Poster Presentation Sydney Spinal Symposium 2024

Fears and beliefs towards running in adults with chronic low back pain: a mixed methods study from the ASTEROID randomised controlled trial (#44)

Christopher Neason 1 2 , Claire L Samanna 1 2 , Scott D Tagliaferri 3 4 , Daniel L Belavy 5 , Paul Buntine 1 6 , Matthew J Clarkson 7 , Clint T Miller 2 , Ulrike H Mitchell 8 , Niamh L Mundell 2 , David Scott 2 9 , Patrick J Owen 1 2 6
  1. Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
  2. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
  3. Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  4. Orygen, Parkville, Victoria, Australia
  5. Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
  6. Eastern Health Emergency Medicine Program, Melbourne, VIC, Australia
  7. Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
  8. Department of Exercise Sciences, Brigham Young University, Provo, Utah, United States of America
  9. School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia

Aims: In individuals with chronic low back pain, preliminary studies showed running training is safe and associated with reduced pain intensity and disability. However, a stigma that running is unsafe for individuals with chronic low back pain remains. Our study examines the beliefs towards running in adults with chronic low back pain.

 

Methods: Adults (n=40, mean [SD] age: 33 [6] years, female: 50%) with non-specific chronic low back pain were randomised to a 12-week digitally-delivered run-walk interval training intervention or waitlist control. All participants recorded average pain intensity (100-point visual analogue scale) and completed the activity specific beliefs questionnaire at baseline and 12 weeks. Intervention participants completed semi-structured qualitative interviews at 12 weeks assessing the beliefs of safety and fear towards running.

 

Results: At baseline, 25% of participants (n=10) reported that running was unsafe. At follow-up, between-group differences favouring the intervention group (i.e. greater belief that running is safe) were detected for the belief of safety towards running on gravel (mean [95%CI]: 0.52 [0.20, 0.84] points, P=0.001), pavement (0.54 [0.18, 0.89]points, P=0.003), treadmill (0.49 [0.14, 0.84] points, P=0.006), and sprinting (0.56 [0.06, 1.06] points, P=0.029). Reflexive thematic analysis of qualitative interviews identified four themes: (a) fear and concerns that running may increase pain or lead to an injury, (b) negative beliefs are influenced by healthcare professionals and past experiences, (c) fears can be overcome and replaced with new beliefs, and (d) positive experience drives change in beliefs.

 

Conclusions: Completing a 12-week run-walk interval training intervention led to positive beliefs towards running among adults with non-specific chronic low back pain who initially held fears and concerns about running, particularly when performed on hard surfaces or at high speed. Incorporating conservative, supported and graded running training may be useful in interventions aimed at increasing participation in guideline-based physical activity.