Paulo Henrique Ferreira

Purpose: Engagement in moderate levels of physical activity appears to be beneficial for low back pain (LBP) prevention and treatment. In this 15-year prospective follow-up study, we aimed to examine whether certain sports and their performance levels are associated with lower odds of experiencing repeatedly observed LBP across a 15-year follow-up. Methods: Study sample composed of participants of the Northern Finland Birth Cohort 1966 ( n = 3352) who had data available on the engagement frequency in the following sports and other physical activities: (a) cross-country skiing; (b) swimming; (c) running; (d) aerobics and gymnastics; (e) gym workouts; (f) floorball, ice hockey, football, rinkball, and basketball; and (h) badminton, volleyball, tennis, and squash at 31 years, and LBP occurrence between 31 and 46 years. Multinomial logistic regression models were used to produce unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Cross-country skiing more than once a month or at least twice a week, running at least twice a week and gym training up to once a month were associated with lower odds of experiencing repeatedly observed LBP than exercising up to once a month. After adjustments, only the cross-country skiing models remained (for up to once a week: OR 0.77, 95% CI 0.60–0.98; for at least twice a week: 0.71, 0.51–1.00). No association was found between sports and incident or resolved LBP. Conclusion: Engagement in cross-country skiing in early adulthood appears to be a protective factor against repeatedly observed LBP between early and mid-adulthood.

In addition to effects on the primary prevention of disease, physical activity has benefits in the management and treatment of many chronic and important conditions. These include cardiovascular disease, diabetes, and the metabolic syndrome, musculoskeletal disorders, as well as many neuropsychiatric conditions, other endocrine conditions, and cancers. Best practice is where clinical guidelines specify the types of physical activity recommended for each condition, cognisant of disease severity and an individual’s capacity to be active. Many conditions benefit from both aerobic (large muscle, movement-related) activities and resistance exercises. Including physical activity advice into clinical management involves the whole management team, including medical, allied health, and specialist exercise professionals. Physical activity may be recommended in hospital or primary care settings, or in disease-specific programmes delivered at home, online, or through structured or unstructured exercise programmes in the community.

Background: Engaging individuals in evidence-based health education can positively influence their health experiences. Personal stories and experiences make health challenges tangible, fostering empathy among policymakers and stakeholders. For low back pain (LBP), as the prevalence rises, innovative methods are needed to translate evidence into practical and actionable strategies. Aims: This study applies the Knowledge-to-Action (KTA) Framework to develop digital storytelling aimed at educating adults on managing LBP through physical activity, thereby reducing medication reliance. Methods: Using the KTA Framework, we structured an animation to convey evidence-based, non-pharmacological strategies for LBP. This model supports the development of similar educational materials focused on physical activity for managing LBP. Results: The animation developed through the KTA Framework presents clear, concise information on non-pharmacological approaches to LBP management, focusing on physical activity as a primary strategy. Key aspects of the animation include evidence-backed messages on safe and effective exercises, guidance on managing flare-ups without medication, and techniques for building physical resilience. The animation is structured to increase viewer engagement through storytelling elements that resonate with the common experiences of LBP sufferers, thus fostering an emotional connection to the content. Each phase of the animation’s content was aligned with best-practice guidelines. Conclusion: Digital storytelling based on the KTA Framework offers an effective approach to LBP education, promoting self-management and reducing medication reliance. Narratives can inspire creative, inclusive, and accessible solutions in addition to advocating for specific reforms or allocating resources towards underfunded areas (e.g., self-management programs).

Introduction People experiencing low back pain (LBP) could potentially benefit from multimedia educational resources that integrate self-management strategies and improve awareness of the benefits of staying active and about medications that offer limited benefits, such as paracetamol. Primary care waiting rooms are potential spaces for presenting health promotion resources to improve health literacy through the dissemination of easily accessible health information. This feasibility study aims to explore the feasibility of conducting a large-scale trial to investigate the benefits of multimedia educational resources delivered at outpatient physiotherapy waiting rooms of public hospitals to support patients to participate in physical activity and reduce paracetamol intake for LBP. Methods and analysis A hybrid type III feasibility study will be conducted at a public hospital in Sydney, Australia, from March to September 2024. The multimedia strategy development (pre-implementation) involves collaborative planning among healthcare professionals, policymakers and community stakeholders in physiotherapy practice. Phase II (implementation) will evaluate the acceptability and implementation processes of delivering the multimedia educational resources in the physiotherapy waiting room following the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework. Findings from the quantitative data will be reported descriptively, and categorical data by counts and percentages. Qualitative (open-ended questions) will be integrated with the feasibility trial outcomes to inform the design of a full-scale randomised controlled trial. Ethics and dissemination This study has ethical approval from the Sydney Local Health District Human Research Ethics Committee (2023/ETH02683). The findings will be disseminated via peer-reviewed publications, articles in relevant newsletters and presentations at national and international conferences. Social media platforms including X will also be used to generate awareness.