707High levels of back disability,but not back pain,are associated with reduced physical activity in women

Background Although clinical guidelines recommend physical activity for low back pain (LBP), our understanding of the physical activity undertaken by people with LBP is limited. We examined the amounts, intensities and types of physical activity performed by community-based women with different levels of pain and disability. Methods 542 women were invited to participate. Physical activity was measured using the International Physical Activity Questionnaire, and LBP and disability were assessed using the Chronic Pain Grade Questionnaire. Participants were categorised into no/low or high pain intensity and disability groups. Results Women with high levels of back disability performed half the total physical activity of those with no/low levels of back disability (MET(hours/week): median(95%CI)=27.3(13.2-41.4) vs. 53.9(44.9-62.8),p=0.002), including less moderate (17.5(10.4-24.7) vs. 32.1(26.8-37.4),p<0.001) and domestic and gardening activity (14.4(7.2- 21.7) vs. 23.5(19.0-28.0), p = 0.02). Moreover, fewer women with high disability participated in vigorous (3(8.11%) vs. 134(32.0%),OR(95%CI)=0.17(0.04-0.75),p=0.02) and leisure activities (17(45.9%) vs. 294(70.2%),OR(95% CI)=0.44(0.21-0.94),p=0.03) compared to those with no/low disability. There were no differences in physical activity between women with no/low and high pain intensity (all p > 0.05). Conclusions High levels of back disability, but not back pain intensity, were associated with reduced physical activity, including less total activity, moderate and vigorous intense activity, and discretionary activity. Key messages These findings highlight the impact of high levels of disability on physical activity. Further work is needed to determine whether targeting these types and intensities of physical activity will help in reducing back disability.

Reframing service innovation: COVID-19 as a catalyst for imposed service innovation

PurposeThe empirical study draws on a crowdsourced database of 221 innovations associated with the COVID-19 pandemic.Design/methodology/approachAside from the health and humanitarian crisis, the COVID-19 pandemic has caused an acute economic downturn in most sectors, forcing public and private organizations to rethink and reconfigure service provision. The paper introduces the concept of imposed service innovation as a new strategic lens to augment the extant view of service innovation as a primarily discretionary activity.FindingsThe identified imposed service innovations were assigned to 11 categories and examined in terms of their strategic horizon and strategic stretch. The innovations are characterized by spatial flexibility, social and health outreach and exploitation of technology.Research limitations/implicationsAs a new area of service innovation research, imposed service innovations highlight strategic issues that include the primacy of customers and the fragility of institutions.Practical implicationsSituations involving imposed service innovation represent opportunities for rapid business development when recognized as such. A severe disruption such as a pandemic can catalyze managerial rethinking as organizations are forced to look beyond their existing business strategies.Social implicationsAs a strategic response to severe disruption of institutions, markets and service offerings, imposed service innovations afford opportunities to implement transformation and enhance well-being. This novel strategic lens foregrounds a societal account of service innovation, emphasizing societal relevance and context beyond the challenges of business viability alone.Originality/valueWhile extant service innovation research has commonly focused on discretionary activities that enable differentiation and growth, imposed service innovations represent actions for resilience and renewal.