Adherence to Home Exercise Program in Patients with Low Back Pain

Abstract

Objectives: The purpose of this study was to evaluate the exercise adherence of the patients according to recommended home exercice program and to determine which exercises were performed more accurately. Materail and Method: 121 consecutive patients who applied to the Physical Medicine and Rehabilitation Department of Hacettepe University Hospital due to low back pain and who were recommended home exercise program were included in the study. The flexion and extension exercises were given. On the 10th day following the introduction of the home program, the patients were invited for first control to assess the accuracy of the practice of the exercises. The accuracy of each exercise was analyzed by the physiotherapists (Likert type scoring system from 0 to 4). After 1 month, the patients were called for the second check of the correctness of the application of exercises. The same assessment was repeated. Findings: While the number of patients was 121 at the beginning, the number of patients in the first control decreased to 73, the number of patients in the second control decreased to 21 after 1 month. A statistically significant increase was found for only isometric strenghtening exercises in terms of the difference in accurate application of exercises between second and first assesstments (p <0.05). Conclusion: It is thought that it would be beneficial to carry out further studies to examine effects of combined interventions to ensure adherence to home exercise program.

Keywords

• adherence
• patient
• exercise

References

1. Airaksinen, O., Brox, J.I., Cedraschi, C., et al. (2006). European guidelines for the management of chronic nonspecific low back pain. Eur Spine J, 15 (Suppl. 2), 192-300. Baxter, G.D., & Gracey, J.H. (2004). Exercise and chronic low back pain: what works? Pain,107, 176-190. Cairns, M.C., Foster, N.E., &Wright, C. (2006). Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine, 31 (19), E670-81. Chan, C.W., Mok, N.W., &Yeung, E.W.(2011). Aerobic exercise training in addition to conventional physiotherapy for chronic low back pain: A randomized controlled trial. Arch Phys Med Rehabil,92, 1681–1685. Chatzitheodorou, D., Kabitsis, C., Malliou, P., &Mougios, V. (2007). A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain. Physical Therapy, 87, 304–312. Chatzitheodorou, D., Mavromoustakos, S., &Milioti, S. (2008). The effect of exercise on adrenocortical responsiveness of patients with chronic low back pain, controlled for psychological strain. Clin Rehabil, 22, 319–328. Coşkun, G., &Can, F. (2012). Kronik bel ağrısında dinamik ve statik stabilizasyon egzersizlerinin ağrı ve fonksiyonel düzeye etkileri. Fizyoterapi ve Rehabilitasyon, 23(2),65-72. Çetin, A., Ozdemir, O., Haghari, F.S., &Taşoğlu, O. (2012). The Impact of Physical therapy programs on pain and quality of life. Turkish Journal of Physical Medicine and Rehabilitation,58, 99-102. Deyo, R.A., & Weinstein, J. (2001). Low back pain. N Engl J Med, 344, 363–70. Frost, H., Lamb, S., &Shackleton, C.H. (2000). A functional restoration programme for chronic low back pain: a prospective outcome study. Physiotherapy, 86, 285–93. Goldby, L. J., Moore , A.P., & Doust, J., et al. (2006). A randomized controlled trial investigating the efficacy of musculoskeletal physiotherapy on chronic low back disorder. Spine, 31(10), 1083-93. Henschke, N., Maher, C.G., Refshauge, K.M., et al. (2008). Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. Br Med J, 337, 154-157. Holmberg A.C., &Thelin, A.G. (2006). Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort in a rural population. BMC Musculoskelet Disord, 7, 66-84. Hayden, J.A., van Tulder, M.W., &Tomlinson, G. (2005). Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med,142, 776–785. Hoy, D., March, L., Brooks, P., Woolf, A., Blyth, F., Vos, T., et al.(2010). Measuring the global burden of low back pain. Best Pract Res Clin Rheumatol, 24, 155-65. Kolt, G.S, Brewer, B.W., Pizzari, T., Schoo, A.M.M., &Garrett, N. (2007). The sport injury rehabilitation adherence scale: a reliable scale for use in clinical physiotherapy. Physiotherapy,93, 17–22. Lundell, L.M. (2015). Adherence to self-directed home-exercises in patients with non-specific low back pain: the relationship with readiness to change (Master thesis). Physiotherapy Sciences Program in Clinical Health Sciences Utrecht University, Holland. Nachemson, A. (2004). Exciting findings interpreted differently: “Back pain” can be related to central hyperexcitability. Lakartidningen,101, 2439-2440. Shnayderman, I., &Katz-Leurer, M. (2013). An aerobic walking programme versus muscle strengthening programme for chronic low back pain: A randomized controlled trial. Clin Rehabil, 27, 207–214. Stanton, T.R., Henschke, N., Maher, C.G., et al. (2008). After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. Spine (Phila Pa 1976), 33, 2923-2928. Ogon, M., Krismer, M., Söllner, W., Kantner-Rumplmair, W., & Lampe, A. (1996). Chronic low back pain measurement with visual analogue scales in different settings. Pain, 64, 425-8. Van Koppen, L.H., Zandwijk, P.J.J., Van Mameren, H., Mesters, I., Winkens, B., &De Bie, R.A. (2016). Patients’ adherence to a walking programme for non-specific low back pain. European Journal of Physiotherapy, 18, 103-115.