title: Does a patient's physical activity predict recovery from an episode of acute low back pain? A prospective cohort study.
abstract: 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.
  
  
  METHODS
  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 prospective cohort study recruited 101 consenting patients with sub-acute LBP (< 6 weeks) who completed the Roland Morris Disability Questionnaire (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 questionnaire.
  
  
  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 questionnaire (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.
  
  
  BACKGROUND
  Clinical Trial Registration Number, ACTRN12609000282280.
authors.affiliation: Division of Physiotherapy Education, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK. paul.hendrick@nottingham.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Hendrick
authors.forename: Stephan
authors.initials: S
authors.lastname: Milosavljevic
authors.forename: Leigh
authors.initials: L
authors.lastname: Hale
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Hurley
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: McDonough
authors.forename: Peter
authors.initials: P
authors.lastname: Herbison
authors.forename: G David
authors.initials: GD
authors.lastname: Baxter
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010147:Pain Measurement / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Behav Res Ther. 2004 Jul;42(7):761-74
references.pmid: 15149897
references.citation: Eur J Cardiovasc Prev Rehabil. 2010 Apr;17(2):127-39
references.pmid: 20215971
references.citation: J Clin Nurs. 2005 Aug;14(7):798-804
references.pmid: 16000093
references.citation: Spine (Phila Pa 1976). 2006 Dec 15;31(26):3045-51
references.pmid: 17173002
references.citation: Arch Phys Med Rehabil. 2009 Jan;90(1):109-17
references.pmid: 19154837
references.citation: Occup Environ Med. 2003 Sep;60(9):618-26
references.pmid: 12937181
references.citation: Arch Intern Med. 2003 Nov 24;163(21):2632-8
references.pmid: 14638564
references.citation: Spine (Phila Pa 1976). 2008 Jan 1;33(1):90-4
references.pmid: 18165753
references.citation: Behav Modif. 1998 Jan;22(1):62-77
references.pmid: 9567737
references.citation: J Am Geriatr Soc. 2001 Jan;49(1):28-35
references.pmid: 11207839
references.citation: Musculoskeletal Care. 2008 Dec;6(4):197-210
references.pmid: 18311847
references.citation: Eur J Pain. 2005 Aug;9(4):417-25
references.pmid: 15979022
references.citation: Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504
references.pmid: 10993420
references.citation: Am J Public Health. 2005 Oct;95(10):1817-24
references.pmid: 16186460
references.citation: Med Sci Sports Exerc. 2003 Oct;35(10):1773-8
references.pmid: 14523319
references.citation: Aust J Physiother. 2006;52(2):149
references.pmid: 16805041
references.citation: Eur J Pain. 2009 Oct;13(9):908-14
references.pmid: 19110456
references.citation: Eur J Pain. 2009 Nov;13(10):1076-9
references.pmid: 19181547
references.citation: Med Sci Sports Exerc. 2004 Feb;36(2):324-30
references.pmid: 14767258
references.citation: Man Ther. 2003 Feb;8(1):29-36
references.pmid: 12586559
references.citation: J Phys Act Health. 2009 May;6(3):354-9
references.pmid: 19564665
references.citation: Eur Spine J. 2006 May;15(5):543-53
references.pmid: 16217664
references.citation: Kidney Int. 2001 Mar;59(3):1121-7
references.pmid: 11231369
references.citation: Arch Phys Med Rehabil. 2001 Feb;82(2):227-31
references.pmid: 11239315
references.citation: JAMA. 1999 Mar 3;281(9):818-23
references.pmid: 10071003
references.citation: Health Educ Res. 2008 Aug;23(4):583-91
references.pmid: 17890759
references.citation: Psychol Health Med. 2009 Jan;14(1):111-24
references.pmid: 19085318
references.citation: Res Q Exerc Sport. 2007 Mar;78(2):1-8
references.pmid: 17479568
references.citation: BMC Musculoskelet Disord. 2009 Nov 06;10:136
references.pmid: 19895697
references.citation: Br J Sports Med. 2008 Jan;42(1):68-70
references.pmid: 18178685
references.citation: Spine (Phila Pa 1976). 1995 Dec 15;20(24):2731-7
references.pmid: 8747252
references.citation: Arch Phys Med Rehabil. 2001 Jun;82(6):735-42
references.pmid: 11387576
references.citation: Pain. 2007 Aug;130(3):279-286
references.pmid: 17467902
references.citation: Eur J Pain. 2003;7(1):33-42
references.pmid: 12527315
references.citation: Behav Res Ther. 2002 May;40(5):585-94
references.pmid: 12038650
references.citation: Adapt Phys Activ Q. 2010 Jul;27(3):173-90
references.pmid: 20571154
references.citation: Int J Epidemiol. 1995 Apr;24(2):381-8
references.pmid: 7635600
references.citation: Spine (Phila Pa 1976). 2007 Dec 15;32(26):E809-15
references.pmid: 18091475
references.citation: J Phys Act Health. 2008 Jul;5(4):527-38
references.pmid: 18648118
references.citation: Med Sci Sports Exerc. 1992 Oct;24(10):1167-72
references.pmid: 1435166
references.citation: Eur J Pain. 2003;7(1):9-21
references.pmid: 12527313
references.citation: Spine (Phila Pa 1976). 2007 Dec 1;32(25):2915-20
references.pmid: 18246018
references.citation: J Aging Phys Act. 2006 Oct;14(4):456-77
references.pmid: 17215562
references.citation: Occup Environ Med. 2000 Feb;57(2):116-20
references.pmid: 10711279
references.citation: Spine (Phila Pa 1976). 2006 Apr 1;31(7):789-98
references.pmid: 16582853
references.citation: Qual Life Res. 2009 May;18(4):473-81
references.pmid: 19238585
references.citation: Spine (Phila Pa 1976). 2004 Nov 1;29(21):E492-501
references.pmid: 15507789
references.citation: Pain. 2007 Aug;130(3):201-202
references.pmid: 17532142
references.citation: Best Pract Res Clin Rheumatol. 2005 Aug;19(4):593-607
references.pmid: 15949778
references.citation: Clin J Pain. 2008 Sep;24(7):604-10
references.pmid: 18716499
references.citation: Pain. 2004 Dec;112(3):343-352
references.pmid: 15561390
references.citation: Eur Spine J. 2006 Mar;15 Suppl 2:S169-91
references.pmid: 16550447
references.citation: Med Sci Sports Exerc. 2003 Aug;35(8):1374-80
references.pmid: 12900693
references.citation: Arthritis Rheum. 2009 Sep 15;61(9):1202-9
references.pmid: 19714601
references.citation: Spine (Phila Pa 1976). 2004 Aug 15;29(16):1810-7
references.pmid: 15303027
references.citation: Arch Phys Med Rehabil. 2008 Sep;89(9):1765-71
references.pmid: 18760161
references.citation: Am J Clin Nutr. 1982 Nov;36(5):936-42
references.pmid: 7137077
references.citation: Pain. 2008 Jan;134(1-2):69-79
references.pmid: 17504729
references.citation: Soc Sci Med. 1994 Jan;38(1):1-14
references.pmid: 8146699
references.citation: Spine (Phila Pa 1976). 1994 Dec 15;19(24):2759-65
references.pmid: 7899975
references.citation: Spine (Phila Pa 1976). 2003 May 15;28(10):1061-7; discussion 1067
references.pmid: 12768149
references.citation: Clin J Pain. 2002 Jul-Aug;18(4):251-61
references.pmid: 12131067