Pedometer-driven Walking for Chronic Low Back Pain
- 1 November 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Clinical Journal of Pain
- Vol. 29 (11), 972-981
- https://doi.org/10.1097/ajp.0b013e31827f9d81
Abstract
Objectives: To evaluate the feasibility of an RCT of a pedometer-driven walking program and education/advice to remain active compared with education/advice only for treatment of chronic low back pain (CLBP). Methods: Fifty-seven participants with CLBP recruited from primary care were randomly allocated to either: (1) education/advice (E, n=17) or (2) education/advice plus an 8-week pedometer-driven walking program (EWP, n=40). Step targets, actual daily step counts, and adverse events were recorded in a walking diary over the 8 weeks of intervention for the EWP group only. All other outcomes (eg, functional disability using the Oswestry Disability Questionnaire (ODQ), pain scores, physical activity (PA) measurement etc.) were recorded at baseline, week 9 (immediately post-intervention), and 6 months in both groups. Results: The recruitment rate was 22% and the dropout rate was lower than anticipated (13% to 18% at 6 mo). Adherence with the EWP was high, 93% (n=37/40) walked for ≥6 weeks, and increased their steps/day (mean absolute increase in steps/d, 2776, 95% confidence interval [CI], 1996-3557) by 59% (95% CI, 40.73%-76.25%) from baseline. Mean percentage adherence with weekly step targets was 70% (95% CI, 62%-77%). Eight (20%) minor-related adverse events were observed in 13% (5/40) of the participants. The EWP group participants demonstrated an 8.2% point improvement (95% CI, −13 to −3.4) on the ODQ at 6 months compared with 1.6% points (95% CI, –9.3 to 6.1) for the E group (between group d=0.44). There was also a larger mean improvement in pain (d=0.4) and a larger increase in PA (d=0.59) at 6 months in EWP. Discussion: This preliminary study demonstrated that a main RCT is feasible. EWP was safe and produced a real increase in walking; CLBP function and pain improved, and participants perceived a greater improvement in their PA levels. These improvements require confirmation in a fully powered RCT.Keywords
This publication has 27 references indexed in Scilit:
- UNISTEP (University Students Exercise and Physical Activity) Study: A Pilot Study of the Effects of Accumulating 10,000 Steps on Health and Fitness Among University StudentsJournal of Physical Activity & Health, 2011
- The effectiveness of walking as an intervention for low back pain: a systematic reviewEuropean Spine Journal, 2010
- A walking programme and a supervised exercise class versus usual physiotherapy for chronic low back pain: a single-blinded randomised controlled trial. (The Supervised Walking In comparison to Fitness Training for Back Pain (SWIFT) Trial)BMC Musculoskeletal Disorders, 2009
- Early management of persistent non-specific low back pain: summary of NICE guidanceBMJ, 2009
- Promoting Lifestyle Physical Activity: Experiences With the First Step ProgramAmerican Journal of Lifestyle Medicine, 2009
- Walking and MeasurementMedicine & Science in Sports & Exercise, 2008
- Amount of Time Spent in Sedentary Behaviors in the United States, 2003-2004American Journal of Epidemiology, 2008
- Adverse events among high-risk participants in a home-based walking study: a descriptive studyInternational Journal of Behavioral Nutrition and Physical Activity, 2007
- The economic burden of back pain in the UKPain, 2000
- Stage Distributions for Five Health Behaviors in the United States and AustraliaPreventive Medicine, 1999