OBJECTIVE: To assess the effect of aerobic walking training as compared to active training, which includes muscle strengthening, on functional abilities among patients with chronic low back pain. DESIGN: Randomized controlled clinical trial with blind assessors. SETTING: Outpatient clinic. SUBJECTS: Fifty-two sedentary patients, aged 18 to 65 years with chronic low back pain. Patients who were post surgery, post trauma, with cardiovascular problems, and with oncological disease were excluded. INTERVENTION: Experimental 'walking' group: moderate intense treadmill walking; control 'exercise' group: specific low back exercise; both, twice a week for six weeks. MAIN MEASURES: Six-minute walking test, Fear-Avoidance Belief Questionnaire, back and abdomen muscle endurance tests, Oswestry Disability Questionnaire, Low Back Pain Functional Scale (LBPFS). RESULTS: Significant improvements were noted in all outcome measures in both groups with non-significant difference between groups. The mean distance in metres covered during 6 minutes increased by 70.7 (95% confidence interval (CI) 12.3 to 127.7) in the 'walking' group and by 43.8 (95% CI 19.6 to 68.0) in the 'exercise' group. The trunk flexor endurance test showed significant improvement in both groups, increasing by 0.6 (95% CI 0.0 to 1.1) in the 'walking' group and by 1.1 (95% CI 0.3 to 1.8) in the 'exercise' group. CONCLUSIONS: A six-week walk training programme was as effective as six weeks of specific strengthening exercises programme for the low back.

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