Department of Health Rehabilitation, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
BMC Musculoskelet Disord. 2010 Jun 17;11:124. doi: 10.1186/1471-2474-11-124.
Among current musculoskeletal interventions used to treat low back pain (LBP), physiotherapy exercise has the highest evidence of effectiveness in avoiding recurrence and chronic disability. However, effectiveness of physiotherapy is thought to be directly related to the patients' adherence to physiotherapy. Since adherence is reported to be directly influenced by socio-cultural factors, this study was conducted to investigate factors related to patients' adherence in a group of Saudi female patients with LBP.
A retrospective chart review was conducted on female LBP patients referred to the department of physiotherapy at a local tertiary hospital over a 12 month period. A total of 98 charts were reviewed. Two physiotherapists specialized in musculoskeletal rehabilitation collected information from the medical files. Data were classified in three categories: patients' personal demographics, patients' medical condition and history, and type of physiotherapy administered. Contingency tables and chi-square test were computed to test for differences in proportions. Spearman rank correlation coefficient was calculated to examine relationships among variables.
Subjects who attended their scheduled appointments were classified as adherent (40%), and those who failed to attend 2 consecutive scheduled appointments and got discharged were classified as non-adherent (60%). Factors that significantly correlated with adherence included: age (r = 0.7, p < 0.05), initial pain intensity (r = 0.5, p < 0.05), and subjective report of improvement (r = 0.7, p < 0.01). Adherence did not correlate with the type of LBP, patient occupation, experience or nationality of the physiotherapist.
This study reveals an alarming level of non-adherence to physiotherapy among patients with LBP. It remains unclear as to what level of adherence is required to achieve beneficial effect of treatment. It is quite evident however, that early withdrawal from treatment would not allow the therapeutic benefits of the treatment to be realized. Future research should be directed toward developing strategies to improve adherence.
在用于治疗下腰痛（LBP）的当前肌肉骨骼干预措施中，物理治疗运动在避免复发和慢性残疾方面具有最高的有效性证据。然而，人们认为物理治疗的有效性直接与患者对物理治疗的依从性有关。由于据报道依从性直接受社会文化因素的影响，因此进行了这项研究，以调查一组沙特女性 LBP 患者与依从性相关的因素。
对在当地三级医院物理治疗部门就诊的女性 LBP 患者进行了为期 12 个月的回顾性图表审查。共审查了 98 份图表。两位专门从事肌肉骨骼康复的物理治疗师从病历中收集信息。数据分为三类：患者个人人口统计学，患者的医疗状况和病史以及实施的物理治疗类型。计算了列联表和卡方检验以检验比例差异。计算了 Spearman 秩相关系数以检验变量之间的关系。
按时参加预约的患者被归类为依从者（40％），而未参加 2 次连续预约并出院的患者被归类为不依从者（60％）。与依从性显著相关的因素包括：年龄（r = 0.7，p <0.05），初始疼痛强度（r = 0.5，p <0.05）和主观改善报告（r = 0.7，p <0.01）。依从性与 LBP 的类型，患者的职业，物理治疗师的经验或国籍无关。
这项研究揭示了 LBP 患者对物理治疗的依从性令人震惊的水平。尚不清楚需要达到多大程度的依从性才能实现治疗的有益效果。但是，很显然，早期退出治疗将无法实现治疗的治疗益处。未来的研究应致力于制定提高依从性的策略。
