Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review

Objective: To establish the effectiveness of walking alone and walking compared to other non-pharmacological management methods to improve disability, quality of life, or function in adults with chronic low back pain. Data sources: A systematic search of the following databases was undertaken: Medline, Embase, CINAHL, Scopus, Pedro, SportDiscus, Cochrane Central Register of Controlled Trials. The following keywords were used: back pain' or low back pain' or chronic low back pain' and walk*' or ambulation' or treadmill*' or pedometer*' or acceleromet*' or recreational' and disability' or quality of life' or function*'. Review methods: Primary research studies with an intervention focus that investigated walking as the primary intervention compared to no intervention or any other non-pharmacological method in adults with chronic low back pain (duration >3 months). Results: Seven randomised controlled trials involving 869 participants were included in the review. There was no evidence that walking was more effective than other management methods such as usual care, specific strength exercises, medical exercise therapy, or supervised exercise classes. One study found over-ground walking to be superior to treadmill walking, and another found internet-mediated walking to be more beneficial than non-internet-mediated walking in the short term. Conclusion: There is low quality evidence to suggest that walking is as effective as other non-pharmacological management methods at improving disability, function, and quality of life in adults with chronic low back pain.