Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study

Abstract

Purpose: Lack of adherence to home exercise programmes is hypothesised to partially explain the modest clinical effects seen in patients with low back pain. This study explored the association between the main biopsychosocial factors and adherence using a theory-driven approach including the fear-avoidance model, the common-sense model and the working alliance concept.

Methods: A repeated measures design was used. During and after an eight-week clinical exercise programme, 48 participants with non-acute and disabling low back pain followed a home exercise programme. Questionnaires assessed home exercise adherence and biopsychosocial factors at baseline, after the eight-week clinical programme and at the six-month follow-up.

Results: The regression model explained 50% of adherence (ICC = 0.50, p < .001) and the highest association was with the global rating of change. In addition, two secondary factors from the common-sense model, illness perceptions and outcome expectations, explained 58% of the global rating of change.

Conclusions: These findings highlight the importance of monitoring individuals/patients’ perceptions of change as a significant factor contributing to adherence. The common-sense model might be helpful in this process.

Keywords:

• Biopsychosocial
• non-acute pain
• exercise therapy
• common-sense model
• fear-avoidance model
• working alliance

Acknowledgements

Thanks go to Sophie Bellefeuille, Marilee Nugent and Cynthia Appleby for data collection, to Hakim Mecheri for engineering assistance and to Marie-Elise Labrecque for editing support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) in Montréal, Canada under the [grant No. 2010-0022].