Design: Secondary exploratory analysis of the WalkBack randomized controlled trial, comparing an individualised and progressive walking and education program delivered by physiotherapists, to a no-treatment control group for preventing new recurrences of low back pain.
Objective: To explore the effect of the WalkBack intervention on the duration and severity of low back pain in participants who reported a recurrence.
Methods: The present study further explored the first recurrence reported by participants (n=596) in the WalkBack trial. The primary outcome was the duration of the recurrence (days). The three secondary outcomes related to recurrence severity, include the level of interference with daily activity and the average and worst pain intensity experienced. Survival analysis, linear, and ordinal regression were used to compare outcomes between intervention (walking and education) and control (no treatment) groups.
Results: The intervention was associated with a shorter duration of a recurrence compared to control; median time to recovery was 3 days (95%CI: 3-4) in the intervention group and 4 days (95%CI: 3-5) in the control group; hazard ratio 1.30 (95%CI: 1.10–1.53, p=0·002). There was no difference between the groups for interference with daily activity or average pain intensity; however, the intervention group reported a lower worst pain intensity than the control group (-0.34 on a 10-point numerical pain scale, 95%CI: -0.65 to -0.03, p=0.03).
Conclusion: Findings from this secondary analysis suggest that participants who received an individualised and progressive walking and education program reported shorter and milder recurrences than those reported by individuals in the control group.