Abstract
BackgroundNeck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs).MethodsAnalyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location.ResultsParticipants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49).ConclusionsPersons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain.Trial registrationRegistration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776
Highlights
Neck and back pain are musculoskeletal conditions with serious individual and societal consequences
Several modifiable and non-modifiable factors may play a role for the prognosis of Neck- and back pain (NBP), summarized evidence is limited in systematic reviews [6, 7]
This study suggests that persons with NBP who have received manual therapy or general evidence-based care have a greater chance of minimal clinically important improvement of pain intensity (MCII) if they prior to treatment frequently practice leisure-time physical activity (LPA) on a vigorous level
Summary
Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/ or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs). Neck- and back pain (NBP) are the most common musculoskeletal conditions worldwide and dominant causes of years lived with disability in high- and middle-income. Physical activity may have multiple physiological effects on pain and could be of prognostic value in NBP recovery [8, 9]. In a cross-sectional study by Hansen et al, leisuretime physical activity (LPA) among workers was associated with higher saliva cortisol levels and self-perceived energy [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
