Pedometer-driven walking for chronic low back pain: A feasibility randomized controlled trial

SM McDonough, MA Tully, Adele Boyd, SR O' Connor, Daniel Paul Kerr, Siobhan O'Neill, A Delitto, I Bradbury, c Tudo-Locke, GD Baxter, DA Hurley

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

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.
LanguageEnglish
JournalClinical Journal of Pain
Volumein pre
DOIs
Publication statusPublished - 26 Feb 2013

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Low Back Pain
Walking
Randomized Controlled Trials
Confidence Intervals
Education
Pain
Primary Health Care
Surveys and Questionnaires
Therapeutics

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McDonough, SM ; Tully, MA ; Boyd, Adele ; O' Connor, SR ; Kerr, Daniel Paul ; O'Neill, Siobhan ; Delitto, A ; Bradbury, I ; Tudo-Locke, c ; Baxter, GD ; Hurley, DA. / Pedometer-driven walking for chronic low back pain: A feasibility randomized controlled trial. In: Clinical Journal of Pain. 2013 ; Vol. in pre.
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abstract = "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.",
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Pedometer-driven walking for chronic low back pain: A feasibility randomized controlled trial. / McDonough, SM; Tully, MA; Boyd, Adele; O' Connor, SR; Kerr, Daniel Paul; O'Neill, Siobhan; Delitto, A; Bradbury, I; Tudo-Locke, c; Baxter, GD; Hurley, DA.

In: Clinical Journal of Pain, Vol. in pre, 26.02.2013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pedometer-driven walking for chronic low back pain: A feasibility randomized controlled trial

AU - McDonough, SM

AU - Tully, MA

AU - Boyd, Adele

AU - O' Connor, SR

AU - Kerr, Daniel Paul

AU - O'Neill, Siobhan

AU - Delitto, A

AU - Bradbury, I

AU - Tudo-Locke, c

AU - Baxter, GD

AU - Hurley, DA

PY - 2013/2/26

Y1 - 2013/2/26

N2 - 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.

AB - 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.

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DO - 10.1097/AJP.0b013e31827f9d81

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VL - in pre

JO - Clinical Journal of Pain

T2 - Clinical Journal of Pain

JF - Clinical Journal of Pain

SN - 0749-8047

ER -