Influence of Social Support on Patients' Adherence to Activity Advice in Low Back Pain: A Double-Blinded Randomised Controlled Trial

Background and Purpose Single interventions of any kind for patients with non-specific low back pain (NSLBP) are reported to be unsuccessful. In the treatment of NSLBP, physiotherapists advise patients to become more active, since an active lifestyle has a positive effect on patients' reported outcomes. However, the literature mentions poor adherence to this advice. Therefore, as a result of Intervention Mapping, this study investigates the influence of social support on adherence.Methods In a double-blind randomised controlled trial, patients were randomised over an intervention and a control group. Both groups received guideline treatment for NSLBP. All patients were advised to walk or cycle for half an hour five times a week during the investigation period. The intervention group received additional social support by a partner or friend by motivational conversation or through participation in the advised activity to adhere to the advice. Activities were measured using the Activ8 move monitor. The outcomes of the move monitor were dichotomised in yes/no adherence to the advice. Also, multiple outcomes of adherence were recorded.Results The trial was performed in 24 physiotherapy practices in the Netherlands and included 110 patients. Nearly half of the patients were male, and the patients had a median age of 50 years, 10 episodes of NSLBP, VAS 7 and QBPDS 40. Most patients had an overweight status. There was a difference in the proportion of adherent patients between the groups depending on how adherence was defined, and patients in the intervention group walked longer on average.Discussion Social support may be an effective intervention for increasing adherence to activity recommendations in physically inactive patients with NSLBP, depending on how strictly adherence is defined.Trial Registration https://register.clinicaltrials.gov/prs/beta/studies/S0006QKD00000089/recordSummary