title: Pedometer-driven walking for chronic low back pain: a feasibility randomized controlled trial.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: *Centre for Health and Rehabilitation Technologies, University of Ulster, Newtownabbey, County Antrim, UK ‡School of Psychology, University of Ulster, Londonderry, Co Londonderry, UK †UKCRC Centre of Excellence for Public Health (NI), Queens' University Belfast, UK ∥Frontier Science Scotland, Kingussie, UK §School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA ¶Walking Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA #Centre for Physiotherapy Research, University of Otago, North Dunedin, New Zealand **School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.
authors: Suzanne M
authors: SM
authors: McDonough
authors: Mark A
authors: MA
authors: Tully
authors: Adele
authors: A
authors: Boyd
authors: Seán R
authors: SR
authors: O'Connor
authors: Daniel P
authors: DP
authors: Kerr
authors: Siobhán M
authors: SM
authors: O'Neill
authors: Antony
authors: A
authors: Delitto
authors: Ian
authors: I
authors: Bradbury
authors: Catrine
authors: C
authors: Tudor-Locke
authors: George David
authors: GD
authors: Baxter
authors: Deirdre A
authors: DA
authors: Hurley
mesh_terms: D056044:Actigraphy; D000328:Adult; D059350:Chronic Pain / Q000534:rehabilitation; D004185:Disability Evaluation; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*