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Final Program


Final Program

Pain

1452 - Factors associated with activity level in adults with chronic low back pain

Thursday, February 19, 2026
5:00 PM - 6:30 PM AST
Objectives: Identify relationships between biopsychosocial factors and physical activity in persons with chronic low back pain (cLBP)

Design: This observational cross-sectional study included 778 adults with cLBP recruited by the overarching Low Back Pain Biological, Biomechanical, Behavioral Phenotypes (LB3P) study of 1007 participants (excluding those missing data for tested variables). Demographic information, a battery of patient reported outcome measures, and actigraphy data were collected for each participant. Activity monitors worn for 4-7 days measured average daily step count (SC) and average daily minutes of moderate to vigorous physical activity (MVPA). Negative binomial regression was used for modeling SC, and logistic regression for identifying predictors of MVPA >=5 minutes versus MVPA< 5 minutes based on distribution. 

Results: The cohort aged 18-95 years (mean 61 +/- 16) and consisted of 316 males (41%) and 462 females (59%). Median SC was 3,397 steps (IQR = 1,860-5,243) and median MVPA was 6.4 minutes (IQR=1.8-17.0). Higher SC and odds of MVPA >=5 minutes were seen in males compared to females (SC: Incidence Rate Ratio [95% CI] (IRR)=1.17[1.07-1.29]; MVPA: Odds Ratio [95% CI] (OR)=1.94[1.36-2.78]), and in employed compared to unemployed persons (SC: IRR=1.13[1.02-1.25]; MVPA: OR=1.75[1.20-2.55]). Both measures of activity were inversely associated with age (SC: IRR=0.99[0.98-0.99]; MVPA: OR=0.93[0.92-0.95]), BMI (SC: IRR=0.97[0.96-0.98]; MVPA: OR=0.93[0.91-0.96]), and pain interference score (SC: IRR=0.99[0.98-0.995]; MVPA: OR=0.94[0.91-0.98]). Odds of MVPA >=5 minutes were additionally inversely associated with fear-avoidance beliefs about physical activity (FABQ-PA) (OR=0.95[0.92-0.98]). Activity levels were not significantly associated with pain severity, sleep disturbance, anxiety, depression, self-efficacy, positive outlook, pain acceptance, pain catastrophizing, education level, or financial stress. 

Conclusions: Physical activity in adults with cLBP is multifaceted. Younger age, male sex, lower BMI, and employment were associated with higher activity. While lower pain interference scores and FABQ-PA were associated with higher activity, there was not a significant relationship between pain severity and activity.