Abstract
A cohort of 38-year-old men and women were studied for leisure time physical exercise in relation to low back pain (LBP), education, work, social class and smoking by a self-administered questionnaire. At the age of 14 years, the subjects had been interviewed by their school doctor regarding history of LBP and radiographs of the thoracic and lumbar spine were taken. The results show no positive correlation between radiographic changes and LBP in the adolescent period and decreased physical activity in adulthood. Physical activity for at least 3 h/week reduces the risk of LBP measured as lifetime, 1-year and point prevalence. Eighty-five percent of the subjects who reported taking physical exercise for at least 3 h/week had participated in sports activity almost constantly since their school days and these reported being in better condition than the rest of the cohort. Otherwise they did not have a healthier mode of life. No physical exercise during leisure time was associated with a short school education, un-skilled work, unemployment and sickness, low social class, divorce, living in an apartment and smoking. Sixty percent had never or not for many years been interested in participating in sports. Badminton and tennis were the most common sports practised (36%), followed by gymnastics (32%), ball games — soccer and team handball - (25%), running (20%) and swimming (18%). Gymnastics and swimming seem to reduce LBP significantly. Our results show a falling interest in participating in sports activities over time, with 68% of the subjects being members of an athletic association previously, but only 29% currently. Women were more physically inactive during leisure time, probably because of their dual role. Logistic regression analysis indicates that physical activity is related to a long school education, high social class and regular sports activity over time.
Key words Low back pain: Physical activity during leisure time, Sports activity, Cohort study
Full Text
The Full Text of this article is available as a PDF (513.8 KB).
References
- 1.Aastrand PO. From exercise physiology to preventive medicine. Ann Clin Res. 1988;20:10–17. [PubMed] [Google Scholar]
- 2.Bredkjær SR. Back disability and other musculoskeletal disorders in the Danish population (in Danish) Copenhagen: Danish Institute of Clinical Epidemiology; 1989. [Google Scholar]
- 3.Cady LD, Bischoff DP, O'Connel ER, Thomas PC, Allan JH. Strength and fitness and subsequent back-injuries among firefighters. J Occup Me. 1979;21:269–272. [PubMed] [Google Scholar]
- 4.Cady LD, Thomas PC, Karwasky RJ. Program for increasing health and physical fitness of firefighters. J Occup Med. 1985;27:110–114. [PubMed] [Google Scholar]
- 5.Dixon WJ. BMDP statistical software. Berkeley: Berkeley University of California Press; 1983. [Google Scholar]
- 6.Goldstein JD, Berger PE, Windler GE, Jackson DW. Spine injuries in gymnasts and swimmers. An epidemic logic investigation. Am J Sport Med. 1991;19:463–468. doi: 10.1177/036354659101900507. [DOI] [PubMed] [Google Scholar]
- 7.Gyntelberg F. One year incidence of low back pain among male residents of Copenhagen aged 40–59. Dan Med Bull. 1974;21:30–36. [PubMed] [Google Scholar]
- 8.Harreby MS, Neergaard K, Hesselsøe G, Kjer J. Are radiological changes in the thoracic and lumbar spine of adolescents risk factors for low back pain in adults? Spine. 1995;21:2298–2302. doi: 10.1097/00007632-199511000-00007. [DOI] [PubMed] [Google Scholar]
- 9.Harreby MS, Kjer J, Hesselsøe G, Neergaard K. Epidemiological aspects and risk factors for low back pain in 38-year-old men and women. Eur Spine J. 1996;5:312–318. doi: 10.1007/BF00304346. [DOI] [PubMed] [Google Scholar]
- 10.Hosmer DW, Lemeshow S. Applied logistic regression. New York: John Wiley; 1989. [Google Scholar]
- 11.Jenne B. Three-year incidence of disability pensions among men. Scand J Soc Med Suppl. 1980;16:17–27. [PubMed] [Google Scholar]
- 12.Kellett KM, Kellett DA, Nordholm LA. Effects of an exercise program on sick leave due to back pain. Phys Ther. 1991;71:283–291. doi: 10.1093/ptj/71.4.283. [DOI] [PubMed] [Google Scholar]
- 13.Kourinka I, Jonsson B, Kiilbom A, Vinterberg H, Bireing-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaire for the analysis of musculoskeletal symptoms. Appl Ergonomics. 1987;18:233–237. doi: 10.1016/0003-6870(87)90010-x. [DOI] [PubMed] [Google Scholar]
- 14.Linton SJ, Bradley LA, Jensen I, Spangfort E, Sundell L. The secondary prevention of low back pain: a controlled study with follow-up. Pain. 1989;36:197–207. doi: 10.1016/0304-3959(89)90024-9. [DOI] [PubMed] [Google Scholar]
- 15.Magora A. Investigation of the relation between low back pain and occupation. 6. Medical history and symptoms. Scand J Rehabil Med. 1974;6:81–88. [PubMed] [Google Scholar]
- 16.Mandel JH, Lohmann W. Low back pain in nurses: the relative importance of medical history, work factors, exercises and demographics. Res Nurs Health. 1987;10:165–170. doi: 10.1002/nur.4770100308. [DOI] [PubMed] [Google Scholar]
- 17.Manniche C, Hesselsøe G, Bentzen L, Christen I, Lundberg E. Clinical trial of intensive muscle training for chronic low back pain. Lancet. 1988;II:1473–1476. doi: 10.1016/s0140-6736(88)90944-0. [DOI] [PubMed] [Google Scholar]
- 18.McQuade KJ, Turner JA, Buchner DM. Physical fitness and chronic low back pain. Clin Orthop. 1988;233:198–204. [PubMed] [Google Scholar]
- 19.Mitchell RI, Carmen GM. Results of a multicenter trial using an intensive active exercise program for the treatment of acute soft tissue and back injuries. Spine. 1990;6:514–521. doi: 10.1097/00007632-199006000-00016. [DOI] [PubMed] [Google Scholar]
- 20.Oland G, Tveiten G. A trial of modern rehabilitation for chronic lowback pain and disability. Spine. 1991;4:457–459. doi: 10.1097/00007632-199104000-00012. [DOI] [PubMed] [Google Scholar]
- 21.Petruzzello SJ, Landers DM, Hatfield BD, Kubitz KA, Salazer W. A metaanalysis on the anxiety-reducing effects of acute and chronic exercise. Outcome and mechanism. Sports Med. 1991;11:143–182. doi: 10.2165/00007256-199111030-00002. [DOI] [PubMed] [Google Scholar]
- 22.Rossi F. Spondylolysis, spondylolisthesis and sports. J Sport Med. 1978;18:317–340. [PubMed] [Google Scholar]
- 23.Svensson HO. Low back pain in forty to forty-seven year old men. 2. Socio-economic factors and previous sickness absence. Scand J Rehabil Med. 1982;14:55–60. [PubMed] [Google Scholar]
- 24.Swærd L, Hellstrom M, Jacobsson B, Nymann R, Peterson L. Disc degeneration and associated abnormalities of elite gymnasts. Spine. 1991;16:437–443. doi: 10.1097/00007632-199104000-00009. [DOI] [PubMed] [Google Scholar]
- 25.Videman T, Nurminen T, Tola S. Low back pain in nurses and some loading factors of work. Spine. 1984;9:400–404. doi: 10.1097/00007632-198405000-00013. [DOI] [PubMed] [Google Scholar]
- 26.Weber H. Lumbar disc herniation. A controlled prospective study with ten years of observation. Spine. 1983;8:131–140. [PubMed] [Google Scholar]