BARRIERS AND FACILITATORS TO PRESCRIBED EXERCISE ADHERENCE IN CHIROPRACTIC PATIENTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN: A FOCUSED ETHNOGRAPHY

Abstract

Background: Non-specific chronic low back pain (NS-CLBP) is an increasing global burden. Chiropractors see a significant proportion of the NS-CLBP population, commonly prescribing exercise as a treatment. Exercise is one of the few interventions for NS-CLBP that has been demonstrated to reduce pain and improve function. However, patient adherence to prescribed exercise is poor. Aim: An exploration of chiropractors’ and patients’ experiences and beliefs regarding the barriers and facilitators to prescribed exercise adherence was undertaken to help inform future exercise prescription. Methods: A focused ethnographic approach was taken, involving semi-structured interviews with six chiropractors who frequently prescribe exercise and six NS-CLBP patients who are currently under chiropractic care and have been prescribed exercise. Results: Identified barriers and facilitators revolved around: Exercise Delivery, the Practitioner-Patient Relationship, Attributions and Expectations, and Pain. Conclusion: Prescribed exercise adherence is impacted by the complex patient-practitioner relationship, with most barriers and facilitators appearing to be modifiable.