Publication
Why Are Patients Not Doing Their Prescribed Home-Based Exercises? An Updated Review of the Factors Affecting Adherence to Prescribed Home-Based Exercise in Patients With Chronic Low Back Pain
Publisher:
SAGE Publications
Date:
11-08-2022
DOI:
10.1177/10848223221116143
Abstract: Prescribed home-based exercise programs have been found to be an effective non-pharmacological treatment for the management of chronic low back pain. However, such programs rely on continued patient adherence to performing the exercises. The purpose of this integrative review is to present the key factors that influence adherence to prescribed home-based exercise for in iduals with chronic low back pain. Searches of AMED, SPORTDiscus, CINAHL, MEDLINE, ScienceDirect, and Cochrane Library databases were performed for the period 2015 to 2021, using the following key search terms: exercise adherence, exercise compliance, exercise therapy, home-based exercise, chronic low back pain, and enabler, barrier or factor. Eight studies met the inclusion criteria and included Qualitative, Prospective Observation, Feasibility, Case Series and Randomised Controlled Trial studies. All participants were adults ranging from 18 to 85 years old with chronic low back pain and there was an overall female representation of 53.4%. Studies were assessed for methodological quality using the Critical Appraisal Skills Programme (CASP) checklist. The findings highlighted 2 key factors influencing adherence to home-based exercise programs for in iduals with chronic low back pain: (1) the need for practitioners to develop effective communication skills that focus on the in idual’s needs, including personalisation of exercise programs aimed at an in idual’s symptoms, lifestyle and treatment goals and (2) follow-up feedback and support strategies via electronic (virtual) or face to face in-clinic and home visits. Adherence to home-based exercise programs requires effective practitioner communication and targeted follow-up support and feedback.