Graded activity with and without daily-monitored-walking in patients with type 2 diabetes with low back pain: secondary analysis of a randomized-clinical trial.
Opeyemi Ayodiipo Idowu, Ade Fatai Adeniyi, Andrew Edo and 1 others
PMID 33853682WHAT IT FOUND
Adding daily pedometer-monitored walking to graded activity improved back pain disability and confidence earlier in treatment than graded activity alone, but the two groups showed no difference by week 12.
Key findings
01Patients receiving graded activity with daily monitored walking had significantly lower back pain disability scores at week 8 compared to those receiving graded activity alone.
02The group with daily monitored walking showed significantly better pain self-efficacy and lower fear-avoidance beliefs at week 4, but these differences disappeared by weeks 8 and 12.
03There was a statistically significant difference in the change of glycaemic control (HbA1c) between the groups, favoring the daily monitored walking group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a secondary analysis of a previously published trial, and the original trial was not prospectively registered. The study only assessed short-term effects (up to 12 weeks), so long-term outcomes are unknown. The sample size was relatively small (58 participants), and the between-group effect sizes were small. There was no standardised time of day for exercise, and compliance with other exercise programs outside the study could not be ascertained.
The easy way to misread this
Do not assume that adding daily monitored walking produces superior long-term back pain outcomes. The significant benefits in disability and psychosocial measures were only present at earlier time points (week 4 and 8) and had disappeared by week 12, where both groups showed similar improvements.