Walking Away From Back Pain, One Step at a Time

A Single-centre, Randomized Controlled Trial Investigating Clinical Utility and Cost-effectiveness of an Individualized Pedometer Driven Walking Programme for People With Chronic Low Back Pain

This study will investigate if a 12-week, individually-tailored walking program, using pedometers will be a more clinically and cost-effective option for the management of chronic low back pain than standardized advice and education.

Specific objectives of the study are:

1. To determine perceived levels of disability and baseline levels of walking activity in a sample of those with chronic low back pain (CLBP)
2. To determine the uptake and adherence to a pedometer-driven walking program for people with CLBP
3. To test the clinical and cost-effectiveness of a walking programme to improve outcomes for CLBP compared to a standardized back care education package
4. To test the feasibility of a walking programme in a sub-sample of rural Saskatchewan farmers/agricultural workers.

Inclusion Criteria:

• males and females aged 18 years or over,
• experiencing low back pain (i.e. between the 12th costal margin and gluteal fold with or without associated leg pain) persisting for a minimum of three months, and
• assessed as capable of participating in a walking programme.

Exclusion Criteria:

• any spinal surgery in the past 12 months;
• evidence of nerve root, spinal cord, or cauda equina compression;
• severe spinal stenosis indicated by signs of neurogenic claudication, grade 3 to 4 spondylolisthesis, fibromyalgia, or systemic/inflammatory disorder;
• as well as any other current lower extremity musculoskeletal injury or contraindication to increasing physical activity (PA) levels.

The latter may include:

• any cardiorespiratory or other medical condition limiting exercise tolerance;
• history of serious psychological or psychiatric illness (mild depression eligible for inclusion); and/or
• pregnancy.