Physical Activity Advice for Prevention and Rehabilitation of Low Back Pain- Same or Different? A Study on Device-Measured Physical Activity and Register-Based Sickness Absence.
Nidhi Gupta, Charlotte Lund Rasmussen, Jan Hartvigsen and 4 others
PMID 34626301WHAT IT FOUND
For workers with low back pain, high-intensity activity at work increased sickness absence risk, while light activity at work and moderate-to-vigorous activity during leisure lowered it.
These associations were not significant for workers without low back pain.
Key findings
01Among employees with low back pain, increasing moderate-to-vigorous physical activity (MVPA) at work was associated with higher risk of long-term sickness absence, while increasing light physical activity (LIPA) at work was associated with lower risk.
02Among employees with low back pain, increasing MVPA during leisure was associated with lower risk of long-term sickness absence.
03No statistically significant associations between physical behavior compositions and sickness absence risk were found for employees without low back pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 37% of the eligible sample was included, which may introduce selection bias. The study measured all-cause long-term sickness absence, not absence specifically due to low back pain. Accelerometry cannot capture the context or type of activity (e.g., lifting vs. walking), nor the psychosocial demands of the work. Sleep time was estimated by time in bed, which is a proxy for actual sleep. The study was observational and cannot prove causation; the associations may be influenced by unmeasured factors. The sample was predominantly blue-collar workers, so findings may not generalize to white-collar or office-based populations.
Declared interests
The study was funded by the Work Environment Research Fund Denmark. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret these findings as proof that high-intensity work causes sickness absence or that light work activity prevents it. This is an observational study showing associations, not a trial testing an intervention. The lack of significance in the no-LBP group does not mean activity is irrelevant for them, only that no clear pattern emerged in this sample.