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Table 4 Characteristics and results of high quality articles regarding low back pain

From: The association between physical activity and neck and low back pain: a systematic review

Study Study design (follow-up period) Study population and participation rate Type and measure of physical activity Measure of pain (recall period) Results (level of physical activity, otherwise stated) Conclusion
Heneweer et al. [20] Cross-sectional General population 47% Routine daily activities and leisure time physical activity assessed by using Short Questionnaire to Assess Health enhancing physical activity (SQUASH) Self-reported questionnaire (the previous 12 months) Low physical activity level (not fulfilling the recommended activity level of at least 0.5 h of moderate activity per day for at least 5 days a week) Both extremely low and high levels of physical activity were associated with an increased risk of chronic low back pain
1.31 (1.08–1.58)
Moderate physical activity level 1.00
High physical activity level (physical activity level with the highest quartile of the amount of physical activity and the performance of high intensive sport activities)
1.22 (1.00–1.49)
Wedderkopp et al. [47] prospective cohorts (3 years) School children ?% Overall physical activity at least 10 h per day assessed by using MTI-accelerometer Interviewing (the past month) Back pain at baseline The tertile with the lowest HPA had an increased odds ratio of having low back pain
High physical activity (HPA)
Bivariate analysis 1.1 (0.1–9.8)
No back pain at baseline
High physical activity (HPA)
Multivariate analysis 4.6 (1.9–11.2)
Bivariate analysis 4.9 (1.7–14.0)
Auvinen et al. [5] Cross-sectional School children 64% Leisure time (outside school hours) assessed by using self-reported questionnaire Self-reported questionnaire (the past 6 months) Very active (>6 h of brisk physical activity per week) Being physically very active was associated with increased prevalence of low back pain
1.16–3.93 (0.91–6.65)
Active (4–6 h of brisk physical activity per week)
0.94–1.61 (0.53–2.65)
Moderately active (2–3 h of brisk physical activity per week) 1.00
Lightly active (1 h of brisk physical activity or <0.5 h of brisk physical activity together with >2 h of light or commuting physical activity per week)
0.75–1.51 (0.41–2.36)
Inactive (<0.5 h of brisk physical activity and <2 h of light or commuting physical activity per week)
0.65–1.14 (0.29–1.93)
Björck-van Dijken et al. [6] Cross-sectional General population 69% Both work and leisure time assessed by using self-reported questionnaire Self-reported questionnaire (lifetime) Sitting work 1.00 High levels of physical activity at work and low physical activity at leisure time was associated with increased prevalence of low back pain
Light physical work 1.13 (0.95–1.35)
Moderate heavy work 1.37 (1.14–1.65)
Heavy work 1.46 (1.09–1.94)
Low physical activity during leisure time in the past year
1.16 (1.02–1.33)
Diepenmaat et al. [14] Cross-sectional School children 92% ? (type of Physical activity) assessed by using self-reported questionnaire Self-reported questionnaire (the past month) 0–0.5 h per day 1.00 No significant association between physical activity and low back pain
0.51–1.0 h per day 1.2 (0.8–1.7)
≥1.01 h per day 1.0 (0.8–1.3)
Mikkelsson et al. [33] Prospective cohorts (25 years) School children 67% Leisure time (outside school hours) assessed by using self-reported questionnaire Self-reported questionnaire (lifetime) School age physical activity Men who were physically active in adolescence were at a lower risk of recurrent low back pain
Men
Inactive (<2 times per week for at least 30 min per session of physical activity outside school hours) 1.00
Active (≥2 times per week for at least 30 min per session of physical activity outside school hours) 0.62 (0.39–0.98)
Women
Inactive 1.00
Active 0.80 (0.48–1.32)
Physical activity at follow up
<1 time a week 1.00
1–4 times a week 0.65–1.31 (0.37–2.14)
5–7 times a week 0.54–0.88 (0.25–1.87)
Sjolie [39] Cross-sectional School children 84% Leisure time assessed by using self-reported questionnaire Self-reported questionnaire (the preceding year) Physical activity (hour), quartiles 0.6 (0.4–0.8) Physical activity was significantly associated with decreased risk of low back pain, in particular with regular walking or bicycling
Walking or bicycling 0.4 (0.2–0.8)
Wedderkopp et al. [46] Cross-sectional School children 79% Leisure time assessed by using self-reported questionnaire and the CSA accelerometer Interviewing (the preceding month) No significant positive or negative associations were noted between self-reported physical inactivity and low back pain (p = 0.41) No significant association between physical activity and low back pain
There were no associations between low back pain and the objectively measured level of physical activity (data not showed)
Brown et al. [9] Cross-sectional General population (women) 99% Leisure time assessed by using self-reported questionnaire Self-reported questionnaire (lifetime) PA score <5 (none or very low; equivalent to no PA or moderate PA once per week) 1.00 Physical activity was significantly associated with decreased risk of low back pain
PA score 5 to <15 (low to moderate; moderate PA 2–4 times or vigorous PA 1–2 times per week, or equivalent combination)
0.83–0.91 (0.74–1.02)
PA score 15 to <25 (moderate to high; moderate PA 5–8 times or vigorous PA 3–5 times per week, or equivalent combination) 0.76–0.85 (0.68–0.95)
PA score ≥25 (high; moderate PA 8–13 times or vigorous PA 5–8 times per week, or equivalent combination)
0.67–0.84 (0.58–0.95)
Kujala et al. [29] Cross-sectional School children ?% Leisure time (outside school hours) assessed by using self-reported questionnaire Self-reported questionnaire (the preceding 12 months) Prevalence of low back pain; High leisure physical activity was associated with increased prevalence of low back pain
Low MET 9.7%
Middle MET 11.7%
High MET 14.6%
p = 0.022