Poster Presentation Sydney Spinal Symposium 2025

Exploring physiotherapists' perspectives on implementing a prevention-based walking program in clinical practice for patients with recurrent low back pain. (#16)

Seong Kyeong Yeom 1 , Georgia Fisher 2 , Deborah Wareham 3 , Andrew Gratchev 1 , Jorden Pavlovski 1 , Mark Hancock 1 , Natasha Pocovi 1
  1. Department of Health Sciences, Macquarie University, Sydney, NSW, Australia
  2. Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
  3. Department of Health Sciences, Macquarie University, Sydney, NSW, Australia

Introduction:
Low back pain (LBP) remains the leading cause of disability globally, with up to 84% of individuals experiencing an episode during their lifetime1,2. Despite most episodes resolving, nearly 70% of individuals experience a recurrence within 12 months3,4. The recent WalkBack trial identified that a progressive walking and education program can significantly reduce recurrences and associated care5. To progress this work and maximise integration into clinical practice, it is essential to explore any foreseeable challenges to implementation as perceived by physiotherapists6.

Purpose/Aim:
Identify potential barriers and facilitators to the future implementation of the WalkBack program.

Methods:
This qualitative study involved semi-structured interviews with registered physiotherapists working in Australia. To attain a breadth of perspectives, interviews were conducted with a group of physiotherapists who (1) delivered the WalkBack program during the original trial, and (2) had no prior WalkBack training. Guided by the RE-AIM framework, interviews explored perceived barriers and facilitators to implementation, as well as suggestions for refining the clinician training7. Participants were purposively sampled to ensure diversity in clinical experience, setting, and demographics. Interviews were transcribed verbatim and analysed using both deductive framework and inductive thematic analysis. Coding was conducted independently by two researchers and refined through iterative discussion.

Results:
Four themes were drawn: (1) WalkBack program is relevant and acceptable to physiotherapists; (2) WalkBack training experience shapes clinical integration and ongoing engagement; (3) flexible delivery and structured resources enable engagement, with standardisation viewed as key to scalable implementation; and (4) successful adoption hinges on system-level enablers, including clinic leadership, funding structures, and alignment with the service setting.

Conclusion:
Participants viewed WalkBack as a relevant, acceptable, and clinically valuable program. Future implementation will need to address training needs, enhance resource provision, and ensure system-level support. Each clinic's unique service and funding structures may support, or deter, broader adoption.

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