Home exercise program adherence in patients with low back pain

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Loretta M. Holmes (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Pamela Kocher Brown

Abstract: Low back pain (LBP) and chronic low back pain (CLBP) are significant causes of disability, and home exercise programs (HEP) are often prescribed to help patients manage their complaints. However, adherence is low with such programs. Factors such as social support, number of exercises prescribed, and positive feedback all have a role in adherence. While adherence to HEP has been studied and recommendations suggested, no clinical practice guidelines or best practices exist to maximize adherence. The purpose of this study was to determine North Carolina (NC) physical therapists’ use of recommended practices for improving HEP adherence and the strategies they consider most effective in this patient population. Using descriptive statistics, frequencies were calculated and reported on the survey responses of 347 NC physical therapists (PTs). Most PTs view four strategies as very or extremely effective (independence with HEP, PT-patient relationship, positive feedback, and follow-up visits). However, only 41.5% of PTs reported that educating patients on the emotional and physiological expectations of the exercises being prescribed was very or extremely effective. Yet when asked to list the most effective strategy, this was the most common theme that emerged. Although the majority of PTs report using most of the recommended strategies frequently or always, there is room for improvement. Over 70% of PTs do not encourage the patient to include their family and friends with their HEP despite the role social support plays in improving adherence. Additionally, almost 30% of PTs do not address patients previous exercise-related behaviors, just over 25% do not address patients time constraints, and 33% do not schedule follow up visits despite each of these factors having a positive impact on adherence. These findings suggest that physical therapists could benefit from education of existing recommendations and how they can incorporate them into daily practice.

Additional Information

Publication
Dissertation
Language: English
Date: 2024
Keywords
Adherence, Home Exercise Program, Low Back Pain, PT Views
Subjects
Backache $x Exercise therapy
Backache $x Physical therapy
Physical therapists $x Attitudes

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