Protection motivation theory screening tool for predicting chronic low back pain rehabilitation adherence: analysis of a randomised controlled trial.

Clint T Miller, Patrick J Owen, Luana C Main, Jon J Ford, Andrew J Hahne, Daniel L Belavy

Journal: BMJ open 2022;12(2):e052644

PMID: 35115351

Abstract

OBJECTIVE

To explore a protection motivation theory screening tool for predicting rehabilitation adherence.

DESIGN

Analysis of a randomised controlled trial.

SETTING

An exercise physiology and physiotherapist clinic.

PARTICIPANTS

Patients with chronic low back pain (n=40).

INTERVENTIONS

General strength and conditioning (GSC) compared with motor control and manual therapy. Primary and secondary outcome measures: predicting patient adherence to supervised sessions and dropout using the Sports Injury Rehabilitation Beliefs Scale, seven-item barriers checklist and Positive and Negative Affect Schedule and Sports Injury Rehabilitation Adherence Scale.

RESULTS

Average attendance was 77% (motor control and manual therapy) and 60% (GSC) with eight dropouts. No Sports Injury Rehabilitation Adherence Scale values other than 5 across all three components were recorded. Treatment efficacy (p=0.019), self-efficacy (p=0.001), rehabilitation value (p=0.028) and injury severity (p=0.002) positively correlated with susceptibility (the extent of vulnerability to having health problems from not taking action). Rehabilitation value positively correlated with self-efficacy (p=0.005). Injury severity positively correlated with rehabilitation value (p=0.011). The final model for number of cancellations included rehabilitation value only and accounted for approximately 12% of variance (p=0.033).

CONCLUSIONS

Perceived value of rehabilitation should be considered by clinicians in the rehabilitation setting to improve treatment adherence in patients with chronic low back pain.

TRIAL REGISTRATION NUMBER

ACTRN12615001270505.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Address: Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia [email protected].; Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia.; Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia.; Advanced HealthCare, Boronia, Victoria, Australia.; Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany.
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