Patients' adherence to a walking programme for non-specific low back pain

The aim of this cross-sectional observational study was to investigate adherence rate and factors influencing the adherence in following home-based activity advice, in patients referred to a physiotherapy clinic for non-specific low back pain. Research suggests that inadequate adherence to home-based activity advice during an intervention period may diminish treatment outcomes. Factors negatively influencing adherence appeared to be related to a person's beliefs and perceptions. Perceived barriers, low self-efficacy and unbeneficial illness beliefs have been consistent predictors for non-adherence across studies. 51 patients who reported non-specific low back pain were advised to walk daily. Physical activity was measured with a validated triaxial seismic accelerometer. The effect of multiple patient-related determinants on the rate of adherence was studied. Only four out of 51 patients (8%) fully adhered to the walking advice. In this study, there were no significant effects of patient-related determinants on the rate of adherence. Factors negatively influencing adherence behaviour were lack of time, weather conditions and increasing low back pain. In conclusion, patient adherence in following home-based activity advice for nonspecific low back pain outside the clinical setting is poor.