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      Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: results from the Nord-Trøndelag Health Study

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          Abstract

          Background

          Physical inactivity is associated with several diseases, but studies evaluating the association between chronic musculoskeletal complaints (MSCs) and physical exercise have shown conflicting results. The aim of this large-scale prospective population-based study was to investigate the association between self-reported physical exercise at baseline and the prevalence of chronic musculoskeletal complaints (MSCs) 11 years later.

          Methods

          The results are based upon two consecutive public health studies conducted within the county of Nord-Trøndelag, Norway (The HUNT studies). A total of 39,520 (83%) out of 47,556 adults who participated in HUNT 1 and HUNT 2 responded to questions about physical exercise at baseline in 1984–86, and to questions about musculoskeletal complaints 11 years later (1995–97). Chronic MSCs was defined as MSCs ≥ 3 months during the past year, and chronic widespread MSCs such as pain ≥ 15 days during the last month from the axial region, above the waist, and below the waist. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). All the final analyses were adjusted for age, gender, body mass index, smoking and education level.

          Results

          At follow-up 20,223 (51%) reported chronic MSCs, and among these 2,318 (5.9%) reported chronic widespread MSCs. Individuals who exercised at baseline were less likely to report chronic MSCs 11 years later (OR 0.91, 95% CI 0.85–0.97) than inactive persons. Among individuals who exercised more than three times per week, chronic widespread MSCs were 28% less common (OR 0.72, 95% CI 0.59–0.88) compared to inactive individuals.

          Conclusion

          In this large-scale population-based study, physical exercise was associated with lower prevalence of chronic MSCs, in particular chronic widespread MSCs. Future studies should try to clarify whether chronic MSCs are a cause or a consequence of inactivity.

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          Most cited references31

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          Reliability and validity of self-reported physical activity in the Nord-Trøndelag Health Study: HUNT 1.

          A large health survey was previously conducted in 1984-86, the Nord-Trøndelag Health Study (HUNT 1), and another was conducted in 1995-97 (HUNT 2). A third, HUNT 3, started in 2006. However, the physical activity (PA) questionnaires have not yet been validated. To assess the reliability and validity of the self-reported physical activity questionnaire in the Nord-Trøndelag Health Study (HUNT 1). The HUNT 1 questionnaire was administered to a random sample of 108 healthy men aged 20-39 years. Repeatability was assessed with a repeat questionnaire after one week, and validity by comparing results with direct measurement of VO(2) during maximal work on a treadmill, with ActiReg, an instrument that measures PA and energy expenditure (EE) and with the International Physical Activity Questionnaire (IPAQ). ActiReg records the main body positions (stand, sit, bent forward and lie) together with the motion of the trunk and/or one leg each second. The results indicated strong, significant agreement on test-retest (weighted kappa frequency, r=0.80, intensity, r=0.82, and duration, r=0.69). We found a moderate, significant correlation, r=0.48 (p< or =0.01), between the index based on questionnaire responses and VO(2max.) Metabolic equivalent (MET) values of 6 or more from ActiReg and "vigorous activity'' from the IPAQ most strongly correlated with the index (r=0.39, r=0.55, respectively). Associations of other measures obtained from ActiReg with questionnaire responses were weaker. Our results indicate that the PA questionnaire in HUNT 1 is reproducible and provides a useful measure of leisure-time PA for men. The questionnaire is very short, and compared favourably with much longer instruments for assessment of more vigorous PA. It should be an appropriate tool for use in further epidemiological studies, particularly when the interest is in aspects of PA reflected in fitness or METs greater than 6.
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            Race/ethnicity, social class, and leisure-time physical inactivity.

            The aims of this study were to determine 1) prevalence of leisure-time physical inactivity in a nationally representative sample of non-Hispanic white, non-Hispanic black, and Hispanic men and women; 2) prevalence of leisure-time inactivity by racial/ethnic group across social class indicators; and 3) the relationship between leisure-time inactivity and occupational physical activity, independent of other social class indicators. The National Physical Activity and Weight Loss Survey was a telephone survey of noninstitutionalized U.S. adults (4695 men, 6516 women) conducted by random digit dialing between September and December 2002. Self-reported physical activity was assessed using questions from the 2001 Behavioral Risk Factor Surveillance System. Respondents who reported no moderate- or vigorous-intensity physical activity during leisure time in a usual week were classified as inactive. Indicators of social class were education, family income, employment status, and marital status. Age-adjusted prevalence of leisure-time inactivity was 9.9% +/- 0.6 SE (standard error) and 12.0 +/- 0.6 for white men and women, respectively; 19.0 +/- 2.5 and 25.2 +/- 2.1 for non-Hispanic black men and women, and 20.9 +/- 2.1 and 27.3 +/- 2.5 for Hispanic men and women. Within each racial/ethnic group, prevalence of leisure-time inactivity was highest among participants of lower social class. Differences in inactivity by racial/ethnic group were less evident after adjustment for social class. Odds of inactivity were similar across quartiles of occupational physical activity after adjustment for age, sex, and social class. Non-Hispanic blacks and Hispanics were more inactive during their leisure time than were non-Hispanic whites. Social class but not occupational physical activity seems to moderate the relationship between race/ethnicity and leisure-time physical inactivity.
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              The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations.

              To assess the association between leisure time physical activity and musculoskeletal morbidity, as well as possible interactions with physical activity at work. A literature search was performed to collect all studies on musculoskeletal disorders in which physical activity was involved as a variable. Next, an analysis was made of questionnaire data on a group of 2,030 workers in various occupations, on self-reported physical activity in leisure time and at work, musculoskeletal symptoms (from low back, neck-shoulder and lower extremity) and sick leave due to these symptoms. A logistic regression analysis was carried out to estimate the association between musculoskeletal morbidity and four physical-activity indices (participation in sports and sedentary activities, active life style, sedentary life style), adjusted for age, gender, education and work load. Interaction of leisure activities with age and work load was tested too. Available literature data (39 studies) showed inconsistent results. Most studies did not show any effects. Some studies indicated favourable effects of physical activity, both on low back and neck pain. Participation in some vigorous sports seemed associated with unfavourable effects. The empirical data showed no association between participation in sports and/or other physical activities in leisure time and musculoskeletal symptoms. Sedentary activity in leisure time was associated with higher prevalence rates of low back symptoms and sick leave due to low back symptoms. Stimulation of leisure time physical activity may constitute one of the means of reducing musculoskeletal morbidity in the working population, in particular in sedentary workers.
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                Author and article information

                Journal
                BMC Musculoskelet Disord
                BMC Musculoskeletal Disorders
                BioMed Central
                1471-2474
                2008
                1 December 2008
                : 9
                : 159
                Affiliations
                [1 ]Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
                [2 ]Norwegian National Headache Centre, section of Neurology, St. Olav's Hospital, Trondheim, Norway
                [3 ]Department of Neurology, Ullevål University Hospital, Oslo, Norway
                [4 ]Faculty of Medicine, University of Oslo, Oslo, Norway
                Article
                1471-2474-9-159
                10.1186/1471-2474-9-159
                2606680
                19046448
                a0e9116a-56f1-4a91-b741-cd8bbff030d0
                Copyright © 2008 Holth et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 June 2008
                : 1 December 2008
                Categories
                Research Article

                Orthopedics
                Orthopedics

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