Influence of Social Support on Patients' Adherence to Activity Advice in Low Back Pain: A Double-Blinded Randomised Controlled Trial.

The study included fewer patients than the sample size calculation required. Twenty-one patients terminated participation, and some questionnaires and activity monitor files were missing or unreadable. Twenty-one patients were not able to find a partner or friend, which the authors describe as selection bias. Data collection took a long time and was interrupted by COVID-19 lockdowns and practice restrictions. Because both groups were treated in the same practices, patients and therapists may have exchanged information about the interventions. The activity monitor could not distinguish lying down from not wearing the device. The social support questionnaire was developed for this study and was not validated. Patients could not help design the activity advice, so it may not fit their preferences. Only physically inactive patients were included, so the result may not apply to more active patients. The activity advice may have been too intensive for the inactive patients included.

The authors report no funding interests and no conflicts of interest.

Do not conclude that partner or friend social support reliably improves adherence. The strict primary adherence outcome showed no difference between groups, and the week 12 result used a looser definition and was not the main outcome.