Jakobsson M.1, Brisby H.1, Hagströmer M.2, Hägg O.3, Lotzke H.1, Smeets R.4, Lundberg M.2,5
1University of Gothenburg, Department of Orthopaedics, Gothenburg, Sweden, 2Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden, 3Spine Center, Gothenburg, Department of Orthopaedics, Västra Frölunda, Sweden, 4Maastricht University, Department of Rehabilitation Medicine, Maastricht, Netherlands, 5Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg, Sweden

Background: The number of patients undergoing lumbar fusion surgery for degenerative disc disease (DDD) has increased worldwide. People who are to undergo spinal surgery are assumed to be less physically active than individuals without pain. Physical activity is of essence, both to avoid the negative health consequences of insufficient physical activity and to promote the analgesic effect from physical activity. Little is known about physical activity and sedentary behaviour among patients with DDD.

Purpose: To describe levels of physical activity and sedentary behaviour among patients with DDD who are to undergo lumbar fusion surgery.

Methods: The study contained 45 women and 39 men (mean age 45 and 47 years) with DDD, diagnosed by an orthopaedic surgeon. They were recruited from three different orthopaedic clinics in Sweden. Physical activity (steps per day and time spent in moderate and vigorous intensity) and sedentary behaviour (time spent sedentary) were assessed with ActiGraph GT3X+ accelerometers. The accelerometers were worn for 7 days, 8 to 12 weeks before surgery. The data were analysed by the software ActiLife v6.12.0. Data were compared to the WHO´s recommendations on physical activity for health. The recommendations state that adults aged 18-64 should perform at least 150 minutes of moderate-intensity physical activity per week, or 75 minutes of vigorous-intensity physical activity per week, or an equivalent combination of moderate- and vigorous-intensity physical activity. This recommendation is comparable to 7000 steps per day.

Results: On average, the patients spent 191 (SD = 139) minutes on moderate-intensity physical activity level and 7 (SD = 18) minutes on vigorous-intensity physical activity per week. Thirty-seven patients (44%) spent less than 150 minutes in moderate-intensity physical activity per week, and 59 patients (70%) did not spend any time in vigorous-intensity physical activity at all. Patients averaged 542 (95% Cl: 518, 566) minutes of sedentary behaviour per day. On average, the patients walked 7 500(SD = 2771) steps per day, equivalent to the recommendation for health set to 7000 steps/day.

Conclusion(s): Nearly half of the study population did not reach the WHO´s recommendation for moderate-intensity physical activity per week. Furthermore, two third of the patients did not spend any time in vigorous-intensity physical activity which might reduce the analgesic effect on pain.

Implications: Patients with CLBP who are physically inactive have an increased risk of developing negative health conditions such as cardiovascular disease, obesity, cancer and diabetes.These aspects must be considered when designing protocols for prehabilitation and rehabilitation for this patient group.

Funding acknowledgements: The trial was supported by The Eurospine Research Grants; The Swedish Research Council (VR); and The AFA Insurance Funding.

Topic: Pain & pain management

Ethics approval: This trial has been approved by the Ethical Committee of Gothenburg, Dnr.586-11.

All authors, affiliations and abstracts have been published as submitted.

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