| Title: | Accelerometer-Measured Intensity-Specific Physical Activity, Genetic Susceptibility, and Back Pain Risk: A UK Biobank Cohort Study |
| Journal: | The Spine Journal |
| Published: | 15 Oct 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41106605/ |
| DOI: | https://doi.org/10.1016/j.spinee.2025.10.021 |
Publication 19160
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Abstract
BACKGROUND CONTEXT: Current clinical guidelines lack clear, quantitative recommendations on intensity-specific physical activity (PA) levels for preventing back pain. Moreover, accelerometer-based evidence regarding dose-response relationships and interactions between PA and genetic susceptibility remains limited.</p>
PURPOSE: To determine the relationships between accelerometer-measured total and intensity-specific PA and incident back pain, and to assess potential effect modification by polygenic risk scores (PRS).</p>
STUDY DESIGN: Prospective, large-scale, population-based study using UK Biobank data.</p>
PATIENT SAMPLE: UK Biobank participants who wore wrist accelerometers for 7 days (N=71,601).</p>
OUTCOME MEASURES: Incident back pain, defined as the first recorded ICD-10 dorsalgia code (M54).</p>
METHODS: Total PA, light PA (LPA), and moderate-to-vigorous PA (MVPA) were derived using validated machine-learning algorithms from raw accelerometer data. Dose-response relationships were modeled using restricted cubic splines within Cox proportional hazards models, with adjustment for and stratification by a polygenic risk score (PRS). Point estimates for the population attributable fraction (PAF) were then calculated. Body mass index (BMI) mediation was assessed.</p>
RESULTS: Over a median follow-up of 7.0 years, total PA and MVPA exhibited nonlinear inverse associations with incident back pain, independent of genetic risk, with thresholds at approximately 35 milli-g (total PA) and 60 min/day (MVPA). The adjusted PAF was 15.9% for low MVPA and 9.9% for low total PA. Associations were strongest for MVPA, followed by total PA; no significant association was observed for LPA. Within both PRS strata, risk declined monotonically across PA quartiles, with similar effect sizes and no PA × PRS interaction. Notably, participants with high PRS and high PA had lower risk than those with low PRS and low PA. BMI mediated 26.2% of the total PA association and 15.5% of the MVPA association.</p>
CONCLUSIONS: Accelerometer-measured MVPA robustly reduces back-pain risk, independent of genetic predisposition. Future guidelines should provide clear, intensity-specific recommendations and account for the observed nonlinear dose-response to optimize prevention.</p>
6 Authors
- Yuanpeng Zhu
- Di Liu
- Xiangjie Yin
- Jie Wang
- Terry Jianguo Zhang
- Nan Wu
1 Application
| Application ID | Title |
|---|---|
| 532823 | Longitudinal Analysis of Musculoskeletal Multimorbidity and Its Interaction with Well-being: Insights from UK Biobank Imaging and Biomarker Data |
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