Author(s): NORHA, J., SJÖROS, T., GARTHWAITE, T., LAINE, S., VERHO, T., LAITINEN, K., HOUTTU, N., VÄHÄ-YPYÄ, H., SIEVÄNEN, H., LÖYTTYNIEMI, E., VASANKARI, T., KALLIOKOSKI, K.K., HEINONEN, I.H.A., Institution: UNIVERSITY OF TURKU, Country: FINLAND, Abstract-ID: 1682

INTRODUCTION:
Reducing sedentary behaviour (SB) could potentially be beneficial for back pain mitigation but the current evidence is conflicting. Moreover, the mechanisms by which SB reduction could affect back pain are poorly understood. Impaired insulin sensitivity (IS) and increased paraspinal muscle fat fraction (FF) are related to both back pain and high SB, or conversely low physical activity (PA), and therefore they may mediate the effects of SB on back pain. Thus, we aimed to investigate the effects of a six-month SB reduction intervention on back pain, disability, and paraspinal muscle IS and FF.
METHODS:
Sixty-four physically inactive adults with overweight or obesity and metabolic syndrome were randomized into intervention (n=33) and control (n=31) groups. Participants in the intervention group aimed at reducing accelerometer-measured SB by 1 h/day for six months. SB was replaced by everyday non-exercise activities based on individual preferences. The control group was advised to maintain usual SB and PA habits. All participants wore accelerometers, which were connected to a smartphone application for self-monitoring of the individually set daily SB and PA goals. Back pain and disability were assessed using 10 cm visual analogue scales and the Oswestry disability index. In a subsample of n=44, paraspinal muscle IS and FF were measured using FDG-PET imaging during hyperinsulinemic-eugclycemic clamp and magnetic resonance imaging, respectively.
RESULTS:
The intervention group reduced SB by 40 min/day and increased moderate-to-vigorous PA by 20 min/day whereas no statistically significant changes in the control group were observed. A significant group x time interaction on back pain intensity was observed in favour of the intervention group (intervention group pre 1.3 [95% CI 0.5, 2.4] cm, post 1.3 [0.5, 2.4] cm; control group pre 1.3 [0.5, 2.3] cm, post 2.6 [1.4, 4.0] cm; group x time p=0.030). No statistically significant changes in disability or paraspinal muscle IS or FF were observed.
CONCLUSION:
A six-month intervention aimed at reducing SB 1 h/day may be feasible for preventing back pain intensity increase regardless of paraspinal muscle IS or FF.