Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies

Shiri, Rahman; Falah‐Hassani, Kobra

doi:10.1136/bjsports-2016-097352

Cited by 186 publications

(197 citation statements)

References 81 publications

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“…Additionally, we found that walking or cycling to work, independent of body weight and other leisure activities, protects against hospitalization for sciatica. In our earlier meta-analyses 13,26 we found that moderate or high level of leisure-time physical activity protects against lumbar radicular pain 13 and chronic low back pain 26 by 11%-16% only, supporting the current result that the protective effects of physical activity on most low back outcomes are minor.…”

Section: Discussionsupporting

confidence: 76%

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies

Shiri

Euro

Heliövaara

et al. 2017

The American Journal of Medicine

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Section: Discussionsupporting

confidence: 76%

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies

Shiri

Euro

Heliövaara

et al. 2017

The American Journal of Medicine

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“…Many systematic reviews have reported on the low quality of evidence concerning the relationship between musculoskeletal disease symptoms and physical activity level. Unfortunately, most studies have focused on generalized pain disorders including fibromyalgia and localized disorders of other body parts including the lower back, neck and shoulders . No study has considered the relationship between general physical activity level and TMD symptoms before, and this is the first attempt to define such an association.…”

Section: Discussionmentioning

confidence: 99%

“…Exercise effectively reduces pain symptoms, even in patients with chronic pain disorders such as fibromyalgia and lower back pain . However, clinical observations also suggest that many patients with musculoskeletal pain experience an increase in pain and fatigue during exercise or even while conducting simple daily activities …”

Section: Introductionmentioning

confidence: 99%

Physical activity level and temporomandibular disorders in South Koreans

Cho

Kim

Park

et al. 2020

Comm Dent Oral Epid

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Objective: This study aimed to investigate the association between general physical activity level and TMD pain in Koreans in a large-scale national database established through a nationwide survey. Methods: Data from the Fourth Korean National Health and Nutrition ExaminationSurvey (KNHANES IV), which was conducted from 2007 to 2009, were analysed. In total, 16 941 participants were included in this cross-sectional study. Data on sociodemographic characteristics, TMD-related variables, and general physical activity level were collected. Participants were divided into moderate-and low-intensity exercise groups according to their physical activity levels. Multivariate logistic regression analyses were performed, adjusting for sociodemographic and other covariates. Results:The adjusted odds ratio (OR) (95% confidence interval; CI) for TMD pain was 1.373 (1.017-1.854) for people doing moderate-intensity exercises and 0.797 (0.629-1.008) among people doing low-intensity exercises. Those who did moderateintensity exercises had significantly more TMD pain. This was higher in the 30-to 39-year age group (OR: 1.991, 95% CI: 1.137-3.488), with significantly higher risk for TMD pain in those who did moderate-intensity exercise, whereas low-intensity exercise significantly decreased the risk for TMD pain in the same age group (OR: 0.625, 95% CI: 0.409-0.958). Conclusions:Moderate-intensity physical activity is associated with more TMD pain.Patients with TMD should avoid high-intensity level exercises and continue low-intensity exercises to prevent pain aggravation. CHO et al. previous studies in terms of pain levels and disease duration. Some reports indicate that regular physical activity decreases pain, 9,10 but a few studies have suggested further pain aggravation with physical activity. 10 Exercise effectively reduces pain symptoms, even in patients with chronic pain disorders such as fibromyalgia and lower back pain. 11,12 However, clinical observations also suggest that many patients with musculoskeletal pain experience an increase in pain and fatigue during exercise or even while conducting simple daily activities. [13][14][15] Unfortunately, previous literature on the interaction between physical activity and musculoskeletal disease status has mostly focused on general chronic pain syndromes such as lower back pain and fibromyalgia, while papers concentrating on orofacial pain (including TMD) are scarce. The few studies concerning TMD have been limited to investigating the effects of specific exercises developed to relax the masticatory muscles and improve mandibular movement. |No study has investigated the association between general physical activity level and TMD symptoms. Since the patient's physical activity level could affect TMD pain severity, the relationship between the two should be examined in order to inform the development of accurate guidelines for prescribing exercise to patients with TMD and to prevent further damage from inappropriate levels of physical activity. Accordingly, this study investiga...

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“…A protective effect of exercise against LBP during pregnancy is plausible, given its effects on LBP in non-pregnant women (Shiri et al, 2016;Steffens et al, 2016;Shiri and Falah-Hassani, 2017), and also limited evidence of benefits in the treatment of LBP during pregnancy (Liddle and Pennick, 2015;Kinser et al, 2017). Furthermore, a prospective cohort study of 2753 pregnant women found that moderate or high level of physical activity was associated with a 10% reduction in new episodes of low back pain after adjustment for age, parity, education, smoking, pre-pregnancy body mass index and low back pain before the current pregnancy (Gjestland et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta‐analysis of randomized controlled trials

Shiri

Coggon

Falah‐Hassani

2017

European Journal of Pain

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Background and objective: The effect of exercise in prevention of low back and pelvic girdle pain during pregnancy is uncertain. This study aimed to assess the effect of exercise on low back pain, pelvic girdle pain and associated sick leave. Databases and data treatment: Literature searches were conducted in PubMed, EMBASE, Cochrane Library, Google Scholar, ResearchGate and ClinicalTrials.gov databases from their inception through May 2017. Randomized controlled trials (RCTs) were eligible for inclusion in the review if they compared an exercise intervention with usual daily activities and at least some of the participants were free from low back pain and/or pelvic girdle pain at baseline. Methodological quality of included studies was evaluated using the Cochrane Collaboration's tool. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed. Results: Eleven randomized controlled trials (2347 pregnant women) qualified for meta-analyses. Exercise reduced the risk of low back pain in pregnancy by 9% (pooled risk ratio (RR) = 0.91, 95% CI 0.83-0.99, I 2 = 0%, seven trials, N = 1175), whereas it had no protective effect on pelvic girdle pain (RR = 0.99, CI 0.81-1.21, I 2 = 0%, four RCTs, N = 565) or lumbopelvic pain (RR = 0.96, CI 0.90-1.02, I 2 = 0%, eight RCTs, N = 1737). Furthermore, exercise prevented new episodes of sick leave due to lumbopelvic pain (RR = 0.79, CI 0.64-0.99, I 2 = 0%, three RCTs, N = 1168). There was no evidence of publication bias. Conclusion: Exercise appears to reduce the risk of low back pain in pregnant women, and sick leave because of lumbopelvic pain, but there is no clear evidence for an effect on pelvic girdle pain. Significance: Exercise has a small protective effect against low back pain during pregnancy.

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Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies

Cited by 186 publications

References 81 publications

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies

Physical activity level and temporomandibular disorders in South Koreans

Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta‐analysis of randomized controlled trials

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