Isotemporal Substitution of Sedentary Behavior by Different Physical Activity Intensities on Pain and Disability of Patients With Chronic Low Back Pain: A Cross-Sectional Study |
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| Institution: | 1. Department of Health Sciences, Central Washington University, Ellensburg, WA;2. Department of Physical Therapy, Western of Sao Paulo University, Presidente Prudente, Brazil;3. Department of Medicine, Western of Sao Paulo University, Presidente Prudente, Brazil;4. Department of Physical Education, Sao Paulo State University, Presidente Prudente, Brazil;5. Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.;1. Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO;2. Department of Neurology, Washington University School of Medicine, St Louis, MO;3. Department of Medicine, Washington University School of Medicine, St Louis, MO;4. Department of Pediatrics, Washington University School of Medicine, St Louis, MO;5. Department of Surgery, Washington University School of Medicine, St Louis, MO;6. Department of Education, Washington University School of Medicine, St Louis, MO;7. Brown School of Social Work, Washington University in St Louis, St Louis, MO;1. Department of Occupational Therapy, Massachusetts General Hospital, Institute of Health Professions, Boston, MA, USA;2. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA;3. Harvard Medical School, Boston, MA, USA;4. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA;1. Department of Medicine, University of Minnesota, Division of General Internal Medicine, Minneapolis, MN;2. Department of Medicine, University of Minnesota, Division of Pulmonary and Critical Care, Minneapolis, MN;3. Department of Rehabilitation Medicine, University of Minnesota, Division of PM&R, Minneapolis, MN;4. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN;5. Department of Surgery, University of Minnesota Division of Acute Care Surgery, Minneapolis, MN;6. Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN;7. Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, MN;8. Institute for Health Informatics, University of Minnesota, Minneapolis, MN |
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| Abstract: | ObjectiveTo investigate the association of isotemporal substitution modeling (ISM) of time spent in sedentary activities with physical activity in different intensities on pain and disability of patients with chronic low back pain (LBP).DesignObservational and cross-sectional study. Device-measured physical activity levels were assessed using an actigraph. Pain intensity was measured using the 11-point numeric rating scale, and disability was measured using the Roland Morris Disability Questionnaire. The ISM was used to estimate the theoretical substitution association of reallocating time from 1 exposure variable to an equal amount of time in another exposure variable while holding total activity time constant.SettingsOutpatient physical therapy clinic.ParticipantsThis study included data from 358 patients (N=358) with chronic LBP aged between 18 and 60 years.Main Outcome MeasuresPain and disability.ResultsOur results suggest that replacing 60 minutes of sedentary behavior with 60 minutes of vigorous activity in a week is significantly associated with a decrease in pain (β=?1.67; 95% confidence interval CI], ?3.18 to ?0.15). Additionally, replacing 60 minutes of light physical activity (β=?1.67; 95% CI, ?3.18 to ?0.16) or moderate activity (β=?1.67; 95% CI, ?3.21 to ?0.13) with the same amount of time of vigorous activity per week may also favorable reductions in pain. For the analysis of disability, no significant associations (P>.05) for disability in any of the isotemporal models were found.ConclusionsOur results showed that replacing 60 minutes of sedentary behavior with equal amounts of vigorous activity per week was associated with reductions in pain intensity. Similarly, replacing a light or moderate activities with vigorous activity was also associated with reductions in pain intensity. Finally, no significant associations were observed between time spent in sedentary activities with physical activity in different intensities for disability. |
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