title: Walking away from back pain: one step at a time - a community-based randomised controlled trial.
abstract: BACKGROUND
  Low back pain is highly prevalent and a significant public health burden in Western society. Feasibility studies suggest personalised pedometer-driven walking is an acceptable and effective motivating tool in the management of chronic low back pain (CLBP ≥ 12 weeks). The proposed study will investigate pedometer-driven walking as a low cost, easily accessible, and sustainable means of physical activity to improve disability and clinical outcomes for people with CLBP in Saskatchewan, Canada.
  
  
  METHODS
  A fully-powered single-blinded randomised controlled trial will compare back care advice and education with back care advice and education followed by a 12-week pedometer-driven walking programme in adults with CLBP. Adults with self-reported CLBP will be recruited from the community and screened for elibility. Two-hundred participants will be randomly allocated to one of two intervention groups. All participants will receive a single back care advice and education session with a physiotherapist. Participants in the walking group will also receive a physiotherapist-facilitated pedometer based walking programme. The physiotherapist will facilitate the participant to monitor and progress the walking programme, by phone, on a weekly basis over 10 weeks following two face-to-face sessions. Outcome measures of self-reported disability, physical activity, participants' low back pain beliefs/perceptions, quality of life and direct/indirect cost estimates will be gathered at baseline, three months, six months, and 12 months by a different physiotherapist blinded to group allocation. Following intervention, focus groups will be used to explore participants' thoughts and experiences of pedometer-driven walking as a management tool for CLBP.
  
  
  CONCLUSIONS
  This paper describes the design of a community-based RCT to determine the effectiveness of a pedometer-driven walking programme in the management of CLBP.
  
  
  BACKGROUND
  United States National Institutes of Health Clinical Trails registry (http://ClinicalTrials.gov/) No. NCT02284958 . Registered on 27(th) October 2014).
authors.affiliation: University of Saskatchewan, School of Physical Therapy, 1121 College Drive, Saskatoon, SK, S7N 0W3, Canada. stephan.milosavljevic@usask.ca.
authors.forename: Stephan
authors.initials: S
authors.lastname: Milosavljevic
authors.affiliation: University of Saskatchewan, School of Physical Therapy, 1121 College Drive, Saskatoon, SK, S7N 0W3, Canada. lynne.clay@usask.ca.
authors.forename: Lynne
authors.initials: L
authors.lastname: Clay
authors.affiliation: University of Saskatchewan, School of Physical Therapy, 1121 College Drive, Saskatoon, SK, S7N 0W3, Canada. brenna.bath@usask.ca.
authors.forename: Brenna
authors.initials: B
authors.lastname: Bath
authors.affiliation: University of Saskatchewan, Canadian Centre for Health and Safety in Agriculture, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada. catherine.trask@usask.ca.
authors.forename: Catherine
authors.initials: C
authors.lastname: Trask
authors.affiliation: Respirology, Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan and Saskatoon Health Region, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada. erika.penz@usask.ca.
authors.forename: Erika
authors.initials: E
authors.lastname: Penz
authors.affiliation: University of Saskatchewan, Canadian Centre for Health and Safety in Agriculture, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada. sam.stewart@usask.ca.
authors.forename: Sam
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences, The University of Nottingham, B90, Clinical Sciences Building, City Hospital Campus, Nottingham, NG5 1PB, UK. Paul.Hendrick@nottingham.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Hendrick
authors.affiliation: Centre for Health, Activity, and Rehabilitation Research, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. david.baxter@otago.ac.nz.
authors.forename: G David
authors.initials: GD
authors.lastname: Baxter
authors.affiliation: School of Public Health, Physiotherapy and Population Science, UCD Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland. deirdre.hurleyosing@ucd.ie.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Hurley
authors.affiliation: School of Health Sciences, Institute of Nursing and Health Research, University of Ulster, Shore Road, Belfast, BT37 0QB, UK. s.mcdonough@ulster.ac.uk.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: McDonough
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000328:Adult; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012525:Saskatchewan; D016037:Single-Blind Method; D014481:United States; D016138:Walking