Background & Purpose: Current clinical guidelines support physical activity programmes for people with low back pain (LBP), but a major factor limiting their efficacy is the patient’s level of adherence, difficult to assess using self-report, and the lack of objective data on activity levels in this population. This study investigated differences in the self-report and objective activity levels of LBP patients and age-matched controls.

Methods: 20 patients with non-specific LBP [5 male, 15 female; mean (SD) age = 43.2 (12.1) years] and 20 healthy controls [10 male, 10 female; mean (SD) age = 39.6 (10.9) years] wore the activPAL™ uniaxial accelerometer on the anterior thigh during waking hours for 7 days, and completed the 7-Day Physical Activity Recall Questionnaire (7DRQ). Data were analysed using SPSS (v12).

Results: There was no difference between groups in energy expenditure as measured by the 7DRQ (p> 0.05), but the activPAL™ data showed LBP subjects expended significantly less energy than controls (p=0.004) over the 7-day period, and failed to reach the recommended 10,000 steps per day [mean (SD) = 8067.9 steps (2581.7)] compared to controls [mean (SD)= 10,864 (3,570.3); t = 2.84, p=0.007)]. The LBP subjects also had a significantly lower mean cadence (p=0.004), a lower walking index (p=0.001), and took significantly more short walks (0–100 steps) and less long walks (> 100 steps) than controls (p< 0.05).

Conclusions & Implications: People with LBP are less physically active than age-matched controls, and this is more evident with objective than subjective evaluation. These findings have informed the design of a targeted walking programme for LBP patients.