Does the performance of five back-associated exercises relate to the presence of low back pain? A cross-sectional observational investigation in regional Australian council workers

Abstract

Objectives Investigate the relationships between the ability/inability to perform five physical test exercises and the presence or absence of low back pain (LBP). Setting Regional Australian council training facility. Participants Consecutive participants recruited during 39 back education classes (8-26 participants per class) for workers in general office/administration, parks/gardens maintenance, roads maintenance, library, child care and management. Total sample (n=539) was reduced through non-consent and insufficient demographic data to n=422. Age 38.6±15.3 years, range 18-64 years, 67.1% male. Methods Cross-sectional, exploratory, observational investigation. LBP presence was ascertained from a three-response option questionnaire: 0=none/rarely (no) 1=sometimes (some), 2=mostly/always (most). Statistical correlation was performed with the number of the five test exercises the individual successfully performed: (1) extension in lying: 3 s; (2) 'toilet squat'; feet flat, feet touched: 3 s; (3) full squat then stand up: 5 times; (4) supine sit-up, knees flexed: 10 times; and (5) leg extension, supine bilateral: 10 times. Interventions Nil. Results For the group 'no-some', 94.3% completed 4-5 test exercises, while for group 'With', 95.7% completed 0-1 test exercises. The relationship between LBP presence and number of exercises performed was highly significant (χ2(10)=300.61, p<0.001). Furthermore, multinomial logistic regression predicting LBP (0=no, 1=some, 2=most) from the number of exercises completed, substantially improved the model fit (initial-2LL=348.246, final-2LL=73.620, χ2(2)=274.626, p<0.001). As the number of exercises performed increased, the odds of reporting 'some LBP' or 'most LBP' dropped substantially (ORs of 0.34 and 0.17, respectively). Conclusion The ability to complete/not complete five test exercises correlated statistically and significantly with a higher LBP absence/presence in a general working population. Training individuals to complete such exercises could facilitate reductions in LBP incidence; however, causality cannot be inferred. Randomised trials are recommended to establish the potential efficacy of exercise-based approaches, considering these five selected exercises, for predicting and managing LBP.