Association between lifestyle behaviors and health-related quality of life in persistent low back pain – 13-year longitudinal cohort-study in primary care

To explore the association between lifestyle behaviors and health-related quality of life in women with PLBP in primary care over a 13-year period. 

In this longitudinal prospective cohort study of women with PLBP, 67% (87/130) were followed up after 13 years. The same study protocol, including, social demographic data, patient-reported outcome measures, pain threshold assessments, and physical capacity tests, was administered at baseline, after two years, and again after 13 years. Linear regression models were used to analyze associations between lifestyle factors (Body Mass Index, tobacco use, alcohol habits, self-reported physical activity level, physical capacity (6-Minute Walk Test), sleep quantity, sleep quality, and symptoms of clinical stress) at baseline and physical and mental health-related quality of life (SF-36: Physical Component Score and Mental Component Score) after 13 years. 

The women’s mean age at baseline was 46 (SD11) years and the PLBP duration was 9.8 (SD 8.9) years. Mean value for pain intensity last week on a Visual Analog Scale (0-100 mm) was 41 (SD25) mm. The preliminary results show that fewer symptoms of clinical stress at baseline were associated with better mental quality of life at the 13-year follow-up. Fewer symptoms of clinical stress, better sleep quantity and quality, and higher physical capacity at baseline were associated with better physical quality of life after 13 years.

The preliminary results indicate that lower levels of clinical stress symptoms at baseline are associated with both better physical and mental quality of life after 13 years. Better physical quality of life was also associated with good sleep quantity and quality, and higher physical capacity at baseline. These findings suggest that managing stress, maintaining good sleep habits, and improving physical fitness may contribute to long-term improvements in health-related quality of life for individuals with PLBP.

PLBP is a condition for which individuals seek physiotherapy in primary care, suggesting that findings from long-term follow-ups can be communicated to promote improved lifestyle behaviors. Furthermore, these results can be used to inform the planning and development of future interventional research.