Tim is the Program Director for Physical Health at Torrens University Australia. He is an experienced health and education professional with an extensive clinical and academic background in musculoskeletal healthcare, having worked with elite and sub-elite sporting teams in both the UK and Australia. His research now focuses on the link between physical activity and persistent pain, supporting more people to lead physically active lives. (Qualifications: PhD (C) | MSc Sports & Exercise Medicine | PG Dip Learning & Teaching | BSc ST | Higher Education Academy Fellow)

Abstract Presentation:
Individuals with musculoskeletal disease who take a greater number of daily steps have improved quality of life, decreased pain, less disability and improved function.

TITLE: Associations of Objectively Measured Step Count with Patient Reported and Functional Outcomes in Chronic Lower Body Musculoskeletal Disease: A Systematic Review and Meta-analysis.

Authors: Mr Tim Trevail MSc^1,2, Mr Michael Fleischmann MSc³, Ms Andrea Williams MSc¹, Professor Margee Hume PhD¹, Emeritus Professor Justin Beilby PhD¹, Professor Tim Gabbett PhD^4,5,6, and Professor Peter Malliaras PhD².

Context: The association of step count to subsequent health outcomes has yet to be established in populations with lower back and extremity musculoskeletal disease. The purpose of this paper was to synthesise data related to the associations of step count with clinically relevant patient reported and functional outcomes through a systematic review and meta-analysis.

Methods: Searches of MEDLINE Complete; CINAHL (EBSCO Host); and EMBASE were undertaken from their inception to January 2023. Any study design that reported on objectively measured step count and measures of pain, quality of life, disability, or functional outcomes in low back and lower extremity persistent musculoskeletal pain populations met the eligibility criteria. This systematic review and meta-analysis was performed in accordance with the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020. Risk of bias was assessed using the Standard Quality Assessment Criteria.

Results: Of the 2347 articles screened, 37 articles describing 35 studies were included (18 cross-sectional, 4 RCTs, 2 secondary analyses of RCTs, 2 feasibility RCTs, 1 pilot RCT, 8 prospective cohort, 1 retrospective cohort, and 1 case-control study; n=6870 participants). Meta-analyses demonstrated that greater step count was associated with improved pain [OR = 1.21 (95% CI 1.12-1.30)], improved quality of life [OR = 1.41 (95% CI 1.2-1.63)], improved disability [OR = 1.2 (95% CI 1.06-1.36)], improved walking speed [OR = 1.69 (95% CI 1.14-2.51)] and stair climb speed [OR = 2.47 (95% CI 2.04-2.98)], and increased strength [OR = 1.37 (95% CI 1.04-1.82)].

Discussion: These results represent the first direct demonstration that individuals with musculoskeletal disease who take a greater number of daily steps may have an improved quality of life, decreased pain, less disability and improved function. The findings support the notion that daily step count may be considered a useful marker of multiple health domains in lower back and lower extremity musculoskeletal pain populations. Further prospective studies examining clinically relevant outcomes, such as daily variations in physical activity and pain are needed.

Impact: