Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial

Introduction Low back pain (LBP) is recognised globally as a prevalent, costly and disabling condition. Recurrences are common and contribute to much of the burden of LBP. Current evidence favours exercise and education for prevention of LBP recurrence, but an optimal intervention has not yet been e...

Full description

Saved in:
Bibliographic Details
Main Authors: Ornella Clavisi, Jane Latimer, Christopher Maher, Maurits W van Tulder, Anne Tiedemann, Dafna Merom, Mark J Hancock, Chung-Wei C Lin, Natasha Celeste Pocovi, Petra Macaskill, Shuk Yin Kate Tong
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/10/e037149.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846166044332261376
author Ornella Clavisi
Jane Latimer
Christopher Maher
Maurits W van Tulder
Anne Tiedemann
Dafna Merom
Mark J Hancock
Chung-Wei C Lin
Natasha Celeste Pocovi
Petra Macaskill
Shuk Yin Kate Tong
author_facet Ornella Clavisi
Jane Latimer
Christopher Maher
Maurits W van Tulder
Anne Tiedemann
Dafna Merom
Mark J Hancock
Chung-Wei C Lin
Natasha Celeste Pocovi
Petra Macaskill
Shuk Yin Kate Tong
author_sort Ornella Clavisi
collection DOAJ
description Introduction Low back pain (LBP) is recognised globally as a prevalent, costly and disabling condition. Recurrences are common and contribute to much of the burden of LBP. Current evidence favours exercise and education for prevention of LBP recurrence, but an optimal intervention has not yet been established. Walking is a simple, widely accessible, low-cost intervention that has yet to be evaluated. This randomised controlled trial (RCT) aims to establish the effectiveness and cost-effectiveness of a progressive and individualised walking and education programme (intervention) for the prevention of LBP recurrences in adults compared with no treatment (control).Methods and analysis A pragmatic, two-armed RCT comparing walking and education (n=349) with a no treatment control group (n=349). Inclusion criteria are adults recovered from an episode of non-specific LBP within the last 6 months. Those allocated to the intervention group will receive six sessions (three face to face and three telephone delivered) with a trained physiotherapist to facilitate a progressive walking programme and education over a 6-month period. The primary outcome will be days to first recurrence of an episode of activity-limiting LBP. The secondary outcomes include days to recurrence of an episode of LBP, days to recurrence of an episode of LBP leading to care seeking, disability and quality of life measured at 3, 6, 9 and 12 months and costs associated with LBP recurrence. All participants will be followed up monthly for a minimum of 12 months. The primary intention-to-treat analysis will assess difference in survival curves (days to recurrence) using the log-rank statistic. The cost-effectiveness analysis will be conducted from the societal perspective.Ethics and dissemination Approved by Macquarie University Human Research Ethics Committee (Reference: 5201949218164, May 2019). Findings will be disseminated through publication in peer-reviewed journals and conference presentations.Trial registration number ACTRN12619001134112.
format Article
id doaj-art-46f4b032f4d5474fb4e9e69d4f428bdd
institution Kabale University
issn 2044-6055
language English
publishDate 2020-10-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-46f4b032f4d5474fb4e9e69d4f428bdd2024-11-16T10:25:12ZengBMJ Publishing GroupBMJ Open2044-60552020-10-01101010.1136/bmjopen-2020-037149Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trialOrnella Clavisi0Jane Latimer1Christopher Maher2Maurits W van Tulder3Anne Tiedemann4Dafna Merom5Mark J Hancock6Chung-Wei C Lin7Natasha Celeste Pocovi8Petra Macaskill9Shuk Yin Kate Tong10Musculoskeletal Australia, Melbourne, Victoria, AustraliaInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia1 Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, AustraliaDepartment of Health Sciences, VU University, Amsterdam, The NetherlandsInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, AustraliaWestern Sydney University School of Health Sciences, Penrith, New South Wales, AustraliaDepartment of Health Professions, Macquarie University, Sydney, New South Wales, AustraliaInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, AustraliaDepartment of Health Professions, Macquarie University, Sydney, New South Wales, Australiaprofessor of biostatisticsDepartment of Health Professions, Macquarie University, Sydney, New South Wales, AustraliaIntroduction Low back pain (LBP) is recognised globally as a prevalent, costly and disabling condition. Recurrences are common and contribute to much of the burden of LBP. Current evidence favours exercise and education for prevention of LBP recurrence, but an optimal intervention has not yet been established. Walking is a simple, widely accessible, low-cost intervention that has yet to be evaluated. This randomised controlled trial (RCT) aims to establish the effectiveness and cost-effectiveness of a progressive and individualised walking and education programme (intervention) for the prevention of LBP recurrences in adults compared with no treatment (control).Methods and analysis A pragmatic, two-armed RCT comparing walking and education (n=349) with a no treatment control group (n=349). Inclusion criteria are adults recovered from an episode of non-specific LBP within the last 6 months. Those allocated to the intervention group will receive six sessions (three face to face and three telephone delivered) with a trained physiotherapist to facilitate a progressive walking programme and education over a 6-month period. The primary outcome will be days to first recurrence of an episode of activity-limiting LBP. The secondary outcomes include days to recurrence of an episode of LBP, days to recurrence of an episode of LBP leading to care seeking, disability and quality of life measured at 3, 6, 9 and 12 months and costs associated with LBP recurrence. All participants will be followed up monthly for a minimum of 12 months. The primary intention-to-treat analysis will assess difference in survival curves (days to recurrence) using the log-rank statistic. The cost-effectiveness analysis will be conducted from the societal perspective.Ethics and dissemination Approved by Macquarie University Human Research Ethics Committee (Reference: 5201949218164, May 2019). Findings will be disseminated through publication in peer-reviewed journals and conference presentations.Trial registration number ACTRN12619001134112.https://bmjopen.bmj.com/content/10/10/e037149.full
spellingShingle Ornella Clavisi
Jane Latimer
Christopher Maher
Maurits W van Tulder
Anne Tiedemann
Dafna Merom
Mark J Hancock
Chung-Wei C Lin
Natasha Celeste Pocovi
Petra Macaskill
Shuk Yin Kate Tong
Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial
BMJ Open
title Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial
title_full Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial
title_fullStr Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial
title_full_unstemmed Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial
title_short Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial
title_sort effectiveness and cost effectiveness of a progressive individualised walking and education programme for prevention of low back pain recurrence in adults study protocol for the walkback randomised controlled trial
url https://bmjopen.bmj.com/content/10/10/e037149.full
work_keys_str_mv AT ornellaclavisi effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT janelatimer effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT christophermaher effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT mauritswvantulder effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT annetiedemann effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT dafnamerom effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT markjhancock effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT chungweiclin effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT natashacelestepocovi effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT petramacaskill effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial
AT shukyinkatetong effectivenessandcosteffectivenessofaprogressiveindividualisedwalkingandeducationprogrammeforpreventionoflowbackpainrecurrenceinadultsstudyprotocolforthewalkbackrandomisedcontrolledtrial