A Cross-Sectional Study Assessing Treatment Preference of People With Chronic Low Back Pain

Abstract

Objective: To assess treatment preference and attributes of 2 exercise-based treatments for people with chronic low back pain (LBP).

Design: Cross-sectional study.

Setting: Academic research setting.

Participants: Individuals (N=154) with chronic LBP.

Interventions: Not applicable.

Main outcome measures: Participants completed a treatment preference assessment (TPA) measure that described 2 treatments for chronic LBP (strength and flexibility [SF] and motor skill training [MST]). Participants rated each treatment on 4 attributes: effectiveness, acceptability/logicality, suitability/appropriateness, and convenience. An overall score for each treatment was calculated as the mean of the 4 attribute ratings. The participants indicated either (1) no treatment preference or (2) preference for SF or MST.

Results: One hundred four participants (67.5%) had a treatment preference; of those, 95 (91.3%) preferred SF and 9 (8.7%) preferred MST. The SF preference group rated SF higher than MST overall and on all attributes (all Ps <.01, ds ranged from .48-1.07). The MST preference group did not rate the treatments differently overall or on any of the attributes (all Ps >.05, ds ranged from .43-.66). Convenience of SF (P=.05, d=.79) and effectiveness (d=1.20), acceptability/logicality (d=1.27), and suitability/appropriateness (d=1.52) of MST (all Ps <.01) were rated differently between the 2 preference groups.

Conclusions: When presented with 2 treatment options, a majority of patients preferred SF over MST. Convenience was a particularly important attribute affecting preference. Assessing treatment preference and attributes prior to treatment initiation allows the clinician to identify factors that may need to be addressed to enhance adherence to, and outcomes of, treatment.

Trial registration: ClinicalTrials.gov NCT02027623.

Keywords: Exercise therapy; Low back pain; Motor skill; Patient preference; Rehabilitation; Spine.

Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1.

Attribute ratings for the (a) SF preference group, and (b) MST preference group *indicates a significant difference (p ≤ .05)

Figure 2.

Attribute ratings between the two preference groups for the (a) SF attributes and (b) MST attributes *indicates a significant difference (p ≤ .05)