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保护动机理论筛查工具预测慢性下背痛康复依从性:一项随机对照试验分析。

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

机构信息

Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia

Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia.

出版信息

BMJ Open. 2022 Feb 3;12(2):e052644. doi: 10.1136/bmjopen-2021-052644.

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.

摘要

目的

探索一种保护动机理论筛选工具,用于预测康复依从性。

设计

随机对照试验分析。

地点

运动生理学和物理治疗师诊所。

参与者

慢性腰痛患者(n=40)。

干预措施

一般力量和调节(GSC)与运动控制和手动治疗相比。主要和次要结果测量:使用运动损伤康复信念量表、七项障碍检查表、积极和消极情感量表以及运动损伤康复依从量表预测患者对监督课程的依从性和脱落率。

结果

平均出勤率为 77%(运动控制和手动治疗)和 60%(GSC),有 8 人退出。所有三个部分的运动损伤康复依从量表值均未记录 5 分以上的值。治疗效果(p=0.019)、自我效能(p=0.001)、康复价值(p=0.028)和损伤严重程度(p=0.002)与易感性(不采取行动导致健康问题的脆弱程度)呈正相关。康复价值与自我效能呈正相关(p=0.005)。损伤严重程度与康复价值呈正相关(p=0.011)。取消次数的最终模型仅包括康复价值,占方差的约 12%(p=0.033)。

结论

临床医生在康复环境中应考虑康复的价值,以提高慢性腰痛患者的治疗依从性。

试验注册号

ACTRN12615001270505。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4251/8814751/b93fc0c77b94/bmjopen-2021-052644f01.jpg

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