Should physical activity recommendation depend on state of low back pain?
ABSTRACT Leisure time physical activity is recommended for preventing long-term sickness absence (LTSA). Although low back pain (LBP) is a risk factor for sickness absence and physical activity is recommended for people with LBP, it is unknown if leisure time physical activity prevents LTSA among persons with different levels of LBP.
Prospective cohort study among 8655 Danish female healthcare workers responding to a questionnaire in 2004-2005 on leisure time physical activity and LBP, and subsequently followed for 1 year on periods with LTSA ∼2 consecutive weeks or more of sickness absence in a national register of social transfer payments (DREAM). Multi-adjusted Cox regression analysis was used to model risk estimates for LTSA associated with low, moderate, high and very high leisure time physical activity at baseline among healthcare workers with no LBP (0 days past 12 months, n = 2761), non-chronic LBP (1-30 days the past 12 months, n = 3942) and persistent LBP (>30 days the past 12 months, n = 1952).
A strongly reduced risk for LTSA from high leisure time physical activity was found among healthcare workers with no LBP [hazard ratio (HR): 95% confidence interval (CI) 0.47:0.23-0.97 for low vs. very high activity] and non-chronic LBP (HR: 95%CI 0.43:0.23-0.84 of low vs. very high activity), but not among healthcare workers with persistent LBP (HR: 95%CI 1.15:0.55-2.44 of low vs. very high activity).
Leisure time physical activity is a strong predictive factor on LTSA among female healthcare workers with no and non-chronic LBP, but not among those with more persistent LBP.
- SourceAvailable from: nih.gov[Show abstract] [Hide abstract]
ABSTRACT: In the United Kingdom (UK), 9% of adults consult their doctor annually with back pain. The treatment recommendations are based on orthopaedic teaching, but the current management is causing increasing dissatisfaction. Many general practitioners (GPs) are confused about what constitutes effective advice. To review all randomized controlled trials of bed rest and of medical advice to stay active for acute back pain. A systematic review based on a search of MEDLINE and EMBASE from 1966 to April 1996 with complete citation tracking for randomized controlled trials of bed rest or medical advice to stay active and continue ordinary daily activities. The inclusion criteria were: primary care setting, patients with low back pain of up to 3 months duration, and patient-centred outcomes (rate of recovery from the acute attack, relief of pain, restoration of function, satisfaction with treatment, days off work and return to work, development of chronic pain and disability, recurrent attacks, and further health care use). Ten trials of bed rest and eight trials of advice to stay active were identified. Consistent findings showed that bed rest is not an effective treatment for acute low back pain but may delay recovery. Advice to stay active and to continue ordinary activities results in a faster return to work, less chronic disability, and fewer recurrent problems. A simple but fundamental change from the traditional prescription of bed rest to positive advice about staying active could improve clinical outcomes and reduce the personal and social impact of back pain.British Journal of General Practice 11/1997; 47(423):647-52. · 2.36 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To determine the effects of sporting activity on absenteeism in a working population. Data were used from a prospective cohort study in a working population with a follow up period of 3 years and were collected with yearly questionnaires or collected from company records. Complete data on absenteeism, sporting activity, and potential confounders were collected for 1228 workers. ANOVA was used to test differences in frequency and duration of absenteeism, correlations were computed to measure the association between number of sporting years (divided by age) and frequency and duration of absenteeism, and survival analysis, according to the Cox proportional hazards model, was used to test differences in relative risk at absenteeism and recovery. All analyses were adjusted for age, gender, smoking, and alcohol consumption, and were stratified for employees with sedentary and with more active jobs. ANOVA showed a statistically significant higher mean duration of absenteeism among employees not practicing sports, of approximately 20 days over a period of 4 years. The survival analysis showed an increased relative risk at absenteeism (relative risk (RR) 1.09; confidence interval (CI) 1.01 to 1.18) and a decreased relative risk at recovery (RR 0.90; CI 0.85 to 0.95) for employees not practicing sports. The effect of sporting activity is larger in employees with sedentary work. No associations were found between number of sporting years and absenteeism. Employees practicing sports take sick leave significantly less often than their colleagues not practicing sports, while their periods of sick leave are shorter, especially when their work is sedentary.British Journal of Sports Medicine 04/2005; 39(3):e15. DOI:10.1136/bjsm.2004.013052 · 5.03 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To establish whether workers with frequent leisure time physical activities are at higher or lower risk of sickness absence compared to inactive workers. Self reported and company recorded sickness absence data were collected during 18 months of follow-up for 8902 workers. Frequency of leisure time physical activities was queried at baseline. Overall, we found that workers active in their leisure time twice or more each week reported significantly less sickness absence compared to inactive workers (14.8 versus 19.5 days/year), mainly due to a decrease in sick leave because of musculoskeletal disorders. Demotivating sports participation by making workers liable for workdays lost due to sporting injuries might be counter-productive in decreasing absenteeism and its related costs. Promoting worker participation in sport might lead to reduced absenteeism.Occupational Medicine 06/2006; 56(3):210-2. DOI:10.1093/occmed/kqj026 · 1.47 Impact Factor