THE DEVELOPMENT OF A WALKING PROGRAMME FOR CHRONIC LOW BACK PAIN PATIENTS USING INTERVENTION MAPPING

Abstract

Background & Purpose: Clinical guidelines support physical activity for people with chronic low back pain (CLBP); walking is an ideal form of physical activity as it is easy to do, requires no special skills and is achievable by virtually all ages with little risk of injury but there are no current evidence-based structured walking programmes (WP) for this population. The purpose of this study was to develop a WP for CLBP patients in preparation for a proposed randomized controlled trial.

Methods: An 8-week structured WP was developed using Intervention Mapping (IM) principles:

1. literature review,

2. 4 focus groups (n=18 CLBP patients),

3. Physiotherapist Interviews (n=4), and then pilot-tested in a consenting sample of 10 CLBP patients [n=5 male, 5 female; mean (SD)= 50.5 (12.6) years], who completed the 10-metre Shuttle Walk Test, Oswestry Disability Index, NRS, Euro-Qol, Fear Avoidance, Back Beliefs, International Physical Activity and Self-Efficacy Questionnaires, at baseline and 8-week follow-up, and wore the activPAL™ accelerometer for 7 days pre and post intervention.

Results: Both the CLBP patients and physiotherapists interviewed endorsed walking as a suitable form of physical activity, and identified possible barriers as fear avoidance, exacerbation of pain, behavioural change, motivation, time, personal safety and adverse weather. The pilot study found 90% compliance with the WP. Descriptive analysis of change scores showed improvements at 8-weeks in all self reported outcomes and objectively measured physical activity and functional capacity.

Conclusion: Intervention Mapping was successfully used to develop a WP intervention for chronic LBP, the efficacy of which is being evaluated in a randomized controlled trial.