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

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posted on 2022-09-20, 02:42 authored by PJ Owen, LC Main, CT Miller, Jon FordJon Ford, Andrew HahneAndrew Hahne, DL Belavy

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.


This work was supported by Deakin University (award/grant number: not applicable) under internal funding (to DB).


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BMJ Open





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BMJ Publishing Group



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© Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: