ADHERENCE TO REHABILITATION FOR LOW BACK PAIN
Kolt, G.S., Auckland University of Technology and McEvoy, J.F., West Suburban Sports Medicine Centre, New Zealand
Physical Therapists spend 40% of their professional time treating patients with low back pathology (Goldby, 1997). The efficacy of physical therapy management, however, is reliant on adherence of patients to various aspects of rehabilitation. The aim of this study was to investigate adherence to low back pain rehabilitation, the relationship between different adherence measures, and the relationship between adherence and rehabilitation outcome. The participants were 105 patients with low back pain (mean age = 39.7). Rehabilitation session attendance rates, a self-report of adherence to prescribed home exercises, and the Sport Injury Rehabilitation Adherence Scale (SIRAS; Brewer et al., 2000) were measured weekly for four weeks. Outcome of the four-week rehabilitation program was measured using the Patients' Measure of Perceived Rehabilitation (PMPR) and the Physiotherapists' Measure of Perceived Rehabilitation (PTMPR). On average, participants attended 87.7% (SD = 13.7) of scheduled rehabilitation sessions and completed 71.6% (SD = 23.4) of prescribed home exercises. Average adherence to clinic-based rehabilitation (SIRAS scores) was 77.4% (SD = 15.3). Hierarchical regression analysis showed that PMPR scores at the end of the four-week rehabilitation period were predicted by average SIRAS scores and length of pain symptoms, F (7, 97) = 9.53, p < .0001. As well hierarchical regression analysis showed that PTMPR scores at the end of the rehabilitation period were predicted by average PTPMR at the commencement of rehabilitation and length of pain symptoms, F (7, 97) = 9.74, p <.0001. Significant correlations existed between SIRAS scores and adherence to home exercise, and between PMPR and PTMPR scores. References: Brewer, B. W., Van Raalte, J. L., Petitpas, A. J., Sklar, J. H., Pohlman, M. H., Krushell, R. J., Ditmar, T. D., Daly, J. M., & Weinstock, J. (2000). Preliminary psychometric evaluation of a measure of adherence to clinic- based sport injury rehabilitation. Physical Therapy in Sport, 2, 68-74. Goldby, L. J. (1997). Low back pain: The evidence for physiotherapy. Physical Therapy Reviews, 2, 7-11.