ArticleRelationship between physical activity and disability in low back pain: A systematic review and meta-analysisLin, Chung-Wei Christinea,*; McAuley, James H.b; Macedo, Lucianac; Barnett, Dominique C.d; Smeets, Rob J.e; Verbunt, Jeanine A.e Author Information aThe George Institute for Global Health and Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia bNeuroscience Research Australia and the University of New South Wales, New South Wales, Australia cCommon Spinal Disorders Research Group, Faculty of Rehabilitation Medicine, University of Alberta, Alta, Edmonton, Canada dThe George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia eAdelante Center of Expertise in Rehabilitation and Audiology, and Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands *Corresponding author. Address: P.O. Box M201, Missenden Rd, Sydney NSW 2050, Australia. Tel.: +61 2 9657 0300; fax: +61 2 9657 0301. E-mail: [email protected] Submitted November 3, 2010; revised November 23, 2010; accepted November 29, 2010. Pain: March 2011 - Volume 152 - Issue 3 - p 607-613 doi: 10.1016/j.pain.2010.11.034 Buy Metrics Abstract It is often assumed that patients with pain-related disability due to low back pain (LBP) will have reduced physical activity levels, but recent studies have provided results that challenge this assumption. The aim of our systematic review was to examine the relationship between physical activity and disability in LBP. The literature search included 6 electronic databases and the reference list of relevant systematic reviews and studies to May 2010. To be included, studies had to measure both disability (eg, with the Roland Morris Disability Questionnaire) and physical activity (eg, by accelerometry) in patients with non-specific LBP. Two independent reviewers screened search results and extracted data, and authors were contacted for additional data. Correlation coefficients were pooled using the random-effects model. The search identified 3213 records and 18 studies were eligible for inclusion. The pooled results showed a weak relationship between physical activity and disability in acute or subacute (<3 months) LBP (r = −0.08, 95% confidence interval = −0.17 to 0.002), and a moderate and negative relationship in chronic (>3 months) LBP (r = −0.33, 95% confidence interval = −0.51 to −0.15). That is, persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability. Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity. Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability. Persons with chronic back pain with high levels of disability will likely have low levels of physical activity. © 2011 Lippincott Williams & Wilkins, Inc.