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Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis

Published:December 18, 2014DOI:https://doi.org/10.1016/j.apmr.2014.12.003

      Abstract

      Objective

      To systematically review the evidence examining effects of walking interventions on pain and self-reported function in individuals with chronic musculoskeletal pain.

      Data Sources

      Six electronic databases (MEDLINE, CINAHL, PsychINFO, PEDro, Sport Discus, and the Cochrane Central Register of Controlled Trials) were searched from January 1980 to March 2014.

      Study Selection

      Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis, or fibromyalgia comparing walking interventions to a nonexercise or nonwalking exercise control group.

      Data Extraction

      Data were independently extracted using a standardized form. Methodological quality was assessed using the U.S. Preventive Services Task Force system.

      Data Synthesis

      Twenty-six studies (2384 participants) were included, and suitable data from 17 studies were pooled for meta-analysis, with a random effects model used to calculate between-group mean differences and 95% confidence intervals (CIs). Data were analyzed according to the duration of follow-up (short-term, ≤8wk postrandomization; medium-term, >2mo to 12mo; long-term, >12mo). Interventions were associated with small to moderate improvements in pain at short-term (mean difference , −5.31; 95% CI, −8.06 to −2.56) and medium-term (mean difference, −7.92; 95% CI, −12.37 to −3.48) follow-up. Improvements in function were observed at short-term (mean difference, −6.47; 95% CI, −12.00 to −0.95), medium-term (mean difference, −9.31; 95% CI, −14.00 to −4.61), and long-term (mean difference, −5.22; 95% CI, −7.21 to −3.23) follow-up.

      Conclusions

      Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared with control interventions but longer-term effectiveness is uncertain. With the use of the U.S. Preventive Services Task Force system, walking can be recommended as an effective form of exercise or activity for individuals with chronic musculoskeletal pain but should be supplemented with strategies aimed at maintaining participation. Further work is required for examining effects on important health-related outcomes in this population in robustly designed studies.

      Keywords

      List of abbreviations:

      CI (confidence interval), CLBP (chronic low back pain), CMP (chronic musculoskeletal pain), OA (osteoarthritis), USPSTF (U.S. Preventive Services Task Force)
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      Supplemental Appendix S3 List of those studies excluded from the systematic review in which walking was not considered to be the predominant component of the intervention

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      • Correction
        Archives of Physical Medicine and RehabilitationVol. 96Issue 6
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          In the article by O'Connor et al, Walking Exercise for Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis, published in the April issue (Arch Phys Med Rehabil 2015;96:724-34), George D. Baxter's degree was incorrect. The correct degree is DPhil.
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