Measurement Properties of the Sedentary Behavior Questionnaire in Patients with Chronic Nonspecific Low Back Pain

A potential environmental paradox in India: Associations between air pollution precautions and sedentary behaviour among children and youth

The negative impact of ambient air pollution on movement behaviours in the global south is a significant concern. Yet, evidence about this complex relationship is limited. This study assessed how precautions taken to prevent ambient air pollution exposure are associated with sedentary behaviour among children and youth in India. Participants aged 5-17 years (N = 986) from 41 schools in 28 urban and rural areas across India completed online surveys to provide information on movement behaviours, including precautions taken to avoid exposure to air pollution, perception of built environment, and sedentary behaviour. Multivariate gamma regression models were developed, adjusting for sociodemographic variables with sedentary behaviour as the primary criterion variable. Apart from an overall sample model, six segregated models were built to understand age, gender, and geographical variations. Children and youth who reported taking precautions to prevent ambient air pollution exposure were associated with significantly higher daily minutes of sedentary behaviour in both the overall sample (β = 0.085, 95 % CI = 0.001, 0.169) and the 13 to 17 age group (β = 0.110, 95 % CI = 0.007, 0.227). However, being able to access outdoor physical activity facilities before or after school was associated with lower sedentary behaviour in the following models: overall, rural, 5 to 12 and 13 to 17 age groups, and boys and girls. To our knowledge, this is the first study to depict a potential paradoxical relationship between precautions taken to avoid exposure to ambient air pollution and higher sedentary behaviour among children and youth in India i.e., a health-preserving behaviour is perpetuating another chronic disease risk factor.

Measuring objective physical activity in people with chronic low back pain using accelerometers: a scoping review

Purpose

Accelerometers can be used to objectively measure physical activity. They could be offered to people with chronic low back pain (CLBP) who are encouraged to maintain an active lifestyle. The aim of this study was to examine the use of accelerometers in studies of people with CLBP and to synthesize the main results regarding the measurement of objective physical activity.

Methods

A scoping review was conducted following Arksey and O'Malley's framework. Relevant studies were collected from 4 electronic databases (PubMed, Embase, CINHAL, Web of Science) between January 2000 and July 2023. Two reviewers independently screened all studies and extracted data.

Results

40 publications out of 810 citations were included for analysis. The use of accelerometers in people with CLBP differed across studies; the duration of measurement, physical activity outcomes and models varied, and several limitations of accelerometry were reported. The main results of objective physical activity measures varied and were sometimes contradictory. Thus, they question the validity of measurement methods and provide the opportunity to discuss the objective physical activity of people with CLBP.

Conclusions

Accelerometers have the potential to monitor physical performance in people with CLBP; however, important technical limitations must be overcome.

Adding Physical Activity Coaching and an Activity Monitor Was No More Effective Than Adding an Attention Control Intervention to Group Exercise for Patients With Chronic Nonspecific Low Back Pain (PAyBACK Trial): A Randomized Trial

OBJECTIVE

To investigate whether adding physical activity coaching and an activity monitor enhanced the effects of a group exercise program on pain intensity and disability for people with chronic nonspecific low back pain.

DESIGN

Randomized controlled trial with concealed allocation, intention-to-treat analysis, and blinding of participants and assessors.

METHODS

One hundred sixty participants with chronic nonspecific low back pain who were aged between 18 and 60 years and seeking care at an outpatient physiotherapy clinic participated. Both groups received supervised group exercise therapy. The intervention group also received physical activity coaching sessions aimed at improving physical activity, and physical activity electronic feedback delivered by an activity monitor. The attention control group received modified approaches of coaching sessions and an activity monitor. Disability was measured using the Roland Morris Disability Questionnaire (0-24), and pain intensity was measured using the 11-point Numerical Rating Scale (0-10). Linear mixed models were performed to test for differences between groups.

RESULTS

There were no differences between groups for reductions in disability (mean difference [MD] = -0.5 out of 24 points; 95% confidence interval [CI]: -2.2, 1.1) and pain intensity (MD = -0.4 out of 10 points; 95% CI: -1.3, 0.5) at 3-month follow-up. There were no between-groups differences at 6- and 12-month follow-up assessments.

CONCLUSION

Adding targeted physical activity coaching and an activity monitor did not reduce pain intensity or disability more than an attention control approach in participants with chronic low back pain who were undertaking a group exercise program. J Orthop Sports Phys Ther 2022;52(5):287-299. doi:10.2519/jospt.2022.10874.