These data suggest that the activity levels of patients with NSLBP are neither associated with , nor predictive of , disability or pain levels .
Although clinical guidelines advocate exercise and activity in the management of non-specific low back pain ( NSLBP ) , the link between levels of physical activity and outcomes is unclear .
This systematic review investigated the relationships between free living activity levels  after onset of low back pain ( LBP ) and measures of pain , and disability in patients with NSLBP .
The effectiveness of graded activity for low back pain in occupational healthcare
Background : Low back pain is a common medical and social problem associated with disability and absence from work . Knowledge on effective return to work ( RTW ) interventions is scarce . Objective : To determine the effectiveness of grade d activity as part of a multistage RTW programme . Design : R and omised controlled trial . Setting : Occupational healthcare . Subjects : 112 workers absent from work for more than eight weeks due to low back pain were r and omised to either grade d activity ( n = 55 ) or usual care ( n = 57 ) . Intervention : Grade d activity , a physical exercise programme aim ed at RTW based on operant-conditioning behavioural principles . Main outcome measures : The number of days off work until first RTW for more then 28 days , total number of days on sick leave during follow up , functional status , and severity of pain . Follow up was 26 weeks . Results : Grade d activity  prolonged RTW . Median time until RTW was equal to the total number of days on sick leave and was 139 ( IQR = 69 ) days in the grade d activity group and 111 ( IQR = 76 ) days in the usual care group ( hazard ratio = 0.52 , 95 % CI 0.32 to 0.86 ) . An interaction between a prior workplace intervention and grade d activity , together with a delay in the start of the grade d activity intervention , explained most of the delay in RTW ( hazard ratio = 0.86 , 95 % CI 0.40 to 1.84 without prior intervention and 0.39 , 95 % CI 0.19 to 0.81 with prior intervention ) . Grade d activity did not improve pain or functional status clinical ly significantly . Conclusions : Grade d activity was not effective for any of the outcome measures . Different interventions combined can lead to a delay in RTW . Delay in referral to grade d activity delays RTW . In implementing grade d activity special attention should be paid to the structure and process of care
These data suggest that the activity levels of patients with NSLBP are neither associated with , nor predictive of , disability or pain levels .
Although clinical guidelines advocate exercise and activity in the management of non-specific low back pain ( NSLBP ) , the link between levels of physical activity and outcomes is unclear .
This systematic review investigated the relationships between free living activity levels  after onset of low back pain ( LBP ) and measures of pain , and disability in patients with NSLBP .