Adherence to home-based exercises and/or activity advice in low back pain patients: a systematic review

Abstract

Background

Poor adherence to treatment is a worldwide problem and is also recognised in managing low back pain (LBP).

Objective

This review aims to evaluate the rate of adhering to physical activity advice.

Data sources

A systematic review was conducted by searching 12 databases from January 2000 to December 2019.

Study selection

Studies were eligible when assessing LBP patients’ adherence to activity advice.

Data extraction

Key data extracted related to adherence to home-based exercise and/or physical activity advice given to patients over 18 who suffer from non-specific LBP.

Data synthesis

After screening, 28 studies (out of 1171) were eligible for analysis. Given the studies’ outcomes, a qualitative summary was created.

Results

Adherence rates varied from 8% to 91%. Bias was likely in three out of 18 randomised trials. Outcomes of the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies ranged from 5 to 11 positive scores out of 14.

Limitations

Variability in describing activity advice, the use of different types of outcomes and the use of subjective measurement tools compromised the outcomes of this review.

Conclusions

The proportion of fully adhering patients is unclear. Therefore, more objective and uniform assessment tools are needed to assess adherence in future studies.

Keywords:

• Musculoskeletal (back pain)
• primary care
• systematic review
• adherence
• exercise

Acknowledgements

The authors thank Mark van Velzen for the risk of bias and clinical relevance assessment of ‘Patients’ adherence to a walking program for non-specific low back pain’ [39]. For translating two of the included articles, the authors thank Bart Vanthillo and Helena Boogaard Santeliz.

Author contributions

Ben van Koppen and Pim Zandwijk were the primary authors; Jurryt de Vries arbitrated if disagreement arose in the assessment processes; and Jurryt de Vries, Henk van Mameren and Rob de Bie gave input to the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).