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. 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.

 

Meta-analyses demonstrated that greater step count was associated with improved pain, improved quality of life, improved disability, improved walking speed and stair climb speed, and increased strength.

 

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.