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Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials

BACKGROUND: Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical...

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Autores principales: Holm, Lena W., Onell, Clara, Carlseus, Martin, Ekwurtzel, Robin, Holmertz, Olle, Bohman, Tony, Skillgate, Eva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501526/
https://www.ncbi.nlm.nih.gov/pubmed/34625083
http://dx.doi.org/10.1186/s12891-021-04727-2
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author Holm, Lena W.
Onell, Clara
Carlseus, Martin
Ekwurtzel, Robin
Holmertz, Olle
Bohman, Tony
Skillgate, Eva
author_facet Holm, Lena W.
Onell, Clara
Carlseus, Martin
Ekwurtzel, Robin
Holmertz, Olle
Bohman, Tony
Skillgate, Eva
author_sort Holm, Lena W.
collection PubMed
description BACKGROUND: Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs). METHODS: Analyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location. RESULTS: Participants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49). CONCLUSIONS: Persons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain. TRIAL REGISTRATION: Registration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776
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spelling pubmed-85015262021-10-20 Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials Holm, Lena W. Onell, Clara Carlseus, Martin Ekwurtzel, Robin Holmertz, Olle Bohman, Tony Skillgate, Eva BMC Musculoskelet Disord Research BACKGROUND: Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs). METHODS: Analyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location. RESULTS: Participants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49). CONCLUSIONS: Persons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain. TRIAL REGISTRATION: Registration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776 BioMed Central 2021-10-08 /pmc/articles/PMC8501526/ /pubmed/34625083 http://dx.doi.org/10.1186/s12891-021-04727-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Holm, Lena W.
Onell, Clara
Carlseus, Martin
Ekwurtzel, Robin
Holmertz, Olle
Bohman, Tony
Skillgate, Eva
Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
title Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
title_full Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
title_fullStr Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
title_full_unstemmed Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
title_short Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
title_sort vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain – a secondary analysis of randomized controlled trials
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501526/
https://www.ncbi.nlm.nih.gov/pubmed/34625083
http://dx.doi.org/10.1186/s12891-021-04727-2
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