Factors associated with exercise adherence to prevent or treat neck and low back pain: A systematic review

Abstract

Background: Much attention has been paid to the evaluation of the efficacy of exercise therapy or increasing physical activity with the aim to prevent or alleviate neck and low back pain. However, exercise adherence is necessary for the effective management of neck and low back pain. Objective: We aimed to systematically review randomized controlled trials and cohort studies to gain insights into the factors associated with adherence to exercise or physical activity programs to prevent or treat neck pain and low back pain. Method: Publications were systematically searched from 1980–December 2019 in several databases. The following key words were used: neck pain or low back pain paired with exercise or physical activity and adherence or compliance. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. Quality of evidence was assessed and rated according to GRADE guidelines. Results: Nine randomized controlled trials and eight cohort studies were included in this review. Randomized controlled trials indicated moderate-quality evidence for the association between exercise adherence and self-efficacy. Cohort studies showed moderate-quality evidence for the association between exercise adherence and education level. Conclusions: Literature investigating factors associated with exercise adherence to prevent or treat neck and low back pain was heterogeneous. Few factors were found to be associated with exercise adherence. More studies are needed before any firm conclusions can be reached.