Nduwimana I1,2, Nindorera F1,2, Thonnard J-L1, Oyene K3,4
1Université Catholique de Louvain/Institute of Neuroscience, Faculté des Sciences de la Motricité, Bruxelles, Belgium, 2National Center of Reference in Physiotherapy and Medical Rehabilitation, University Hospital Roi Khaled, Physiotherapy, Bujumbura, Burundi, 3University Hospital of Parakou, Unit of Rehabilitation, Parakou, Benin, 4Faculty of Public Health and Epidemiology, University of Parakou, Department of Rehabilitation, Parakou, Benin

Background: Nonspecific low back pain is an increasing problem and is often associated with functional limitations, psychosocial impact and higher healthcare costs. Vanti et al (2017) demonstrated that walking and exercise have similar effectiveness in improving pain, disability, quality of life and fear-avoidance in chronic low back pain patients and concluded that walking may be a less-expensive alternative to physical exercise in chronic low back pain.

Purpose: To highlight which technique, between walking and mind-body therapies could be more effective for nonspecific chronic low back pain.

Methods: We included Randomized controlled trials comparing walking to mind body exercise or to any other intervention or to no intervention. We also selected studies comparing walking or mind body exercise, as an adjunct to other therapies, versus those other therapies. Studies were identified using the MEDLINE/PubMed, Cochrane library, PsycInfo, Scopus, SciencesDirect database. The research was limited to studies published, in English and French, between January/2008 and April/2018. Two reviewers independently selected the studies and extracted the results. Two other reviewers assessed the Studies quality using the DELPHI list quality assessment and the risk of bias of the studies with the Cochrane risk of bias tool. In the case of disagreement, a third author has been consulted. Statistical analyses will be conducted using Review Manager 5.3 Software and results will be added in the manuscript in the next two months.

Results: Thirty studies met the inclusion criteria. Unfortunately, we only found one study comparing mind body therapy (tai chi) with walking. All thirty studies showed that walking and mind body therapies are effective in reducing pain and improving function. Particularly, three studies concluded that walking was as affective as exercise program or usual physiotherapy; three studies concluded that internet mediated walking is effective in reducing pain and functional improvement; one study concluded that walking added to an education and advice session demonstrated an improvement in functional disability, pain, and perceived physical activity; seven studies concluded that yoga could be more effective than usual care; eight studies demonstrated psychological well-being improvement of yoga and two studies concluded that tai chi is more effective in catastrophizing decrease than usual care. Only one study compared mind body therapy (tai chi) to walking and concluded that tai chi seem to be more effective than backward walking, more evidence is needed to support this finding. Walking and mind body therapies seem cost effective alternative and can be easily practiced by every age group; this is supported by Herman et al (2017) and Hartfiel et al (2017).

Conclusion(s): Mind body therapies could be more effective, due to the psychological well-being improvement, than walking in chronic low back pain treatment. Walking and mind body therapies could make good combination due to the less cost of walking and the psychological well-being improvement of the mind body exercise.

Implications: This study has been undertaken as part of the plan for choosing an effective, cheap and accessible physical activity to propose to nonspecific chronic low back pain patients during and after a functional rehabilitation program, especially, in developing countries.

Keywords: chronic low back pain, Walking, Mind body therapies, Systematic review, Meta-analysis

Funding acknowledgements: This work was supported by Association pour la Promotion de l´Éducation et de la Formation à l'Étranger (APEFE)

Topic: Pain & pain management; Musculoskeletal: spine; Disability & rehabilitation

Ethics approval required: No
Institution: Neuroscience Institute
Ethics committee: UCL ethic committee
Reason not required: this is a no interventional work

All authors, affiliations and abstracts have been published as submitted.

Back to the listing