Poster Presentation Sydney Spinal Symposium 2024

Barriers and enablers to exercise adherence in people with chronic low back pain (#28)

Yannick L Gilanyi 1 2 , Brishna Shah 1 2 , Aidan G Cashin 1 2 , Mitchell T Gibbs 1 2 , Jessica Bellamy 2 , Ric Day 3 , James H McAuley 1 2 , Matt D Jones 1 2
  1. Neuroscience Research Australia, Sydney, NSW, Australia
  2. University of New South Wales, Kensington, NSW, Australia
  3. St Vincent’s Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia

Exercise is a first line treatment for chronic low back pain, reducing pain and disability in the short-term [1]. However, exercise benefits decrease over time, with a lack of long-term exercise adherence a potential reason for this. This study aimed to synthesize the perceptions and beliefs of individuals with chronic low back pain and identify their barriers and enablers to exercise adherence. We searched CENTRAL, EMBASE, CINAHL, SPORTDiscus, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to 28th February 2023 for qualitative studies that explored the factors influencing exercise adherence for people with chronic low back pain. A hybrid approach combining thematic synthesis with the Theoretical Domains Framework was used to analyze data. We assessed methodological quality using the Critical Appraisal Skills Programme checklist and the level of confidence of the themes generated using the Confidence in the Evidence from Reviews of Qualitative Studies (GRADE-CERQual). Twenty-three papers (n=21 studies) were included (n=677 participants). Four main themes impacted exercise adherence: 1) exercise, pain, and the body, 2) psychological factors, 3) social factors and 4) external factors. These themes contained 16 subthemes that were predominantly both barriers and enablers to exercise adherence. The individual’s experiences of barriers and enablers were most appropriately represented across a spectrum, where influencing factors could be a barrier or enabler to exercise adherence, and these could be specific to pre-exercise, during exercise and post-exercise situations. These findings may be used to improve exercise adherence and ultimately treatment outcomes in people with chronic low back pain.

  1. 1. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev 2021;9: CD009790.