The aim of this cross-sectional pilot-study was to investigate the relationship 
between psychological distress and free-living physical activity (PA) in 
individuals with chronic low back pain (CLBP). Thirty-eight participants with 
non-specific CLBP (29=distressed; 9=non-distressed) were recruited. PA levels 
were measured using an accelerometer (activPAL activity monitor) over a one week 
period. The following parameters of physical activity were recorded: time 
upright (standing or walking), time standing, time walking, and step count. 
Psychological distress was assessed using a modified version of the distress 
risk assessment method (DRAM) which is a combination of somatic anxiety and 
depressive symptoms. The Distressed group spent significantly less time upright 
over a mean 24h day (-1.47h, 95% CI -2.70 to -0.23h, p<0.05), attributable to 
1.01h less standing and 0.46h less walking. Depressive symptoms were a 
statistically significant independent predictor of time upright (beta=-0.49, 
p<0.05). This pilot-study found that individuals with CLBP and elevated levels 
of distress spend less time upright than their non-distressed counterparts. 
Clinically, when treating individuals with CLBP and elevated distress levels, 
free-living PA may be low and interventions aimed at increasing upright activity 
may be appropriate.