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

Poor adherence to treatment is a worldwide problem and is also recognised in managing low back pain (LBP). This review aims to evaluate the rate of adhering to physical activity advice. A systematic review was conducted by searching 12 databases from January 2000 to December 2019. Studies were eligible when assessing LBP patients’ adherence to activity advice. 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. After screening, 28 studies (out of 1171) were eligible for analysis. Given the studies’ outcomes, a qualitative summary was created. 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. 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. The proportion of fully adhering patients is unclear. Therefore, more objective and uniform assessment tools are needed to assess adherence in future studies.