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Does a patient’s physical activity predict recovery from an episode of acute low back pain? A prospective cohort study

Paul Hendrick1*, Stephan Milosavljevic2, Leigh Hale2, Deirdre A Hurley3, Suzanne M McDonough4, Peter Herbison5 and G David Baxter2

Author Affiliations

1 Division of Physiotherapy Education, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK

2 Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand

3 School of Public Health, Physiotherapy and Population Science, College of Life Sciences, University College Dublin, Belfield, Ireland

4 Faculty of Life and Health Sciences, University of Ulster, Newtownabbey, Northern Ireland

5 Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

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BMC Musculoskeletal Disorders 2013, 14:126  doi:10.1186/1471-2474-14-126

Published: 5 April 2013



Advice to remain active and normalisation of activity are commonly prescribed in the management of low back pain (LBP). However, no research has assessed whether objective measurements of physical activity predict outcome and recovery in acute low back pain.


The aims of this study were to assess the predictive relationship between activity and disability at 3 months in a sub-acute LBP population. This prospective cohort study recruited 101 consenting patients with sub-acute LBP (< 6 weeks) who completed the Roland Morris Disability Questionnaire (RMDQ), the Visual Analogue Scale, and resumption of full ‘normal’ activity question (Y/N), at baseline and 3 months. Physical activity was measured for 7 days at both baseline and at 3 months with an RT3 accelerometer and a recall questionnaire.


Observed and self-reported measures of physical activity at baseline and change in activity from baseline to 3 months were not independent predictors of RMDQ (p > 0.05) or RMDQ change (p > 0.05) over 3 months. A self-report of a return to full ‘normal’ activities was significantly associated with greater RMDQ change score at 3 months (p < 0.001). Paired t-tests found no significant change in activity levels measured with the RT3 (p = 0.57) or the recall questionnaire (p = 0.38) from baseline to 3 months.


These results question the predictive role of physical activity in LBP recovery, and the assumption that activity levels change as LBP symptoms resolve. The importance of a patient’s perception of activity limitation in recovery from acute LBP was also highlighted.

Trial registration

Clinical Trial Registration Number, ACTRN12609000282280

Physical activity; Acute low back pain; Recovery; Predictor; Cohort