Sci Rep. 2019; 9: 8244
- Physical activity and low back pain: a U-shaped relation?.Pain. 2009; 143: 21-25
- Sedentary lifestyle and nonspecific low back pain in medical personnel in north-east Poland.Biomed Res Int. 2018; 20181965807
- The disabling role of fluctuations in physical activity in patients with chronic low back pain.Eur J Pain. 2009; 13: 1076-1079
- Trajectories of low back pain.Best Pract Res Clin Rheumatol. 2013; 27: 601-612
- Characterizing the course of low back pain: a latent class analysis.Am J Epidemiol. 2006; 163: 754-761
- Patients with low back pain had distinct clinical course patterns that were typically neither complete recovery nor constant pain. A latent class analysis of longitudinal data.Spine J. 2015; 15: 885-894
- The course of chronic and recurrent low back pain in the general population.Pain. 2010; 150: 451-457
- Trajectories of acute low back pain: a latent class growth analysis.Pain. 2016; 157: 225-234
- Cohort profile: the AUstralian Twin BACK pain and physical activity study (AUTBACK study).BMJ Open. 2020; 10e036301
- Protective and harmful effects of physical activity for low back pain: a protocol for the AUstralian Twin BACK Pain (AUTBACK) feasibility study.Twin Res Hum Genet. 2016; 19: 502-509
- Australian Twin Registry: a nationally funded resource for medical and scientific research, incorporating match and WATCH.Twin Res Hum Genet. 2006; 9: 707-711
- Validation of automatic wear-time detection algorithms in a free-living setting of wrist-worn and hip-worn ActiGraph GT3X+.BMC Public Health. 2019; 19: 244
- Defining trajectories in older adults with back pain presenting in general practice.Age Ageing. 2016; 45: 878-883
- Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill Pain Questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP).Arthritis Care Res (Hoboken). 2011; 63: S240-S252
- Validity of four pain intensity rating scales.PAIN®. 2011; 152: 2399-2404
- A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain.Spine (Phila Pa 1976). 1983; 8: 141-144
- The Roland-Morris disability questionnaire and the Oswestry disability questionnaire.Spine (Phila Pa 1976. 2000; 25: 3115-3124
- Responsiveness of the 24-, 18- and 11-item versions of the Roland Morris disability questionnaire.Eur Spine J. 2011; 20: 458-463
- The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research.Psychiatry Res. 1989; 28: 193-213
- An introduction to latent class growth analysis and growth mixture modeling.Soc Personal Psychol Compass. 2008; 2: 302-317
- Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study.Struct Equ Modeling. 2007; 14: 535-569
- Latent class and latent transition analysis: with applications in the social, behavioral, and health sciences. 718. John Wiley & Sons, 2009
- Group-based modeling of development.Harvard University Press, 2009
- Evaluating latent class analysis models in qualitative phenotype identification.Comput Stat Data Anal. 2006; 50: 1090-1104
- World Health Organization 2020 guidelines on physical activity and sedentary behaviour.Br J Sports Med. 2020; 54: 1451-1462
- Association between chronic low back pain and regular exercise, sedentary behaviour and mental health before and during COVID-19 pandemic: insights from a large-scale cross-sectional study in Germany.BMC Musculoskelet Disord. 2022; 23: 860
- Association between sedentary behavior and low back pain; a systematic review and meta-analysis.Health Promot Perspect. 2021; 11: 393-410
- Characterizing the course of low back pain: a latent class analysis.Am J Epidemiol. 2006; 163: 754-761
- Trajectories of pain in adolescents: a prospective cohort study.Pain. 2011; 152: 66-73
- Using few and scattered time points for analysis of a variable course of pain can be misleading: an example using weekly text message data.Spine J. 2014; 14: 1454-1459
- Objective vs. self-reported physical activity and sedentary time: effects of measurement method on relationships with risk biomarkers.PLoS One. 2012; 7: e36345
- Influencing factors on the overestimation of self-reported physical activity: a cross-sectional analysis of low back pain patients and healthy controls.BioMed Res Int. 2016; 20161497213
- Is self-reported time spent sedentary and in physical activity differentially biased by age, gender, body mass index, and low-back pain?.Scand J Work Environ Health. 2018; 44: 163-170
Article info
Publication history
Published online: March 20, 2023
Accepted:
March 13,
2023
Received in revised form:
March 11,
2023
Received:
December 23,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: MH: Nothing to disclose. EH: Nothing to disclose. AK: Nothing to disclose. TP: Nothing to disclose. PF: Nothing to disclose.
Identification
Copyright
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