The influence of cognitive factors in relation to the patients' treatment adherence for non-specific chronic low-back pain. A case series

Abstract

IntroductionThe positive effects of exercise programs in relation to chronic low-back pain have been long established and patient adherence has a fundamental role in the impact of the resulting benefits. On the other hand, cognitive factors have shown to be the predictors of poor outcomes in patient suffering from this condition to the point of possibly affecting adherence. ObjectiveTo determine the influence of cognitive factors on the adherence to a home exercise program, the patient's pain intensity and their level of disability at a two-month follow-up, specifically regarding patients with non-specific chronic low-back pain (NSCLBP). Methodology: Ten patients with NSLBP underwent a home exercise program. This study was undertaken to assess their adherence rate after two months. The assessment tools included the Visual Analogue Scale (VAS), the Oswestry Disability Index pre-follow-up and post-follow-up (ODI1 and ODI2), the Tampa Kinesiophobia Scale (TSK-11), the Pain Catastrophism Scale (PCS), the Fear-Avoidance Beliefs Questionnaire (FABQ) and the General Self-efficacy Scale (GSS) respectively. ResultsThere were no significant associations found between adherence and the selected cognitive factors. There was an association between GSS and VAS (R = 0.68, p = 0.031). A clinically relevant improvement of 6.8 points in the mean of ODI2 in relation to ODI1 was observed. ConclusionThe influence of cognitive factors on adherence has not been ruled out because the study had a low sample size. Future studies should replicate the evaluation protocol in a larger population.