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"WALK30X5": a feasibility study of a physiotherapy walking programme for people with mild to moderate musculoskeletal conditions [with consumer summary]
Minns Lowe CJ, Kelly P, Milton K, Foster C, Barker K
Physiotherapy 2020 Jun;107:275-285
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To explore the feasibility of delivering and evaluating a web-based walking intervention for people with long term musculoskeletal conditions (LTMCs), to determine its acceptability and the feasibility of conducting a definitive trial. DESIGN: Prospective randomised feasibility study, with blind outcome assessment at baseline, 3 and 6 months. SETTING: Hospital based physiotherapy service. PARTICIPANTS: Forty one adults referred for assessment and advice for any mild/moderate LTMCs. doing < 120 minutes of moderate intensity activity per week. INTERVENTIONS: Participants randomised to: (1) Usual care: one usual physiotherapy advice and assessment session, including setting a physical activity goal and one follow up session (8 weeks). (2) "Walk 30x5": session one, usual care plus intervention of walking programme. Participants were shown the website and podcasts and practiced how to use them. One follow up session (8 weeks). OUTCOME MEASURES: Primary: timed six minute walk test (T6MWT). Secondary: step count, self-reported pain, fatigue, mood, self-efficacy, happiness, objective blood pressure, peak expiratory flow rate, and self-report and accelerometer measured physical activity. RESULTS: Recruitment target achieved. No adverse events occurred. Adherence was high and the intervention acceptable. Loss to follow up n = 3 (7%) at 3 months, n = 8 (20%) at 6 months. T6MWT and step count proved suitable outcomes, unlike accelerometry. Estimated sample size for a definitive trial is 216. CONCLUSIONS: "Walk 30x5" is ready for evaluation in a future, appropriately powered (n = 216), phase III trial. If effective, the intervention will provide a cheap, highly accessible intervention to enable people with mild/moderate LTMCs to achieve UK physical activity guidelines. CLINICAL TRIAL REGISTRATION NUMBER: ISRCTN78581097.

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