A feasibility study for Walk With Ease UK - a community-based walking programme for adults with arthritis and musculoskeletal conditions

This feasibility study had three main aims – 1) to identify and make cultural adaptations to ensure the relevance and adoption of an existing physical activity intervention, “Walk With Ease” (WWE) in a UK setting; 2) to examine aspects of recruitment, randomisation, compliance to assessments, extent of data variation, and adherence to activity to inform the design of a future RCT of WWE-UK; and 3) to explore the perceptions and experiences of WWE among participants and community partners to identify processes implicit in integrating a community-based walking programme for individuals with arthritis/MSK conditions into current care.

Participants were recruited across three study group formats: WWE instructor-led, WWE self-directed and non-walking. Participants completed a self-report survey and physical performance assessment at baseline and six-weeks, with mailed survey at three-months. Participant observation, biographical narratives and semi-structured interviews explored the implementation processes and experiences of WWE.

Outcome and Translation

In total, 149 participants were allocated to the WWE programme: 52 chose instructor-led; 45 chose self-directed, and a further 52 were participants were randomised to usual care. Participants were mostly women (70%) and aged ≥60 years (77%), with the majority reporting osteoarthritis (58%) and/or back pain (53%). Statistically significant differences in pain were observed amongst respondents who undertook the programme using the self-directed rather than instructor-led format.  Loss to follow-up among WWE program participants was approximately 20% at 6-weeks. Nearly all (99%) would recommend WWE to family or friends and 81% reported they were satisfied with the programme. At 6 weeks, about half reported that their health was at least moderately better, with noticeable improvement in physical health (47%) and emotional well-being (53%).  These findings indicate that WWE is a relevant, acceptable and feasible walking program when delivered in the UK. Wider implementation of this evidence-based program may benefit the physical health and well-being of people with arthritis.

HERU researchers involved in this research project:  Paul McNamee

External Collaborators: Martin, K. (Institute of Applied Health Sciences, University of Aberdeen); MacFarlane, G. (Epidemiology, University of Aberdeen); Morrison, Z., Rae, R. (AURIS Business Centre, University of Aberdeen); Smith, T. (University of East Anglia) and Neilson, A. (University of Edinburgh)


Martin, K.R., Smith, T.O., Gaihre, S., Macfarlane, G., Neilson, A.R., McNamee, P., Rae, R. and Morrison, Z.J. (2018) 'A mixed-methods feasibility study exploring the cultural adaptation of Walk With Ease to the United Kingdom', American College of Rheumatology / Association of Rheumatology Health Professionals Annual Meeting, Chicago, USA, 19-24 October 2018.

Martin, K.R., Stelfox, K., Morrison, Z.J., McNamee, P., Smith, T.O. on behalf of the Walk with Ease Research Study Team (2019) 'The more I go out and the more I walk it eases up, the pain: a mixed-methods approach to exploring participants’ pain symptoms and their experience of the Walk With Ease programme', Scottish Pain Research Community Annual Scientific Meeting, West Park Conference Centre, Dundee, 29 March 2019.