# Beyond Low Back Pain! The Influence of Physical Activity on Mental Health, Reflected in the Functionality of People with Low Back Pain

## TL;DR

This study shows that higher physical activity, especially vigorous exercise, can improve mental health and reduce disability in people with low back pain.

## Contribution

The study reveals that physical activity levels influence psychological and functional outcomes in acute low back pain patients.

## Key findings

- Higher emotional distress correlates with greater functional impairment in low back pain patients across all activity levels.
- Vigorous physical activity is linked to better psychological health and lower disability compared to lower activity levels.
- Canonical correlation analysis confirmed significant multivariate associations between psychological and functional variables.

## Abstract

Background/Objectives: Psychological factors play a crucial role in the experience of acute low back pain and may influence functional outcomes. However, the interplay between these factors and levels of physical activity remains poorly understood. Methods: This cross-sectional observational study examined the relationship between psychological variables and functional disability in individuals with acute low back pain, considering different levels of physical activity. Data were collected from 1021 participants through an online platform between 8 June 2022 and 8 April 2023. Standardized instruments were used to assess functional limitations, emotional distress (depression, anxiety, and stress), daily pain catastrophizing, and physical activity levels. A canonical correlation analysis was conducted to explore the multivariate associations between psychological and functional variables. Results: There was a statistically significant association between higher levels of emotional distress and greater functional impairment related to low back pain. This association was observed in both the light-physical-activity group (canonical coefficient = 0.266; p = 0.017), the moderate-physical-activity group (0.237; p = 0.092), and the vigorous-physical-activity group (0.177; p = 0.013). Participants engaging in vigorous physical activity exhibited more favorable psychological profiles and lower functional disability compared to those with lower levels of activity. Conclusions: Regular and vigorous physical activity appears to be a protective factor for mental health and may help reduce functional disability in individuals with acute low back pain. These findings underscore the importance of considering physical activity levels when addressing psychological and functional outcomes in this population.