Nordic walking and chronic low back pain: design of a randomized clinical trial

Lars Morsø, Jan Hartvigsen, Lis Puggaard, Claus Manniche, Lars Morsø, Jan Hartvigsen, Lis Puggaard, Claus Manniche

Abstract

Background: Low Back Pain is a major public health problem all over the western world. Active approaches including exercise in the treatment of low back pain results in better outcomes for patients, but it is not known exactly which types of back exercises are most beneficial or whether general physical activity provide similar benefits. Nordic Walking is a popular and fast growing type of exercise in Northern Europe. Initial studies have demonstrated that persons performing Nordic Walking are able to exercise longer and harder compared to normal walking thereby increasing their cardiovascular metabolism. Until now no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to low back pain. The primary aim of this study is to investigate whether supervised Nordic Walking can reduce pain and improve function in a population of chronic low back pain patients when compared to unsupervised Nordic Walking and advice to stay active. In addition we investigate whether there is an increase in the cardiovascular metabolism in persons performing supervised Nordic Walking compared to persons who are advised to stay active. Finally, we investigate whether there is a difference in compliance between persons receiving supervised Nordic Walking and persons doing unsupervised Nordic Walking.

Methods: One hundred and fifty patients with low back pain for at least eight weeks and referred to a specialized secondary sector outpatient back pain clinic are included in the study. After completion of the standard back centre treatment patients are randomized into one of three groups: A) Nordic Walking twice a week for eight weeks under supervision of a specially trained instructor; B) Unsupervised Nordic Walking for eight weeks after one training session with an instructor; C) A one hour motivational talk including advice to stay active. Outcome measures are pain, function, overall health, cardiovascular ability and activity level.

Results: No results available at this point.

Discussion: This study will investigate the effect of Nordic Walking on pain and function in a population of people with chronic LBP.

Trial registration: ClinicalTrials.gov NCT00209820.

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References

    1. Danish Institute for Health Technology Assessment Low Back Pain. Frequency, Management and Prevention from an HTA perspective. Danish Health Technology Assessment [In Danish] 1999.
    1. Brinck B, Kjøller M, Rasmussen LK. Muskuloskeletal diseases in Denmark. Prevalence and illness-behavior [In Danish] Copenhagen: Danish Institute for Clinical Epidemiology; 1995.
    1. van Tulder M, Malmivaara A, Esmail R, Koes B. Exercise therapy for low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine. 2000;25:2784–96. doi: 10.1097/00007632-200011010-00011.
    1. Kool J, de Bie R, Oesch P, Knusel O, van den Brandt P, Bachmann S. Exercise reduces sick leave in patients with non-acute non-specific low back pain: a meta-analysis. J Rehabil Med. 2004;36:49–62. doi: 10.1080/16501970310020104.
    1. Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 142:776–85. 2005 May 3;
    1. Hurwitz EL, Norgenstern H, Chiao C. Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA low back pain study. Am J Public Health. 2005;95:1817–24. doi: 10.2105/AJPH.2004.052993.
    1. Kristiansen I. Stavgang – Nordic Walking for alle [In Danish] Bazar Publishers. Copenhagen; 2003. pp. 26–30.
    1. Church TS, Earnest CP, Morss GM. Field testing of physiological responses associated with Nordic Walking. Res Q Exerc Sport. 2002;73:296–300.
    1. Porcari JP, Hendrickson TL, Walter PR, Terry L, Walsko G. The physiological responses to walking with and without Power Poles on treadmill exercise. Res Q Exerc Sport. 1997;68:161–6.
    1. Harkapaa K, Jarvikoski A, Mellin G, Hurri H. A controlled study of the outcome of inpatient and outpatient treatment of low back pain. Part I. Pain, disability, compliance, and reported treatment benefits three months after treatment. Scan J of rehabilitation Medicine. 1989;21:81–9.
    1. Manniche C, Asmussen K, Lauritsen B, Vinterberg H, Kreiner S, Jordan A. Low Back Pain Rating scale: Validation of a tool for assessment of low back pain. Pain. 1994;57:317–26. doi: 10.1016/0304-3959(94)90007-8.
    1. Stratford P, Gill C, Westaway M, Binkley J. Assessing Disability and Change on Individual Patients: A Report of a Patient Specific Measure. Physiotherapy Canada. 1995;47:258–263.
    1. Wolfe F, Hawley DJ. Measurement of the quality of life in rheumatic disorders using the EuroQuol. Br J Rheumatol. 1997;36:786–93. doi: 10.1093/rheumatology/36.7.786.
    1. Andersen LB. A maximal cycle exercise protocol to predict maximal oxygen uptake. Scan J Med Sci in Sports. 1995;5:143–146.
    1. Brage S, Brage N, Franks PW. Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol. 2004;96:343–51. doi: 10.1152/japplphysiol.00703.2003.
    1. Brage S, Brage N, Wedderkopp N, Froberg K. Technical Reability and Validity of the CSA Accelerometer: Should we Re-calibrate or Re-think. Med & Sci in Sports & Exercise. 2003;35:283–89. doi: 10.1097/00005768-200305001-01573.
    1. Welk Gregory J, Scaben, Jodee A, Morrow James R., JR Reliability of Accelerometry-based activity monitors: A generalizability study. Med Sci Sports Exerc. 2004;36:1637–45.
    1. Washburn Richard A, Smith Kevin W, Jette Alan M, Janney Carol A. The physical activity scale for the elderly (PASE): Development and evaluation. J Clin Epidemiol. 1993;46:153–62. doi: 10.1016/0895-4356(93)90053-4.

Source: PubMed

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