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Towards an understanding of physical activity in people with chronic low back pain

Creator:

Griffin, Derek William;

Institution: University of Limerick
Subject Keywords: back pain; physical activity; CLBP;
Topic: Chronic Conditions
Conditions
Back pain
Mental Health
Chronic Conditions
Catalogue: Research and Evaluation
Report
Type: Article
Region: Republic of Ireland
Description:

Physical activity (PA) is well recognised as an essential component of a
healthy lifestyle and is commonly recommended as part of a multimodal
management approach for people with chronic low back pain (CLBP). However,
to date there is limited evidence of how best to promote PA in people with
CLBP. Knowledge of the correlates and determinants of PA in this patient group
is necessary to facilitate and promote PA in patients’ everyday lives. The main
aim of this thesis was to determine the physical and psychological correlates of
objectively measured PA in people with CLBP. This doctoral thesis examined
the correlates of PA and sedentary activity in people with CLBP using a mixed
methods approach.
Initially, a systematic review was undertaken to examine the common
assumption that patients with CLBP are less active than healthy individuals.
There was no consistent evidence supporting this hypothesis for adults or
adolescents. For older adults, there was evidence that they are less active than
healthy control based on self-reported levels of PA.
The ActivPAL™ activity monitor has previously been validated as a
measure of postural PA in people with CLBP. To further examine this monitor, a
study was designed to determine if the ActivPAL™ can also accurately measure
the intensity of PA in this patient group. The findings were positive and suggest
that the ActivPAL™ “counts” function may be useful, from which one can
accurately determine PA intensity especially during locomotor activity.
A study designed to examine the correlates of free-living PA and
sedentary activity in people with CLBP revealed an important role of depression
and elevated body mass index (BMI) respectively. Moreover, given the
heterogeneity of people with CLBP, the comparative PA and sedentary activity
profile of patients with and without a neuropathic pain (NeuP) component was
examined. The findings are in line with previous findings which suggest that
patients with a NeuP component are more disabled and have poorer
psychological functioning. However, there was no significant difference in the
level of PA or sedentary activity between the groups.
Finally, to add perspective and aid in the interpretation of the quantitative
findings of this thesis, a qualitative study was undertaken to explore the
perceptions and attitudes towards PA among patients with CLBP. The results,
while highlighting a number of important barriers and motivations for PA,
support recent experimental evidence which suggests that a decision to engage
in or avoid activity is partly dependent on the motivational context of the activity.
When patients are intrinsically motivated by non-pain goals, they are more likely
to persist with an activity.
In summary, only depression and BMI were associated with objectively
measured free-living PA and sedentary activity respectively. From a qualitative
perspective, a number of potential barriers and motivations for PA were
indentified although it was clear from the results that choosing to engage in or
avoid activity was highly task- and context-specific.

Suggested citation:

Griffin, Derek William; . () Towards an understanding of physical activity in people with chronic low back pain [Online]. Available from: http://publichealthwell.ie/node/668986 [Accessed: 17th November 2019].

  

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