A comparison of a pedometer-based walking program versus physiotherapy for patients suffering from nociceptive or neuropathic chronic, recurrent low back pain in Johannesburg. Richard Feher a, Dr Antonia Wadley b, Dr Nikki Coghill a a Professional Doctorate in Health, School For Health, University of Bath, United Kingdom b Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg RELEVANCE TO PRACTICE INTRODUCTION AIMS &OBJECTIVES REFERENCES This study aims to investigate whether a walking program will aid standard physiotherapy treatment in patients diagnosed with chronic, recurrent lower back pain (CLBP). Internationally, CLBP is one of the most prevalent musculoskeletal problems for which patients seek treatment [4]. Pharmaceutical investigations match diagnosis specific treatments to pain phenotypes, however physiotherapy is less discerning [1]. Exercise prescription, walking, massage and manipulation are established physiotherapy treatments for CLBP [2-3]. This study will compare usual care physiotherapy and walking for the treatment of different CLBP phenotypes. The primary outcome measures will be pain and function. Research Aim: To assess whether a pedometer based walking program assist standard physiotherapy treatment to decrease pain and improve function in patients who report chronic or recurrent LBP. Research Objectives: To assess whether a walking program will decrease lower back and/or leg pain*. To assess if a walking program will increase function*. To assess the duration, frequency and speed of walking necessary to change pain and dysfunction*. To assess which pain phenotype best matches treatment expectation to outcome. *objectives 1-4 relate to either or both of the CLBP phenotypes. [1] Chetty, S., Bhigjee, A.I., Baalbergen, E., et al.2012 Clinical practice guidelines for management of neuropathic pain. Expert panel recommendations for South Africa. SAMJ, 102: [2] Chou, R., Qaseem, A., Snow, V., et al Diagnosis and treatment of Low Back Pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 147: [3] Hendrick, P., Te Wake, A.M., Tikkisetty, A.S., et al The effectiveness of walking as an intervention for low back pain: a systematic review. Eur Spine J 19: [4] Koes, B.W., van Tulder, M., Lin, C.C.W., et al An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J, 19: Over 50% of the population consulting the physiotherapy private practices in this study suffer from chronic or recurrent lower back pain. With the rising cost of healthcare in context of a proposed NHI model, comparison of three non-surgical treatments may assist planning future clinical treatment of Chronic Lower Back Pain. The research surrounding the topic may influence fellow colleges and patients into a broader understanding of Biopsychosocial components of CLBP. MATERIALS & METHODS