Evaluation of the Effects of Physical Activity, Cardiorespiratory Condition, and Neuromuscular Fitness on Direct Healthcare Costs and Sickness-Related Absence Among Nursing Personnel With Recurrent Nonspecific Low Back Pain

Spine (Phila Pa 1976). 2017 Jun 1;42(11):854-862. doi: 10.1097/BRS.0000000000001922.


Study design: A cross-sectional study, part of a randomized controlled trial.

Objective: To evaluate the association of physical activity, cardiorespiratory fitness, and neuromuscular fitness with direct healthcare costs and sickness-related absence among nursing personnel with nonspecific low back pain.

Summary of background data: Low back pain creates a huge economic burden due to increased sick leave and use of healthcare services.

Methods: Female nursing personnel with nonspecific low back pain were included (n = 219). Physical activity was assessed with accelerometry and a questionnaire. In addition, measurements of cardiorespiratory and muscular fitness were conducted. Direct costs and sickness-related absence for a 6-month period were collected retrospectively by questionnaire. Health care utilization and absence from work were analyzed with a general linear model.

Results: The mean total costs were 80.5% lower among women who met physical activity recommendations than inactive women. Those with a higher mean daily intensity level of 10-minute activity sessions showed lower total costs than women in the lowest tertile (middle: 64.0% of the lowest; highest: 54.3% of the lowest). Women with good cardiorespiratory fitness (the highest tertile) as measured with the 6-minute-walk test (based on walking distance) had 77.0% lower total costs when compared with the lowest tertile. Women in the highest third for the modified push-up test had 84.0% lower total costs than those with the poorest results (the bottom tertile).

Conclusion: High cardiorespiratory and muscular fitness and meeting physical activity recommendations for aerobic and muscular fitness were strongly associated with lower total costs among nursing personnel with pain-related disorders of recurrent nonspecific low back pain. Actions to increase physical activity and muscle conditioning may significantly save on healthcare costs and decrease sick-leave costs due to low back pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Female
  • Health Care Costs*
  • Humans
  • Low Back Pain / economics
  • Low Back Pain / physiopathology*
  • Middle Aged
  • Nurses*
  • Physical Fitness / physiology*
  • Sick Leave / economics*