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