Isotemporal Substitution of Sedentary Behavior by Different Physical Activity Intensities on Pain and Disability of Patients With Chronic Low Back Pain: A Cross-Sectional Study

Author(s)

Freire, Ana Paula Coelho Figueira ; Oliveira, Crystian Bitencourt Soares de ; Christofaro, Diego Giulliano Destro ; Shumate, Sean ; Marques, Larissa Braganca Falcao ; Pinto, Rafael Zambelli

• Document type: Journal article
• Source: ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION; v. 103, n. 10, p. 7-pg., 2022-10-01.

Abstract

Objective: To investigate the association of isotemporal substitution modeling (ISM) of time spent in sedentary activities with physical activity in different intensities on pain and disability of patients with chronic low back pain (LBP).Design: Observational and cross-sectional study. Device-measured physical activity levels were assessed using an actigraph. Pain intensity was measured using the 11-point numeric rating scale, and disability was measured using the Roland Morris Disability Questionnaire. The ISM was used to estimate the theoretical substitution association of reallocating time from 1 exposure variable to an equal amount of time in another expo-sure variable while holding total activity time constant.Settings: Outpatient physical therapy clinic.Participants: This study included data from 358 patients (N=358) with chronic LBP aged between 18 and 60 years.Main Outcome Measures: Pain and disability.Results: Our results suggest that replacing 60 minutes of sedentary behavior with 60 minutes of vigorous activity in a week is significantly associ-ated with a decrease in pain (b=-1.67; 95% confidence interval [CI],-3.18 to-0.15). Additionally, replacing 60 minutes of light physical activ-ity (b=-1.67; 95% CI,-3.18 to-0.16) or moderate activity (b=-1.67; 95% CI,-3.21 to-0.13) with the same amount of time of vigorous activity per week may also favorable reductions in pain. For the analysis of disability, no significant associations (P>.05) for disability in any of the isotemporal models were found.Conclusions: Our results showed that replacing 60 minutes of sedentary behavior with equal amounts of vigorous activity per week was associated with reductions in pain intensity. Similarly, replacing a light or moderate activities with vigorous activity was also associated with reductions in pain intensity. Finally, no significant associations were observed between time spent in sedentary activities with physical activity in different intensities for disability. Archives of Physical Medicine and Rehabilitation 2022;103:1944-50 (c) 2022 by the American Congress of Rehabilitation Medicine. (AU)

• FAPESP's process: 14/14077-8 - Investigating the role of physical activity domains in the prognosis of non-specific low back pain
• Grantee: Rafael Zambelli de Almeida Pinto
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 16/03826-5 - Investigating the effect of a physical activity intervention enhanced with health coaching and FitBit on physical activity levels of patients with chronic low back pain: a randomized controlled trial
• Grantee: Crystian Bitencourt Soares de Oliveira
• Support Opportunities: Scholarships in Brazil - Doctorate