Background & Purpose: Clinical guidelines support physical activity for people with chronic low back pain (CLBP); walking is an ideal form of physical activity as it is easy to do, requires no special skills and is achievable by virtually all ages with little risk of injury but there are no current evidence-based structured walking programmes (WP) for this population. The purpose of this study was to develop a WP for CLBP patients in preparation for a proposed randomized controlled trial.

Methods: An 8-week structured WP was developed using Intervention Mapping (IM) principles:

literature review,

Results: Both the CLBP patients and physiotherapists interviewed endorsed walking as a suitable form of physical activity, and identified possible barriers as fear avoidance, exacerbation of pain, behavioural change, motivation, time, personal safety and adverse weather. The pilot study found 90% compliance with the WP. Descriptive analysis of change scores showed improvements at 8-weeks in all self reported outcomes and objectively measured physical activity and functional capacity.

Conclusion: Intervention Mapping was successfully used to develop a WP intervention for chronic LBP, the efficacy of which is being evaluated in a randomized controlled trial.

Background: European guidelines recommend supervised group exercise for treating large groups of non specific low back pain patients. The class was established in Beaumont Hospital in 2006 and consists of an eight week supervised exercise programme and workshops in management of chronic low back pain using a bio psychosocial model. The purpose of this six month audit was to assess the outcomes of patients who attended a ‘Back to Fitness’ programme two years after it was set up.

Methods: Data was analysed using Data Desk ©. Demographic details were detailed for age, sex, body mass index (BMI) and number of classes attended. Pre- class and post class comparisons were made using the Wilcoxin signed-ranks test for the SF- 36, Oswestry Disability Index Questionnaire (ODI), Fear Avoidance Beliefs Questionnaire (FABQ) and Visual Analogue Scale (VAS) for pain scores.

Results: Twenty one patients (17 female and 4 male) started the programme, mean age was 49 years (SD= 9.6) and mean BMI was 31.6 kg/m². The average class attendance was five and 62% completed the programme. Significant improvements were reported in SF 36 (p< 0.0001), ODI (p=0.0078) and pain intensity (p=0.03). The FABQ showed an improvement post class (pre-class mean= 17.89, SD= 3.55, post class mean= 12.57, SD= 6.78 (p=0.27)).

Conclusion: The Back to Fitness class continues to be an effective treatment in the management of chronic low back pain. Analysis of the FABQ in a larger sample may show significant changes post intervention.