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  • Effects of reducing sedentary behaviour on back pain, paraspinal muscle insulin sensitivity and muscle fat fraction and their associations: a secondary analysis of a 6-month randomised controlled trial

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Rehabilitation medicine
Original research
Effects of reducing sedentary behaviour on back pain, paraspinal muscle insulin sensitivity and muscle fat fraction and their associations: a secondary analysis of a 6-month randomised controlled trial
  1. Jooa Norha1,2,
  2. Tanja Sjöros2,
  3. Taru Garthwaite2,
  4. Saara Laine2,
  5. Tiina Verho2,
  6. Virva Saunavaara1,3,
  7. Kirsi Laitinen4,
  8. Noora Houttu4,
  9. Jussi Hirvonen5,6,
  10. Henri Vähä-Ypyä7,
  11. Harri Sievänen7,
  12. Eliisa Löyttyniemi8,
  13. Tommi Vasankari5,7,
  14. Kari Kalliokoski2,
  15. Ilkka Heinonen2
  1. 1Turku University Hospital, Turku, Finland
  2. 2Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
  3. 3Department of Medical Physics, Turku University Hospital, Turku, Finland
  4. 4Institute of Biomedicine & Functional Foods Forum, University of Turku, Turku, Finland
  5. 5Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
  6. 6Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
  7. 7UKK-Institute, Tampere, Finland
  8. 8Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
  1. Correspondence to Jooa Norha; jooa.norha{at}utu.fi

Abstract

Objectives Sedentary behaviour (SB) is a plausible intervention target for back pain mitigation. Therefore, this study aimed to investigate the effects of a 6-month SB reduction intervention on back pain and related disability outcomes, and paraspinal muscle (ie, erector spinae and transversospinales separately) insulin sensitivity (glucose uptake, GU) and muscle fat fraction (FF).

Methods Sixty-four adults with overweight or obesity and metabolic syndrome were randomised into intervention (n=33) and control (n=31) groups. The intervention group aimed to reduce SB by 1 hour/day (measured with accelerometers) and the control group continued as usual. Back pain intensity and pain-related disability were assessed using 10 cm Visual Analogue Scales and the Oswestry Disability Index (ODI) questionnaire. Paraspinal muscle GU was measured using 18-fluorodeoxyglucose positron emission tomography during hyperinsulinaemic-euglycaemic clamp. FF was measured using MRI.

Results Pain-related disability increased during the intervention in both groups. Back pain intensity increased significantly more in the control group than in the intervention group in which back pain intensity remained unchanged (group×time p=0.030). No statistically significant between-group changes in pain-related disability, ODI or paraspinal GU and FF were observed. In the whole study group, the change in daily steps was associated positively with the change in paraspinal muscle GU.

Conclusion An intervention focusing on SB reduction may be feasible for preventing back pain worsening regardless of paraspinal muscle GU or FF.

Trial registration number NCT03101228.

  • back pain
  • pain management
  • clinical trial
  • overweight
  • magnetic resonance imaging

Data availability statement

Data are available on reasonable request. Data are available on reasonable request from the corresponding author.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi-org.ezproxy.u-pec.fr/10.1136/bmjopen-2024-084305

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    Data availability statement

    Data are available on reasonable request. Data are available on reasonable request from the corresponding author.

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    Footnotes

    • JN and TS contributed equally.

    • Contributors IH, KK, TVasankari and TS conception and design of the study. TS, SL, TG, KL and NH acquisition of data. TS, JN, HV-Y, HS, TG, SL, TVerho, VS, JH, EL and IH analysis and interpretation of data. JN drafted the manuscript and all authors edited and revised the manuscript. IH acted as the guarantor.

    • Funding This study was funded by the Research Council of Finland (324243), the Finnish Cultural Foundation, the Juho Vainio Foundation, the Hospital District of Southwest Finland, the Yrjö Jahnsson Foundation, the Turku University Foundation, the Finnish Diabetes Research Foundation, Turku University Hospital Foundation and the Päivikki and Sakari Sohlberg foundation (220068).

    • Disclaimer The funding bodies did not take part in designing the study, collecting, analysing or interpreting the data or preparing the manuscript.

    • Competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: TS received a speaker fee from Pihlajalinna Plc, Tampere, Finland. The other authors report no conflicts of interest. The results are presented clearly and honestly without fabrication, falsification or inappropriate data manipulation.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.