Active Lifestyle Protects Against Incident Low Back Pain in Seniors: A Population-Based 2-Year Prospective Study of 1387 Danish Twins Aged 70–100 Years The Predictive Relationship of Physical Activity on the Incidence of Low Back Pain in an Occupational Cohort Effect of a multidisciplinary program for the prevention of low back pain in hospital employees: a randomized controlled trial. Occupational, Personal and Psychosocial Resources for Preventing Persistent Low Back Pain Low back pain incident episodes: a community-based study. 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 Prevention of Low Back Pain in Female Eldercare Workers: Randomized Controlled Work Site Trial Control of the Lumbar Neutral Zone Decreases Low Back Pain and Improves Self-Evaluated Work Ability: A 12-Month Randomized Controlled Study Graded Exercise for Recurrent Low-Back Pain: A Randomized, Controlled Trial With 6-, 12-, and 36-Month Follow-ups Low back pain and physical activity – A 6.5 year follow-up among young adults in their transition from school to working life 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 Reducing sedentary behaviour to decrease chronic low back pain: the stand back randomised trial A Prospective Study of Incidence and Risk Factors for the Onset and Persistence of Low Back Pain in Thai University Students Evaluation of a randomized controlled trial in the management of chronic lower back pain in a French automotive industry: an observational study. Dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain Does physical activity change predict functional recovery in low back pain? Protocol for a prospective cohort study 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
Study Design . Prospect i ve cohort study of twins . Objectives . To investigate associations between physical activity , physical function , and incident low back pain ( LBP ) in an elderly population . Summary of Background Data . The relationship between an active lifestyle and LBP in seniors is unknown . Methods . Participants in the population -based Longitudinal Study of Aging Danish Twins free from LBP at baseline ( no LBP during the past month ) were included , and interview data on physical activity , overall physical function , and LBP at baseline and follow-up were obtained . Associations between levels of  physical activity and LBP were estimated using logistic regression for the entire cohort , and using a matched case-control design for twin pairs discordant for physical activity . Absolute risk and relative risks for incident LBP in relation to physical activity were calculated for participants with higher or lower than average physical function at baseline . Absolute risk for LBP was also calculated for participants based on whether they remained active or inactive between baseline and follow-up or changed activity level . Results . A total of 1387 persons aged 70–100 at baseline were included in the analyses , including 86 twin pairs discordant for physical activity at baseline . In the total sample , 83 % were engaged in light physical activity  , and 42 % of men and 35 % of women were engaged in strenuous  physical activity  at least weekly . Being engaged in strenuous physical activity at baseline was strongly protective in relation to both having had any LBP ( odds ratio 0.21 , 95 % confidence interval 0.12–0.37 for intra-pair analysis ) and having had LBP lasting more than 30 days altogether during the past year at follow-up ( odds ratio 0.08 , 95 % confidence interval 0.03–0.18 for intra-pair analysis ) . Statistically significant dose-response associations between increasing frequency of strenuous physical activity and magnitude of this protective effect were found . Participants with poor initial physical function experienced the strongest protective effect of strenuous physical activity . Finally , LBP does not appear to be an important factor affecting whether participants remained engaged in strenuous physical activity at baseline and follow-up or vice versa . Conclusions . Strenuous physical activity at least once a week is protective for incident LBP in seniors 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 BACKGROUND Hospital workers with physically dem and ing jobs are at risk for developing recurrent LBP . There is a lack of studies evaluating multidisciplinary prevention of  low back pain ( LBP ) in hospital workers . OBJECTIVE This r and omized controlled trial evaluates the effect of a multidisciplinary prevention program , focusing on a client-centred approach , on hospital workers at risk for developing LBP . METHODS Caregiving hospital workers were allocated to an experimental ( 12-week lasting multidisciplinary prevention program ) or control group ( no intervention ) . They were evaluated prior to the intervention and after a 6 months follow-up period . Primary outcome measures included incidence of LBP , work absenteeism and general health . Secondary outcomes included daily physical activity , job satisfaction and coping strategies . RESULTS A significant improvement was seen for passive coping after 6 months follow-up , but no significant differences were observed between groups in primary or other secondary outcome measures ( p > 0.05 ) . CONCLUSIONS A multidisciplinary prevention program fitting into a bio-psychosocial context may not have been intensive enough to promote a change in daily habitudes , and had no effect on work absenteeism , incidence of LBP or general health . Further research should determine whether prevention of LBP is possible in caregiving personnel The aim of this prospect i ve cohort study was to identify modifiable protective factors of the progression of acute/subacute low back pain ( LBP ) to the persistent state at an early stage to reduce the socioeconomic burden of persistent LBP .  Patients attending a health practitioner for acute/subacute LBP were assessed at baseline addressing occupational , personal and psychosocial factors , and followed up over 12 weeks . Pearson correlations were calculated between these baseline factors and the presence of nonpersistent LBP at 12-week follow-up . For those factors found to be significant , multivariate logistic regression analyses were performed . The final 3-predictor model included job satisfaction , mental health and social support . The accuracy of the model was 72 % , with 81 % of nonpersistent and 60 % of persistent LBP patients correctly identified . Further research is necessary to confirm the role of different types of social support regarding their prognostic influence on the development of persistent 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 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 Study Design . R and omized controlled trial . Objective . To evaluate the effectiveness of an ergonomic and psychosocial intervention in reducing  low back pain ( LBP ) among health care workers . Summary of Background Data . LBP and injuries are reported frequently among health care workers worldwide . Improvement of person-transfer techniques is the preferred tool in the prevention of both . Although popular , to our knowledge , any effect has not been documented in controlled trials . Methods . Study participants were eldercare workers from 19 eldercare groups r and omly assigned to the transfer technique , stress management , or reference arm . A total of 163 individuals ( 79 % of the source population ) participated in both baseline and follow-up after 2 years . Outcome was intra-individual change in rating of LBP during the past 3 and 12 months . Results . We found no difference in LBP in any of the intervention arms over the study period . Conclusion . The study showed no effect of a transfer technique or stress management program targeting LBP . Thus , there is a need for discussing other priorities in the prevention of LBP among health care workers Study Design . A r and omized controlled study with 12 months intervention . Objective . To study the effectiveness of a training intervention with emphases on the control of lumbar neutral zone ( NZ ) and behavior modeling as secondary prevention of  low back pain ( LBP ) and disability .  Summary of Background Data . Improving the control of lumbar NZ and enhancing muscle activation patterns ensuring spinal stability have been proposed as means for secondary prevention of LBP and disability . In addition , cognitive behavior interventions have been shown to lower the risk of recurrence of LBP and long-term disability . Methods . Middle-aged working men with recent LBP but without severe disability were r and omly allocated to either a training ( TG , n = 52 ) or control group ( CG , n = 54 ) . The aim was to exercise twice a week for 12 months , once guided and once independently . The outcome measures were the changes in intensity of LBP , disability , self-evaluated future work ability , and neuromuscular fitness . Results . The intensity of LBP decreased significantly more ( 39 % ) in the TG than in CG at 12 months . The proportion of subjects with negative expectations about their future work ability decreased in both groups at 6 and 12 months ; however , the proportion was significantly bigger in TG compared with CG ( P = 0.028 ) . There effects on disability indexes and fitness were not statistically significant . Conclusions . Controlling lumbar NZ is a specific form of exercise and daily self-care with potential for prevention of recurrent nonspecific LBP and disability among middle aged working men Study Design . The study was a r and omized controlled trial . Treatment was for 8 weeks , with follow-up posttreatment and at 6- , 12- , and 36- months . Objective . The purpose was to evaluate the effect of a grade d exercise intervention emphasizing stabilizing exercises in patients with nonspecific , recurrent low back pain ( LBP ) . Summary of Background Data . Exercise therapy is recommended and widely used as treatment for LBP . Although stabilizing exercises are reportedly effective in the management of certain subgroups of LBP , such intervention protocol s have not yet been evaluated in relation to a more general exercise regimen in patients with recurrent LBP , all at work . Methods . Seventy-one patients recruited consecutively ( 36 men , 35 women ) with recurrent nonspecific LBP seeking care at an outpatient physiotherapy clinic were r and omized into 2 treatment groups ; grade d exercise intervention or daily walks . The primary outcome was perceived disability and pain at 12-month follow-up . Secondary outcomes included physical health , fear-avoidance , and self-efficacy beliefs . Results . Of the participants , 83 % provided data at the 12-month follow-up and 79 % at 36 months . At 12 months , between-group comparison showed a reduction in perceived disability in favor of the exercise group , whereas such an effect for pain emerged only immediately postintervention . Ratings of physical health and self-efficacy beliefs also improved in the exercise group over the long term , though no changes were observed for fear-avoidance beliefs . Conclusion . A grade d exercise intervention , emphasizing stabilizing exercises , for patients with recurrent LBP still at work seems more effective in improving disability and health parameters than daily walks do . However , no such positive results emerged for improvement regarding pain over a longer term , or for fear-avoidance beliefs Background The association between leisure time physical activity and  low back pain in young adults is unclear and is in the need of prospect ively obtained evidence . This study examined the course of low back pain and the association between low back pain and leisure time physical activity in a cohort of young adults in their transition from school to working life . Methods Both low back pain and leisure time physical activity was monitored over a 6.5 year period in 420 subjects starting out as students within hairdressing , electrical installation and media/ design . The association between physical activity and low back pain was investigated through the follow-up period by using linear mixed models analysis . Results Low back pain was significantly influenced by time and overall there was a decreasing trend of low back pain prevalence throughout the follow-up . Analysis showed a weak trend of decreasing low back pain with moderate/high physical activity levels , but this association was not significant . Conclusions Low back pain decreased during follow-up with baseline as reference . Findings in our study did show non-significant trends of reduced low back pain with increased leisure time physical activity . Still , we could not support the theory of moderate/high levels of physical activity acting protective against low back pain in young adults entering working life . Our results , in combination with previous relevant research , can not support a clear relationship between  physical activity and low back pain for young adults . Thus , recommendations regarding effect of physical activity on reducing low back pain for this group are not clear 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 Objective The St and Back study evaluated the feasibility and effects of a multicomponent intervention targeting reduced prolonged sitting and pain self-management in desk workers with chronic low back pain ( LBP ) . Methods This r and omised controlled trial recruited 27 individuals with chronic LBP , Oswestry Disability Index ( ODI ) > 10 % and desk jobs ( sitting ≥20 hours/week ) . Participants were r and omised within strata of ODI ( > 10%–<20 % , ≥20 % ) to receive bimonthly behavioural counselling ( in-person and telephone ) , a sit-st and desk attachment , a wrist-worn activity-prompting device and cognitive behavioural therapy for LBP self-management or control . Self-reported work sitting time , visual analogue scales ( VAS ) for LBP and the ODI were assessed by monthly , online question naires and compared across intervention groups using linear mixed models . Results Baseline mean ( SD ) age was 52 ( 11 ) years , 78 % were women , and ODI was 24.1 (10.5)% . Across the 6-month follow-up in models adjusted for baseline value , work sitting time was 1.5 hour/day ( P<0.001 ) lower comparing intervention to controls . Also across follow-up , ODI was on average 8 points lower in intervention versus control ( P=0.001 ) . At 6 months , the relative decrease in ODI from baseline was 50 % in intervention and 14 % in control ( P=0.042 ) . LBP from VAS was not significantly reduced in intervention versus control , though small-to-moderate effect sizes favouring the intervention were observed ( Cohen ’s d ranged from 0.22 to 0.42 ) . Conclusion An intervention coupling behavioural counselling targeting reduced sedentary behaviour and pain self-management is a translatable treatment strategy that shows promise for treating chronic LBP in desk-bound employees . Trial registration number NCT0224687 ; Pre- results This study aim ed to examine the 12-month incidence and risk factors for the onset and persistence of low back pain ( LBP ) in undergraduate students . A 1-year prospect i ve study was carried out among 684 healthy students in a large public university in Thail and . Data were collected using a self-administered question naire and a physical examination . Follow-up data were collected every 3 months . A total of 524 ( 77 % ) students were followed for 1 year . A total of 31 % reported a new onset of LBP , of whom 31 % reported persistent LBP . Having no low back support during computer work was a significant predictor for the onset and persistence of LBP . The onset of LBP was also associated with quadriceps muscle tightness . LBP is common among undergraduate students , and many of them may have persistent symptoms . Physical risk factor plays a significant role for the onset and persistence of LBP among the study population OBJECTIVE To evaluate a specific workplace intervention for the management of  chronic lower back pain among employees working in assembly positions in the automotive industry . DESIGN R and omized controlled trial . SETTING On site at the workplace of a French automotive manufacturer . PARTICIPANTS Subjects ( N=75 volunteers ) were recruited on site and r and omly assigned to either an experimental group ( n=37 ) or a control group ( n=38 ) . INTERVENTION The experimental group followed a supervised 60-minute session , 3 times per week , of muscle strengthening , flexibility , and endurance training during 2 months . The control group received no direct intervention . Evaluation took place at baseline , 2 months , and 6 months . MAIN OUTCOME MEASURES Pain related parameters were evaluated using vali date d question naires and scales translated into French ( Quebec Back Pain Disability Scale , Rolan Morris Disability Question naire , Dallas Pain Question naire , and the Tampa Scale for Kinesiophobia ) . Perceived pain intensity was evaluated using the numerical rating scale , and physical outcome measures were evaluated using specific indicators ( flexibility , Biering-Sorensen Test , Shirado test ) . The multivariate analysis of variance , t test , and Wilcoxon signed-rank test were used for statistical analysis . RESULTS We observed a significant beneficial effect ( P<.025 ) for the experimental group at 2 and 6 months in pain parameters , specific flexibility , and in back functions , and a significant improvement at 6 months in the control group for the perceived pain intensity , anterior flexion , flexibility of quadriceps , and Dallas Pain Question naire 's work recreational score . An increase in the practice of physical activity outside the workplace was noted in both groups at 2 months but persisted at 6 months for the experimental group . CONCLUSIONS This study reinforces the multiple health benefits of physical activity and physical therapy modalities in the workplace by assisting individuals at risk who have chronic LBP Aims : To assess dose-response relations between occupational exposures to physical and psychosocial factors and the risk of  low back pain .  Methods : A cohort of 523 subjects , working in nursing homes and homes for the elderly , was followed prospect ively for one year . Physical load for different occupations was assessed by quantitative observations at the workplace . Information on low back pain and other factors was gathered with question naires administered at baseline and at one year . Two outcome measures of low back pain incidence were used : any new episode of pain lasting for at least a few hours during follow up ( LBP ) ; and any new episode of disabling pain that interfered with daily activities during follow up ( LBP/D ) . Hierarchical regression analysis with a spline function was used to estimate dose-response relations . Results : The risk of LBP was not associated with physical factors , controlling for confounders ; but this outcome was inversely associated with age and weakly , though imprecisely , associated with two psychosocial factors — low decision authority and high work dem and s. In contrast , the risk of LBP/D was positively associated with age and not associated with the psychosocial factors . Trunk flexion over 45 degrees was monotonically associated with the risk of LBP/D ; the estimated relative risk was 3.18 ( 95 % CI 1.13 to 9.00 ) for 1 hour and 45 minutes of bending per week ( 90th centile ) , relative to 30 minutes per week . The hierarchical estimates of effect were more stable than were the maximum likelihood estimates . Conclusion : Occupational exposure to trunk flexion over 45 degrees appears to be a risk factor for low back pain with disability among persons employed in nursing homes and homes for the elderly in the Netherl and 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 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
Conclusions Leisure time physical activity may reduce the risk of chronic LBP by 11%–16 % .
Background There are plausible mechanisms whereby leisure time physical activity may protect against  low back pain ( LBP )  but there have been no quality systematic review s and meta-analyses of the subject .
Objective This review aims to assess the effect of leisure time physical activity on non-specific LBP .