Non-Pharmacologic Managements of Rheumatic Illnesses - New Findings About Exercise - Benefits
of a Walking Program
Abstract 1951 The Effect of Physical Conditioning Through Walking in Chronic Low Back Pain Patients
M Freire, M Natour, San Paulo, Brazil
Objective: To evaluate the effects of a walking program in persons with chronic low back pain (LBP) receiving NSAID therapy
Methods: Participants were 60 persons between the ages of 20 and 50 with a history of chronic LBP (but no neurological signs or symptoms) and a sedentary lifestyle. Participants were randomized to receive either diclofenac only (control) or diclofenac + a walking program for 3 months.
Results: Of the 49 treatment completers, those in the diclofenac + walking program demonstrated significant improvements in physical fitness (i.e., VO2max; p = 0.001) and range of motion (p = 0.04). Nearly all (i.e., 92%) individuals in the walking program reported significant reductions in pain as compared with only 40% of those receiving medication only (p<.001). Mean pills taken by the diclofenac only group was 27 as compared with 8 pills in the medication + walking group.
Editorial Comments: These data demonstrate that in persons with LBP, the addition of a program of moderate intensity exercise (i.e., walking) is associated with positive outcomes. Sedentary persons who increased their level of physical activity reported improvements in fitness, flexibility, reductions in pain and less reliance on NSAIDS as compared with the medication only control group.
Bottom line: While the benefits of modest increases in physical activity have been documented in healthy adults, this is one of the first studies to demonstrate that in persons with LBP, a walking program is feasible and can provide substantial benefits above those achieved with medication. Previous work by others has shown that the benefits of activity are similar when the walking is completed in one continuous bout (i.e., one 30 minute walk) or broken into several bouts (i.e., three 10-minute walks). Many patients recognize the link between physical activity and health, but do not view walking as a form of exercise. Physicians can now confidently advise their patients with LBP (who have been medically cleared to exercise) that a walking program of 30 minutes performed on most days of the week can offer substantial improvements in health and pain relief.