O’Connor SR, et al. – The aim of this study is to systematically review the evidence examining effects of walking interventions on pain and self–reported function in individuals with chronic musculoskeletal pain. Evidence of fair methodological quality suggests that walking is associated with significant improvements in outcome compared to control interventions but longer–term effectiveness is uncertain.

Methods

• Six electronic databases (Medline, CINAHL, PsychINFO, PEDro, Sport Discus and the Cochrane Central Register of Controlled Trials) were searched from January 1980 up to March 2014.
• Randomized and quasi-randomized controlled trials in adults with chronic low back pain, osteoarthritis or fibromyalgia comparing walking interventions to a non-exercise or non-walking exercise control group.
• Data were independently extracted using a standardized form.
• Methodological quality was assessed using the United States Preventative Services Task Force (USPSTF) system.

Results

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

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