In this episode, Joe Tatta, PT, DPT, speaks with physiotherapist and researcher Tash Pocovi, PhD, about her groundbreaking study in the Lancet on the effectiveness and cost-effectiveness of an individualized, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomized controlled trial.
The trial, known as the Walk Back Trial, involved 24 physiotherapists across Australia who delivered an individualized and progressive walking program along with education. The participants, who were mostly sedentary, were given walking prescriptions tailored to their current activity levels, age, BMI, and comorbidities. The goal was to gradually increase their walking to 30 minutes most days of the week over six months.
The results were promising, showing a relative risk reduction in low back pain recurrences and a reduction in care-seeking episodes. This has significant implications for both individual health and healthcare system burdens, highlighting the potential of simple interventions like walking combined with education.
Dr. Pocovi also discussed the cost-effectiveness of the intervention, noting that it was highly likely to be cost-effective based on willingness-to-pay thresholds. The biggest savings were seen in reduced work absenteeism.
Thank you for listening.
Joe Tatta, PT, DPT
CEO Integrative Pain Science Institute
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Timestamps
00:00:00 – Introduction and Guest Welcome
00:00:23 – Overview of Back Pain Research
00:00:59 – Why Walking for Back Pain?
00:01:10 – Background on Prevention Focus
00:02:03 – Frequency of Recurrent Low Back Pain
00:02:24 – Importance of Prevention
00:02:45 – Exercise and Education in Pain Research
00:03:06 – Choosing Walking for Accessibility
00:03:40 – The Walk Back Trial
00:04:09 – Simplicity in Pain Treatment
00:04:33 – Other Exercises for Prevention
00:05:05 – McKenzie-Based Exercise Study
00:05:48 – Self-Management in Pain Prevention
00:06:24 – Effectiveness of Education Alone
00:06:49 – Pain Neuroscience Education
00:07:00 – Details of Educational Intervention
00:08:29 – Walk Back Intervention Details
00:08:49 – Role of Physiotherapists
00:09:00 – Participant Demographics
00:09:43 – Walking Prescription Matrix
00:10:56 – Health Coaching Techniques
00:12:30 – Tracking Walking Progress
00:14:00 – Step Count Data
00:17:17 – Study Duration and Outcomes
00:17:50 – Primary Outcomes Explained
00:19:41 – Difference Between Trial and Control Groups
00:21:06 – Economic Impact of Back Pain
00:21:48 – Cost-Effectiveness of the Intervention
00:24:17 – Implications for Employers
00:25:02 – Preventive Care in Healthcare Systems
00:26:05 – Public and Research Interest
00:27:09 – Physiotherapists’ Role in Preventive Care
00:27:40 – Comparison to Dental Care
00:28:38 – Broader Health Benefits of Walking
00:30:16 – Next Steps in Research
00:31:09 – Implementation in Clinical Care
00:32:02 – Impact of COVID on the Trial
00:33:06 – Telehealth Delivery
00:34:27 – Clinicians’ Preference for Telehealth
00:35:10 – Conclusion and Contact Information
Links and Resources Mentioned in this Episode
Dr. Natasha Pocovi holds a post-doctoral position within the Discipline of Physiotherapy at the Faculty of Medicine, Health and Human Sciences at Macquarie University. She is an early-career researcher who led the NHMRC-funded WalkBack trial, which aimed to investigate the clinical and cost-effectiveness of a low-cost and accessible walking and education intervention for preventing the recurrence of low back pain. She is the first author of this study published in The Lancet and is currently progressing this work in implementation, with an ongoing interest in research related to enhancing the management of recurrent and persistent spinal pain.
