Physical performance, pain, pain behavior and subjective disability in patients with subacute low back pain. Low Back Pain in a General Population. Natural Course and Influence of Physical Exercise–A 5-Year Follow-up of the Musculoskeletal Intervention Center-Norrtälje Study Does a patient’s physical activity predict recovery from an episode of acute low back pain? A prospective cohort study A comparison of high intensity aerobic exercise and passive modalities for the treatment of workers with chronic low back pain: a randomized, controlled trial. The Role of Physical Fitness as Risk Indicator of Increased Low Back Pain Intensity Among People Working With Physically and Mentally Disabled Persons: A 30-Month Prospective Study Does physical activity change predict functional recovery in low back pain? Protocol for a prospective cohort study Health locus of control beliefs and psychological distress as predictors for treatment outcome in low-back pain patients: results of a 3-month follow-up of a controlled intervention study The Predictive Relationship of Physical Activity on the Incidence of Low Back Pain in an Occupational Cohort Physical and Mental Function and Incident Low Back Pain in Seniors: A Population-Based Two-Year Prospective Study of 1387 Danish Twins Aged 70 to 100 Years It's time for change with the management of non-specific chronic low back pain One-year prognosis in sick-listed low back pain patients with and without radiculopathy. Prognostic factors influencing pain and disability. A controlled study on the outcome of inpatient and outpatient treatment of low back pain. Part III. Long-term follow-up of pain, disability, and compliance. Are prognostic indicators for poor outcome different for acute and chronic low back pain consulters in primary care? The Therapeutic Alliance Between Clinicians and Patients Predicts Outcome in Chronic Low Back Pain Low back pain and limitations of daily living in Asia: longitudinal findings in the Thai cohort study Fear of Movement/(Re)Injury Predicting Chronic Disabling Low Back Pain: A Prospective Inception Cohort Study Low back pain incident episodes: a community-based study.
The aim of this paper was to study the physical performance , pain , pain behavior and disability in patients with subacute low back pain ( LBP ) . The patients were blue-collar workers and had been sick-listed for 8 weeks due to subacute low back pain . A total of 103 patients were r and omized , 51 of them to the intervention group and the other to a control group .  Recordings of physical performance and complaints of LBP were done before and after treatment in the intervention group . The proportion of patients with no complaints of LBP was significantly greater in the intervention group than in the control group at the one-year follow-up . The patients who intra-individually improved their physical performance also intra-individually decreased their complaints of LBP . The intra-individual improvements were suggested to be important for the individual return to work Study Design . A 5-year prospect i ve cohort study was conducted of men and women seeking care for a new period of low back pain ( LBP ) . Objectives . To study the natural course of pain and disability due to LBP during a 5-year follow-up period , and to investigate the possible influence of regular physical exercise on recovery . Summary of Background Data . LBP is major health problem , but its natural course is not very well studied . Several studies have investigated the role of physical exercise on LBP disorders , with inconsistent results . Methods . At baseline , a total of 790 subjects seeking care for LBP were interviewed about physical exercise during leisure time . Over 5 years , 3 follow-up assessment s were made by postal question naire . At all measuring points , pain intensity ratings and disability scores were compared between men and women , and among 3 exercise categories . Results . The pain intensity and disability scores were improved after 5 years for both men and women . The most prominent improvements occurred after 6 months , but less so thereafter . There were no significant differences between men and women with regard to individual changes at the 5-year follow-up concerning the pain intensity or disability scores . There were no significant differences , either for women or men , between low , median , or high intensity exercise groups regarding pain intensity or disability values for the individual change at the 5-year follow-up . Conclusions . Over a 5-year period , both men and women who had sought care for LBP reported a decrease in pain and disability ; however , only a few were fully restored . In this study , we found no effect of nonspecific physical exercise on recovery from LBP in men and women Background Advice 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 . Method The aims of this study were to assess the predictive relationship between activity and disability at 3 months in a sub-acute LBP population . This prospect i ve cohort study recruited 101 consenting patients with sub-acute LBP ( < 6 weeks ) who completed the Rol and Morris Disability Question naire ( 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 question naire . Results Observed 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 question naire ( p = 0.38 ) from baseline to 3 months . Conclusions These 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 registration Clinical Trial Registration Number , BACKGROUND In recent years , disability due to chronic low back pain ( LBP ) has steadily increased in all industrialized countries . In the treatment of chronic LBP , the objectives are to reduce pain , to improve function and minimize avoiding behavior .  Exercise therapy is a management strategy that is widely used as a treatment for LBP . AIM The aim of this study was to investigate the effects of high- intensity aerobic exercise on pain , disability , anxiety or depression in people with chronic LBP . DESIGN This was a r and omized controlled trial SETTING Institute of Occupational Medicine , Department of Physical Medicine and Rehabilitation - Outpatient Ward POPULATION Kosovo power plant workers . METHODS Participants with chronic low back pain , excluding those with " red flag " criteria were assigned r and omly to one of the two treatment groups : an aerobic exercise group ( N.=50 ) , and an passive modalities group ( N.=51 ) . Data on low back pain intensity ( visual analogue scale ) , disability ( Oswestry Low Back Pain Disability Question naire ) , fingertip-to-floor distance , and psychosocial factors ( Hospital Anxiety and Depression Scale ) were collected at baseline and after 12-weeks follow-up points . RESULTS At 12-week follow-up , significant improvements in pain intensity and disability had occurred in the exercise group . We have verified significant improvements in comparison with basic values in pain intensity ( 6 ± 2.6 vs. 2 ± 1.7 , diff . of mean=3.9 , P < 0.001 ) , disability ( 31 ± 17.4 vs. 15.8 ± 12.7 , diff . of mean=15.2 , P<0.001 ) , anxiety and depression ( 21.1 ± 8.2 vs. 14 ± 6.7 , diff . of mean=7.1 , P < 0.001 ) , and fingertip- to-floor distance ( 27.8 ± -9.1 vs. 14.2 ± -5.7 , P<0.001 ) . Whereas , differences in average pain , disability , anxiety and depression and fingertip-to-floor distance are not significant in the control group . CONCLUSION High intensity aerobic exercise  reduces pain , disability and psychological strain in patients with chronic low back pain . CLINICAL REHABILITATION IMPACT This research is important for the fact that High Intensity Aerobic Exercise Programs are not so exploited in the current available literature for the treatment of LBP . Therefore , this is another modest contribution which can reinforce the need for more frequent use of High Intensity Aerobic Exercise Programs in the treatment of LBP Study Design . A prospect i ve cohort study . Objective . To study if low level of physical fitness was associated with increased  low back pain ( LBP ) intensity at 30-month follow-up . Summary of Background Data . The evidence of low physical fitness as a risk factor for LBP is inconclusive due to contradictory results . Methods . Study participants were 327 employees ( women = 271 , men = 56 ) at institutions for physically and mentally disabled persons . Physical fitness was measured by tests of : back extension and flexion endurance , flexibility and balance ; and by self-assessed aerobic fitness , muscle strength , endurance , flexibility and balance , using visual analogue scales .  Low back pain , lifestyle parameters , and physical and psychosocial work factors were assessed by question naires at baseline and at follow-up . Outcome was defined as an increase above 2 steps in average LBP intensity during the previous year ( 0–10 ) . Results . Persons with low level back endurance showed an insignificantly higher risk of increased LBP intensity ( OR = 2.4 , P = 0.076 ) , whereas persons with medium level back endurance were at significantly higher risk ( OR = 2.7 , P = 0.034 ) compared with those with high level back endurance . The general association between isometric back extension endurance and increased LBP intensity was insignificant ( P = 0.067 ) . Persons with medium level self-assessed aerobic fitness were at lower risk of increased LBP intensity compared with those with high level ( OR = 0.37 , P = 0.02 ) , although the general association of aerobic fitness was insignificant ( 0.066 ) . Performance-based back flexion endurance , flexibility , and balance ; and self-assessed muscle strength , endurance , flexibility , and balance were not associated with increased LBP intensity . Conclusion . The significant association between medium level back extension endurance and increased LBP intensity supports the finding of other studies that particularly back extension endurance is an important physicalfitness component in preventing LBP and that the subcomponents of physical fitness are related in different ways to LBP Background Activity 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 . Methods An 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 question naires . The primary outcome measure of functional recovery will be the Rol and Morris Disability Question naire ( 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 . Discussion This 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 & NA ; Association of health locus of control beliefs ( HLC ) and psychological distress ( GHQ‐12 ) with short‐term outcome of low‐back pain ( LBP ) rehabilitation was studied in patients with chronic or recurrent LBP ( n = 459 ; aged 35–54 years ; 63 % men ) . These patients were r and omly assigned to 3 study groups , namely the inpatient , the outpatient and the control group . The results showed a significant decrease in disability due to LBP in the 2 treated groups ; in addition , the accomplishment and frequency of back exercises was significantly better in the treated groups . HLC beliefs were associated with a successful outcome ; those patients with stronger internal beliefs had gained more from the treatment , had learned their exercises better and had done the exercises more frequently during the follow‐up period . Symptoms of psychological distress were significantly associated with poorer accomplishment of back exercises Objective : Quantify the relationship between physical activity and development of  incident low back pain ( LBP ) .  Methods : This nested prospect i ve cohort study utilized an objective measure of physical activity in 68 participants with 30 incident cases of LBP .  Physical activity was divided into tertiles and quartiles . Univariate and multivariate relative risks and hazard ratios were calculated . Results : Comparing highest to middle tertile of light activity demonstrated a statistically significant relative risk of 3.68 for developing incident LBP . Lowest and highest tertile of minutes of moderate/vigorous activity yielded statistically significant relative risks of 4.60 and 6.14 , respectively . Multivariate analyses demonstrated similar associations . Conclusions : Moderate amounts of physical activity were protective for the development of LBP  in this cohort , after adjustment for risk factors . This nonlinear relationship suggests higher levels of activity do not confer increased LBP prevention Study Design . Prospect i ve cohort study . Objectives . To investigate whether physical performance , grip strength , cognitive function , and depression symptomatology are risk factors for incident low back pain ( LBP ) over a 2-year period in seniors . Summary of Background Data . LBP is common in the older age groups , but little is known about predictors of LBP in this age group . Methods . Data from the 2001 and 2003 data collection from the population -based Longitudinal Study of Aging Danish Twins formed the basis of this analysis . Participants free from LBP at baseline ( no LBP during the past month , N = 1387 ) were included and interview data on overall physical function , and assessment of grip strength , overall cognitive function , and depression at baseline were obtained . LBP status at follow-up was assessed using a modified version of the St and ardized Nordic Question naire . Logistic regression was used to assess the associations between the baseline risk factors and LBP at follow-up . Results . A total of 1387 persons 70 to 100 years of age at baseline were included in the analyses . Of the initially LBP-free individuals , 7 % had experienced LBP more than 30 days out of the past year , 7 % had altered or decreased their physical activities due to LBP , and 11 % had received treatment for LBP at follow-up . Good overall physical function ( being among the top 50 % ) at baseline was protective for LBP of more than 30 days duration and for diminishing physical activities due to LBP and for care seeking due to LBP . High depression scores ( being among the top 25 % ) were strongly associated with altering or decreasing daily activities because of LBP . Grip strength and overall cognitive performance at baseline were associated with lower incidence of LBP and decreasing activities due to LBP at follow-up ; however , these associations were not statistically significant . Conclusion . Poor overall physical function and depression symptomatology are associated with LBP and consequences of LBP in persons 70 years of age and older Low back pain ( LBP ) is the second greatest cause of disability in the USA.1 USA data supports that in spite of an enormous increase in the health re sources spent on LBP disorders , the disability relating to them continues to increase.2 The management of LBP is underpinned by the exponential increase in the use of physical therapies , opiod medications , spinal injections as well as disc replacement and fusion surgery.2 This is maintained by the underlying belief that LBP is fundamentally a patho-anatomical disorder and should be treated within a biomedical model.1 This is in spite of calls over a number of years to adopt a bio-psycho-social approach , and evidence that only 8–15 % of patients with LBP have an identified patho-anatomical diagnosis , result ing in the majority being diagnosed as having non-specific LBP.3 Of this population , a small but significant group becomes chronic and disabled , labelled non-specific chronic low back pain ( NSCLBP ) , consuming a disproportionate amount of healthcare re sources .4 1 . Over the past decade , the traditional biomedical view of LBP has been greatly challenged . This is a result of : the failure of simplistic single-dimensional therapies to show large effects in patients with NSCLBP5–8 ; 2 . the results of clinical trials testing commonly prescribed interventions demonstrating that no management approaches are clearly superior5–7 9 ; 3 . the stories of NSCLBP patients relating their own ongoing pain experiences of multiple failed treatments , conflicting diagnoses , lost hope and ongoing suffering10 ; 4 . the indisputable evidence supporting the multidimensional nature of NSCLBP as a disorder , where disability levels are more closely associated with cognitive and behavioural aspects of pain rather than sensory and biomedical ones11 12 ; 5 . positive outcomes in r and omised controlled trials ( RCTs ) are best predicted by changes in psychological distress , fear avoidance beliefs , self-efficacy in BACKGROUND CONTEXT Previous research has documented various psychosocial risk factors with influence on outcome in low back pain ( LBP ) patients , but the value of clinical predictors has been less well documented . PURPOSE To identify clinical and psychosocial risk factors at baseline influencing disability and pain at 1 year in LBP patients sick-listed 3 to 16 weeks , and to look for differences between nonspecific LBP and radiculopathy . STUDY DESIGN Cohort study with 1-year follow-up based on a r and omized clinical trial . OUTCOME MEASURES Disability and change of disability , pain and change in pain at 1 year . METHODS In a r and omized clinical study evaluating multidisciplinary versus brief intervention , 325 patients were followed for 1 year . At baseline , they completed a question naire and went through a clinical low back examination , including measure of forward flexion and side flexion as well as tender point examination , a method to estimate diffuse tenderness . Furthermore , degenerative changes on plain X-rays of the lumbar spine were quantified , and sciatica was investigated by magnetic resonance imaging . RESULTS Radiculopathy was verified by magnetic resonance imaging in 111 ( 34 % ) patients . At 1 year , questions of disability in daily life activities and pain were answered by 60 % and 67 % , respectively . The intensity of back+leg pain and disability was closely correlated . Statistically significant predictors for both disability and back+leg pain at 1 year were intensity of back+leg pain , worrying and health anxiety , many tender points , and little or moderate exercise in leisure time . Two additional risk factors were identified in patients with radiculopathy : older age and " drinking alcohol less than once per month . " Furthermore , disability at 1 year was associated with initial disability and compensation cl aim , and back+leg pain at 1 year was associated with fear avoidance about physical activity and the duration of pain . Change in disability was more closely associated with return to work than change in pain . Disc degeneration was not associated with disability or pain at 1 year . General health was not statistically significantly associated with outcome when adjusted for back+leg pain , disability , and worrying and health anxiety . CONCLUSIONS Disability and pain at 1 year were associated with baseline disability and pain , diffuse tenderness , worrying and health anxiety , compensation cl aim , fear avoidance , and baseline exercise habits . Only in patients with verified nerve root affection , older age , and restrained alcohol seemed to play a role . The multivariate models were insufficient in predicting disability and pain , partly because disability and pain were also strongly associated with return to work The long-term outcome results of  inpatient and outpatient treatment  of low back pain ( LBP ) were studied in 476 subjects ( aged 35 - 54 , 63 % men ) r and omly assigned to three study groups : in patients ( n = 157 ) , out patients ( n = 159 ) , and controls ( n = 160 ) . The study included changes in the severity of low back pain , grade and disability , compliance with self-care , data on disability pensions , and days of sickness allowance  during a 2.5-year follow-up period . These variables were used as outcome criteria . Pain and disability had decreased significantly in the two treated groups up to the 3-month follow-up . LBP was still a little slighter in the in patients at the 1.5-year and 22-month follow-ups , but there were no significant differences between the groups in disability caused by LBP . The refresher programme carried out 1.5 years after the first one did not bring about as clear short-term improvement in pain and disability as the first treatment . During the whole 2.5-year follow-up compliance with self-care was better in the two treated groups , especially in the in patients . Days of sickness allowance had increased somewhat more in the controls than in the in patients during the follow-up . No differences between the groups were found in the number of disability pensions granted & NA ; Few studies have investigated whether prognostic indicators , which contribute to the transition from acute to chronic low back pain ( LBP ) , are also those which contribute to continuing persistence of chronic LBP . We compared the contribution of physical , psychological and social indicators to predicting disability after one year between consulters with LBP of less than 3 months duration and more than 3 months duration . Data from two large prospect i ve cohort studies of consecutive patients consulting with LBP in general practice s were merged , providing complete data for 258 cases with acute/subacute LBP and 668 cases with chronic LBP at 12 months follow‐up . There were significant differences between the two LBP groups in baseline characteristics and clinical course of disability , assessed by Rol and Morris Disability Question naire , during the year of follow‐up . Adjusted associations between potential prognostic indicators and disability at 12 months were carried out in the two LBP subgroups . The final multivariable regression models showed that being non‐employed , having widespread pain , a high level of Chronic Pain Grade , and catastrophising were the strongest prognostic indicators for disability at 12 months in both LBP groups . Fear of pain was significantly associated with disability in chronic LBP . Importantly , beyond baseline disability , the effect size of the other prognostic indicators for poor outcome was rather low . These findings must continue to challenge research ers to identify useful early predictors of outcome in persons with disabling back pain , as screening and targeted treatment approaches are dependent upon prognostic indicators with clinical significance Background The impact of the relationship ( therapeutic alliance ) between patients and physical therapists on treatment outcome in the rehabilitation of patients with chronic low back pain ( LBP ) has not been previously investigated . Objective The purpose of this study was to investigate whether the therapeutic alliance between physical therapists and patients with chronic LBP predicts clinical outcomes . Design This was a retrospective observational study nested within a r and omized controlled trial . Methods One hundred eighty-two patients with chronic LBP who volunteered for a r and omized controlled trial that compared the efficacy of exercises and spinal manipulative therapy  rated their alliance with physical therapists by completing the Working Alliance Inventory at the second treatment session . The primary outcomes of function , global perceived effect of treatment , pain , and disability were assessed before and after 8 weeks of treatment . Linear regression models were used to investigate whether the alliance was a predictor of outcome or moderated the effect of treatment . Results The therapeutic alliance was consistently a predictor of outcome for all the measures of treatment outcome . The therapeutic alliance moderated the effect of treatment on global perceived effect for 2 of 3 treatment contrasts ( general exercise versus motor control exercise , spinal manipulative therapy versus motor control exercise ) . There was no treatment effect modification when outcome was measured with function , pain , and disability measures . Limitations Therapeutic alliance was measured at the second treatment session , which might have biased the interaction during initial stages of treatment . Data analysis was restricted to primary outcomes at 8 weeks . Conclusions Positive therapeutic alliance ratings between physical therapists and patients are associated with improvements of outcomes in LBP . Future research should investigate the factors explaining this relationship and the impact of training interventions aim ed at optimizing the alliance Background Low back pain ( LBP ) is a major cause of disability throughout the world . However , longitudinal evidence to relate low back pain and functional limitations is mostly confined to Western countries . In this study , we investigate the associations between low back pain and functional limitations in a prospect i ve cohort of Thai adults . Methods We analysed information from the Thai Cohort Study of adult Open University adults which included 42,785 participants in both 2009 and 2013 , with the majority aged 30 to 65 years and residing nationwide . We used multivariate logistic regression to explore the longitudinal associations between LBP in 2009 and 2013 ( ‘ never ’ : no LBP in 2009 or 2013 ; ‘ reverting ’ : LBP in 2009 but not in 2013 ; ‘ incident ’ : no LBP in 2009 but LBP in 2013 ; and ‘ chronic ’ : reporting LBP at both time points ) and the outcome of functional limitations relating to Activities of Daily Living ( ADL ) in 2013 . Results Low back pain was common with 30 % of cohort members reporting low back pain in both 2009 and 2013 ( ‘ chronic LBP ’ ) . The ‘ chronic LBP ’ group was more likely than the ‘ never ’ back pain group to report functional limitations in 2013 : adjusted odds ratios 1.60 [ 95 % Confidence Interval : 1.38–1.85 ] for difficulties getting dressed ; 1.98 [ 1.71–2.30 ] for walking ; 2.02 [ 1.71–2.39 ] for climbing stairs ; and 3.80 [ 3.38–4.27 ] for bending/kneeling . Those with ‘ incident LBP ’ or ‘ reverting LBP ’ both had increased odds of functional limitations in 2013 but the odds were not generally as high . Conclusions Our nationwide data from Thail and suggests that LBP is a frequent public health problem among economically productive age groups with adverse effects on the activities of daily living . This study adds to the limited longitudinal evidence on the substantial impact of low back pain in Southeast Asia Study Design . Prospect i ve inception cohort study . Objective . To investigate prospect ively whether pain-related fear predicts future perceived disability and participation in patients with acute low back pain ( LBP ) . Summary of Background Data . There are indications that fear of movement/(re)injury , as measured by the Tampa Scale for Kinesiophobia , is present early in an episode of LBP , and that it might be a predictor of future perceived disability and participation . Methods . A cohort of 555 patients with acute LBP included by general practitioners and physical therapists in primary care setting s was followed for 6 months . Results . Results indicate that baseline fear of movement/(re)injury was predictive of future perceived disability and , to a lesser extent ( and together with duration and radiation ) , of participation . Conclusions . The results suggest that interventions aim ed at reducing pain-related fear in the acute stage of LBP might prevent restrictions of activity and participation because of pain , and might be a way of preventing the transition from acute to chronic LBP BACKGROUND CONTEXT The available evidence regarding low back pain ( LBP ) incident episodes is not consistent . Such knowledge can add information for the potential contribution of preventive programs . PURPOSE a ) To evaluate annual incident episodes of LBP among the general population . b ) To evaluate the contribution of demographic , lifestyle , and back pain history to LBP incident episodes . STUDY DESIGN A community-based longitudinal study . PATIENT SAMPLE A r and omized sample of individuals , free of LBP at a previous cross-sectional survey . OUTCOME MEASURES Low back pain during the past year . METHODS Subjects were followed up after 1 year . Baseline data included back pain history , perception of general health , physical activity , smoking , work satisfaction , and demographic characteristics . RESULTS Annual incident episodes of LBP were 18.4 % . Those who experienced LBP during the past year had a lower baseline perception of general health and were less involved in sporting activities than those free of pain . Those without history of LBP were more likely to be free of back pain after 1 year . CONCLUSIONS The annual incident episodes of LBP are relatively high and relate indirectly to baseline perception of general health and to level of sporting activities . Those without history of LBP are more likely to be free of back pain after 1 year . These results raise the potential of LBP preventive programs for adult population
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
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 .