Are reallocations of time between physical activity, sedentary behaviour and sleep associated with low back pain? A compositional data analysis

Kaja Kastelic; Nejc Šarabon; Ty Stanford; Dorothea Dumuid; Željko Pedišić

doi:10.1136/bmjsem-2023-001701

Are reallocations of time between physical activity, sedentary behaviour and sleep associated with low back pain? A compositional data analysis

BMJ Open Sport Exerc Med. 2023 Nov 24;9(4):e001701. doi: 10.1136/bmjsem-2023-001701. eCollection 2023.

Authors

Kaja Kastelic^{1

2}, Nejc Šarabon^{2

3}, Ty Stanford⁴, Dorothea Dumuid⁴, Željko Pedišić⁵

Affiliations

¹ Department of Health Studies, Andrej Marušič Institute, University of Primorska, Koper, Slovenia.
² InnoRenew CoE, Izola, Slovenia.
³ Faculty of Health Sciences, University of Primorska, Izola, Slovenia.
⁴ Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
⁵ Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.

Abstract

Objectives: The aim of this cross-sectional study was to explore the associations of reallocating time between moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behaviour (SB) and sleep with occurrence, frequency and intensity of low back pain (LBP) among adults using compositional isotemporal substitution analysis.

Methods: A total of 2333 participants from the general adult population completed the Daily Activity Behaviours Questionnaire asking about their time-use composition consisting of sleep, SB, LPA and MVPA, and they self-reported their frequency and intensity of LBP in the past year.

Results: Regression analyses adjusted for age, sex, body mass index, smoking, stress, education and socioeconomic status found that the time-use composition is associated with the frequency (p=0.009) and intensity of LBP (p<0.001). Reallocating time from SB or LPA to sleep was associated with lower frequency and intensity of LBP (p<0.05). Reallocating time from MVPA to sleep, SB or LPA and from SB to LPA was associated with a lower intensity of LBP (p<0.05). For example, reallocating 30 min/day from SB to sleep was associated with 5% lower odds (95% CI: 2% to 8%, p=0.001) of experiencing LBP more frequently, and 2% lower LBP intensity (95% CI: 1% to 3%, p<0.001).

Conclusion: LBP sufferers may benefit from getting additional sleep and spending more time in LPA, while engaging less in SB and MVPA. These reallocations of time may be meaningful from clinical and public health perspectives.