Use of a goal setting intervention to increase adherence to low back pain rehabilitation: a randomized controlled trial

Abstract

Objective: To examine the effects of a goal setting intervention on self-efficacy, treatment efficacy, adherence and treatment outcome in patients undergoing low back pain rehabilitation. Design: A mixed-model 2 (time) × 3 (group) randomized controlled trial. Setting: A residential rehabilitation centre for military personnel. Subjects: UK military personnel volunteers ( N = 48); mean age was 32.9 (SD 7.9) with a diagnosis of non-specific low back pain. Interventions: Subjects were randomly assigned to either a goal setting experimental group (Exp, n = 16), therapist-led exercise therapy group (C1, n = 16) or non-therapist-led exercise therapy group (C2, n = 16). Treatment duration for all groups was three weeks. Main measures: Self-efficacy, treatment efficacy and treatment outcome were recorded before and after the treatment period. Adherence was rated during regularly scheduled treatment sessions using the Sports Injury Rehabilitation Adherence Scale (SIRAS). The Biering-Sørensen test was used as the primary measure of treatment outcome. Results: ANCOVA results showed that adherence scores were significantly higher in the experimental group (13.70 ± 1.58) compared with C2 (11.74 ± 1.35), ( P < 0.025). There was no significant difference for adherence between the experimental group and C1 ( P = 0.13). Self-efficacy was significantly higher in the experimental group compared to both C1 and C2 ( P < 0.05), whereas no significant difference was found for treatment efficacy. Treatment outcome did not differ significantly between the experimental and two control groups. Conclusions: The findings provide partial support for the use of goal setting to enhance adherence in clinical rehabilitation.

Facilitators and barriers to physical activity in people with chronic low back pain: A qualitative study

“…Some people with CLBP explained that a follow-up helped them to set objectives. Coppack et al did not find any significant difference regarding adherence to an exercise routine between a group of people with CLBP who received set objectives to reach and another one who only had to do exercises supervised by a physiotherapist [38]. Liddle et al did highlight in their focus group that people with CLBP were in favor of a structured exercise program associated with personalized advice and follow-up [39].…”

Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review

“…Eight randomized controlled trials were included in this review (Coppack, Kristensen, & Karageorghis, 2012;Friedrich, Gittler, Arendasy & Friedrich, 2005;Friedrich, Gittler, Halberstadt, Cermak, & Heiller, 1998;Harkapaa, Jarvikoski, Mellin, Hurri, & Luoma, 1991;Harkapaa, Mellin, Jarvikoski, & Hurri, 1990;Huyser, Buckelew, Hewett, & Johnson, 1997;Linton, Hellsing, & Bergstrom, 1996;Peterson et al, 2015;Reilly, Lovejoy, Williams, & Roth, 1989;Vong, Cheing, Chan, So, & Chan, 2011) (Table 1). Study sample sizes ranged from 40 to 459 participants, totalling 1,018 participants.…”

“…Study sample sizes ranged from 40 to 459 participants, totalling 1,018 participants. Six trials included participants with persistent low back pain (Coppack et al, 2012;Friedrich et al, 1998;Harkapaa et al, 1990;Linton et al, 1996;Reilly et al, 1989;Vong et al, 2011), while the remaining two investigated participants with fibromyalgia (Huyser et al, 1997) or whiplash disorders (Peterson et al, 2015). Trials were conducted in: United States (Huyser et al, 1997;Reilly et al, 1989), China (Vong et al, 2011), United Kingdom (Coppack et al, 2012), Sweden (Linton et al, 1996;Peterson et al, 2015), Austria (Friedrich et al, 1998), and Finland (Harkapaa et al, 1990).…”

Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

“…Reflections on recurring themes in one's life are thought to guide one's expectations of future events (Kelly). Performance profiling used in athletic training is based on this theory, and stresses that the athlete's perspective is essential when it comes to agreeing on the goals and content of an agreed training plan, and to determining the training activities and process that would motivate that particular individual (Coppack, Kristensen, & Karageorghis, 2012). Application of Personal Construct Theory to rehabilitation requires that the clinician "enter the patients' 'world view', and gain their perspective upon treatment provision before meaningful goals can be set."…”