Physical activity as a prognostic factor of pain intensity and disability in patients with low back pain: A systematic review

Abstract

Background and objective Identifying factors that influence the course of low back pain (LBP) is important to help clinicians to identify those patients at higher risk of non‐recovery. The objective of this systematic review was to investigate the prognostic role of physical activity in the course of LBP. Databases and data treatment Literature searches were conducted in five electronic databases from their inception to February 2018. Prospective cohort studies investigating the influence of any type of physical activity in people with LBP were considered eligible. The primary outcomes were pain intensity and disability. Two independent reviewers extracted the data and assessed the methodological quality of the included studies. Results were stratified according to participants’ symptoms duration at baseline. Results Twelve studies were considered eligible for this review. Of these, six included patients with chronic LBP, four studies did not specify the patients’ duration of symptoms, one study included patients with acute LBP, and one study included patients with subacute LBP. Included studies were heterogeneous in terms of physical activity assessment, outcomes, follow‐up duration, and statistical methods, therefore, pooling of results was not performed. We found limited evidence to support the prognostic role of physical activity in the course of LBP. Conclusions Our review identified limited evidence supporting physical activity as a prognostic factor in LBP. Future cohort studies are needed to clarify the strength and importance of this association. Significance Despite recent research in the area, this systematic review shows that there is low quality evidence that physical activity may not be a prognostic factor for predicting pain and disability in patients with LBP.

High levels of low back disability, but not low back pain intensity, are associated with reduced physical activity: a community-based, cross-sectional study

“…In contrast to disability, we found no differences in physical activity in those with different levels of back pain. These results are novel, as previous systematic reviews and epidemiological studies have largely examined whether physical activity is a risk factor for LBP, rather than characterising the physical activity performed by individuals with different levels of pain and disability (5,6,19). Moreover, few epidemiological studies have examined the relationship between both LBP and disability and physical activity in community-based individuals (7).…”

“…A number of systematic reviews have examined the relationship between physical activity and LBP and disability, with a focus on determining whether reduced physical activity is a risk factor for the development and progression of LBP (5,6). In contrast, few studies have investigated the physical activity patterns of individuals with LBP.…”

Correlation Between Chronic Low Back Pain and Female Sexual Function

“…The etiology of low back pain is multifactorial, associated with sociodemographic factors (age, sex and education level), health, life style (tobacco use and physical inactivity), occupation (physical effort and repetitive movements), and other factors related to metabolic conditions (obesity and other chronic diseases). [1][2][3][4][7][8][9][10][11][12][13] As a result, about 90 to 95% of cases of low back pain become chronic due to the complexity of the diagnosis. 3,7,[9][10][11][12]14 Lumbar pain compromises the individual's quality of life, including sexual function, 7,8,10,11 and is directly related to work absenteeism and difficulties with the activities of daily life, as it causes disabilities and reduced functionality, greatly impacting public health because of the costs involved.…”

“…3,7,[9][10][11][12]14 Lumbar pain compromises the individual's quality of life, including sexual function, 7,8,10,11 and is directly related to work absenteeism and difficulties with the activities of daily life, as it causes disabilities and reduced functionality, greatly impacting public health because of the costs involved. [1][2][3][4][5][6]9,10,12,13,15 Another prominent factor in human life is sexuality, considered intrinsic to the quality of life and whose functioning is inherent to the well-being of the individual and the longevity of affective relationships. 9,11,16 The sexual act is dependent on the interaction of body systems, including the integrity and function of the lumbar and pelvic region.…”

“…9,11,16 The sexual act is dependent on the interaction of body systems, including the integrity and function of the lumbar and pelvic region. 7 The relationship between chronic low back pain, the quality of life, and sexual function is equally important to both sexes, [9][10][11][12][13][14][15][16][17] although women have greater interference from low back pain than men. 18 The presence of musculoskeletal disorders contributes to limitations on the sexual act due to pain, immobility, and decreased muscle strength, thus promoting an attenuation of sexual stimulation and difficulty in positioning for the act.…”