Adherence to home-based exercises and/or activity advice in low back pain patients: a systematic review

Ben van Koppen*, Pim Zandwijk, Jurryt de Vries, Henk van Mameren, Rob de Bie

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Background: Poor adherence to treatment is a worldwide problem and is also recognised in managing low back pain (LBP).

Objective: This review aims to evaluate the rate of adhering to physical activity advice.

Data sources: A systematic review was conducted by searching 12 databases from January 2000 to December 2019.

Study selection: Studies were eligible when assessing LBP patients' adherence to activity advice.

Data extraction: Key data extracted related to adherence to home-based exercise and/or physical activity advice given to patients over 18 who suffer from non-specific LBP.

Data synthesis: After screening, 28 studies (out of 1171) were eligible for analysis. Given the studies' outcomes, a qualitative summary was created.

Results: Adherence rates varied from 8% to 91%. Bias was likely in three out of 18 randomised trials. Outcomes of the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies ranged from 5 to 11 positive scores out of 14.

Limitations: Variability in describing activity advice, the use of different types of outcomes and the use of subjective measurement tools compromised the outcomes of this review.

Conclusions: The proportion of fully adhering patients is unclear. Therefore, more objective and uniform assessment tools are needed to assess adherence in future studies.

Original languageEnglish
Pages (from-to)227-242
Number of pages16
JournalEuropean Journal of Physiotherapy
Issue number4
Early online date13 Nov 2020
Publication statusPublished - 4 Jul 2022


  • Musculoskeletal (back pain)
  • primary care
  • systematic review
  • adherence
  • exercise


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