An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial

Objective: To assess the effect of aerobic walking training as compared to active training, which includes muscle strengthening, on functional abilities among patients with chronic low back pain. Design: Randomized controlled clinical trial with blind assessors. Setting: Outpatient clinic. Subjects: Fifty-two sedentary patients, aged 18–65 years with chronic low back pain. Patients who were post surgery, post trauma, with cardiovascular problems, and with oncological disease were excluded. Intervention: Experimental ‘walking’ group: moderate intense treadmill walking; control ‘exercise’ group: specific low back exercise; both, twice a week for six weeks. Main measures: Six-minute walking test, Fear-Avoidance Belief Questionnaire, back and abdomen muscle endurance tests, Oswestry Disability Questionnaire, Low Back Pain Functional Scale (LBPFS). Results: Significant improvements were noted in all outcome measures in both groups with non-significant difference between groups. The mean distance in metres covered during 6 minutes increased by 70.7 (95% confidence interval (CI) 12.3–127.7) in the ‘walking’ group and by 43.8 (95% CI 19.6–68.0) in the ‘exercise’ group. The trunk flexor endurance test showed significant improvement in both groups, increasing by 0.6 (95% CI 0.0–1.1) in the ‘walking’ group and by 1.1 (95% CI 0.3–1.8) in the ‘exercise’ group. Conclusions: A six-week walk training programme was as effective as six weeks of specific strengthening exercises programme for the low back.