"The influence of prescribed frequency, dosage, and type of physiotherapeutic home-based exercises on adherence in patients with non-specific low back pain"

BACKGROUND: Non-specific low back pain is commonly treated with exercise therapy. Unfortunately, exercise adherence is low. Several factors influencing adherence have already been identified, but the influence of frequency, dosage, and type of exercise on exercise adherence in patients with non-specific low back pain seems unknown.

OBJECTIVE: The aim of this study is to determine the influence of prescribed frequency, dosage, and type of physiotherapeutic home-based exercises on adherence in patients with non-specific low back pain.

METHODS: An observational longitudinal prospective cohort study with a secondary analysis of the e-Exercise low back pain trial was conducted on 185 patients with non-specific low back pain. The Exercise Adherence Scale (0-100) was measured each physiotherapy session during the treatment period. Missing data was imputed using Multivariate Imputations by Chained Equations. Linear mixed model analyses were conducted to determine the influence of prescribed frequency, dosage, and type of home-based exercises on adherence.

RESULTS: A higher prescribed frequency and dosage is significantly associated with lower adherence to home-based exercises. Every point increase in frequency is associated with a decrease of 0.45 points (confidence interval -0.62: 0.30) in adherence. Similarly, every point increase in dosage is associated with a decrease of 0.24 points (confidence interval -0.39: 0.10) in adherence. Type of home-based exercise is not significantly associated with adherence.

CONCLUSIONS: A higher prescribed frequency and dosage of home-based exercises appears to negatively influence adherence in patients with non-specific low back pain. The prescribed type of exercise does not seem to influence adherence.