The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61045

Eric L. Hurwitz, DC, PhD, Hal Morgenstern, PhD, and Chi Chiao, MS, MPH. Department of Epidemiology, UCLA School of Public Health, Box 951772, Los Angeles, CA 90095-1772, 310-206-4074, ehurwitz@ucla.edu

Physical activity has been shown to help prevent low-back pain. However, the literature is less consistent regarding the effectiveness of specific exercises in improving LBP prognosis. Little is known about the cross-sectional and longitudinal associations of leisure-time physical activity and back exercises with physical and psychological health outcomes among patients with LBP. The objective of this study is to estimate the effects of physical activity and back exercises on LBP, related disability, and psychological distress among 681 LBP patients followed for 18 months in a randomized clinical trial of medical and chiropractic care. Participation in recreational physical activities and use of back exercises were measured at baseline and at each follow-up assessment. LBP intensity was measured with 0-10 rating scales of most severe and average pain in the past week; LBP-related disability was measured with the 24-item Roland-Morris Disability Questionnaire. Multivariable logistic and linear regression modeling with generalized estimating equations were used to estimate associations adjusted for the effects of potential confounders. For logistic modeling, the pain and distress scales were dichotomized at values reflecting clinically meaningful levels. Participation in recreational physical activities was inversely associated both cross-sectionally and longitudinally with LBP, related disability, and psychological distress. In contrast, back exercise was positively associated both cross-sectionally and longitudinally with LBP and related disability. These results suggest that persons with LBP might refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health.

Learning Objectives:

• Participants will acquire knowledge about the methods and measures used to assess physical activity and exercise, as well as the statistical models used to estimate their effects on pain, disability, and psychological distress in the UCLA Low-Back Pain Study. Participants will be able to describe the study design and population, discuss pertinent results, identify the study’s strengths and limitations, and develop ideas for subsequent research.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.