Physical activity levels in adults with chronic low back pain: A national survey in the general Spanish population

Abstract

Objective: To identify and compare physical activity levels in the Spanish population with chronic low back pain and their associated factors. Design: Cross-sectional national study. Subjects: A total of 3,220 adults with chronic low back pain from the 2017 Spanish National Health Survey. Methods: Three groups were defined according to physical activity level (low, moderate, and high) assessed with the International Physical Activity Questionnaire. Descriptive analysis and an ordinal regression model were performed. Results: Thirty percent of the subjects were classed as doing a low level of physical activity, 53% moderate, and 17% high. Females predominated in the low and moderate groups, and the subjects in the high group were younger. Subjects in the low group reported more use of pain-relief, more severe-extreme pain, more functional limitations, and worse quality of life and mental health. Factors more likely to be associated with higher levels of physical activity were: being male, normal body mass index or overweight, better health status, less pain, less physical and cognitive limitations, and more social support. Conclusion: Different aspects of the biopsychosocial framework were associated with the different levels of physical activity in subjects with chronic low back pain. These findings should be taken into consideration in order to establish suitable public health strategies. LAY ABSTRACT Physical activity benefits subjects with chronic pain, although its performance depends on various factors. This study analysed 3,220 adults with chronic low back pain from the 2017 Spanish National Health Survey, in order to identify and compare levels of physical activity (International Physical Activity Questionnaire) and their associated factors. Thirty percent of subjects were classed as doing low levels of physical activity, 53% moderate, and 17% high. Females predominated in the low and moderate level groups, and subjects with a high level of physical activity were younger. Subjects in the low level of physical activity group reported more consumption of pain-relief, more severe-extreme pain, more functional limitations, and worse quality of life and mental health. Factors associated with more physical activity were being male, normal body mass index (BMI) or overweight, better health status, less pain, less physical and cognitive limitations, and more social support. In conclusion, different biopsychosocial aspects were associated with the different levels of physical activity in subjects with chronic low back pain, and this information should be taken into consideration in order to establish suitable public health strategies.

Keywords

• biopsychosocial model
• chronic pain
• low back pain
• musculoskeletal pain
• physical activity