Abstract
BackgroundActivity advice and prescription are commonly used in the management of low back pain (LBP). Although there is evidence for advising patients with LBP to remain active, facilitating both recovery and return to work, to date no research has assessed whether objective measurements of free living physical activity (PA) can predict outcome, recovery and course of LBP.MethodsAn observational longitudinal study will investigate PA levels in a cohort of community-dwelling working age adults with acute and sub-acute LBP. Each participant's PA level, functional status, mood, fear avoidance behaviours, and levels of pain, psychological distress and occupational activity will be measured on three occasions during for 1 week periods at baseline, 3 months, and 1 year. Physical activity levels will be measured by self report, RT3 triaxial accelerometer, and activity recall questionnaires. The primary outcome measure of functional recovery will be the Roland Morris Disability Questionnaire (RMDQ). Free living PA levels and changes in functional status will be quantified in order to look at predictive relationships between levels and changes in free living PA and functional recovery in a LBP population.DiscussionThis research will investigate levels and changes in activity levels of an acute LBP cohort and the predictive relationship to LBP recovery. The results will assess whether occupational, psychological and behavioural factors affect the relationship between free living PA and LBP recovery. Results from this research will help to determine the strength of evidence supporting international guidelines that recommend restoration of normal activity in managing LBP.Trial registration[Clinical Trial Registration Number, ACTRN12609000282280]
Highlights
Activity advice and prescription are commonly used in the management of low back pain (LBP)
One study found that regular exercise outside of work tended to protect against recurrence of work-related LBP [19], and another that leisure time physical activity (PA) levels were predictive of return to work in patients who had undergone a light mobilization program after initial LBP sick leave [17]
This research will investigate whether relationships exist between objectively measured PA and functional recovery in a LBP population
Summary
Whether the participant is working or off-work due to the current LBP episode, the number of days of the week and total average hours that each participant works, and whether the participant considers their work to be either manual or sedentary This occupational information will be used to provide a baseline descriptive account of the group, and included as a potential http://www.biomedcentral.com/1471-2474/10/136 confounder in the relationship between PA and functional recovery. Adjusted analyses will include the following variables, shown to be putatively associated with both PA and functional recovery in LBP: age, gender, occupation, baseline pain level (pain questionnaire), functional status (baseline RMDQ) and baseline measurements of depression, anxiety, emotional distress and fear avoidance (GHQ12 and FABQ). At 1 year the relationship between the BPAQ change score from baseline (pre-LBP) to BPAQ score at 1 year ('BPAQ) with the outcome of on-going LBP (Y/N) will be explored using logistic regression
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