Lenoir D1,2, Coppieters I2, Willaert W2, Kregel J1, Danneels L3, Cagnie B1, Meeus M1, Nijs J2, Malfliet A2
1Ghent University, Ghent, Belgium, 2Vrije Universiteit Brussel, Brussels, Belgium, 3Ghent University Hospital, Ghent, Belgium
Background: Nonspecific chronic spinal pain (nCSP) is highly prevalent in the European population, and is associated with an important personal, social and socio-economic impact. Several conservative treatments have been proposed for nCSP management but the effectiveness of these treatments does not only depend on the modality because adherence to the therapy is another important factor contributing to the effectiveness of an intervention. However, previous studies have shown that obtaining adherence is a serious challenge. To address this problem of adherence to therapy, it would be interesting to determine the variables that are related with non-adherence.
Purpose: As most of this research is limited by small sample sizes, research including a large sample size is needed to determine the importance of socio-demographic and pain-related variables in therapy adherence within the current best evidence setting for patients having nCSP. Therefore, the aim of this research is to examine the link between therapy adherence and demographic variables, pain, function and pain beliefs in people suffering from nCSP.
Methods: All participants had to experience nCSP at least 3 days/week for at least 3 months for inclusion and received 3 education sessions followed by 15 exercise sessions if they were eligible and willing to participate.
Pain was evaluated using the numeric rating scale (NRS) and pressure pain thresholds (PPT), and pain catastrophizing was evaluated using the Pain Catastrophizing Scale (PCS). The 36-Item Short Form Health Survey (SF-36) was used to evaluate the health-related quality of life.
Based on the difference between evaluation at follow-up and evaluation at baseline, delta (δ)-values were calculated for the scores on the NRS, PPT, SF-36 and PCS.
Results: 120 participants were included in this study.
For the total group, the number of completed sessions did not differ between sex (p=.83), age categories (p=.66), and educational levels (p=.23).
Spearman correlation coefficients were used to examine the possible association between therapy adherence and PPT, PCS, SF-36 and NRS scores (baseline and change in δ scores), but none of the investigated associations reached significance (all p-values >.01).
Conclusion(s): No significant associations could be found between therapy adherence on one hand and pain, beliefs and functionality on the other hand in people with nCSP. Similarly, no significant correlations were obtained between the number of attended therapy sessions and sexes, age groups or educational categories. As the power of these findings was high, we conclude that there is no relationship between the examined demographic or clinical measures and therapy adherence in people with nCSP.
Implications: Firstly, a clear cut-off for therapy (non-) adherence should be decided upon as this would create uniformity across different studies and facilitate the comparison between obtained outcomes in different studies.
Secondly, as these analyses did not point in the direction of any of the included variables to play an important role in the determination of therapy adherence, and as this research was already based on a large sample size, future research should focus on factors that were not included in our analyses and investigate the influence of these factors on therapy adherence on a large scale.
Keywords: therapy adherence, chronic non specific spinal pain, physiotherapy
Funding acknowledgements: Research Foundation - Flanders (FWO), Brussels, Belgium
Purpose: As most of this research is limited by small sample sizes, research including a large sample size is needed to determine the importance of socio-demographic and pain-related variables in therapy adherence within the current best evidence setting for patients having nCSP. Therefore, the aim of this research is to examine the link between therapy adherence and demographic variables, pain, function and pain beliefs in people suffering from nCSP.
Methods: All participants had to experience nCSP at least 3 days/week for at least 3 months for inclusion and received 3 education sessions followed by 15 exercise sessions if they were eligible and willing to participate.
Pain was evaluated using the numeric rating scale (NRS) and pressure pain thresholds (PPT), and pain catastrophizing was evaluated using the Pain Catastrophizing Scale (PCS). The 36-Item Short Form Health Survey (SF-36) was used to evaluate the health-related quality of life.
Based on the difference between evaluation at follow-up and evaluation at baseline, delta (δ)-values were calculated for the scores on the NRS, PPT, SF-36 and PCS.
Results: 120 participants were included in this study.
For the total group, the number of completed sessions did not differ between sex (p=.83), age categories (p=.66), and educational levels (p=.23).
Spearman correlation coefficients were used to examine the possible association between therapy adherence and PPT, PCS, SF-36 and NRS scores (baseline and change in δ scores), but none of the investigated associations reached significance (all p-values >.01).
Conclusion(s): No significant associations could be found between therapy adherence on one hand and pain, beliefs and functionality on the other hand in people with nCSP. Similarly, no significant correlations were obtained between the number of attended therapy sessions and sexes, age groups or educational categories. As the power of these findings was high, we conclude that there is no relationship between the examined demographic or clinical measures and therapy adherence in people with nCSP.
Implications: Firstly, a clear cut-off for therapy (non-) adherence should be decided upon as this would create uniformity across different studies and facilitate the comparison between obtained outcomes in different studies.
Secondly, as these analyses did not point in the direction of any of the included variables to play an important role in the determination of therapy adherence, and as this research was already based on a large sample size, future research should focus on factors that were not included in our analyses and investigate the influence of these factors on therapy adherence on a large scale.
Keywords: therapy adherence, chronic non specific spinal pain, physiotherapy
Funding acknowledgements: Research Foundation - Flanders (FWO), Brussels, Belgium
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: University of Ghent and of Brussels
Ethics committee: University hospital of Ghent and of Brussels
Ethics number: 2013/1133 and 2013/385
All authors, affiliations and abstracts have been published as submitted.
