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

Ana Paula Coelho Figueira Freire; Crystian Bitencourt Soares de Oliveira; Diego Giulliano Destro Christofaro; Sean Shumate; Larissa Bragança Falcão Marques; Rafael Zambelli Pinto

doi:10.1016/j.apmr.2022.03.017

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

Arch Phys Med Rehabil. 2022 Oct;103(10):1944-1950. doi: 10.1016/j.apmr.2022.03.017. Epub 2022 Apr 15.

Authors

Ana Paula Coelho Figueira Freire¹, Crystian Bitencourt Soares de Oliveira², Diego Giulliano Destro Christofaro³, Sean Shumate⁴, Larissa Bragança Falcão Marques⁵, Rafael Zambelli Pinto⁵

Affiliations

¹ Department of Health Sciences, Central Washington University, Ellensburg, WA; Department of Physical Therapy, Western of Sao Paulo University, Presidente Prudente, Brazil. Electronic address: anapcff@hotmail.com.
² Department of Medicine, Western of Sao Paulo University, Presidente Prudente, Brazil.
³ Department of Physical Education, Sao Paulo State University, Presidente Prudente, Brazil.
⁴ Department of Health Sciences, Central Washington University, Ellensburg, WA.
⁵ Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

PMID: 35430240
DOI: 10.1016/j.apmr.2022.03.017

Abstract

Objective: To 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).

Design: Observational 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.

Settings: Outpatient physical therapy clinic.

Participants: This study included data from 358 patients (N=358) with chronic LBP aged between 18 and 60 years.

Main outcome measures: Pain and disability.

Results: Our 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.

Conclusions: Our 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.

Keywords: Exercise; Low back pain; Rehabilitation; Sedentary behavior.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Cross-Sectional Studies
Exercise
Humans
Low Back Pain*
Middle Aged
Pain Measurement
Sedentary Behavior*
Young Adult