Trajectories of Adherence to Home-Based Exercise Recommendations Among People With Low Back Pain: A Longitudinal Analysis.
Remco M Arensman, Martijn W Heymans, Corelien J J Kloek and 4 others
PMID 37669137WHAT IT FOUND
Adherence to home exercises in low back pain varied across three distinct trajectories, but baseline patient characteristics could not predict which group a patient would join.
Clinicians should monitor adherence during treatment rather than attempting to predict it at the start.
Key findings
01Patients with low back pain fell into three distinct adherence trajectory groups: declining, stable, and increasing.
02There were no statistically significant differences in baseline characteristics between the three adherence trajectory groups.
03The study suggests monitoring adherence during treatment is more useful than trying to predict it based on initial assessments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Missing data was common due to therapist reporting errors, requiring imputation which may affect precision. The study only tracked adherence during active treatment, which averaged 5.1 sessions over 51 days, so long-term adherence patterns are unknown. Baseline characteristics were assessed only once, so changes in these factors during treatment were not analyzed. The sample had a higher proportion of patients with acute or subacute low back pain compared to chronic, though the authors argue generalizability is reasonable.
Declared interests
The funder played no role in the design, conduct, or reporting of this study.
The easy way to misread this
Do not assume that patients with high fear-avoidance or low self-efficacy at baseline will inevitably have poor adherence. This study found no difference in these baseline characteristics between patients who adhered well and those who did not.