Discussion
degenerative disc disorder, LBP, pain, Death, disability
ADVERSE EFFECTS, SYNDROME
To our knowledge, this is the first study to explore the association between pain-related psychological factors and postoperative SB and MVPA in patients with LBP and degenerative disc disorder, up to 12 months following lumbar fusion surgery. We found that preoperative fear of movement was significantly associated with SB, at 6 and 12 months after surgery. This key finding suggests that patients who enter surgery with preoperative fear of movement have an increased likelihood of poor health after surgery. More specifically, patients with a high level of SB may be more inclined to suffer from the well-documented adverse effects of the “Sedentary Death Syndrome”, including negative cardiovascular, musculoskeletal, metabolic and physiological outcomes [So far, fear of movement has mainly been studied in relation to physical activity rather than to SB. A study by Mancuso et al. [Our results also demonstrated that pain catastrophising was not significantly associated with either SB or MVPA, 6 and 12 months post-surgery. This finding contrasts with a recent meta-analysis that pointed to studies where pain catastrophising was a significant predictor for disability, pain and health-related quality of life outcomes [Furthermore, self-efficacy for exercise was not significantly associated with either SB or MVPA in the current study. Interestingly, one of our prior studies with the same patient population reported that self-efficacy for exercise was significantly associated with changes in absolute time in MVPA six months after surgery [Regarding the generalizability of the results, the patients’ mean age and level of disability and pain are similar to the data in the Swedish spine register [