Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis
Chung-Wei Christine Lin1, James H McAuley, Luciana Macedo
1The George Institute for Global Health and Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Neuroscience Research Australia and the University of New South Wales, New South Wales, Australia Common Spinal Disorders Research Group, Faculty of Rehabilitation Medicine, University of Alberta, Alta, Edmonton, Canada The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia Adelante Center of Expertise in Rehabilitation and Audiology, and Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Abstract:
It is often assumed that patients with pain-related disability due to low back pain (LBP) will have reduced physical activity levels, but recent studies have provided results that challenge this assumption. The aim of our systematic review was to examine the relationship between physical activity and disability in LBP. The literature search included 6 electronic databases and the reference list of relevant systematic reviews and studies to May 2010. To be included, studies had to measure both disability (eg, with the Roland Morris Disability Questionnaire) and physical activity (eg, by accelerometry) in patients with non-specific LBP. Two independent reviewers screened search results and extracted data, and authors were contacted for additional data. Correlation coefficients were pooled using the random-effects model. The search identified 3213 records and 18 studies were eligible for inclusion. The pooled results showed a weak relationship between physical activity and disability in acute or subacute (<3months) LBP (r=-0.08, 95% confidence interval=-0.17 to 0.002), and a moderate and negative relationship in chronic (>3months) LBP (r=-0.33, 95% confidence interval=-0.51 to -0.15). That is, persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability. Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity. Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability. Persons with chronic back pain with high levels of disability will likely have low levels of physical activity.