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Abstract
BackgroundAdvice to remain active and normalisation of activity are commonly prescribed in the management of low back pain (LBP). However, no research has assessed whether objective measurements of physical activity predict outcome and recovery in acute low back pain.MethodThe aims of this study were to assess the predictive relationship between activity and disability at 3 months in a sub-acute LBP population. This prospective cohort study recruited 101 consenting patients with sub-acute LBP (< 6 weeks) who completed the Roland Morris Disability Questionnaire (RMDQ), the Visual Analogue Scale, and resumption of full ‘normal’ activity question (Y/N), at baseline and 3 months. Physical activity was measured for 7 days at both baseline and at 3 months with an RT3 accelerometer and a recall questionnaire.ResultsObserved and self-reported measures of physical activity at baseline and change in activity from baseline to 3 months were not independent predictors of RMDQ (p > 0.05) or RMDQ change (p > 0.05) over 3 months. A self-report of a return to full ‘normal’ activities was significantly associated with greater RMDQ change score at 3 months (p < 0.001). Paired t-tests found no significant change in activity levels measured with the RT3 (p = 0.57) or the recall questionnaire (p = 0.38) from baseline to 3 months.ConclusionsThese results question the predictive role of physical activity in LBP recovery, and the assumption that activity levels change as LBP symptoms resolve. The importance of a patient’s perception of activity limitation in recovery from acute LBP was also highlighted.Trial registrationClinical Trial Registration Number, ACTRN12609000282280
Highlights
Advice to remain active and normalisation of activity are commonly prescribed in the management of low back pain (LBP)
Paired t-tests found no significant change in activity levels measured with the RT3 (p = 0.57) or the recall questionnaire (p = 0.38) from baseline to 3 months
These results question the predictive role of physical activity in LBP recovery, and the assumption that activity levels change as LBP symptoms resolve
Summary
Advice to remain active and normalisation of activity are commonly prescribed in the management of low back pain (LBP). No research has assessed whether objective measurements of physical activity predict outcome and recovery in acute low back pain. Few studies have objectively measured PA in a prospective, longitudinal design to assess the influence of type and level of physical activity on long-term outcomes in this population. Investigation using an RT3 accelerometer to measure activity found no relationship between activity change and disability at the 1-year point in a sub-acute LBP population [10]. A number of studies have prospectively assessed the relationship of activity to recovery in LBP populations employing questionnaire-based activity recall instruments. Other studies have found no relationship between levels and types of activity in various LBP cohorts and measures of LBP disability, pain [12,13] or return to work [14]
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