Efficacy Of Breaking Up Sedentary Time On Pain And Mood In Chronic Low Back Pain

High sedentary time negatively influences health and is associated with an increased risk for chronic low back pain (CLBP). Emerging evidence suggests breaking up prolonged bouts of sedentary behavior may be effective for reducing chronic pain. PURPOSE: This randomized controlled pilot study examined the efficacy of an intervention based on motivational interviewing (MI) and habit theory to reduce and break up sedentary behaviors on pain, depression, and quality of life in individuals with CLBP and elevated symptoms of depression. METHODS: Forty adults with CBLP were randomized to receive a wearable activity tracker with an idle alert along with MI-based health coaching (INT) or a wait-list control condition (WLC) for eight weeks with a 12-week follow-up. Time spent in total and prolonged sedentary behaviors (activPAL and SIT-Q-7D), pain (short-form McGill Pain Questionnaire (MPQ)), depressed mood (Patient Health Questionnaire 9 (PHQ-9)), quality of life (Short-Form 36 (SF-36), Patient Global Impression of Change (PGIC)), and habits surrounding sedentary behavior (Automaticity Scale of the Self-reported habit Index (AS-SRHI)) were assessed pre- and post-intervention and at follow-up. Effect size calculations and repeated measures ANOVAs were used to examine changes in outcomes over the course of the intervention and follow-up. RESULTS: Results demonstrated that, on average, INT reduced time spent in prolonged bouts of sedentary time by ~53 minutes/day compared to WLC who decreased by less than 1 minute/day. INT also experienced large, non-significant improvements in pain and depressed mood (g = 0.70-1.72, p > 0.05) over the intervention and follow-up periods. Quality of life (physical health and bodily pain SF-36 subscales and PGIC) and automaticity of habits surrounding sedentary behavior improved significantly for INT over WLC (p < 0.05). CONCLUSIONS: The present results provide support for the potential utility of decreasing prolonged sedentary behaviors to improve symptoms, and especially quality of life, in those with CLBP. Fully-powered efficacy trials are needed to thoroughly examine the use of this behavioral intervention strategy in clinical settings.