Interventions such as supervised or individualised exercise therapy and self-management techniques may enhance exercise adherence .
BACKGROUND Chronic musculoskeletal pain ( CMP ) is a major health problem , accounting for approximately one-quarter of general practice ( GP ) consultations in the United Kingdom ( UK ) .
Exercise and physical activity is beneficial for the most common types of CMP , such as back and knee pain .
However , poor adherence to exercise and physical activity may limit long-term effectiveness .
OBJECTIVES To assess the effects of interventions to improve adherence to exercise and physical activity for people with chronic musculoskeletal pain .
Does it Matter Which Exercise?: A Randomized Control Trial of Exercise for Low Back Pain
Study Design . Multicentered r and omized controlled trial . Objectives . To determine if previously vali date d low back pain ( LBP ) subgroups respond differently to contrasting exercise prescriptions . Summary of Background Data . The role of “ patient-specific ” exercises in managing LBP is controversial . Methods . A total of 312 acute , subacute , and chronic patients , including LBP-only and sciatica , underwent a st and ardized mechanical assessment classifying them by their pain response , specifically eliciting either a “ directional preference ” ( DP ) ( i.e. , an immediate , lasting improvement in pain from performing either repeated lumbar flexion , extension , or sideglide/rotation tests ) , or no DP . Only DP subjects were r and omized to : 1 ) directional exercises “ matching ” their preferred direction ( DP ) , 2 ) exercises directionally “ opposite ” their DP , or 3 ) “ nondirectional ” exercises . Outcome measures included pain intensity , location , disability , medication use , degree of recovery , depression , and work interference . Results . A DP was elicited in 74 % ( 230 ) of subjects . One third of both the opposite and non-directionally treated subjects withdrew within 2 weeks because of no improvement or worsening ( no matched subject withdrew ) . Significantly greater improvements occurred in matched subjects compared with both other treatment groups in every outcome ( P values < 0.001 ) , including a threefold decrease in medication use . Conclusions . Consistent with prior evidence , a st and ardized mechanical assessment identified a large subgroup of LBP patients with a DP . Regardless of subjects ’ direction of preference , the response to contrasting exercise prescriptions was significantly different : exercises matching subjects ’ DP significantly and rapidly decreased pain and medication use and improved in all other outcomes . If repeatable , such subgroup validation has important implication s for LBP management
Interventions such as supervised or individualised exercise therapy and self-management techniques may enhance exercise adherence .
BACKGROUND Chronic musculoskeletal pain ( CMP ) is a major health problem , accounting for approximately one-quarter of general practice ( GP ) consultations in the United Kingdom ( UK ) .
Exercise and physical activity is beneficial for the most common types of CMP , such as back and knee pain .
However , poor adherence to exercise and physical activity may limit long-term effectiveness .
OBJECTIVES To assess the effects of interventions to improve adherence to exercise and physical activity for people with chronic musculoskeletal pain .