Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis

Seán R O'Connor, Mark A Tully, Brigid Ryan, Chris M Bleakley, George D Baxter, Judy Bradley, S M McDonough

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Objective To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain. Data Sources Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014. Study Selection Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group. Data Extraction Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system. Data Synthesis Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95% confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, ≤8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , −5.31; 95% CI, −8.06 to −2.56) and medium-term (mean difference, −7.92; 95% CI, −12.37 to −3.48) follow-up. Improvements in function were observed at short-term (mean difference, −6.47; 95% CI, −12.00 to −0.95), medium-term (mean difference, −9.31; 95% CI, −14.00 to −4.61), and long-term (mean difference, −5.22; 95% CI, −7.21 to −3.23) follow-up. Conclusions Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.
Original languageEnglish
Pages (from-to)724-734.e3
Number of pages14
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number4
DOIs
Publication statusE-pub ahead of print - 18 Dec 2014

Fingerprint

Musculoskeletal Pain
Chronic Pain
Walking
Meta-Analysis
Confidence Intervals
Advisory Committees
Pain
Fibromyalgia
Low Back Pain
MEDLINE
Osteoarthritis
Sports
Randomized Controlled Trials
Databases
Control Groups
Health
Population

Keywords

  • Musculoskeletal pain
  • Exercise
  • Meta-analysis
  • Rehabilitation
  • Walking

Cite this

O'Connor, Seán R ; Tully, Mark A ; Ryan, Brigid ; Bleakley, Chris M ; Baxter, George D ; Bradley, Judy ; McDonough, S M. / Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis. In: Archives of Physical Medicine and Rehabilitation. 2014 ; Vol. 96, No. 4. pp. 724-734.e3.
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title = "Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis",
abstract = "Objective To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain. Data Sources Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014. Study Selection Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group. Data Extraction Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system. Data Synthesis Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95{\%} confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, ≤8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , −5.31; 95{\%} CI, −8.06 to −2.56) and medium-term (mean difference, −7.92; 95{\%} CI, −12.37 to −3.48) follow-up. Improvements in function were observed at short-term (mean difference, −6.47; 95{\%} CI, −12.00 to −0.95), medium-term (mean difference, −9.31; 95{\%} CI, −14.00 to −4.61), and long-term (mean difference, −5.22; 95{\%} CI, −7.21 to −3.23) follow-up. Conclusions Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.",
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Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis. / O'Connor, Seán R; Tully, Mark A; Ryan, Brigid; Bleakley, Chris M; Baxter, George D; Bradley, Judy; McDonough, S M.

In: Archives of Physical Medicine and Rehabilitation, Vol. 96, No. 4, 18.12.2014, p. 724-734.e3.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis

AU - O'Connor, Seán R

AU - Tully, Mark A

AU - Ryan, Brigid

AU - Bleakley, Chris M

AU - Baxter, George D

AU - Bradley, Judy

AU - McDonough, S M

PY - 2014/12/18

Y1 - 2014/12/18

N2 - Objective To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain. Data Sources Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014. Study Selection Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group. Data Extraction Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system. Data Synthesis Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95% confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, ≤8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , −5.31; 95% CI, −8.06 to −2.56) and medium-term (mean difference, −7.92; 95% CI, −12.37 to −3.48) follow-up. Improvements in function were observed at short-term (mean difference, −6.47; 95% CI, −12.00 to −0.95), medium-term (mean difference, −9.31; 95% CI, −14.00 to −4.61), and long-term (mean difference, −5.22; 95% CI, −7.21 to −3.23) follow-up. Conclusions Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.

AB - Objective To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain. Data Sources Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014. Study Selection Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group. Data Extraction Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system. Data Synthesis Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95% confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, ≤8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , −5.31; 95% CI, −8.06 to −2.56) and medium-term (mean difference, −7.92; 95% CI, −12.37 to −3.48) follow-up. Improvements in function were observed at short-term (mean difference, −6.47; 95% CI, −12.00 to −0.95), medium-term (mean difference, −9.31; 95% CI, −14.00 to −4.61), and long-term (mean difference, −5.22; 95% CI, −7.21 to −3.23) follow-up. Conclusions Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.

KW - Musculoskeletal pain

KW - Exercise

KW - Meta-analysis

KW - Rehabilitation

KW - Walking

UR - https://pure.ulster.ac.uk/en/publications/walking-exercise-for-chronic-musculoskeletal-pain-systematic-revi-3

U2 - 10.1016/j.apmr.2014.12.003

DO - 10.1016/j.apmr.2014.12.003

M3 - Article

VL - 96

SP - 724-734.e3

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 4

ER -