Chikaka Tapiwa, Keller Monique M
Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Physiother. 2024 Dec 20;80(1):2077. doi: 10.4102/sajp.v80i1.2077. eCollection 2024.
Adherence to management regimes is pivotal to successfully managing patients with low back pain (LBP). Barriers decrease adherence, resulting in disability.
Our pilot study aimed to determine barriers associated with physiotherapy treatment attendance and home exercise programme adherence among patients with LBP and treating physiotherapists in Eswatini.
A cross-sectional descriptive pilot study using a self-developed Research Electronic Data Capture (REDCap) survey was conducted with 62 LBP patients. Descriptive, regression and bivariate statistical analyses with odds ratios (OR) were used to identify adherence barriers.
Twenty-two (35.5%) participants missed appointments because of feeling better. Twenty-one participants (33.9%) missed scheduled appointments due to painful sessions, cost and the burden of changing their routines. Home exercise adherence was positively associated with understanding the condition ( = 0.001) and negatively with too many exercises ( = 0.005).
Our study identified patient barriers to physiotherapy adherence, particularly females aged 40-69 years. Although doctor referrals improved adherence, time constraints and pain remained significant barriers. Barriers to prescribed home exercise programme adherence included pain during exercises, fear, no time, forgetting/no reference and too many exercises. While most participants understood their condition, some lacked understanding, underscoring the need for better education. Addressing these barriers could enhance adherence and reduce the impact of LBP.
To overcome the barrier of adherence to keeping appointments, prioritising health education and providing reasons for exercises should be empathised. Exercise programme adherence could be improved by providing reference material, less and more meaningful and/or functional exercises.
坚持治疗方案对于成功管理腰痛（LBP）患者至关重要。障碍会降低依从性，导致残疾。
我们的试点研究旨在确定斯威士兰腰痛患者和治疗物理治疗师中与物理治疗出勤和家庭锻炼计划依从性相关的障碍。
对62名腰痛患者进行了一项横断面描述性试点研究，使用自行开发的研究电子数据采集（REDCap）调查。使用描述性、回归和双变量统计分析以及优势比（OR）来确定依从性障碍。
22名（35.5%）参与者因感觉好转而错过预约。21名参与者（33.9%）因治疗过程疼痛、费用以及改变日常安排的负担而错过预定预约。家庭锻炼依从性与对病情的理解呈正相关（=0.001），与锻炼项目过多呈负相关（=0.005）。
我们的研究确定了患者在物理治疗依从性方面的障碍，尤其是40 - 69岁的女性。尽管医生转诊提高了依从性，但时间限制和疼痛仍然是重大障碍。规定的家庭锻炼计划依从性的障碍包括锻炼时疼痛、恐惧、没有时间、忘记/没有参考以及锻炼项目过多。虽然大多数参与者了解自己的病情，但一些人缺乏理解，这凸显了加强教育的必要性。解决这些障碍可以提高依从性并减少腰痛的影响。
为克服遵守预约的障碍，应强调优先进行健康教育并提供锻炼的理由。通过提供参考资料、减少且更有意义和/或功能性的锻炼，可以提高锻炼计划的依从性。
