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Open Access 01-12-2021 | Back Pain | Research article

A randomized controlled trial investigating effects of an individualized pedometer driven walking program on chronic low back pain

Authors: Angelica E. Lang, Paul A. Hendrick, Lynne Clay, Prosanta Mondal, Catherine M. Trask, Brenna Bath, Erika D. Penz, Samuel A. Stewart, G. David Baxter, Deidre A. Hurley, Suzanne M. McDonough, Stephan Milosavljevic

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Walking is an easily prescribed physical activity for people with low back pain (LBP). However, the evidence for its effectiveness to improve pain and disability levels for people with chronic low back pain (CLBP) within a community setting has not been evaluated. This study evaluates the effectiveness of a clinician guided, pedometer-driven, walking intervention for increasing physical activity and improving clinical outcomes compared to education and advice.

Methods

Randomized controlled trial recruiting N = 174 adults with CLBP. Participants were randomly allocated into either a standardized care group (SG) or pedometer based walking group (WG) using minimization allocation with a 2:1 ratio to the WG. Prior to randomization all participants were given a standard package of education and advice regarding self-management and the benefits of staying active. Following randomization the WG undertook a physiotherapist guided pedometer-driven walking program for 12 weeks. This was individually tailored by weekly negotiation of daily step targets. Main outcome was the Oswestry Disability Index (ODI) recorded at baseline, 12 weeks, 6 and 12 months. Other outcomes included, numeric pain rating, International Physical Activity Questionnaire (IPAQ), Fear-Avoidance Beliefs Questionnaire (FABQ), Back Beliefs questionnaire (BBQ), Physical Activity Self-efficacy Scale, and EQ-5D-5L quality of life estimate.

Results

N = 138 (79%) participants completed all outcome measures at 12 weeks reducing to N = 96 (55%) at 12 months. Both observed and intention to treat analysis did not show any statistically significant difference in ODI change score between the WG and the SG at all post-intervention time points. There were also no significant between group differences for change scores in all secondary outcome measures. Post hoc sensitivity analyses revealed moderately disabled participants (baseline ODI ≥ 21.0) demonstrated a greater reduction in mean ODI scores at 12 months in the WG compared to SG, while WG participants with a daily baseline step count < 7500 steps demonstrated a greater reduction in mean ODI scores at 12 weeks.

Conclusions

Overall, we found no significant difference in change of levels of (ODI) disability between the SG and WG following the walking intervention. However, ODI responses to a walking program for those with moderate levels of baseline disability and those with low baseline step count offer a potential future focus for continued research into the benefit of walking as a management strategy for chronic LBP.

Trial registration

United States National Institutes of Health Clinical Trails registry (http://ClinicalTrials.gov/) No. NCT02284958 (27/10/2014).

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Title: A randomized controlled trial investigating effects of an individualized pedometer driven walking program on chronic low back pain
Authors: Angelica E. Lang
Paul A. Hendrick
Lynne Clay
Prosanta Mondal
Catherine M. Trask
Brenna Bath
Erika D. Penz
Samuel A. Stewart
G. David Baxter
Deidre A. Hurley
Suzanne M. McDonough
Stephan Milosavljevic
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Back Pain
Back Pain
Back Pain
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04060-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A randomized controlled trial investigating effects of an individualized pedometer driven walking program on chronic low back pain

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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