title: Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study.
abstract: OBJECTIVE
  We sought to estimate the effects of recreational physical activity and back exercises on low back pain, related disability, and psychological distress among patients randomized to chiropractic or medical care in a managed care setting.
  
  
  METHODS
  Low back pain patients (n=681) were randomized and followed for 18 months. Participation in recreational physical activities, use of back exercises, and low back pain, related disability, and psychological distress were measured at baseline, at 6 weeks, and at 6, 12, and 18 months. Multivariate logistic regression modeling was used to estimate adjusted associations of physical activity and back exercises with concurrent and subsequent pain, disability, and psychological distress.
  
  
  RESULTS
  Participation in recreational physical activities was inversely associated--both cross-sectionally and longitudinally--with low back pain, related disability, and psychological distress. By contrast, back exercise was positively associated--both cross-sectionally and longitudinally--with low back pain and related disability.
  
  
  CONCLUSIONS
  These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health.
authors.affiliation: School of Public Health, Department of Epidemiology, University of California-Los Angeles, Box 951772, Los Angeles, CA 90095-1772, USA. ehurwitz@ucla.edu
authors.forename: Eric L
authors.initials: EL
authors.lastname: Hurwitz
authors.forename: Hal
authors.initials: H
authors.lastname: Morgenstern
authors.forename: Chi
authors.initials: C
authors.lastname: Chiao
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D011998:Recreation / Q000502:physiology / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome