INTRODUCTION
Chronic low-back pain is a major global public health problem, and the leading cause of disability worldwide. One of the main lines of treatment is physical exercise therapy, learned under supervision and then practiced at home. Adherence to these exercises is necessary to obtain the best clinical results, but there is no reproducible standardized measure of it, and its determinants are poorly understood. We aimed 1/ to report adherence to exercise therapy and physical activity in patients with non-specific chronic low back pain, 2/ to assess whether supervision and its different modalities could influence adherence, and 3/ to identify contributors to adherence.
METHODS
We measured exercise adherence in a sample of patients from the ComPaRe low back pain online cohort, using the Exercise Adherence Rating Scale (EARS) questionnaire. Adherence was defined as a score ≥ 3/4 on the first item of the EARS. We also asked participants about the supervision they received and its modalities, and compared them between adherent and non-adherent patients. Logistic regression was used to identify potential contributors to adherence.
RESULTS
Overall, 491 patients were included in the analysis; adherence was 45%. Univariate analysis revealed that adherent patients more often benefited from recent (within the last 6 months) supervised sessions; other supervision modalities did not differ between adherent and non-adherent patients. Multivariate analysis revealed that a high level of previous physical activity (OR [1.77;3.98]), a high level of pain [1;1.02]) and a low perceived treatment burden (OR [0938;0962]) positively influenced adherence.
DISCUSSION
In the present study, we found that 45% of individuals with non-specific chronic low back pain were adherent to exercise therapy and physical activity. Supervision seems to have little influence on adherence, contrary to what has been previously reported.