Do depression and pain intensity interfere with physical activity in daily life in patients with Chronic Low Back Pain?

AbstractWe assessed the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis (OA), who are overweight or obese. We conducted causal mediation analyses of aggregated data from two RCTs; which included 160 patients with chronic low back pain, and 120 patients with knee OA. Participants were randomised via one central randomisation schedule, to the intervention, or usual care. The intervention consisted of brief advice and referral to a 6-month telephone-based healthy lifestyle coaching service. Participants in the back pain trial were also offered a single physiotherapy consultation. The hypothesised primary mediator was self-reported weight, and alternative mediators were diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Data were analysed using causal mediation analyses with sensitivity analyses for sequential ignorability. All mediation models were specified a priori. The intervention had no effect on pain intensity, disability or physical QoL. The intervention significantly improved mental QoL, however, the intervention effect was not channelled via the selected mediators. The intervention did not reduce weight, or the alternative mediators (diet, physical activity, pain beliefs), and these mediators were not associated with the outcomes (with one exception; poor diet was associated with lower mental QoL). The sensitivity analyses showed that our estimates were stable across all possible levels of residual confounding. Our findings show that the intervention did not cause a meaningful change in the hypothesised mediators, and these mediators were not associated with patient outcomes.

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Physical activity in daily life in patients with chronic low back pain

Archives of Physical Medicine and Rehabilitation ◽

10.1053/apmr.2001.23182 ◽

2001 ◽

Vol 82 (6) ◽

pp. 726-730 ◽

Cited By ~ 96

Author(s):

Jeanine A. Verbunt ◽

Klaas R. Westerterp ◽

Geert J. van der Heijden ◽

Henk A. Seelen ◽

Johan W. Vlaeyen ◽

...

Keyword(s):

Physical Activity ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Daily Life ◽

Low Back

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An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720820966082 ◽

2020 ◽

pp. 001872082096608

Author(s):

Pongsatorn Saiklang ◽

Rungthip Puntumetakul ◽

James Selfe ◽

Gillian Yeowell

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Muscle Fatigue ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Trunk Muscle ◽

Low Back ◽

Prolonged Sitting ◽

Lumbar Extension

Objective The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. Background Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. Method Thirty participants with CLBP were randomly allocated: (a) control—sitting without exercise, and (b) intervention—supported dynamic lumbar extension with the ADIM technique. Results Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. Conclusion The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. Application Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.

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Causal mechanisms of a healthy lifestyle intervention for patients with musculoskeletal pain who are overweight or obese

Clinical Rehabilitation ◽

10.1177/0269215519831419 ◽

2019 ◽

Vol 33 (6) ◽

pp. 1088-1097 ◽

Cited By ~ 1

Author(s):

Amanda Williams ◽

Hopin Lee ◽

Steven J Kamper ◽

Kate M O’Brien ◽

John Wiggers ◽

...

Keyword(s):

Physical Activity ◽

Low Back Pain ◽

Back Pain ◽

Knee Osteoarthritis ◽

Lifestyle Intervention ◽

Chronic Low Back Pain ◽

Healthy Lifestyle ◽

Low Back ◽

Pain Beliefs ◽

Causal Mechanisms

Purpose: To assess the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis, who are overweight or obese. Methods: We conducted causal mediation analyses of aggregated data from two randomized controlled trials (RCTs); which included 160 patients with chronic low back pain, and 120 patients with knee osteoarthritis. The intervention consisted of brief advice and referral to a six-month telephone-based healthy lifestyle coaching service. We used causal mediation to estimate the indirect, direct and path-specific effects of hypothesized mediators including: self-reported weight, diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Results: The intervention did not reduce weight, improve diet or physical activity or change pain beliefs, and these mediators were not associated with the outcomes. Sensitivity analyses showed that our estimates were robust to the possible effects of unknown and unmeasured confounding. Conclusions: Our findings show that the intervention did not cause a meaningful change in the hypothesized mediators, and these mediators were not associated with patient-reported outcomes.

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Pain Intensity and Fear Avoidance Explain Disability Related to Chronic Low Back Pain in a Saudi Arabian Population

Spine ◽

10.1097/brs.0000000000003002 ◽

2019 ◽

Vol 44 (15) ◽

pp. E889-E898 ◽

Cited By ~ 2

Author(s):

Dalyah M. Alamam ◽

Niamh Moloney ◽

Andrew Leaver ◽

Hana I. Alsobayel ◽

Martin G. Mackey

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Saudi Arabian ◽

Low Back ◽

Fear Avoidance ◽

Arabian Population

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Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity

Physical Therapy ◽

10.2522/ptj.20150335 ◽

2016 ◽

Vol 96 (7) ◽

pp. 1049-1056 ◽

Cited By ~ 10

Author(s):

Corey B. Simon ◽

Trevor A. Lentz ◽

Mark D. Bishop ◽

Joseph L. Riley ◽

Roger B. Fillingim ◽

...

Keyword(s):

Working Memory ◽

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Pain Catastrophizing ◽

Future Research ◽

Low Back ◽

Cross Sectional ◽

Daily Pain

Abstract Background Because of its high global burden, determining biopsychosocial influences of chronic low back pain (CLBP) is a research priority. Psychological factors such as pain catastrophizing are well established. However, cognitive factors such as working memory warrant further investigation to be clinically useful. Objective The purpose of this study was to determine how working memory and pain catastrophizing are associated with CLBP measures of daily pain intensity and movement-evoked pain intensity. Design This study was a cross-sectional analysis of individuals with ≥3 months of CLBP (n=60) compared with pain-free controls (n=30). Method Participants completed measures of working memory, pain catastrophizing, and daily pain intensity. Movement-evoked pain intensity was assessed using the Back Performance Scale. Outcome measures were compared between individuals with CLBP and those who were pain-free using nonparametric testing. Associations were determined using multivariate regression analyses. Results Participants with CLBP (mean age=47.7 years, 68% female) had lower working memory performance (P=.008) and higher pain catastrophizing (P<.001) compared with pain-free controls (mean age=47.6 years, 63% female). For individuals with CLBP, only working memory remained associated with daily pain intensity (R2=.07, standardized beta=−.308, P=.041) and movement-evoked pain intensity (R2=.14, standardized beta=−.502, P=.001) after accounting for age, sex, education, and interactions between pain catastrophizing and working memory. Limitations The cross-sectional design prevented prospective analysis. Findings also are not indicative of overall working memory (eg, spatial) or cognitive performance. Conclusion Working memory demonstrated the strongest association with daily pain and movement-evoked pain intensity compared with (and after accounting for) established CLBP factors. Future research will elucidate the prognostic value of working memory on prevention and recovery of CLBP.

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