Aims: The primary aims of this study were to; 1) Identify what motivates individuals to start a walking program for the prevention of low back pain, 2) Identify which strategies optimise short-term and long-term adherence to a walking program, and 3) Develop a set of recommendations to aid clinicians (in this case physiotherapists) in promoting a walking-based exercise program.
Methods: The WalkBack trial is a randomised controlled trial examining the effectiveness of a six-month, progressive, and individualised walking program for low back pain prevention. The intervention is delivered by a physiotherapist trained in health-coaching. This qualitative study was undertaken on a sample of WalkBack participants. Semi-structured focus groups were conducted following completion of the walking program. Interview questions explored: primary motivations for starting a walking program; and the identification of elements useful in optimising adherence. Audio was transcribed, and thematic analysis followed.
Results: Twenty-two participants provided data across five focus groups. Three major themes were identified. Theme one identified that strong motivators to start a walking program were anticipated improvements in low back pain management and the added general health benefits of a more active lifestyle. Theme two identified that fear of high-impact exercises led to avoidance; however, walking was considered a safe exercise option. Theme three identified accountability, enjoyment of exercise and health benefits were critical to adherence.
Conclusions: Participants recently recovered from low back pain reflected positively on a physiotherapist-prescribed walking program. Participants described what elements of the program were crucial to starting exercise and optimising adherence. These findings have informed a list of practical recommendations for physiotherapists to improve patient commencement and adherence to exercise.